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Grigoroiu-Serbanescu M, van der Veen T, Bigdeli T, Herms S, Diaconu CC, Neagu AI, Bass N, Thygesen J, Forstner AJ, Nöthen MM, McQuillin A. Schizophrenia polygenic risk scores, clinical variables and genetic pathways as predictors of phenotypic traits of bipolar I disorder. J Affect Disord 2024; 356:507-518. [PMID: 38640977 DOI: 10.1016/j.jad.2024.04.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2023] [Revised: 04/05/2024] [Accepted: 04/16/2024] [Indexed: 04/21/2024]
Abstract
AIM We investigated the predictive value of polygenic risk scores (PRS) derived from the schizophrenia GWAS (Trubetskoy et al., 2022) (SCZ3) for phenotypic traits of bipolar disorder type-I (BP-I) in 1878 BP-I cases and 2751 controls from Romania and UK. METHODS We used PRSice-v2.3.3 and PRS-CS for computing SCZ3-PRS for testing the predictive power of SCZ3-PRS alone and in combination with clinical variables for several BP-I subphenotypes and for pathway analysis. Non-linear predictive models were also used. RESULTS SCZ3-PRS significantly predicted psychosis, incongruent and congruent psychosis, general age-of-onset (AO) of BP-I, AO-depression, AO-Mania, rapid cycling in univariate regressions. A negative correlation between the number of depressive episodes and psychosis, mainly incongruent and an inverse relationship between increased SCZ3-SNP loading and BP-I-rapid cycling were observed. In random forest models comparing the predictive power of SCZ3-PRS alone and in combination with nine clinical variables, the best predictions were provided by combinations of SCZ3-PRS-CS and clinical variables closely followed by models containing only clinical variables. SCZ3-PRS performed worst. Twenty-two significant pathways underlying psychosis were identified. LIMITATIONS The combined RO-UK sample had a certain degree of heterogeneity of the BP-I severity: only the RO sample and partially the UK sample included hospitalized BP-I cases. The hospitalization is an indicator of illness severity. Not all UK subjects had complete subphenotype information. CONCLUSION Our study shows that the SCZ3-PRS have a modest clinical value for predicting phenotypic traits of BP-I. For clinical use their best performance is in combination with clinical variables.
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Affiliation(s)
- Maria Grigoroiu-Serbanescu
- Psychiatric Genetics Research Unit, Alexandru Obregia Clinical Psychiatric Hospital, Bucharest, Romania.
| | - Tracey van der Veen
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK
| | - Tim Bigdeli
- SUNY Downstate Medical Center, Brooklyn, NY, USA
| | - Stefan Herms
- Department of Biomedicine, University of Basel, Basel, Switzerland; Institute of Human Genetics, University of Bonn, School of Medicine, University Hospital Bonn, Germany
| | | | | | - Nicholas Bass
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK
| | - Johan Thygesen
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK; Institute of Health Informatics, University College London, London, UK
| | - Andreas J Forstner
- Institute of Human Genetics, University of Bonn, School of Medicine, University Hospital Bonn, Germany
| | - Markus M Nöthen
- Institute of Human Genetics, University of Bonn, School of Medicine, University Hospital Bonn, Germany
| | - Andrew McQuillin
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK
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2
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Jonsson L, Hörbeck E, Primerano A, Song J, Karlsson R, Smedler E, Gordon-Smith K, Jones L, Craddock N, Jones I, Sullivan PF, Pålsson E, Di Florio A, Sparding T, Landén M. Association of Occupational Dysfunction and Hospital Admissions With Different Polygenic Profiles in Bipolar Disorder. Am J Psychiatry 2024:appiajp20230073. [PMID: 38859703 DOI: 10.1176/appi.ajp.20230073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/12/2024]
Abstract
OBJECTIVE Many but not all persons with bipolar disorder require hospital care because of severe mood episodes. Likewise, some but not all patients experience long-term occupational dysfunction that extends beyond acute mood episodes. It is not known whether these dissimilar outcomes of bipolar disorder are driven by different polygenic profiles. Here, polygenic scores (PGSs) for major psychiatric disorders and educational attainment were assessed for associations with occupational functioning and psychiatric hospital admissions in bipolar disorder. METHODS A total of 4,782 patients with bipolar disorder and 2,963 control subjects were genotyped and linked to Swedish national registers. Longitudinal measures from at least 10 years of registry data were used to derive percentage of years without employment, percentage of years with long-term sick leave, and mean number of psychiatric hospital admissions per year. Ordinal regression was used to test associations between outcomes and PGSs for bipolar disorder, schizophrenia, major depressive disorder, attention deficit hyperactivity disorder (ADHD), and educational attainment. Replication analyses of hospital admissions were conducted with data from the Bipolar Disorder Research Network cohort (N=4,219). RESULTS Long-term sick leave and unemployment in bipolar disorder were significantly associated with PGSs for schizophrenia, ADHD, major depressive disorder, and educational attainment, but not with the PGS for bipolar disorder. By contrast, the number of hospital admissions per year was associated with higher PGSs for bipolar disorder and schizophrenia, but not with the other PGSs. CONCLUSIONS Bipolar disorder severity (indexed by hospital admissions) was associated with a different polygenic profile than long-term occupational dysfunction. These findings have clinical implications, suggesting that mitigating occupational dysfunction requires interventions other than those deployed to prevent mood episodes.
