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A new research centre at the Douglas Hospital may be able to shed light on why some people choose to kill themselves. The McGill Group for Suicide Studies (MGSS) is the first of its kind in Canada, funded in part by the Canada Foundation for Innovation.
Director Gustav Turecki, a psychiatric geneticist, said the centre's multidisciplinary team hopes to identify risk factors associated with suicide. The centre has one of the world's largest collections of DNA from people who have committed suicide, as well as a dedicated brain bank.
"The idea was to develop a facility that allows for the integrity of research. That means incorporating clinical aspects as well as biological aspects. We already had the nucleus of the group with people working on different areas of suicide," said Turecki.
There are more than 40 people associated with the MGSS, with 10 principal investigators. Due to their different approaches and specialties, they will be able to take a more global approach to the subject than has been taken in the past.
"We already have a lot of researchers looking at psychosocial aspects of suicide in Canada, but there was nothing in terms of more multidisciplinary research in suicide, and almost nothing in terms of biological research here in Canada," explained Turecki.
The MGSS will be looking mainly at what Turecki terms "suicide completion" as opposed to attempted suicides. To do this, they have an agreement with the coroner's office to gain access to suicides.
"One member of our team goes to the central morgue daily, and when the families come to the morgue we ask them to participate. You can imagine it's a very difficult moment in the lives of these families. We're careful in respecting their wishes, and we also provide them with resources when needed," he said.
There are few things more emotionally wrenching for a family than to lose a loved one to suicide. One may think that families would not react well to being approached to participate in a scientific survey at this juncture. Not so, said Turecki.
"They're completely torn apart by the experience, and that is why they want to find answers as to why this person died by suicide. That's why they're willing to participate: it differs from case to case, but in general the participation rate is very good," he said.
"It's very helpful for them to go through the process."
The process can include taking a sample of brain tissue or DNA, and involve "psychological autopsies." These are in-depth interviews with family members, usually four months after the suicide, to determine personality traits of the victim, as well as of the family, and to do a psychosocial assessment.
Turecki's own research looks at biomedical risk factors, such as genetics, as well as clinical and behavioural aspects to suicide.
"We want to see if there is any specific gene signature or gene expression pattern in the brains of those who have died by suicide," he said.
However, he stressed that there is no one cause that leads people to kill themselves.
"There are no genes for suicide -- we believe genes might increase predisposition, but this is in the context of other factors as well. One example -- and this is not a simplistic relation either -- is that people who have high levels of aggressive or impulsive behaviour might be somewhat more predisposed to commit suicide, given a number of circumstances. It's possible that genes might play a role, that they might make people more impulsive or react more aggressively, but not that genes can cause suicide," he said.
Depression is another research area of interest. Between seven and 15 percent of those with major depression are at a lifetime risk of committing suicide. "There are over 85 percent of people with major depression who don't die of suicide. So what is different between those who die by suicide and those who do not?"
Quebec currently has the highest suicide rate in the country, with about a third of Canada's suicides every year. Turecki said one shouldn't read too much into this statistic. First of all, the numbers change from year to year. Secondly, what constitutes an official suicide differs from province to province.
"For example, in Ontario, the coroner needs to be more assured that the case had a past psychiatric history, and needs more evidence of intentionality. They would not consider a case as suicide below a certain age, whereas here a coroner might consider a case [as suicide] below even 10 years," he said.
"It might be cultural as well -- how the different societies look at these phenomena. Also, there seems to be a difference in the overall treatment of depression. In Quebec the total number of people treated for depression is lower than in other provinces."
It's precisely because of these many factors that a centre like the MGSS is required. Suicide is complicated, and there is no one approach to figuring it out.
"In order to be able to understand suicide more fully we need to be able to do multidisciplinary research," Turecki said.