Cited by 83Suicide and Self-Harm StudiesGenetic Associations and EpidemiologyBipolar Disorder and Treatment

Genetic contributions to suicidal thoughts and behaviors

Open access
DiBlasi, Emily, Kang, Jooeun, Docherty, Anna R.·2021·Psychological Medicine

Abstract

Suicidal ideation, suicide attempt (SA) and suicide are significantly heritable phenotypes. However, the extent to which these phenotypes share genetic architecture is unclear. This question is of great relevance to determining key risk factors for suicide, and to alleviate the societal burden of suicidal thoughts and behaviors (STBs). To help address the question of heterogeneity, consortia efforts have recently shifted from a focus on suicide within the context of major psychopathology (e.g. major depressive disorder, schizophrenia) to suicide as an independent entity. Recent molecular studies of suicide risk by members of the Psychiatric Genomics Consortium and the International Suicide Genetics Consortium have identified genome-wide significant loci associated with SA and with suicide death, and have examined these phenotypes within and outside of the context of major psychopathology. This review summarizes important insights from epidemiological and biometrical research on suicide, and discusses key empirical findings from molecular genetic examinations of STBs. Polygenic risk scores for these phenotypes have been observed to be associated with case−control status and other risk phenotypes. In addition, estimated shared genetic covariance with other phenotypes suggests specific medical and psychiatric risks beyond major depressive disorder. Broadly, molecular studies suggest a complexity of suicide etiology that cannot simply be accounted for by depression. Discussion of the state of suicide genetics, a growing field, also includes important ethical and clinical implications of studying the genetic risk of suicide.

Verified 2026-10-09 · 1 reference not checked yet

AI snapshot

Written from the paper’s full text.

TL;DR

This review synthesizes epidemiological, biometrical, and molecular genetic evidence indicating that suicidal ideation, suicide attempt, and suicide are heritable but genetically heterogeneous phenotypes. Recent GWAS have identified genome-wide significant loci for suicidal ideation/self-harm, suicide attempt, and suicide death, but samples remain small, mostly European-ancestry, and polygenic risk scores lack clinical utility.

Key findings

  • STBs are moderately heritable, with combined family, twin, and adoption estimates ranging from 30% to 55%; risk of suicide attempt is increased 5-fold in offspring whose parents have a history of suicide attempt.
  • In Swedish registry data of offspring born 1973–2001 (N = 2,762,883), genetic factors were the primary factor in intergenerational transmission of STBs; another Swedish study found suicide attempt transmission equally from genetic and environmental influences, with parental psychiatric and substance use disorders explaining up to 40% of genetic transmission effects, and a cross-generational genetic correlation between suicide attempt and suicide of 0.84.
  • GWAS findings include 3 genome-wide significant loci for suicidal ideation/self-harm with SNP-based heritability 7.6%; 3 loci for suicide attempt with SNP-based heritability 3.5–4.6%; and 2 loci for suicide death with SNP-based heritability 25%. A Japanese suicide GWAS found no significant loci but SNP-based heritability 35–48% and PRS variance explained of 1.3–2.4%.
  • PRS for STB phenotypes have been associated with case−control status and other risk phenotypes; suicide cases show elevated PRS for multiple psychiatric traits, with largest effect sizes for behavioral disinhibition, major depressive disorder, and schizophrenia.

Methods

  • Design: narrative review summarizing epidemiological and biometrical research on suicide and molecular genetic examinations of suicidal thoughts and behaviors (SI, SA, suicide death).
  • Data: synthesizes family, twin, adoption, registry, GWAS, rare variant, and functional genomic studies, including more than 20 GWASs of STBs and a table of GWAS efforts with genome-wide significant findings.
  • Analysis: no new primary data analysis; reports heritability estimates, genetic correlations, PRS associations, and genome-wide significant loci from cited studies.

Limitations

  • The paper states that current genetic studies of STBs have relatively small sample sizes, making genome-wide significant hits vulnerable to systematic biases; most GWASs are limited to European ancestry, and signals await replication.
  • The paper states that low base rates of suicide, heterogeneous and complex measurement of STBs, and limited examination of sex differences with genetic data constrain research; PRS for STBs have not achieved clinical utility.
  • Evident from the text: this is a narrative review without a described systematic search strategy or meta-analysis, so study selection and synthesis may not be comprehensive.

Model-written summary. Check it against the paper before relying on it.