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Affiliation(s)
- Lina Jonsson
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden (Jonsson, Hörbeck, Smedler, Pålsson, Sparding, Landén); National Centre for Mental Health, Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Primerano, Craddock, I. Jones, Di Florio); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Song, Karlsson, Sullivan, Landén); Mental Health Center and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China (Song); Department of Psychological Medicine, University of Worcester, Worcester, U.K. (Gordon-Smith, L. Jones); Departments of Genetics and Psychiatry, University of North Carolina at Chapel Hill (Sullivan)
| | - Elin Hörbeck
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden (Jonsson, Hörbeck, Smedler, Pålsson, Sparding, Landén); National Centre for Mental Health, Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Primerano, Craddock, I. Jones, Di Florio); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Song, Karlsson, Sullivan, Landén); Mental Health Center and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China (Song); Department of Psychological Medicine, University of Worcester, Worcester, U.K. (Gordon-Smith, L. Jones); Departments of Genetics and Psychiatry, University of North Carolina at Chapel Hill (Sullivan)
| | - Amedeo Primerano
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden (Jonsson, Hörbeck, Smedler, Pålsson, Sparding, Landén); National Centre for Mental Health, Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Primerano, Craddock, I. Jones, Di Florio); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Song, Karlsson, Sullivan, Landén); Mental Health Center and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China (Song); Department of Psychological Medicine, University of Worcester, Worcester, U.K. (Gordon-Smith, L. Jones); Departments of Genetics and Psychiatry, University of North Carolina at Chapel Hill (Sullivan)
| | - Jie Song
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden (Jonsson, Hörbeck, Smedler, Pålsson, Sparding, Landén); National Centre for Mental Health, Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Primerano, Craddock, I. Jones, Di Florio); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Song, Karlsson, Sullivan, Landén); Mental Health Center and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China (Song); Department of Psychological Medicine, University of Worcester, Worcester, U.K. (Gordon-Smith, L. Jones); Departments of Genetics and Psychiatry, University of North Carolina at Chapel Hill (Sullivan)
| | - Robert Karlsson
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden (Jonsson, Hörbeck, Smedler, Pålsson, Sparding, Landén); National Centre for Mental Health, Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Primerano, Craddock, I. Jones, Di Florio); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Song, Karlsson, Sullivan, Landén); Mental Health Center and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China (Song); Department of Psychological Medicine, University of Worcester, Worcester, U.K. (Gordon-Smith, L. Jones); Departments of Genetics and Psychiatry, University of North Carolina at Chapel Hill (Sullivan)
| | - Erik Smedler
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden (Jonsson, Hörbeck, Smedler, Pålsson, Sparding, Landén); National Centre for Mental Health, Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Primerano, Craddock, I. Jones, Di Florio); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Song, Karlsson, Sullivan, Landén); Mental Health Center and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China (Song); Department of Psychological Medicine, University of Worcester, Worcester, U.K. (Gordon-Smith, L. Jones); Departments of Genetics and Psychiatry, University of North Carolina at Chapel Hill (Sullivan)
| | - Katherine Gordon-Smith
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden (Jonsson, Hörbeck, Smedler, Pålsson, Sparding, Landén); National Centre for Mental Health, Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Primerano, Craddock, I. Jones, Di Florio); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Song, Karlsson, Sullivan, Landén); Mental Health Center and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China (Song); Department of Psychological Medicine, University of Worcester, Worcester, U.K. (Gordon-Smith, L. Jones); Departments of Genetics and Psychiatry, University of North Carolina at Chapel Hill (Sullivan)
| | - Lisa Jones
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden (Jonsson, Hörbeck, Smedler, Pålsson, Sparding, Landén); National Centre for Mental Health, Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Primerano, Craddock, I. Jones, Di Florio); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Song, Karlsson, Sullivan, Landén); Mental Health Center and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China (Song); Department of Psychological Medicine, University of Worcester, Worcester, U.K. (Gordon-Smith, L. Jones); Departments of Genetics and Psychiatry, University of North Carolina at Chapel Hill (Sullivan)
| | - Nicholas Craddock
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden (Jonsson, Hörbeck, Smedler, Pålsson, Sparding, Landén); National Centre for Mental Health, Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Primerano, Craddock, I. Jones, Di Florio); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Song, Karlsson, Sullivan, Landén); Mental Health Center and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China (Song); Department of Psychological Medicine, University of Worcester, Worcester, U.K. (Gordon-Smith, L. Jones); Departments of Genetics and Psychiatry, University of North Carolina at Chapel Hill (Sullivan)
| | - Ian Jones
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden (Jonsson, Hörbeck, Smedler, Pålsson, Sparding, Landén); National Centre for Mental Health, Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Primerano, Craddock, I. Jones, Di Florio); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Song, Karlsson, Sullivan, Landén); Mental Health Center and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China (Song); Department of Psychological Medicine, University of Worcester, Worcester, U.K. (Gordon-Smith, L. Jones); Departments of Genetics and Psychiatry, University of North Carolina at Chapel Hill (Sullivan)
| | - Patrick F Sullivan
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden (Jonsson, Hörbeck, Smedler, Pålsson, Sparding, Landén); National Centre for Mental Health, Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Primerano, Craddock, I. Jones, Di Florio); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Song, Karlsson, Sullivan, Landén); Mental Health Center and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China (Song); Department of Psychological Medicine, University of Worcester, Worcester, U.K. (Gordon-Smith, L. Jones); Departments of Genetics and Psychiatry, University of North Carolina at Chapel Hill (Sullivan)
| | - Erik Pålsson
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden (Jonsson, Hörbeck, Smedler, Pålsson, Sparding, Landén); National Centre for Mental Health, Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Primerano, Craddock, I. Jones, Di Florio); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Song, Karlsson, Sullivan, Landén); Mental Health Center and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China (Song); Department of Psychological Medicine, University of Worcester, Worcester, U.K. (Gordon-Smith, L. Jones); Departments of Genetics and Psychiatry, University of North Carolina at Chapel Hill (Sullivan)
| | - Arianna Di Florio
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden (Jonsson, Hörbeck, Smedler, Pålsson, Sparding, Landén); National Centre for Mental Health, Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Primerano, Craddock, I. Jones, Di Florio); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Song, Karlsson, Sullivan, Landén); Mental Health Center and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China (Song); Department of Psychological Medicine, University of Worcester, Worcester, U.K. (Gordon-Smith, L. Jones); Departments of Genetics and Psychiatry, University of North Carolina at Chapel Hill (Sullivan)
| | - Timea Sparding
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden (Jonsson, Hörbeck, Smedler, Pålsson, Sparding, Landén); National Centre for Mental Health, Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Primerano, Craddock, I. Jones, Di Florio); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Song, Karlsson, Sullivan, Landén); Mental Health Center and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China (Song); Department of Psychological Medicine, University of Worcester, Worcester, U.K. (Gordon-Smith, L. Jones); Departments of Genetics and Psychiatry, University of North Carolina at Chapel Hill (Sullivan)
| | - Mikael Landén
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at University of Gothenburg, Gothenburg, Sweden (Jonsson, Hörbeck, Smedler, Pålsson, Sparding, Landén); National Centre for Mental Health, Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Primerano, Craddock, I. Jones, Di Florio); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Song, Karlsson, Sullivan, Landén); Mental Health Center and West China Biomedical Big Data Center, West China Hospital, Sichuan University, Chengdu, China (Song); Department of Psychological Medicine, University of Worcester, Worcester, U.K. (Gordon-Smith, L. Jones); Departments of Genetics and Psychiatry, University of North Carolina at Chapel Hill (Sullivan)
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Patel KHS, Walters GB, Stefánsson H, Stefánsson K, Degenhardt F, Nothen M, Van Der Veen T, Demontis D, Borglum A, Kristiansen M, Bass NJ, McQuillin A. Predicting ADHD in alcohol dependence using polygenic risk scores for ADHD. Am J Med Genet B Neuropsychiatr Genet 2024; 195:e32967. [PMID: 37946686 DOI: 10.1002/ajmg.b.32967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 09/15/2023] [Accepted: 10/24/2023] [Indexed: 11/12/2023]
Abstract
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder with a high degree of comorbidity, including substance misuse. We aimed to assess whether ADHD polygenic risk scores (PRS) could predict ADHD diagnosis in alcohol dependence (AD). ADHD PRS were generated for 1223 AD subjects with ADHD diagnosis information and 1818 healthy controls. ADHD PRS distributions were compared to evaluate the differences between healthy controls and AD cases with and without ADHD. We found increased ADHD PRS means in the AD cohort with ADHD (mean 0.30, standard deviation (SD) 0.92; p = 3.9 × 10-6); and without ADHD (mean - 0.00, SD 1.00; p = 5.2 × 10-5) compared to the healthy control subjects (mean - 0.17, SD 0.99). The ADHD PRS means differed within the AD group with a higher ADHD PRS mean in those with ADHD, odds ratio (OR) 1.34, confidence interval (CI) 1.10 to 1.65; p = 0.002. This study showed a positive relationship between ADHD PRS and risk of ADHD in individuals with co-occurring AD indicating that ADHD PRS may have utility in identifying individuals that are at a higher or lower risk of ADHD. Further larger studies need to be conducted to confirm the reliability of the results before ADHD PRS can be considered as a robust biomarker for diagnosis.
