000171784 001__ 171784 000171784 005__ 20260603114408.0 000171784 0247_ $$2doi$$a10.1136/bmjopen-2025-106685 000171784 0248_ $$2sideral$$a149531 000171784 037__ $$aART-2026-149531 000171784 041__ $$aeng 000171784 100__ $$aArtés, Carmen 000171784 245__ $$aDesigning interventions guided by digital phenotype and pharmacogenetics in Spain for suicidal behaviour based on retrospective data: the multicentre SMARTomicS study protocol 000171784 260__ $$c2026 000171784 5060_ $$aAccess copy available to the general public$$fUnrestricted 000171784 5203_ $$aIntroduction: Each year, suicide claims approximately 700 000 lives worldwide and generates a significant financial burden. Integrating genomic data, exposomic factors and digital phenotypes can enhance the development of short-term predictive models. Current knowledge and available tools provide the basis for designing personalised treatment strategies that incorporate real-time interventions to prevent suicide attempt recurrence cost-effectively. This study aims to develop a predictive algorithm for suicidal behaviour integrating psychiatric assessments, genetic risk markers, digital phenotypes and exposomic data. Methods and analysis: This protocol describes a retrospective multicentre study that will recruit participants with a clinical history of suicide across 25 hospitals across Spain with a catchment area of 8.6 million people (17.8% of Spain’s population). Our sample target is over 5000 participants, aged over 12 years old, ensuring 93.5% statistical power for genetic analysis. Eligible participants must be over 12 years old. Data collection will include psychiatric assessments, biospecimen collections (DNA, RNA, plasma and serum), Google Takeout data for digital phenotyping, and a standardised set of administrative and clinical data registered for each patient. Genotyping will be performed with the Axiom Spanish array (>750 000 markers), and genome-wide association studies (GWAS) will be performed after genetic imputation in a whole sample of >10 000 individuals (5000 suicide attempters; 5000 controls). Prescription and clinical history will also be retrospectively integrated, and codified data statistics forms will periodically be sent to the Government. Statistical analyses will combine traditional regression models and AI-based algorithms to identify predictive behavioural, genomic profiles, and digital markers of suicidal behaviour. Cost-effectiveness analyses of pharmacogenomic markers for antidepressant response will also be conducted. By successfully implementing this project, we aim to help reduce suicide reattempts and lessen the emotional and economic burden on families and the healthcare system. 000171784 536__ $$9info:eu-repo/grantAgreement/ES/ISCIII/PI23-00614$$9info:eu-repo/grantAgreement/ES/ISCIII/PMP24-00026 000171784 540__ $$9info:eu-repo/semantics/openAccess$$aby-nc$$uhttps://creativecommons.org/licenses/by-nc/4.0/deed.es 000171784 655_4 $$ainfo:eu-repo/semantics/article$$vinfo:eu-repo/semantics/publishedVersion 000171784 700__ $$aPorras-Segovia, Alejandro 000171784 700__ $$aRuiz-Veguilla, Miguel 000171784 700__ $$aGiner, Lucas 000171784 700__ $$0(orcid)0000-0002-3797-4218$$aGarcia-Campayo, Javier$$uUniversidad de Zaragoza 000171784 700__ $$0(orcid)0000-0002-1690-4130$$aLópez del Hoyo, Yolanda$$uUniversidad de Zaragoza 000171784 700__ $$aAlejandra-Saiz, Pilar 000171784 700__ $$aGarcía-Fernández, Ainoa 000171784 700__ $$aMartínez-Jambrina, Juan José 000171784 700__ $$aVilla-Díez, Rocío 000171784 700__ $$aGili, Margalida 000171784 700__ $$aRoca, Miquel 000171784 700__ $$ade Andrés, Fernando 000171784 700__ $$aPérez Sola, Víctor 000171784 700__ $$aElices, Matilde E. 000171784 700__ $$aGrande, Iria 000171784 700__ $$aCebria, Ana Isabel 000171784 700__ $$aIrigoyen-Otiñano, Maria 000171784 700__ $$aGalván-Santiago, Leonardo 000171784 700__ $$aAguilar Garcia-Iturrospe, Eduardo Jesús 000171784 700__ $$aMesones-Peral, Jesús 000171784 700__ $$aMora-Marín, Rafael 000171784 700__ $$aSierra, Pîlar 000171784 700__ $$aPenas-Lledo, Eva 000171784 700__ $$aLLerena, Adrian 000171784 700__ $$aLopez-Castroman, Jorge 000171784 700__ $$aCruz, Raquel 000171784 700__ $$aArrojo, Manuel 000171784 700__ $$aOvejero, Santiago 000171784 700__ $$ade la Torre-Luque, Alejandro 000171784 700__ $$aPalao-Tarrero, Ángela 000171784 700__ $$aVaquero-Lorenzo, Concepción 000171784 700__ $$aToma, Claudio 000171784 700__ $$aBarrigon, Maria Luisa 000171784 700__ $$aArtes, Antonio 000171784 700__ $$aDíaz-Marsá, Marina 000171784 700__ $$aAyad-Ahmed, Wala 000171784 700__ $$aIbáñez, Ángela 000171784 700__ $$aDíaz-Sastre, Carmen 000171784 700__ $$aSalvador-Robert, Mercè 000171784 700__ $$aÁlvarez-García, Raquel 000171784 700__ $$aMata-Iturralde, Laura 000171784 700__ $$aBenavente-López, Sergio 000171784 700__ $$aMuñoz-Lorenzo, Laura 000171784 700__ $$aDi Stasio, Ezequiel Fernando 000171784 700__ $$aCarmona-Camacho, Rodrigo 000171784 700__ $$aPeñuelas-Calvo, Inmaculada 000171784 700__ $$aValencia, Miguel 000171784 700__ $$aLópez Peña, Purificación 000171784 700__ $$aAlbarracín-García, Lucía 000171784 700__ $$aBaca-Garcia, Enrique 000171784 7102_ $$14009$$2730$$aUniversidad de Zaragoza$$bDpto. Psicología y Sociología$$cÁrea Psicología Básica 000171784 7102_ $$11007$$2745$$aUniversidad de Zaragoza$$bDpto. Medicina, Psiqu. y Derm.$$cArea Psiquiatría 000171784 773__ $$g16 (2026), e106685 [10 pp.]$$pBMJ Open$$tBMJ Open$$x2044-6055 000171784 8564_ $$s672048$$uhttps://zaguan.unizar.es/record/171784/files/texto_completo.pdf$$yVersión publicada 000171784 8564_ $$s3250446$$uhttps://zaguan.unizar.es/record/171784/files/texto_completo.jpg?subformat=icon$$xicon$$yVersión publicada 000171784 909CO $$ooai:zaguan.unizar.es:171784$$particulos$$pdriver 000171784 951__ $$a2026-06-03-11:05:19 000171784 980__ $$aARTICLE