Integrity signals

Registry

Crossref · 10.1017/s0033291721001720

Cites

70 of 71 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

0 of 73 cited sources checked · 0 supported · 0 flagged

  • Premisecitation

    The largest GWAS of STBs identified three loci meeting criteria for genome-wide significance for SI/self-harm.

    “This study identified three loci meeting criteria for genome-wide significance (see Table 1)”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Strawbridge et al., 2019

      Not checked in the free run.

  • Premisecitation

    Heritability estimates of STBs range from 30% to 55%.

    “Combined evidence from family, twin, and adoption studies have heritability estimates of STBs that range from 30% to 55% (Voracek & Loibl, 2007).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Voracek & Loibl, 2007

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  • Premisecitation

    The cross-generational genetic correlation between SA and suicide is substantial (0.84).

    “This study also examined the cross-generational genetic correlation between SA and suicide, and found estimates to be substantial (0.84)”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Kendler et al., 2020

      Not checked in the free run.

  • Premisereasoning

    The low predictive power of STBs GWAS results has prevented suicide polygenic risk scores from achieving any clinical utility.

    “Currently, the low predictive power of STBs GWAS results has prevented suicide polygenic risk scores (PRS) from achieving any clinical utility.”
    Quote in the paperSubstantial claim
  • Premisecitation

    The risk of SA is increased 5-fold in offspring whose parents have a history of SA.

    “The risk of SA is increased 5-fold in offspring whose parents have a history of SA (Brent et al., 2015).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Brent et al., 2015

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  • May combine two claims. 26
  • Classified as probably not a substantial claim. 17
  • May combine two claims.

    Premisecitation

    Recent most well-powered GWASs have identified genome-wide significant variants, but these signals still await replication.

    “The recent, most well-powered GWASs to date have identified genome-wide significant variants, but these signals still await replication.”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites Mullins et al., 2019

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    • cites Docherty et al., 2020

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  • May combine two claims.

    Premisereasoning

    Across a putative spectrum of suicide - suicide, SA, SI - phenotypic base rates rise while measurement becomes increasingly complex.

    “Across a putative ‘spectrum’ of suicide – suicide, SA, SI – phenotypic base rates rise while measurement becomes increasingly complex.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Premisecitation

    STBs run in families and can be transmitted independently of psychiatric comorbidities.

    “STBs run in families and can be transmitted independently of psychiatric comorbidities (Brent & Mann, 2005; Pedersen & Fiske, 2010; Tidemalm et al., 2011).”
    Quote in the paperSubstantial claim0 of 3 sources checked
    • cites Brent & Mann, 2005

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    • cites Pedersen & Fiske, 2010

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    • cites Tidemalm et al., 2011

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  • Classified as probably not a substantial claim.

    Premisereasoning

    Efforts to harmonize data across large GWAS cohorts is exceedingly difficult as more variation is introduced.

    “As more variation is introduced, efforts to harmonize data across large GWAS cohorts is exceedingly difficult.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S4 (based).

    Premisenone given

    Lifetime SA can vary in both frequency and intensity (i.e. intentionality, lethality).

    “The more common occurrence of lifetime SA can vary in both frequency and intensity (i.e. intentionality, lethality).”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Interpretationreasoning

    SA and suicide are partially distinct and SA is not simply a milder form of suicide.

    “This suggests that SA and suicide are partially distinct and that SA is not simply a milder form of suicide.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Premisecitation

    Suicidal ideation, suicide attempt (SA) and suicide are significantly heritable phenotypes.

    “Suicidal ideation, suicide attempt (SA) and suicide are significantly heritable phenotypes.”
    • Also stated in: § Introduction · plain
      “These phenotypes are each moderately heritable, with a significant proportion of risk attributed to genetic variation.”
    • Also stated in: § Genetic epidemiology · plain
      “Combined evidence from family, twin, and adoption studies have heritability estimates of STBs that range from 30% to 55% (Voracek & Loibl, 2007).”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Voracek & Loibl, 2007

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisenone given

    Ideation varies in frequency and intensity.

    “Ideation also varies in frequency and intensity.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Premisenone given

    The largest cohorts tend to be of those phenotypes with the highest base rates.

    “And naturally, the largest cohorts tend to be of those phenotypes with the highest base rates.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

    Premisenone given

    The rarer occurrence of suicide reflects a concrete, binary phenotype with virtually no measurement error, but a collection of such data is quite difficult.