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Affiliation(s)
- Kejal H S Patel
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK
| | - G Bragi Walters
- deCODE genetics/Amgen, Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | | | - Kári Stefánsson
- deCODE genetics/Amgen, Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Franziska Degenhardt
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, LVR Klinikum Essen, University of Duisburg-Essen, Essen, Germany
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital, Bonn, Germany
| | - Markus Nothen
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital, Bonn, Germany
| | - Tracey Van Der Veen
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK
| | - Ditte Demontis
- Department of Biomedicine-Human Genetics, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Center for Genomics and Personalized Medicine, Aarhus, Denmark
| | - Anders Borglum
- Department of Biomedicine-Human Genetics, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Center for Genomics and Personalized Medicine, Aarhus, Denmark
| | - Mark Kristiansen
- University College London Genomics, Institute of Child Health, University College London, London, UK
| | - Nicholas J Bass
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK
| | - Andrew McQuillin
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK
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Yao K, van der Veen T, Thygesen J, Bass N, McQuillin A. Multiple psychiatric polygenic risk scores predict associations between childhood adversity and bipolar disorder. J Affect Disord 2023; 341:137-146. [PMID: 37643680 DOI: 10.1016/j.jad.2023.08.116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Revised: 08/17/2023] [Accepted: 08/23/2023] [Indexed: 08/31/2023]
Abstract
BACKGROUND It remains unclear how adverse childhood experiences (ACE) and increased genetic risk for bipolar disorder (BD) interact to influence BD symptom outcomes. Here we calculated multiple psychiatric polygenic risk scores (PRS) and used the measures of ACE to understand these gene-environment interactions. METHOD 885 BD subjects were included for analyses. BD, ADHD, MDD and SCZ PRSs were calculated using the PRS-CS-auto method. ACEs were evaluated using the Children Life Event Questionnaire (CLEQ). Participants were divided into groups based on the presence of ACE and the total number of ACEs. The associations between total ACE number, PRSs and their interactions were evaluated using multiple linear and logistic regressions. Secondary analyses were performed to evaluate the influence of ACE and PRS on sub-phenotypes of BD. RESULTS The number of ACEs increased with the ADHD PRS. BD participants who had ACEs showed an earlier age of BD onset and higher odds of having rapid cycling. Increased BD PRS was associated with increased odds of developing psychotic symptoms. Higher ADHD PRS was associated with increased odds of having rapid cycling. No prediction effect was observed from MDD and SCZ PRS. And, we found no significant interaction between ACE numbers and any of the PRSs in predicting any selected BD sub-phenotypes. LIMITATIONS The study was limited by sample size, ACE definition, and cross-sectional data collection method. CONCLUSIONS The findings consolidate the importance of considering multiple psychiatric PRSs in predicting symptom outcomes among BD patients.
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Affiliation(s)
- Kai Yao
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK
| | - Tracey van der Veen
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK
| | - Johan Thygesen
- Institute of Health Informatics, University College London, UK
| | - Nick Bass
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK
| | - Andrew McQuillin
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK.
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Bartoli F, Callovini T, Cavaleri D, Cioni RM, Bachi B, Calabrese A, Moretti F, Canestro A, Morreale M, Nasti C, Palpella D, Piacenti S, Nacinovich R, Riboldi I, Crocamo C, Carrà G. Clinical correlates of comorbid attention deficit hyperactivity disorder in adults suffering from bipolar disorder: A meta-analysis. Aust N Z J Psychiatry 2023; 57:34-48. [PMID: 35786010 DOI: 10.1177/00048674221106669] [Citation(s) in RCA: 15] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
OBJECTIVE Attention deficit hyperactivity disorder is a frequent comorbid condition in adults with bipolar disorder. We performed a meta-analysis aimed at assessing sociodemographic and clinical correlates of attention deficit hyperactivity disorder in bipolar disorder. METHOD We searched main electronic databases up to June 2021. Random-effects meta-analyses, with relevant meta-regression and quality-based sensitivity analyses, were carried out to estimate the association between attention deficit hyperactivity disorder and putative correlates, grading the quality of evidence. RESULTS We included 43 studies, based on 38 independent samples. Attention deficit hyperactivity disorder participants were more likely to be males (odds ratio = 1.46; p < 0.001) and unemployed (odds ratio = 1.45; p = 0.045), and less likely to be married (odds ratio = 0.62; p = 0.014). They had an earlier onset of bipolar disorder (standardized mean difference = -0.36; p < 0.001); more mood episodes (standardized mean difference = 0.35; p = 0.007), particularly depressive (standardized mean difference = 0.30; p = 0.011) and mixed (standardized mean difference = 0.30; p = 0.031) ones; higher odds of using antidepressants (odds ratio = 1.80; p = 0.024) and attempted suicides (odds ratio = 1.83; p < 0.001) and lower odds of psychotic features (odds ratio = 0.63; p = 0.010). Moreover, they were more likely to have generalized anxiety disorder (odds ratio = 1.50; p = 0.019), panic disorder (odds ratio = 1.89; p < 0.001), social phobia (odds ratio = 1.61; p = 0.017), eating disorders (odds ratio = 1.91; p = 0.007), antisocial personality disorder (odds ratio = 3.59; p = 0.004) and substance (odds ratio = 2.29; p < 0.001) or alcohol (odds ratio = 2.28; p < 0.001) use disorders. Quality of the evidence was generally low or very low for the majority of correlates, except for bipolar disorder onset and alcohol/substance use disorders (high), and suicide attempts (moderate). CONCLUSION Comorbid bipolar disorder/attention deficit hyperactivity disorder may have some distinctive clinical features including an earlier onset of bipolar disorder and higher comorbid alcohol/substance use disorder rates. Further research is needed to identify additional clinical characteristics of this comorbidity.
