The causal effect of education and cognitive performance on risk for suicide attempt : A combined instrumental variable and co-relative approach in a Swedish national cohort
(2022) In Journal of Affective Disorders 305. p.115-121- Abstract
Background: The aim of this study was to clarify the possible causal associations between education phenotypes and non-fatal suicide attempts. In particular, we evaluated the roles of academic achievement (school grades), cognitive performance (IQ), and educational attainment (education level). Methods: Based on longitudinal Swedish registry data, we included 2,335,763 individuals (48.7% female) with available school grades, 1,448,438 men with IQ measures, and 4,352,989 individuals (48.4% female) with available data on education level. We combined two different approaches to aid in causal inference: 1) instrumental variables analysis, using month of birth as an instrument related to education but not suicide attempt, to control for... (More)
Background: The aim of this study was to clarify the possible causal associations between education phenotypes and non-fatal suicide attempts. In particular, we evaluated the roles of academic achievement (school grades), cognitive performance (IQ), and educational attainment (education level). Methods: Based on longitudinal Swedish registry data, we included 2,335,763 individuals (48.7% female) with available school grades, 1,448,438 men with IQ measures, and 4,352,989 individuals (48.4% female) with available data on education level. We combined two different approaches to aid in causal inference: 1) instrumental variables analysis, using month of birth as an instrument related to education but not suicide attempt, to control for measured and unmeasured confounders, and 2) co-relative analysis, comparing pairs of different genetic relatedness (cousins, half, and full siblings) to control for genetic and environmental influences. Results: High education was associated with reduced risk of suicide attempt. Instrumental variable analysis indicated evidence of a likely causal association between higher school grades and lower risk of suicide attempts (HR = 0.71). Co-relative analyses supported the causality between the three predictors and suicide attempt risk (school grades, HR = 0.80, IQ, HR = 0.83, education level, HR = 0.76). Finally, we examined the specificity of education phenotypes and found that both cognitive (IQ) and non-cognitive (school grades, education level) processes were involved in suicide attempt risk. Limitations: IQ was only available in men, limiting the generalizability of this analysis in women. Conclusions: Efforts to support causal associations in psychiatric research are needed to offer better intervention. Programs improving education during adolescence would decrease suicide attempt risk.
(Less)
- author
- Lannoy, Séverine ; Ohlsson, Henrik LU ; Kendler, Kenneth S. LU ; Sundquist, Jan LU ; Sundquist, Kristina LU and Edwards, Alexis C. LU
- organization
- publishing date
- 2022-05-15
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Causality, Education level, IQ, School grades, Suicide
- in
- Journal of Affective Disorders
- volume
- 305
- pages
- 7 pages
- publisher
- Elsevier
- external identifiers
-
- scopus:85125834153
- pmid:35271869
- ISSN
- 0165-0327
- DOI
- 10.1016/j.jad.2022.03.004
- language
- English
- LU publication?
- yes
- id
- 352de7df-4955-4083-a2f3-f7a758b10acb
- date added to LUP
- 2022-04-19 15:37:02
- date last changed
- 2024-04-20 13:57:48
@article{352de7df-4955-4083-a2f3-f7a758b10acb,
abstract = {{<p>Background: The aim of this study was to clarify the possible causal associations between education phenotypes and non-fatal suicide attempts. In particular, we evaluated the roles of academic achievement (school grades), cognitive performance (IQ), and educational attainment (education level). Methods: Based on longitudinal Swedish registry data, we included 2,335,763 individuals (48.7% female) with available school grades, 1,448,438 men with IQ measures, and 4,352,989 individuals (48.4% female) with available data on education level. We combined two different approaches to aid in causal inference: 1) instrumental variables analysis, using month of birth as an instrument related to education but not suicide attempt, to control for measured and unmeasured confounders, and 2) co-relative analysis, comparing pairs of different genetic relatedness (cousins, half, and full siblings) to control for genetic and environmental influences. Results: High education was associated with reduced risk of suicide attempt. Instrumental variable analysis indicated evidence of a likely causal association between higher school grades and lower risk of suicide attempts (HR = 0.71). Co-relative analyses supported the causality between the three predictors and suicide attempt risk (school grades, HR = 0.80, IQ, HR = 0.83, education level, HR = 0.76). Finally, we examined the specificity of education phenotypes and found that both cognitive (IQ) and non-cognitive (school grades, education level) processes were involved in suicide attempt risk. Limitations: IQ was only available in men, limiting the generalizability of this analysis in women. Conclusions: Efforts to support causal associations in psychiatric research are needed to offer better intervention. Programs improving education during adolescence would decrease suicide attempt risk.</p>}},
author = {{Lannoy, Séverine and Ohlsson, Henrik and Kendler, Kenneth S. and Sundquist, Jan and Sundquist, Kristina and Edwards, Alexis C.}},
issn = {{0165-0327}},
keywords = {{Causality; Education level; IQ; School grades; Suicide}},
language = {{eng}},
month = {{05}},
pages = {{115--121}},
publisher = {{Elsevier}},
series = {{Journal of Affective Disorders}},
title = {{The causal effect of education and cognitive performance on risk for suicide attempt : A combined instrumental variable and co-relative approach in a Swedish national cohort}},
url = {{http://dx.doi.org/10.1016/j.jad.2022.03.004}},
doi = {{10.1016/j.jad.2022.03.004}},
volume = {{305}},
year = {{2022}},
}