    “For example, the rarer occurrence of suicide reflects a concrete, binary phenotype with virtually no measurement error, but a collection of such data is quite difficult.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisenone given

    SI reflects a symptom but not a behavior, and is typically assessed clinically by questionnaire or interview.

    “And the occurrence of SI reflects a symptom but not a behavior, and is typically assessed clinically by questionnaire or interview.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Premisecitation

    The lack of ancestral diversity in psychiatric genetics limits the identification and generalizability of potential genetic risk factors and can contribute to health disparities.

    “The lack of ancestral diversity in psychiatric genetics to date limits the identification and generalizability of potential genetic risk factors and can contribute to health disparities (Kang & Ruderfer, 2020).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Kang & Ruderfer, 2020

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  • May combine two claims.

    Premisenone given

    Most genetic studies of STBs have focused on common genetic variants, with only a small number of studies investigating rare genetic variation.

    “Most genetic studies of STBs have focused on common genetic variants, with only a small number of studies investigating rare genetic variation.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Among people who attempt suicide, only 10-15% eventually go on to die from suicide, with 1.6% of suicides occurring within 1 year and 3.9% within 5 years of an attempt.

    “Among people who attempt suicide, only 10–15% eventually go on to die from suicide, with 1.6% of suicides occurring within 1 year and 3.9% within 5 years of an attempt (Olfson et al., 2017; Suominen et al., 2004).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Olfson et al., 2017

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    • cites Suominen et al., 2004

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  • May combine two claims.

    Premisereasoning

    Mental health conditions comprise an important risk factor for STBs, but they do not fully account for STBs.

    “Notably, mental health conditions comprise an important risk factor for STBs, but they do not fully account for STBs.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Premisecitation

    SNP-based heritability estimates of SA in Europeans are significant and range from 3.5% to 4.6%.

    “SNP-based heritability estimates of SA in Europeans have been significant and range from 3.5% to 4.6% (Erlangsen et al., 2018; Ruderfer et al., 2019).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Erlangsen et al., 2018

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    • cites Ruderfer et al., 2019

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  • May combine two claims.

    Premisecitation

    Two whole-exome sequencing studies have suggested that rare SNVs may be implicated in SA in bipolar disorder and suicide in major depressive disorder.

    “Two whole-exome sequencing studies have suggested that rare SNVs may be implicated in SA in bipolar disorder (Monson et al., 2017) and suicide in major depressive disorder (Monson et al., 2017; Tombácz et al., 2017).”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites Monson et al., 2017

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    • cites Tombácz et al., 2017

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  • May combine two claims.

    Premisecitation

    PRS of SI/SA were tested in an independent sample and associated with a higher risk of suicide at most significance thresholds.

    “PRS of SI/SA were tested in an independent sample and associated with a higher risk of suicide at most significance thresholds.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Strawbridge et al., 2019

      Not checked in the free run.

  • May combine two claims.

    Premisecitation

    Suicide cases had elevated PRS for multiple psychiatric traits, with the largest effect sizes observed for behavioral disinhibition, major depressive disorder, and schizophrenia.

    “Suicide cases were observed to have elevated PRS for multiple psychiatric traits, with the largest effect sizes observed for behavioral disinhibition, major depressive disorder, and schizophrenia.”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites Docherty et al., 2020

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Premisenone given

    Identification of rare genetic risk can more directly pinpoint genes of interest.

    “Identification of rare genetic risk can more directly pinpoint genes of interest.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Premisecitation

    CNV studies in SA have been underpowered, but also suggest a possible role for CNVs in STBs.

    “CNV studies in SA have been underpowered, but also suggest a possible role for CNVs in STBs (Gross et al., 2015; Perlis, Ruderfer, Hamilton, & Ernst, 2012; Sokolowski, Wasserman, & Wasserman, 2016; Tombácz et al., 2017).”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Gross et al., 2015

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    • cites Perlis et al., 2012

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    • cites Sokolowski et al., 2016

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  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Lifetime prevalence rates are roughly 9.2% for SI and 2.7% for SA.

    “Lifetime prevalence rates are roughly 9.2% for SI and 2.7% for SA.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Nock et al., 2008

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  • May combine two claims.

    Premisecitation

    Sex ratios of suicide and SA differ dramatically, with a 4:1 ratio of males to females for suicide death and virtually the opposite pattern for SA.

