The Interpersonal‐Psychological Theory of Suicide proposes that capability for suicide is acquired through exposure to painful and provocative events (PPEs). Although there is robust evidence for a positive association between aggregate measures of PPEs and risk for suicidal behavior, little is known about the contributions of physical injuries. The present study investigated the relationship between injuries and risk of subsequent suicide attempt (SA).

Clarifying the relationship between physical injuries and risk for suicide attempt in a Swedish national sample.

INTRODUCTION
Alcohol use disorder (AUD) is among the strongest correlates of suicide death, but it is unclear whether AUD status is differentially associated with risk of suicide by particular methods.


METHODS
The authors used competing risks models to evaluate the association between AUD status and risk of suicide by poisoning, suffocation, drowning, firearm, instruments, jumping, or other means in a large Swedish cohort born 1932-1995 (total N = 6,581,827; 48.8% female). Data were derived from Swedish national registers, including the Cause of Death Register and a range of medical registers.


RESULTS
After adjusting for sociodemographic factors and familial liability to suicidal behavior, AUD was positively associated with risk of suicide for each method evaluated (cumulative incidence differences: 0.006-1.040 for females, 0.046-0.680 for males), except the association with firearm suicide in females. AUD was most strongly associated with risk of suicide by poisoning. Sex differences in the effects of AUD and family liability were observed for some, but not all, methods. Furthermore, high familial liability for suicidal behavior exacerbated AUD's impact on risk for suicide by poisoning (both sexes) and suffocation and jumping (males only), while the inverse interaction was observed for firearm suicide (males only).


CONCLUSIONS
AUD increases risk of suicide by all methods examined and is particularly potent with respect to risk of suicide by poisoning. Differences in risk related to sex and familial liability to suicidal behavior underscore AUD's nuanced role in suicide risk. Future research should investigate targeted means restriction effectiveness among persons with AUD.

Alcohol use disorder and risk of specific methods of suicide death in a national cohort.

Background Alcohol consumption contributes to excess morbidity and mortality in part through the development of alcohol-related medical conditions (AMCs, including alcoholic cardiomyopathy, hepatitis, cirrhosis, etc.). The current study aimed to clarify the extent to which risk for these outcomes differs as a function of socioeconomic position (SEP), as discrepancies could lead to exacerbated health disparities. Methods and findings We used longitudinal Swedish national registries to estimate the individual and joint associations between 2 SEP indicators, educational attainment and income level, and risk of AMC based on International Classification of Diseases codes, while controlling for other sociodemographic covariates and psychiatric illness. We conducted Cox proportional hazards models in sex-stratified analyses (N = 1,162,679 females and N = 1,196,659 males), beginning observation at age 40 with follow-up through December 2018, death, or emigration. By the end of follow-up, 4,253 (0.37%) females and 11,183 (0.93%) males had received an AMC registration, corresponding to overall AMC incidence rates among females and males of 2.01 and 5.20, respectively. In sex-stratified models adjusted for birth year, marital status, region of origin, internalizing and externalizing disorder registrations, and alcohol use disorder (AUD) registration, lower educational attainment was associated with higher risk of AMC in both females (hazard ratios [HRs] = 1.40 to 2.46 for low- and mid-level educational attainment across 0 to 15 years of observation) and males (HRs = 1.13 to 1.48). Likewise, risk of AMC was increased for those with lower income levels (females: HRs = 1.10 to 5.86; males: HRs = 1.07 to 6.41). In secondary analyses, we further adjusted for aggregate familial risk of AUD by including family genetic risk scores for AUD (FGRSAUD), estimated using medical, pharmacy, and criminal registries in extended families, as covariates. While FGRSAUD were associated with risk of AMC in adjusted models (HR = 1.17 for females and HR = 1.21 for males), estimates for education and income level remained largely unchanged. Furthermore, FGRSAUD interacted with income level, but not education level, such that those at higher familial liability to AUD were more susceptible to the adverse effect of low income. Limitations of these analyses include the possibility of false negatives for psychiatric illness registrations, changes in income after age 40 that were not accounted for due to modeling restrictions, restriction to residents of a high-income country, and the inability to account for individual-level alcohol consumption using registry data. Conclusions Using comprehensive national registry data, these analyses demonstrate that individuals with lower levels of education and/or income are at higher risk of developing AMC. These associations persist even when accounting for a range of sociodemographic, psychiatric, and familial risk factors. Differences in risk could contribute to further health disparities, potentially warranting increased screening and prevention efforts in clinical and public health settings.

