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The relationship of impulsive aggressiveness to suicidality and other depression-linked behaviors

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Abstract

Suicide is a leading cause of death worldwide, among the top 10 causes of death in every country, and one of the three leading causes of death for people aged 15 to 34 years. It has been increasingly recognized in recent years that people who attempt or commit suicide have a certain individual predisposition, part of which is given by personality traits, and in particular, impulsive-aggressive behaviors. This article reviews evidence suggesting that impulsive-aggressive traits are part of a developmental cascade that increases suicide risk among a subset of suicides. These personality traits, which do not appear to be a consequence of psychiatric disorder, seem to play a larger role among younger suicides and may mediate familial transmission of suicidal behavior. However, not all suicides are associated with impulsive-aggressive behaviors, and we need to better understand vulnerability to suicide among non-impulsive-aggressive suicide.

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References and Recommended Reading

  1. World Health Organization: Figures and Facts About Suicide. Geneva: World Health Organization; 1999.

    Google Scholar 

  2. Narrow WE, Rae DS, Robins LN, Regier DA: Revised prevalence estimates of mental disorders in the United States: using a clinical significance criterion to reconcile 2 surveys’ estimates. Arch Gen Psychiatry 2002, 59:115–123.

    Article  PubMed  Google Scholar 

  3. Ustun TB, Ayuso-Mateos JL, Chatterji S, et al.: Global burden of depressive disorders in the year 2000. Br J Psychiatry 2004, 184:386–392.

    Article  PubMed  CAS  Google Scholar 

  4. Arsenault-Lapierre G, Kim C, Turecki G: Psychiatric diagnoses in 3275 suicides: a meta-analysis. BMC Psychiatry 2004, 4:37.

    Article  PubMed  Google Scholar 

  5. Coryell W, Young EA: Clinical predictors of suicide in primary major depressive disorder. J Clin Psychiatry 2005, 66:412–417.

    Article  PubMed  Google Scholar 

  6. Barraclough BM, Pallis DJ: Depression followed by suicide: a comparison of depressed suicides with living depressives. Psychol Med 1975, 5:55–61.

    Article  PubMed  CAS  Google Scholar 

  7. Maris RW, Berman AL, Silverman MM: Comprehensive Textbook of Suicidology. New York: Guilford Press; 2000.

    Google Scholar 

  8. Mann JJ, Waternaux C, Haas GL, Malone KM: Toward a clinical model of suicidal behavior in psychiatric patients. Am J Psychiatry 1999, 156:181–189.

    PubMed  CAS  Google Scholar 

  9. Guze SB, Robins E: Suicide and primary affective disorders. Br J Psychiatry 1970, 117:437–438.

    PubMed  CAS  Google Scholar 

  10. Barraclough B, Bunch J, Nelson B, Sainsbury P: A hundred cases of suicide: clinical aspects. Br J Psychiatry 1974, 125:355–373.

    PubMed  CAS  Google Scholar 

  11. Caspi A, Moffitt TE, Newman DL, Silva PA: Behavioral observations at age 3 years predict adult psychiatric disorders. Longitudinal evidence from a birth cohort. Arch Gen Psychiatry 1996, 53:1033–1039.

    PubMed  CAS  Google Scholar 

  12. Evenden JL: Varieties of impulsivity. Psychopharmacology (Berl) 1999, 146:348–361.

    Article  CAS  Google Scholar 

  13. Zouk H, Tousignant M, Seguin M, et al.: Characterization of the role of impulsivity in suicide completers: clinical, behavioral and psychosocial dimensions. J Affect Disord 2006, 92:195–204.

    Article  PubMed  Google Scholar 

  14. Martin CS, Earleywine M, Blackson TC, et al.: Aggressivity, inattention, hyperactivity, and impulsivity in boys at high and low risk for substance abuse. J Abnorm Child Psychol 1994, 22:177–203.

    Article  PubMed  CAS  Google Scholar 

  15. Brodsky BS, Oquendo M, Ellis SP, et al.: The relationship of childhood abuse to impulsivity and suicidal behavior in adults with major depression. Am J Psychiatry 2001, 158:1871–1877.