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Affiliation(s)
- Francesco Bartoli
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Tommaso Callovini
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Daniele Cavaleri
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | | | - Bianca Bachi
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Angela Calabrese
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Federico Moretti
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Aurelia Canestro
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Marco Morreale
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Christian Nasti
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Dario Palpella
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Susanna Piacenti
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Renata Nacinovich
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Ilaria Riboldi
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Cristina Crocamo
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy
| | - Giuseppe Carrà
- Department of Medicine and Surgery, University of Milano-Bicocca, Monza, Italy.,Division of Psychiatry, University College London, London, UK
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Green A, Baroud E, DiSalvo M, Faraone SV, Biederman J. Examining the impact of ADHD polygenic risk scores on ADHD and associated outcomes: A systematic review and meta-analysis. J Psychiatr Res 2022; 155:49-67. [PMID: 35988304 DOI: 10.1016/j.jpsychires.2022.07.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 07/12/2022] [Accepted: 07/18/2022] [Indexed: 11/29/2022]
Abstract
Early identification of attention-deficit/hyperactivity disorder (ADHD) is critical for mitigating the many negative functional outcomes associated with its diagnosis. Because of the strong genetic basis of ADHD, the use of polygenic risk scores (PRS) could potentially aid in the early identification of ADHD and associated outcomes. Therefore, a systematic search of the literature on the association between ADHD and PRS in pediatric populations was conducted. All articles were screened for a priori inclusion and exclusion criteria, and, after careful review, 33 studies were included in our systematic review and 16 studies with extractable data were included in our meta-analysis. The results of the review were categorized into three common themes: the associations between ADHD-PRS with 1) the diagnosis of ADHD and ADHD symptoms 2) comorbid psychopathology and 3) cognitive and educational outcomes. Higher ADHD-PRS were associated with increased odds of having a diagnosis (OR = 1.37; p<0.001) and more symptoms of ADHD (β = 0.06; p<0.001). While ADHD-PRS were associated with a persistent diagnostic trajectory over time in the systematic review, the meta-analysis did not confirm these findings (OR = 1.09; p = 0.62). Findings showed that ADHD-PRS were associated with increased odds for comorbid psychopathology such as anxiety/depression (OR = 1.16; p<0.001) and irritability/emotional dysregulation (OR = 1.14; p<0.001). Finally, while the systematic review showed that ADHD-PRS were associated with a variety of negative cognitive outcomes, the meta-analysis showed no significant association (β = 0.08; p = 0.07). Our review of the available literature suggests that ADHD-PRS, together with risk factors, may contribute to the early identification of children with suspected ADHD and associated disorders.
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Affiliation(s)
- Allison Green
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA; Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA
| | - Evelyne Baroud
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Massachusetts General Hospital and McLean Hospital, Harvard Medical School, Boston, MA, United States
| | - Maura DiSalvo
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA
| | | | - Joseph Biederman
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
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7
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Niarchou M, Sealock JM, Straub P, Sanchez‐Roige S, Sutcliffe JS, Davis LK. A phenome-wide association study of polygenic scores for attention deficit hyperactivity disorder across two genetic ancestries in electronic health record data. Am J Med Genet B Neuropsychiatr Genet 2022; 189:185-195. [PMID: 35841203 PMCID: PMC9378640 DOI: 10.1002/ajmg.b.32911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/06/2021] [Revised: 05/10/2022] [Accepted: 06/14/2022] [Indexed: 11/24/2022]
Abstract
Testing the association between genetic scores for Attention Deficit Hyperactivity Disorder (ADHD) and health conditions, can help us better understand its complex etiology. Electronic health records linked to genetic data provide an opportunity to test whether genetic scores for ADHD correlate with ADHD and additional health outcomes in a health care context across different age groups. We generated polygenic scores (ADHD-PGS) trained on summary statistics from the latest genome-wide association study of ADHD (N = 55,374) and applied them to genome-wide data from 12,383 unrelated individuals of African-American ancestry and 66,378 unrelated individuals of European ancestry from the Vanderbilt Biobank. Overall, only Tobacco use disorder (TUD) was associated with ADHD-PGS in the African-American ancestry group (Odds ratio [95% confidence intervals] = 1.23[1.16-1.31], p = 9.3 × 10-09 ). Eighty-six phenotypes were associated with ADHD-PGS in the European ancestry individuals, including ADHD (OR[95%CIs] = 1.22[1.16-1.29], p = 3.6 × 10-10 ), and TUD (OR[95%CIs] = 1.22[1.19-1.25], p = 2.8 × 10-46 ). We then stratified outcomes by age (ages 0-11, 12-18, 19-25, 26-40, 41-60, and 61-100). Our results suggest that ADHD polygenic scores are associated with ADHD diagnoses early in life and with an increasing number of health conditions throughout the lifespan (even in the absence of ADHD diagnosis). This study reinforces the utility of applying trait-specific PGSs to biobank data, and performing exploratory sensitivity analyses, to probe relationships among clinical conditions.
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Affiliation(s)
- Maria Niarchou
- Vanderbilt Genetics InstituteVanderbilt University Medical CenterNashvilleTennesseeUSA
- Division of Genetic Medicine, Department of MedicineVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Julia M. Sealock
- Vanderbilt Genetics InstituteVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Peter Straub
- Vanderbilt Genetics InstituteVanderbilt University Medical CenterNashvilleTennesseeUSA
| | - Sandra Sanchez‐Roige
- Division of Genetic Medicine, Department of MedicineVanderbilt University Medical CenterNashvilleTennesseeUSA
- Department of PsychiatryUniversity of California San DiegoLa JollaCaliforniaUSA
| | - James S. Sutcliffe
- Vanderbilt Genetics InstituteVanderbilt University Medical CenterNashvilleTennesseeUSA
- Department of Psychiatry and Behavioral SciencesVanderbilt University Medical CenterNashvilleTennesseeUSA
- Department of Molecular Physiology and BiophysicsVanderbilt UniversityNashvilleTennesseeUSA
| | - Lea K. Davis
- Vanderbilt Genetics InstituteVanderbilt University Medical CenterNashvilleTennesseeUSA
- Division of Genetic Medicine, Department of MedicineVanderbilt University Medical CenterNashvilleTennesseeUSA
- Department of Psychiatry and Behavioral SciencesVanderbilt University Medical CenterNashvilleTennesseeUSA
- Department of Molecular Physiology and BiophysicsVanderbilt UniversityNashvilleTennesseeUSA
- Department of Biomedical InformaticsVanderbilt University Medical CenterNashvilleTennesseeUSA
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8
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Akingbuwa WA, Hammerschlag AR, Bartels M, Middeldorp CM. Systematic Review: Molecular Studies of Common Genetic Variation in Child and Adolescent Psychiatric Disorders. J Am Acad Child Adolesc Psychiatry 2022; 61:227-242. [PMID: 33932494 DOI: 10.1016/j.jaac.2021.03.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 03/08/2021] [Accepted: 03/19/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE A systematic review of studies using molecular genetics and statistical approaches to investigate the role of common genetic variation in the development, persistence, and comorbidity of childhood psychiatric traits was conducted. METHOD A literature review was performed using the PubMed database, following PRISMA guidelines. There were 131 studies meeting inclusion criteria, having investigated at least one type of childhood-onset or childhood-measured psychiatric disorder or trait with the aim of identifying trait-associated common genetic variants, estimating the contribution of single nucleotide polymorphisms (SNPs) to the amount of variance explained (SNP-based heritability), investigating genetic overlap between psychiatric traits, or investigating whether the stability in traits or the association with adult traits is explained by genetic factors. RESULTS The first robustly associated genetic variants have started to be identified for childhood psychiatric traits. There were substantial contributions of common genetic variants to many traits, with variation in single nucleotide polymorphism heritability estimates depending on age and raters. Moreover, genetic variants also appeared to explain comorbidity as well as stability across a range of psychiatric traits in childhood and across the life span. CONCLUSION Common genetic variation plays a substantial role in childhood psychiatric traits. Increased sample sizes will lead to increased power to identify genetic variants and to understand genetic architecture, which will ultimately be beneficial to targeted and prevention strategies. This can be achieved by harmonizing phenotype measurements, as is already proposed by large international consortia and by including the collection of genetic material in every study.