    “However, sex ratios of suicide and SA differ dramatically, with a 4:1 ratio of males to females for suicide death and virtually the opposite pattern for SA (Nock et al., 2008)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Nock et al., 2008

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  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisenone given

    All SNV and CNV results await replication.

    “All SNV and CNV results await replication”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Premisecitation

    Risk factors with the strongest evidence of epidemiological association with suicide include drug and alcohol misuse, the presence of a neuropsychiatric disorder, and a family history of STBs.

    “Currently, risk factors with the strongest evidence of epidemiological association with suicide include drug and alcohol misuse, the presence of a neuropsychiatric disorder, and a family history of STBs.”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Fazel & Runeson, 2020

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  • May combine two claims.

    Premisecitation

    Other significant risk factors include access to lethal means, adverse life events, diagnoses of chronic and/or terminal illness, previous SAs, and adverse childhood experiences.

    “Other significant risk factors include access to lethal means, adverse life events, diagnoses of chronic and/or terminal illness, previous SAs, and adverse childhood experiences (Fazel & Runeson, 2020).”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Fazel & Runeson, 2020

      Not checked in the free run.

  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Interpretationnone given

    The degree of pleiotropy in suicidal thoughts and behaviors phenotypes remains unclear.

    “The degree of pleiotropy in STBs phenotypes remains unclear.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Premisecitation

    Over 2500 genes have been associated with suicide, with varying levels of statistical support.

    “To date, over 2500 genes have been associated with suicide, with varying levels of statistical support”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Sokolowski & Wasserman, 2020

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  • May combine two claims.

    Interpretationreasoning

    Low base rates of suicide and the complexity of measurement of suicidal thoughts and behaviors present significant challenges to suicide research.

    “However, as reviewed above, it is apparent that the low base rates of suicide and the complexity of measurement of STBs present significant challenges to suicide research.”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based). May combine two claims.

    Premisenone given

    Examination of sex differences in suicidal thoughts and behaviors has largely been limited to epidemiological observations and has not yet been examined with genetic data.

    “Examination of sex differences in STBs, likewise, has largely been limited to epidemiological observations and has not yet been examined with genetic data.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationreasoning

    There is some room for refinement of nosology and risk assessment by examining suicide within and across diagnostic groups.

    “Yet there is some room for refinement of nosology and risk assessment by examining suicide within and across diagnostic groups.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Premisenone given

    Genetic liability for major depressive disorder is increased in individuals who attempt suicide within a variety of psychiatric diagnoses.

    “Genetic liability for major depressive disorder is increased in individuals who attempt suicide within a variety of psychiatric diagnoses.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing), S4 (based).

    Premisenone given

    Only recently have suicide GWAS become large enough to derive estimates of molecular genetic correlations with other conditions.

    “In addition, only recently have suicide GWAS become large enough to derive estimates of molecular genetic correlations with other conditions.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    Major depressive disorder is the most prevalent psychiatric disorder, with approximately 16% prevalence.

    “Major depressive disorder is the most prevalent psychiatric disorder (~16% prevalence)”
    Quote in the paperNot a substantial claim0 of 1 sources checked
    • cites Orsolini et al., 2020

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  • Probably not a substantial claim: may not pass S2 (checkable).

    Interpretationcitation

    Recognizing suicidal thoughts and behaviors as a distinct condition or set of behaviors, rather than a symptom of a given psychiatric diagnosis, allows researchers to look for risk factors involved in suicide beyond the confines of a particular psychiatric condition.

    “Recognizing STBs as a distinct condition or set of behaviors, rather than a symptom of a given psychiatric diagnosis, allows researchers to look for risk factors involved in suicide beyond the confines of a particular psychiatric condition”
    Quote in the paperNot a substantial claim0 of 3 sources checked
    • cites Mann & Rizk, 2020

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    • cites Salloum, 2017

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    • cites Sisti et al., 2020

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  • May combine two claims.

    Interpretationreasoning

    Few successful functional genomic replications have been observed, possibly due to heterogeneity of phenotyping and methods across studies.

    “Similar to genetic architecture studies, we see few successful functional genomic replications, possibly due to heterogeneity of the phenotyping and methods across studies.”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Interpretationreasoning

    Because suicidal thoughts and behaviors are polygenic, genetic risk for suicide can be more easily modeled across phenotypes and populations, and modeled conditional on other phenotypes.

