AbstractBackgroundAdolescent suicide is a major health problem in the US marked by a recent increase in Black/African American youth suicide trends. While genetic factors partly account for familial transmission of suicidal behavior, it is not clear whether polygenic risk scores of suicide attempt have clinical utility in youth suicide risk classification.ObjectivesTo evaluate the contribution of a polygenic risk score for suicide attempt (PRS-SA) in explaining variance in suicide attempt by

more »

... ly adolescence.MethodsWe studied N=5,214 non-related Black and White youth from the Adolescent Brain Cognitive Development (ABCD) Study (ages 8.9-13.8 years) who were evaluated between 2016 and 2021. Regression models tested associations between PRS-SA and parental history of suicide attempt/death with youth-reported suicide attempt. Covariates included age, sex, and race.ResultsOver three waves of assessments, 182 youth (3.5%) reported a past suicide attempt, with Black youth reporting significantly more suicide attempts than their White counterparts (6.1% vs 2.8%, P<.001). PRS-SA was associated with suicide attempt (odds ratio [OR]=1.3, 95% confidence interval [CI] 1.1-1.5, P=.001). Inclusion of PRS-SA explained 2.7% of the variance in suicide attempts, significantly more than the base model including only age, sex and race, which explained 1.9% of the variance (P=.001). Parental history of suicide attempt/death was also associated with youth suicide attempt (OR=2.9, 95%CI 1.9-4.4, P<.001). Addition of PRS-SA to the model that included parental history significantly increased the variance explained from 3.3% to 4% (P=.002).ConclusionsFindings suggest that PRS-SA may be useful for suicide risk classification in diverse youth.Contribution to the Field StatementAdolescent suicidal behavior is a major health problem, with suicide being the 2nd leading cause of death in youth. Research that improves our understanding regarding drivers of suicide risk in youth can inform youth suicide prevention strategies. Family history of suicide is an established risk factor for youth suicidal behavior. Current methods in psychiatric genetics allow calculation of polygenic risk scores that represent genetic liability to specific conditions. It is not clear whether polygenic risk score of suicide attempt can assist in risk classification, beyond family history. In this work, we show that in a sample of 5,214 youth ages 9-13, of which 3.5% reported past suicide attempt, polygenic score of suicide attempt was associated with youth suicide attempt. This association additively explained variance over and above parental history of suicide attempt/death. Findings make a case for the potential utility of incorporating polygenic risk scores as part of suicide attempt risk classification in youth, and suggest that polygenic scores may reveal genetic liability that is not captured by family history of suicide.