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Affiliation(s)
- Wonuola A Akingbuwa
- Ms. Akingbuwa, Dr. Hammerschlag, and Profs. Bartels and Middeldorp are with Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Ms. Akingbuwa, Dr. Hammerschlag, and Prof. Bartels are also with Amsterdam Public Health Research Institute, Amsterdam University Medical Centres, Amsterdam, The Netherlands.
| | - Anke R Hammerschlag
- Ms. Akingbuwa, Dr. Hammerschlag, and Profs. Bartels and Middeldorp are with Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Ms. Akingbuwa, Dr. Hammerschlag, and Prof. Bartels are also with Amsterdam Public Health Research Institute, Amsterdam University Medical Centres, Amsterdam, The Netherlands; Dr. Hammerschlag and Prof. Middeldorp are also with the Child Health Research Centre, the University of Queensland, Brisbane, Queensland, Australia
| | - Meike Bartels
- Ms. Akingbuwa, Dr. Hammerschlag, and Profs. Bartels and Middeldorp are with Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Ms. Akingbuwa, Dr. Hammerschlag, and Prof. Bartels are also with Amsterdam Public Health Research Institute, Amsterdam University Medical Centres, Amsterdam, The Netherlands
| | - Christel M Middeldorp
- Ms. Akingbuwa, Dr. Hammerschlag, and Profs. Bartels and Middeldorp are with Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Dr. Hammerschlag and Prof. Middeldorp are also with the Child Health Research Centre, the University of Queensland, Brisbane, Queensland, Australia; Prof. Middeldorp is also with the Child and Youth Mental Health Service, Children's Health Queensland Hospital and Health Services, Brisbane, Queensland, Australia
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9
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Nunez NA, Coombes BJ, Romo-Nava F, Bond DJ, Vande Voort J, Croarkin PE, Leibman N, Gardea Resendez M, Veldic M, Betcher H, Singh B, Colby C, Cuellar-Barboza A, Prieto M, Moore KM, Ozerdem A, McElroy SL, Frye MA, Biernacka JM. Clinical and Genetic Correlates of Bipolar Disorder With Childhood-Onset Attention Deficit Disorder. Front Psychiatry 2022; 13:884217. [PMID: 35492709 PMCID: PMC9047940 DOI: 10.3389/fpsyt.2022.884217] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/25/2022] [Accepted: 03/17/2022] [Indexed: 01/26/2023] Open
Abstract
BACKGROUND Bipolar disorder (BD) with co-occurring attention deficit-hyperactivity disorder (ADHD) is associated with an unfavorable course of illness. We aimed to identify potential clinical and genetic correlates of BD with and without ADHD. METHODS Among patients with BD (N = 2,198) enrolled in the Mayo Clinic Bipolar Biobank we identified those with ADHD diagnosed in childhood (BD+cADHD; N = 350), those with adult-onset attention deficit symptoms (BD+aAD; N = 254), and those without ADHD (N = 1,594). We compared the groups using linear or logistic regression adjusting for age, sex, and recruitment site. For genotyped patients (N = 1,443), logistic regression was used to compare ADHD and BD polygenic risk scores (PRSs) between the BD groups, as well as to non-BD controls (N = 777). RESULTS Compared to the non-ADHD BD group, BD+cADHD patients were younger, more often men and had a greater number of co-occurring anxiety and substance use disorders (all p < 0.001). Additionally, BD+cADHD patients had poorer responses to lithium and lamotrigine (p = 0.005 and p = 0.007, respectively). In PRS analyses, all BD patient subsets had greater genetic risk for BD and ADHD when compared to non-BD controls (p < 0.001 in all comparisons). BD+cADHD patients had a higher ADHD-PRS than non-ADHD BD patients (p = 0.012). However, BD+aAD patients showed no evidence of higher ADHD-PRS than non-ADHD BD patients (p = 0.38). CONCLUSIONS BD+cADHD was associated with a greater number of comorbidities and reduced response to mood stabilizing treatments. The higher ADHD PRS for the BD+cADHD group may reflect a greater influence of genetic factors on early presentation of ADHD symptoms.