    “This allows genetic risk for suicide to be more easily modeled across phenotypes and populations, and also modeled conditional on other phenotypes.”
    Quote in the paperSubstantial claim
37 of 37
  • The paper relies on this without support.

    The extent to which SI, SA, and suicide share genetic architecture is unclear.

    “However, the extent to which these phenotypes share genetic architecture is unclear.”
  • The paper relies on this without support.

    Most STB GWASs have been statistically underpowered to detect specific loci at genome-wide significance levels.

    “However, most of these GWAS have been limited to European ancestry populations, and have been statistically underpowered to detect specific loci at genome-wide significance levels.”
  • The paper relies on this without support.

    Functional genomic approaches can identify risk genes and molecular pathways involved in suicide risk.

    “Risk genes and molecular pathways involved in suicide risk can also be identified with functional genomic approaches.”
  • The paper relies on this without support.

    Sample size is a major factor in the genetic discovery of risk variants.

    “The sample size is a major factor in the genetic discovery of risk variants.”
  • The paper relies on this without support.

    Suicidal thoughts and behaviors comprise heritable phenotypes.

    “Genetic examination of the heritable phenotypes comprising STBs will help to better model the heterogeneity and understand the sequelae of STBs.”
5 of 5

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Suicidal behaviors can arise from genetic influences partly independent of psychiatric disorders such as major depressive disorder, bipolar disorder, and schizophrenia.

    “Genetic predisposition often overlaps with psychiatric disorders such as major depressive disorder (MDD), bipolar disorder, and schizophrenia, yet increasing evidence suggests that suicidal behaviors can arise from genetic influences partly independent of these conditions (37).”
  • Genetic predisposition to suicidal behavior often overlaps with psychiatric disorders such as major depressive disorder, bipolar disorder, and schizophrenia.

    “Genetic predisposition often overlaps with psychiatric disorders such as major depressive disorder (MDD), bipolar disorder, and schizophrenia, yet increasing evidence suggests that suicidal behaviors can arise from genetic influences partly independent of these conditions (37).”

Cites

Flagged first, then by citations

Research works printed but not linked: 4

  1. World Health Organization, 2014, Suicide prevention: A global imperative
  2. 2017, Global burden of disease study 2017, The Lancet, 392, 1789
  3. Nock, 2012, Suicide: Global perspectives from the WHO world mental health surveys. Suicide: Global perspectives from the WHO world mental health surveys, xi, 391
  4. 2020, Web-based injury statistics query and reporting system (WISQARS)

Cited by

Sorted by citations

Authors
DiBlasi, E., Kang, J., & Docherty, A. R.
Affiliations
  • University of Utah (US)
  • Vanderbilt University (US)
  • Virginia Commonwealth University (US)
Corresponding author
DiBlasi, Emily
Venue
Psychological Medicine
Published
2021-05-25
Volume
51
Issue
13
Pages
2148-2155
ISSN
  • 0033-2917 (ISSN-L)
  • 1469-8978
OpenAlex
W3165176692
Cited by
83
References
71
Citations by year
2026: 15 · 2025: 19 · 2024: 15 · 2023: 19 · 2022: 12 · 2021: 3
FWCI
1.63
Type
journal article
Language
en
Open access
Locations
  • Psychological Medicine (publishedVersion, cc-by-nc-sa)
  • Europe PMC (PubMed Central) (publishedVersion, other-oa)
  • PubMed Central (publishedVersion, cc-by-nc-sa)
  • PubMed (publishedVersion)
Funders
  • American Foundation for Suicide Prevention (PDF-0-038-18)
  • National Institutes of Health (UL1TR002538)
  • National Institute of Mental Health (R01MH123619)
  • National Institute of General Medical Sciences (T32GM007347, T32GM152284)
  • National Center for Advancing Translational Sciences
Topics
  • Social Sciences › Psychology › Clinical Psychology › Suicide and Self-Harm Studies
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetic Associations and Epidemiology
  • Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
Keywords
suicide, suicidal ideation, suicide attempts, heritability, genetic architecture, polygenic risk score, genome-wide association loci, major depressive disorder, psychopathology, psychiatric genomics
MeSH terms
Humans, Phenotype, Risk Factors, Suicide, Attempted, Molecular Epidemiology, Genome-Wide Association Study, Suicidal Ideation

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