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High-Suicide Families Eyed By Genetic Scientists

Suicide can run in families, but psychiatrists aren't sure whether high-suicide families are plagued by genetic inheritance or learned behavior.

Allen Boyd Jr. watched suicide burn its way through his family.

First was his mother, with a .38 caliber handgun in a hotel room; then his brother, with a shotgun in the basement; then his second brother, poisoned in a boarding house; then his pretty sister, dead in her master bedroom. Then, three years ago, his father turned a gun on himself, leaving Allen Boyd Jr. alone with a dark history.

Worried About the Suicide Gene

Suicide can run in families, but psychiatrists aren't sure whether high-suicide families are plagued by genetic inheritance or learned behavior.Boyd has never loaded a gun, never stuck one in his mouth. At 45, the North Carolina man thinks about meeting a "really jolly woman" and starting a family. But he knows, too, that he is a Boyd: For a while after his father's death, the thoughts crept into his head every five minutes, repeating themselves, disrupting his sleep.

"It's in me," he said.

Psychiatrists agree now on a point that was long debated: Suicide can run in families. They do not know, however, how this risk is transferred from one family member to another -- whether it is "learned" behavior, passed on through a grim emotional ripple effect, or a genetic inheritance, as some scientists theorize. But new research published this week in the American Journal of Psychiatry prepares ground for a genetic search, suggesting that the trait that links high-suicide families is not simply mental illness, but mental illness combined with a more specific tendency to "impulsive aggressiveness."

"It gets us beyond the witchcraft argument, that you're a walking time bomb," said Dr. J. Raymond DePaulo, a Johns Hopkins psychiatrist and prominent suicide researcher.

At stake in this discussion is the hope that doctors could intervene more effectively if they could identify risk factors. Dr. David Brent, the study's lead author, was launched on a career researching suicide while he was working on an adolescent psychiatric ward where a very common professional judgment call was determining which children were suicidal. One day, after he had sent one girl to a psychiatric ward and another home, the father of one girl confronted him angrily, asking what he had seen in one girl and not the other. Brent, now a professor of psychiatry at the University of Pittsburgh School of Medicine, realized he had no good answer.

"I found myself, and the field, bereft of knowledge," he said. "It was like the toss of a coin."

Suicide on the Brain

In recent years, researchers have edged closer to a physiological marker of suicide. When analyzed after death, the brains of people who committed suicide show a low level of a metabolite of seratonin, a neurotransmitter that is involved in the control of impulses. But although a seratonin deficiency may mark a heightened risk of suicide -- as much as 10 times what is normal -- that discovery is useless to clinicians, since it would require patients to undergo a spinal tap.

As they search for genetic commonality, researchers are drawn to those rare, unlucky families who have suffered from rashes of suicide.

When Margaux Hemingway's overdose death was ruled a suicide in 1996, she was the fifth member of her family to kill herself in four generations -- after her grandfather, the novelist Ernest Hemingway; his father, Clarence; Ernest's sister, Ursula, and his brother, Leicester.

Other clusters have been sought by researchers. Among the Old Order Amish, researchers from the University of Miami found that half the suicides of the last century -- they numbered only 26 -- could be traced to two extended families, and 73 percent of them could be traced to four families that made up only 16 percent of the population. The clustering could not be explained by mental illness alone, since other families carried risks for mental illness but no risk for suicide.

The successive studies have shed little light on what differentiates them from their more resilient neighbors -- and whether the differences are sociological, psychological, or genetic, said one suicidologist. Most specialists say that many factors interact to cause suicide.

"It's impossible to differentiate [between causes]. When you have a family history that is quite profound, how do you rule out the fact that you have one deceased parent and a second parent bereaved?" said Dr. Alan Berman, president of the American Society for Suicide Prevention. "We'll be arguing this for the next hundred years."

For Boyd, as for many survivors, the genetic explanation is less important than the long, bitter reverberation of his mother's death.

When his mother shot herself in a hotel room, Boyd said, the family splintered in their reactions: Although his father bitterly criticized her act, his brother Michael immediately said he wanted to be with her, and shot himself, at 16, a month later. Michael's twin, Mitchell, followed suit in a long series of attempts, including an attempt to throw himself off of the tallest building in Asheville, N.C., and was ultimately diagnosed with paranoid schizophrenia. He died in a boarding house at age 36, after drinking toxic chemicals.

Last Updated: 14 June 2016
Reviewed by Harry Croft, MD

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