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Affiliation(s)
- Nicolas A Nunez
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, United States
| | - Brandon J Coombes
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, United States
| | - Francisco Romo-Nava
- Lindner Center of HOPE /University of Cincinnati, Cincinnati, OH, United States
| | - David J Bond
- Department of Psychiatry & Behavioral Sciences, University of Minnesota Medical School, Minneapolis, MN, United States
| | - Jennifer Vande Voort
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, United States
| | - Paul E Croarkin
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, United States
| | - Nicole Leibman
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, United States
| | | | - Marin Veldic
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, United States
| | - Hannah Betcher
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, United States
| | - Balwinder Singh
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, United States
| | - Colin Colby
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, United States
| | | | - Miguel Prieto
- Department of Psychiatry, Facultad de Medicina, Universidad de los Andes, Santiago, Chile
| | - Katherine M Moore
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, United States
| | - Aysegul Ozerdem
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, United States
| | - Susan L McElroy
- Lindner Center of HOPE /University of Cincinnati, Cincinnati, OH, United States
| | - Mark A Frye
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, United States
| | - Joanna M Biernacka
- Department of Psychiatry & Psychology, Mayo Clinic, Rochester, MN, United States.,Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, United States
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10
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Coombes BJ, Millischer V, Batzler A, Larrabee B, Hou L, Papiol S, Heilbronner U, Adli M, Akiyama K, Akula N, Amare AT, Ardau R, Arias B, Aubry JM, Backlund L, Bauer M, Baune BT, Bellivier F, Benabarre A, Bengesser S, Bhattacharjee AK, Cervantes P, Chen HC, Chillotti C, Cichon S, Clark SR, Colom F, Cruceanu C, Czerski PM, Dalkner N, Degenhardt F, Del Zompo M, DePaulo JR, Étain B, Falkai P, Ferensztajn-Rochowiak E, Forstner AJ, Frisen L, Gard S, Garnham JS, Goes FS, Grigoroiu-Serbanescu M, Grof P, Hashimoto R, Hauser J, Herms S, Hoffmann P, Jamain S, Jiménez E, Kahn JP, Kassem L, Kato T, Kelsoe JR, Kittel-Schneider S, König B, Kuo PH, Kusumi I, Laje G, Landén M, Lavebratt C, Leboyer M, Leckband SG, Maj M, Manchia M, Martinsson L, McCarthy MJ, McElroy SL, Mitchell PB, Mitjans M, Mondimore FM, Monteleone P, Nievergelt CM, Nöthen MM, Novák T, O'Donovan C, Osby U, Ozaki N, Pfennig A, Pisanu C, Potash JB, Reif A, Reininghaus E, Rietschel M, Rouleau GA, Rybakowski JK, Schalling M, Schofield PR, Schubert KO, Schweizer BW, Severino G, Shekhtman T, Shilling PD, Shimoda K, Simhandl C, Slaney CM, Squassina A, Stamm T, Stopkova P, Tortorella A, Turecki G, Vieta E, Witt SH, Zandi PP, Fullerton JM, Alda M, Frye MA, Schulze TG, McMahon FJ, Biernacka JM. Association of Attention-Deficit/Hyperactivity Disorder and Depression Polygenic Scores with Lithium Response: A Consortium for Lithium Genetics Study. Complex Psychiatry 2021; 7:80-89. [PMID: 36408127 PMCID: PMC8740189 DOI: 10.1159/000519707] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 07/09/2021] [Indexed: 07/28/2023] Open
Abstract
Response to lithium varies widely between individuals with bipolar disorder (BD). Polygenic risk scores (PRSs) can uncover pharmacogenomics effects and may help predict drug response. Patients (N = 2,510) with BD were assessed for long-term lithium response in the Consortium on Lithium Genetics using the Retrospective Criteria of Long-Term Treatment Response in Research Subjects with Bipolar Disorder score. PRSs for attention-deficit/hyperactivity disorder (ADHD), major depressive disorder (MDD), and schizophrenia (SCZ) were computed using lassosum and in a model including all three PRSs and other covariates, and the PRS of ADHD (β = -0.14; 95% confidence interval [CI]: -0.24 to -0.03; p value = 0.010) and MDD (β = -0.16; 95% CI: -0.27 to -0.04; p value = 0.005) predicted worse quantitative lithium response. A higher SCZ PRS was associated with higher rates of medication nonadherence (OR = 1.61; 95% CI: 1.34-1.93; p value = 2e-7). This study indicates that genetic risk for ADHD and depression may influence lithium treatment response. Interestingly, a higher SCZ PRS was associated with poor adherence, which can negatively impact treatment response. Incorporating genetic risk of ADHD, depression, and SCZ in combination with clinical risk may lead to better clinical care for patients with BD.
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Affiliation(s)
- Brandon J Coombes
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
| | - Vincent Millischer
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
- Department for Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Anthony Batzler
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
| | - Beth Larrabee
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
| | - Liping Hou
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health, US Department of Health & Human Services, Bethesda, Maryland, USA
| | - Sergi Papiol
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, Munich, Germany
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University Munich, Munich, Germany
| | - Urs Heilbronner
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, Munich, Germany
| | - Mazda Adli
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Germany
| | - Kazufumi Akiyama
- Department of Biological Psychiatry and Neuroscience, Dokkyo Medical University School of Medicine, Mibu, Japan
| | - Nirmala Akula
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health, US Department of Health & Human Services, Bethesda, Maryland, USA
| | - Azmeraw T Amare
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
- South Australian Academic Health Science and Translation Centre, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia
| | - Raffaella Ardau
- Unit of Clinical Pharmacology, Hospital University Agency of Cagliari, Cagliari, Italy
| | - Barbara Arias
- Unitat de Zoologia i Antropologia Biològica (Dpt. Biologia Evolutiva, Ecologia i Ciències Ambientals), Facultat de Biologia and Institut de Biomedicina (IBUB), University of Barcelona, CIBERSAM, Barcelona, Spain
| | - Jean-Michel Aubry
- Department of Psychiatry, Mood Disorders Unit, HUG-Geneva University Hospitals, Geneva, Switzerland
| | - Lena Backlund
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Michael Bauer
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Medical Faculty, Technische Universität Dresden, Dresden, Germany
| | - Bernhard T Baune
- Department of Psychiatry, University of Münster, Münster, Germany
- Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne Parkville, Parkville, Victoria, Australia
| | - Frank Bellivier
- INSERM UMR-S 1144, Université Paris Diderot, Département de Psychiatrie et de Médecine Addictologique, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-F.Widal, Paris, France
| | - Antoni Benabarre
- Bipolar Disorder Program, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - Susanne Bengesser
- Department of Psychiatry and Psychotherapeutic Medicine, Research Unit for Bipolar Affective Disorder, Medical University of Graz, Graz, Austria
| | | | - Pablo Cervantes
- The Neuromodulation Unit, McGill University Health Centre, Montreal, Québec, Canada
| | - Hsi-Chung Chen
- Department of Psychiatry & Center of Sleep Disorders, National Taiwan University Hospital, Taipei, Taiwan
| | - Caterina Chillotti
- Unit of Clinical Pharmacology, Hospital University Agency of Cagliari, Cagliari, Italy
| | - Sven Cichon
- Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
- Institute of Neuroscience and Medicine (INM-1), Research Center Jülich, Jülich, Germany
- Human Genomics Research Group, Department of Biomedicine, University Hospital Basel, Basel, Switzerland
| | - Scott R Clark
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
| | - Francesc Colom
- Mental Health Research Group, IMIM-Hospital del Mar, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Cristiana Cruceanu
- Douglas Mental Health University Institute, McGill University, Montreal, Québec, Canada
| | - Piotr M Czerski
- Psychiatric Genetic Unit, Poznan University of Medical Sciences, Poznan, Poland
| | - Nina Dalkner
- Department of Psychiatry and Psychotherapeutic Medicine, Research Unit for Bipolar Affective Disorder, Medical University of Graz, Graz, Austria
| | - Franziska Degenhardt
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Maria Del Zompo
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - J Raymond DePaulo
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, Maryland, USA
| | - Bruno Étain
- INSERM UMR-S 1144, Université Paris Diderot, Département de Psychiatrie et de Médecine Addictologique, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-F.Widal, Paris, France
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University Munich, Munich, Germany
| | | | - Andreas J Forstner
- Institute of Neuroscience and Medicine (INM-1), Research Center Jülich, Jülich, Germany
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
- Centre for Human Genetics, University of Marburg, Marburg, Germany
| | - Louise Frisen
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Sébastien Gard
- Service de Psychiatrie, Hôpital Charles Perrens, Bordeaux, France
| | - Julie S Garnham
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Fernando S Goes
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, Maryland, USA
| | - Maria Grigoroiu-Serbanescu
- Biometric Psychiatric Genetics Research Unit, Alexandru Obregia Clinical Psychiatric Hospital, Bucharest, Romania