    Article  PubMed  CAS  Google Scholar 

  16. Galfalvy H, Oquendo M, Carballo JJ, et al.: Clinical predictors of suicidal acts after major depression in bipolar disorder: a prospective study. Bipolar Disord 2006, 8:586–595.

    Article  PubMed  Google Scholar 

  17. Kausch O: Suicide attempts among veterans seeking treatment for pathological gambling. J Clin Psychiatry 2003, 64:1031–1038.

    PubMed  Google Scholar 

  18. Brezo J, Paris J, Tremblay R, et al.: Personality traits as correlates of suicide attempts and suicidal ideation in young adults. Psychol Med 2005, 7:1–12.

    Article  Google Scholar 

  19. Fergusson DM, Woodward LJ, Horwood LJ: Risk factors and life processes associated with the onset of suicidal behavior during adolescence and early adulthood. Psychol Med 2000, 30:23–39.

    Article  PubMed  CAS  Google Scholar 

  20. Brent DA, Bridge J, Johnson BA, Connolly J: Suicidal behavior runs in families. A controlled family study of adolescent suicide victims. Arch Gen Psychiatry 1996, 53:1145–1152.

    PubMed  CAS  Google Scholar 

  21. Brent DA, Johnson BA, Perper J, et al.: Personality disorder, personality traits, impulsive violence, and completed suicide in adolescents. J Am Acad Child Adolesc Psychiatry 1994, 33:1080–1086.

    PubMed  CAS  Google Scholar 

  22. Dumais A, Lesage AD, Alda M, et al.: Risk factors for suicide completion in major depression: a case-control study of impulsive and aggressive behaviors in men. Am J Psychiatry 2005, 162:2116–2124.

    Article  PubMed  CAS  Google Scholar 

  23. Ernst C, Lalovic A, Lesage A, et al.: Suicide and no axis I psychopathology. BMC Psychiatry 2004, 4:7.

    Article  PubMed  Google Scholar 

  24. McGirr A, Paris J, Lesage A, et al.: Risk factors for suicide completion in borderline personality disorder: a case-control study of cluster B comorbidity and impulsive aggression. J Clin Psychiatry 2007, 68:721–729.

    Article  PubMed  Google Scholar 

  25. Renaud J, Berlim MT, McGirr A, et al.: Current psychiatric morbidity, aggression/impulsivity, and personality dimensions in child and adolescent suicide: a case-control study. J Affect Disord 2007 [Epub ahead of print].

  26. Dervic K, Grunebaum MF, Burke AK, et al.: Protective factors against suicidal behavior in depressed adults reporting childhood abuse. J Nerv Ment Dis 2006, 194:971–974.

    Article  PubMed  Google Scholar 

  27. Keilp JG, Gorlyn M, Oquendo MA, et al.: Aggressiveness, not impulsiveness or hostility, distinguishes suicide attempters with major depression. Psychol Med 2006, 36:1779–1788.

    Article  PubMed  Google Scholar 

  28. Sarchiapone M, Carli V, Cuomo C, Roy A: Childhood trauma and suicide attempts in patients with unipolar depression. Depress Anxiety 2007, 24:268–272.

    Article  PubMed  Google Scholar 

  29. Grunebaum MF, Ramsay SR, Galfalvy HC, et al.: Correlates of suicide attempt history in bipolar disorder: a stress-diathesis perspective. Bipolar Disord 2006, 8:551–557.

    Article  PubMed  Google Scholar 

  30. Oquendo MA, Waternaux C, Brodsky B, et al.: Suicidal behavior in bipolar mood disorder: clinical characteristics of attempters and nonattempters. J Affect Disord 2000, 59:107–117.

    Article  PubMed  CAS  Google Scholar 

  31. Brezo J, Paris J, Tremblay R, et al.: Identifying correlates of suicide attempts in suicidal ideators: a population-based study. Psychol Med 2007 [Epub ahead of print].

  32. Oquendo MA, Bongiovi-Garcia ME, Galfalvy H, et al.: Sex differences in clinical predictors of suicidal acts after major depression: a prospective study. Am J Psychiatry 2007, 164:134–141.

    Article  PubMed  Google Scholar 

  33. Black DW, Blum N, Pfohl B, Hale N: Suicidal behavior in borderline personality disorder: prevalence, risk factors, prediction, and prevention. J Personal Disord 2004, 18:226–239.