Socioeconomic position indicators and risk of alcohol-related medical conditions: A national cohort study from Sweden

We used Swedish national-register data ( N = 2,828,777) to examine divorce and its associated patterns of family genetic-risk scores (FGRSs; personalized measures of genetic risk inferred from diagnoses in relatives) across 10 psychiatric disorders: major depression, anxiety disorders, obsessive compulsive disorder, bipolar disorder, schizophrenia, anorexia nervosa, alcohol use disorder, drug use disorder, attention-deficit/hyperactive disorder, and autism spectrum disorder. Individuals who divorced had elevated FGRSs across all disorders compared with individuals who were stably married or never married. FGRSs for all disorders were higher among divorced females compared with divorced males and among individuals who did not go on to have a stable second marriage compared with individuals who had a stable second marriage and increased as the cumulative number of divorces increased. In summary, genetic predispositions for psychiatric disorders are associated with the propensity to divorce and with several differences as a function of sex, remarriage, and the cumulative number of divorce transitions.

Family Genetic-Risk Profiles Associated With Divorce

BACKGROUND
The concept of schizotypal personality disorder (SPD) emerged from observations of personality characteristics common in relatives of schizophrenic patients. While often studied in family designs, few studies and none with genetic measures, have examined SPD in epidemiological samples.


METHODS
We studied individuals born in Sweden 1940-2000 with an ICD-10 diagnosis of SPD with no prior schizophrenia (SZ) diagnosis (n = 2292). Demographic features, patterns of comorbidity, and Family Genetic Risk Scores (FGRS) were assessed from multiple Swedish registries. Prediction of progression to SZ was assessed by Cox models.


RESULTS
SPD was rare, with a prevalence of 0.044%, and had high levels of comorbidity with autism spectrum disorder (ASD), OCD, ADHD, and major depression (MD), and increased rates of being single, unemployed and in receipt of welfare. Affected individuals had elevated levels of FGRS for SZ (+0.42), ASD (+0.30), MD (+0.29), and ADHD (+0.20). Compared to cases of schizophrenia, they had significantly lower rates of FGRSSZ, but significantly elevated rates of genetic risk for ASD, MD, and ADHD. Over a mean follow-up of 8.7 years, 14.6% of SPD cases received a first diagnosis of SZ, the risk for which was significantly increased by levels of FGRSSZ, male sex, young age at SPD diagnosis and an in-patient SPD diagnosis and significantly decreased by comorbidity with MD, ASD, and ADHD.


CONCLUSIONS
Our results not only support the designation of SPD as a schizophrenia spectrum disorder but also suggest potentially important etiologic links between SPD and ASD and, to a lesser extent, ADHD, OCD, and MD.

https://www.cambridge.org/core/services/aop-cambridge-core/content/view/7CE211F11966E259E2B9DB32C6D361ED/S0033291724000230a.pdf/div-class-title-the-genetic-epidemiology-of-schizotypal-personality-disorder-div.pdf

The genetic epidemiology of schizotypal personality disorder.

The state-of-the-field in complex disorder genetics is marked by large-scale, biobank-ascertained data sets that integrate broad demographic, health, survey, and genetic data. Leveraging the richness of this data can advance our understanding of complex disorders by improving predictions, describing etiology, and augmenting gene-mapping. These themes are especially, but not exclusively, relevant to Major Depressive Disorder (MDD), a leading cause of disability for which genetic predictors underperform, clinical heterogeneity is etiologically enigmatic, and missing heritability persists. The iPSYCH 2015 case-cohort presents a unique opportunity to integrate genotypes, register-based clinical outcomes, and extended genealogies of 30,949 MDD cases and 39,655 random population controls. To make full use of our data, we introduce the Pearson-Aitken framework for Family Genetic Risk Scores (PA-FGRS) to estimate individuals' liabilities for major depressive disorder from extended genealogies of partially observed relatives. PA-FGRS extends previous methods by accounting for censoring, leveraging distant relatives, and utilizing a flexible, model-based approach amenable to analysis and extension, advantages we highlight in simulations. Combining PA-FGRS with genotype data improves classification, replicates and extends known genetic contributions to clinical heterogeneity, and increases power for genome-wide association studies. This study combines novel analyses of unique data and can serve as a model for studies of other outcomes.

/pdf/pa-fgrs-is-a-novel-estimator-of-pedigree-based-genetic-1bh3kkhj.pdf

PA-FGRS is a novel estimator of pedigree-based genetic liability that complements genotype-based inferences into the genetic architecture of major depressive disorder

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The relationship between genotype- and phenotype-based estimates of genetic liability to psychiatric disorders, in practice and in theory.

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