| | - Paul Grof
- Mood Disorders Center of Ottawa, Ottawa, Ontario, Canada
| | - Ryota Hashimoto
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
- Department of Psychiatry, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Joanna Hauser
- Psychiatric Genetic Unit, Poznan University of Medical Sciences, Poznan, Poland
| | - Stefan Herms
- Human Genomics Research Group, Department of Biomedicine, University Hospital Basel, Basel, Switzerland
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Per Hoffmann
- Human Genomics Research Group, Department of Biomedicine, University Hospital Basel, Basel, Switzerland
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Stephane Jamain
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University Munich, Munich, Germany
| | - Esther Jiménez
- Bipolar Disorder Program, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - Jean-Pierre Kahn
- Service de Psychiatrie et Psychologie Clinique, Centre Psychothérapique de Nancy-Université de Lorraine, Nancy, France
| | - Layla Kassem
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health, US Department of Health & Human Services, Bethesda, Maryland, USA
| | - Tadafumi Kato
- Department of Psychiatry and Behavioral Science, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - John R Kelsoe
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Sarah Kittel-Schneider
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - Barbara König
- Department of Psychiatry and Psychotherapeutic Medicine, Landesklinikum Neunkirchen, Neunkirchen, Austria
| | - Po-Hsiu Kuo
- Department of Public Health & Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Ichiro Kusumi
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Gonzalo Laje
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health, US Department of Health & Human Services, Bethesda, Maryland, USA
| | - Mikael Landén
- Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the Gothenburg University, Gothenburg, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Catharina Lavebratt
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Marion Leboyer
- AP-HP, Hôpital Henri Mondor, Département Médico-Universitaire de Psychiatrie et d'Addictologie (DMU IMPACT), Fédération Hospitalo-Universitaire de Médecine de Précision (FHU ADAPT), Créteil, France
- Université Paris Est Créteil, INSERM U955, IMRB, Laboratoire Neuro-Psychiatrie Translationnelle, Créteil, France
- Fondation FondaMental, Créteil, France
| | - Susan G Leckband
- Office of Mental Health, VA San Diego Healthcare System, San Diego, California, USA
| | - Mario Maj
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Mirko Manchia
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Department of Pharmacology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Lina Martinsson
- Department of Clinical Neurosciences, Karolinska Institutet, Stockholm, Sweden
| | - Michael J McCarthy
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
- Department of Psychiatry, VA San Diego Healthcare System, San Diego, California, USA
| | - Susan L McElroy
- Department of Psychiatry, Lindner Center of Hope/University of Cincinnati, Mason, Ohio, USA
| | - Philip B Mitchell
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Marina Mitjans
- Departament de Genètica, Microbiologia i Estadística, Facultat de Biologia, Universitat de Barcelona, Barcelona, Spain
- Institut de Biomedicina de la Universitat de Barcelona (IBUB), Barcelona, Spain
- Centro de Investigación Biomédica en Salud Mental (CIBERSAM), Madrid, Spain
| | - Francis M Mondimore
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, Maryland, USA
| | - Palmiero Monteleone
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
- Neurosciences Section, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
| | - Caroline M Nievergelt
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Markus M Nöthen
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Tomas Novák
- National Institute of Mental Health, Klecany, Czechia
| | - Claire O'Donovan
- Centre for Human Genetics, University of Marburg, Marburg, Germany
| | - Urban Osby
- Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet and Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Norio Ozaki
- Department of Psychiatry & Child and Adolescent Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Andrea Pfennig
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Medical Faculty, Technische Universität Dresden, Dresden, Germany
| | - Claudia Pisanu
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - James B Potash
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, Maryland, USA
| | - Andreas Reif
- Service de Psychiatrie et Psychologie Clinique, Centre Psychothérapique de Nancy-Université de Lorraine, Nancy, France
| | - Eva Reininghaus
- Department of Psychiatry and Psychotherapeutic Medicine, Research Unit for Bipolar Affective Disorder, Medical University of Graz, Graz, Austria
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Guy A Rouleau
- Montreal Neurological Institute and Hospital, McGill University, Montreal, Québec, Canada
| | - Janusz K Rybakowski
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Martin Schalling
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Peter R Schofield
- Neuroscience Research Australia, Sydney, New South Wales, Australia
- School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Klaus Oliver Schubert
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
- Northern Adelaide Local Health Network, Mental Health Services, Adelaide, South Australia, Australia
| | - Barbara W Schweizer
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, Maryland, USA
| | - Giovanni Severino
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Tatyana Shekhtman
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Paul D Shilling
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Katzutaka Shimoda
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Mibu, Japan
| | - Christian Simhandl
- Bipolar Center Wiener Neustadt, Sigmund Freud University, Medical Faculty, Vienna, Austria
| | - Claire M Slaney
- Centre for Human Genetics, University of Marburg, Marburg, Germany
| | - Alessio Squassina
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Thomas Stamm
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Germany
| | | | | | - Gustavo Turecki
- Douglas Mental Health University Institute, McGill University, Montreal, Québec, Canada
| | - Eduard Vieta
- Bipolar Disorder Program, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - Stephanie H Witt
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Peter P Zandi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Janice M Fullerton
- Neuroscience Research Australia, Sydney, New South Wales, Australia
- School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Martin Alda
- Centre for Human Genetics, University of Marburg, Marburg, Germany
| | - Mark A Frye
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | - Thomas G Schulze
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health, US Department of Health & Human Services, Bethesda, Maryland, USA
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, Munich, Germany
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center (UMG), Georg-August University Göttingen, Göttingen, Germany
| | - Francis J McMahon
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health, US Department of Health & Human Services, Bethesda, Maryland, USA
| | - Joanna M Biernacka
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
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11
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Ronald A, de Bode N, Polderman TJC. Systematic Review: How the Attention-Deficit/Hyperactivity Disorder Polygenic Risk Score Adds to Our Understanding of ADHD and Associated Traits. J Am Acad Child Adolesc Psychiatry 2021; 60:1234-1277. [PMID: 33548493 PMCID: PMC11164195 DOI: 10.1016/j.jaac.2021.01.019] [Citation(s) in RCA: 48] [Impact Index Per Article: 16.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 01/04/2021] [Accepted: 01/28/2021] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To investigate, by systematically reviewing the literature, whether the attention-deficit/hyperactivity disorder (ADHD) polygenic risk score (PRS) associates with ADHD and related traits in independent clinical and population samples. METHOD PubMed, Embase and PsychoInfo were systematically searched, alongside study bibliographies. Quality assessments were conducted, and a best-evidence synthesis was applied. Studies were excluded when the predictor was not based on the latest ADHD genome-wide association study, when PRS was not based on genome-wide results, or when the study was a review. Initially, 197 studies were retrieved (February 22, 2020), and a second search (June 3, 2020) yielded a further 49 studies. From both searches, 57 studies were eligible, and 44 studies met inclusion criteria. RESULTS Included studies were published in the last 3 years. Over 80% of the studies were rated excellent, based on a standardized quality assessment. Evidence of associations between ADHD PRS and the following categories was strong: ADHD, ADHD traits, brain structure, education, externalizing behaviors, neuropsychological constructs, physical health, and socioeconomic status. Evidence for associations with addiction, autism, and mental health were mixed and were, so far, inconclusive. Odds ratios for PRS associating with ADHD ranged from 1.22% to 1.76%; variance explained in dimensional assessments of ADHD traits was 0.7% to 3.3%. CONCLUSION A new wave of high-quality research using the ADHD PRS has emerged. Eventually, symptoms may be partly identified based on PRS, but the current ADHD PRS is useful for research purposes only. This review shows that the ADHD PRS is robust and reliable, associating not only with ADHD but many outcomes and challenges known to be linked to ADHD.