    Article  PubMed  Google Scholar 

  34. Kim C, Lesage A, Seguin M, et al.: Patterns of co-morbidity in male suicide completers. Psychol Med 2003, 33:1299–1309.

    Article  PubMed  CAS  Google Scholar 

  35. McGirr A, Tousignant M, Routhier D, et al.: Risk factors for completed suicide in schizophrenia and other chronic psychotic disorders: a case-control study. Schizophr Res 2006, 84:132–143.

    Article  PubMed  CAS  Google Scholar 

  36. Conwell Y, Brent D: Suicide and aging. I: Patterns of psychiatric diagnosis. Int Psychogeriatr 1995, 7:149–164.

    Article  PubMed  CAS  Google Scholar 

  37. Heikkinen ME, Isometsa ET, Aro HM, et al.: Age-related variation in recent life events preceding suicide. J Nerv Ment Dis 1995, 183:325–331.

    Article  PubMed  CAS  Google Scholar 

  38. Isometsa ET, Henriksson MM, Heikkinen ME, et al.: Suicide among subjects with personality disorders. Am J Psychiatry 1996, 153:667–673.

    PubMed  CAS  Google Scholar 

  39. Marttunen MJ, Aro HM, Henriksson MM, Lonnqvist JK: Mental disorders in adolescent suicide. DSM-III-R axes I and II diagnoses in suicides among 13-to 19-year-olds in Finland. Arch Gen Psychiatry 1991, 48:834–839.

    PubMed  CAS  Google Scholar 

  40. Henriksson MM, Marttunen MJ, Isometsa ET, et al.: Mental disorders in elderly suicide. Int Psychogeriatr 1995, 7:275–286.

    Article  PubMed  CAS  Google Scholar 

  41. McGirr A, Renaud J, Seguin M, et al.: Impulsive-aggressive behaviors and completed suicide across the life cycle: a predisposition for younger age of suicide. Psychol Med 2007, In Press.

  42. Malone KM, Haas GL, Sweeney JA, Mann JJ: Major depression and the risk of attempted suicide. J Affect Disord 1995, 34:173–185.

    Article  PubMed  CAS  Google Scholar 

  43. Tsuang MT: Risk of suicide in the relatives of schizophrenics, manics, depressives, and controls. J Clin Psychiatry 1983, 44:396–400.

    PubMed  CAS  Google Scholar 

  44. Murphy GE, Wetzel RD: Family history of suicidal behavior among suicide attempters. J Nerv Ment Dis 1982, 170:86–90.

    PubMed  CAS  Google Scholar 

  45. Johnson BA, Brent DA, Bridge J, Connolly J: The familial aggregation of adolescent suicide attempts. Acta Psychiatr Scand 1998, 97:18–24.

    Article  PubMed  CAS  Google Scholar 

  46. Baldessarini RJ, Hennen J: Genetics of suicide: an overview. Harv Rev Psychiatry 2004, 12:1–13.

    PubMed  Google Scholar 

  47. Egeland JA, Sussex JN: Suicide and family loading for affective disorders. JAMA 1985, 254:915–918.

    Article  PubMed  CAS  Google Scholar 

  48. Kim CD, Seguin M, Therrien N, et al.: Familial aggregation of suicidal behavior: a family study of male suicide completers from the general population. Am J Psychiatry 2005, 162:1017–1019.

    Article  PubMed  Google Scholar 

  49. Mann JJ, Bortinger J, Oquendo MA, et al.: Family history of suicidal behavior and mood disorders in probands with mood disorders. Am J Psychiatry 2005, 162:1672–1679.

    Article  PubMed  Google Scholar 

  50. Baca-Garcia E, Diaz-Sastre C, Basurte E, et al.: A prospective study of the paradoxical relationship between impulsivity and lethality of suicide attempts. J Clin Psychiatry 2001, 62:560–564.

    Article  PubMed  CAS  Google Scholar 

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Correspondence to Gustavo Turecki.

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McGirr, A., Turecki, G. The relationship of impulsive aggressiveness to suicidality and other depression-linked behaviors. Curr Psychiatry Rep 9, 460–466 (2007). https://doi.org/10.1007/s11920-007-0062-2

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