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Affiliation(s)
| | - Nora de Bode
- Vrije Universiteit Amsterdam, the Netherlands, and Amsterdam UMC, the Netherlands
| | - Tinca J C Polderman
- Vrije Universiteit Amsterdam, the Netherlands, and Amsterdam UMC, the Netherlands.
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12
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O'Connell KS, Coombes BJ. Genetic contributions to bipolar disorder: current status and future directions. Psychol Med 2021; 51:2156-2167. [PMID: 33879273 PMCID: PMC8477227 DOI: 10.1017/s0033291721001252] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Revised: 03/12/2021] [Accepted: 03/19/2021] [Indexed: 12/12/2022]
Abstract
Bipolar disorder (BD) is a highly heritable mental disorder and is estimated to affect about 50 million people worldwide. Our understanding of the genetic etiology of BD has greatly increased in recent years with advances in technology and methodology as well as the adoption of international consortiums and large population-based biobanks. It is clear that BD is also highly heterogeneous and polygenic and shows substantial genetic overlap with other psychiatric disorders. Genetic studies of BD suggest that the number of associated loci is expected to substantially increase in larger future studies and with it, improved genetic prediction of the disorder. Still, a number of challenges remain to fully characterize the genetic architecture of BD. First among these is the need to incorporate ancestrally-diverse samples to move research away from a Eurocentric bias that has the potential to exacerbate health disparities already seen in BD. Furthermore, incorporation of population biobanks, registry data, and electronic health records will be required to increase the sample size necessary for continued genetic discovery, while increased deep phenotyping is necessary to elucidate subtypes within BD. Lastly, the role of rare variation in BD remains to be determined. Meeting these challenges will enable improved identification of causal variants for the disorder and also allow for equitable future clinical applications of both genetic risk prediction and therapeutic interventions.
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Affiliation(s)
- Kevin S. O'Connell
- Division of Mental Health and Addiction, NORMENT Centre, Institute of Clinical Medicine, University of Oslo, Oslo University Hospital, 0407Oslo, Norway
| | - Brandon J. Coombes
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota, USA
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13
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Cognitive heterogeneity in the offspring of patients with schizophrenia or bipolar disorder: a cluster analysis across family risk. J Affect Disord 2021; 282:757-765. [PMID: 33601716 DOI: 10.1016/j.jad.2020.12.090] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2020] [Revised: 11/13/2020] [Accepted: 12/22/2020] [Indexed: 01/22/2023]
Abstract
BACKGROUND Neurocognitive impairment is considered to lie on a continuum of severity across schizophrenia (SZ) and bipolar disorder (BP), possibly reflecting a gradient of neurodevelopmental load. Cluster analyses have identified different levels of impairment across the two disorders, from none to widespread and severe. We for the first time used this approach to examine cognitive function pooling together children and adolescents at familial risk of SZ or BP. METHODS 220 participants, 49 offspring of individuals with schizophrenia (SZO), 90 offspring of individuals with bipolar disorder (BPO) and 81 offspring of healthy control parents (HC), aged 6 to 17 years, underwent a comprehensive clinical and cognitive assessment. Cognitive measures were used to group SZO and BPO using K-means clustering. Cognitive performance within each of the clusters was compared to that of HC and clinical variables were compared between clusters. RESULTS We identified three cognitive subgroups: a moderate impairment group, a mild impairment group, and a cognitively intact group. Both SZO and BPO were represented in each of the clusters, yet not evenly, with a larger proportion of the SZO in the moderately impaired cluster, but also a subgroup of BPO showing moderate cognitive dysfunction. LIMITATIONS Participants have yet to reach the age of onset for the examined disorders. CONCLUSIONS The findings point to a range of neurodevelopmental loadings across youth at familial risk of both SZ and BP. They have therefore important implications for the stratification of cognitive functioning and the possibility to tailor interventions to individual levels of impairment.
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14
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Coombes BJ, Ploner A, Bergen SE, Biernacka JM. A principal component approach to improve association testing with polygenic risk scores. Genet Epidemiol 2020; 44:676-686. [PMID: 32691445 DOI: 10.1002/gepi.22339] [Citation(s) in RCA: 41] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2020] [Revised: 05/13/2020] [Accepted: 07/10/2020] [Indexed: 12/16/2022]
Abstract
Polygenic risk scores (PRSs) have become an increasingly popular approach for demonstrating polygenic influences on complex traits and for establishing common polygenic signals between different traits. PRSs are typically constructed using pruning and thresholding (P+T), but the best choice of parameters is uncertain; thus multiple settings are used and the best is chosen. Optimization can lead to inflated Type I error. Permutation procedures can correct this, but they can be computationally intensive. Alternatively, a single parameter setting can be chosen a priori for the PRS, but choosing suboptimal settings results in loss of power. We propose computing PRSs under a range of parameter settings, performing principal component analysis (PCA) on the resulting set of PRSs, and using the first PRS-PC in association tests. The first PC reweights the variants included in the PRS to achieve maximum variation over all PRS settings used. Using simulations and a real data application to study PRS association with bipolar disorder and psychosis in bipolar disorder, we compare the performance of the proposed PRS-PCA approach with a permutation test and an a priori selected p-value threshold. The PRS-PCA approach is simple to implement, outperforms the other strategies in most scenarios, and provides an unbiased estimate of prediction performance.
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Affiliation(s)
- Brandon J Coombes
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota
| | - Alexander Ploner
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Sarah E Bergen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Joanna M Biernacka
- Department of Health Sciences Research, Mayo Clinic, Rochester, Minnesota.,Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota
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