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Baek JH, Lee D, Lee D, Jeong H, Cho EY, Ha TH, Ha K, Hong KS. Exploring intra-diagnosis heterogeneity and inter-diagnosis commonality in genetic architectures of bipolar disorders: association of polygenic risks of major psychiatric illnesses and lifetime phenotype dimensions. Psychol Med 2024:1-7. [PMID: 38813618 DOI: 10.1017/s003329172400120x] [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: 05/31/2024]
Abstract
BACKGROUND Bipolar disorder (BD) shows heterogeneous illness presentation both cross-sectionally and longitudinally. This phenotypic heterogeneity might reflect underlying genetic heterogeneity. At the same time, overlapping characteristics between BD and other psychiatric illnesses are observed at clinical and biomarker levels, which implies a shared biological mechanism between them. Incorporating these two issues in a single study design, this study investigated whether phenotypically heterogeneous subtypes of BD have a distinct polygenic basis shared with other psychiatric illnesses. METHODS Six lifetime phenotype dimensions of BD identified in our previous study were used as target phenotypes. Associations between these phenotype dimensions and polygenic risk scores (PRSs) of major psychiatric illnesses from East Asian (EA) and other available populations were analyzed. RESULTS Each phenotype dimension showed a different association pattern with PRSs of mental illnesses. PRS for EA schizophrenia showed a significant negative association with the cyclicity dimension (p = 0.044) but a significant positive association with the psychotic/irritable mania dimension (p = 0.001). PRS of EA major depressive disorder demonstrated a significant negative association with the elation dimension (p = 0.003) but a significant positive association with the comorbidity dimension (p = 0.028). CONCLUSION This study demonstrates that well-defined phenotype dimensions of lifetime-basis in BD have distinct genetic risks shared with other major mental illnesses. This finding supports genetic heterogeneity in BD and suggests a pleiotropy among BD subtypes and other psychiatric disorders beyond BD. Further genomic analyses adopting deep phenotyping across mental illnesses in ancestrally diverse populations are warranted to clarify intra-diagnosis heterogeneity and inter-diagnoses commonality issues in psychiatry.
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Affiliation(s)
- Ji Hyun Baek
- Department of Psychiatry, Sunkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
- Dauten Family Center for Bipolar Treatment Innovation, Massachusetts General Hospital, Boston, USA
| | - Dongbin Lee
- Department of Digital Health, Samsung Advanced Institute for Health Sciences and Technology, Sungkyunkwan University, Samsung Medical Center, Seoul, Korea
| | - Dongeun Lee
- Department of Psychiatry, Sunkyunkwan University School of Medicine, Samsung Medical Center, Seoul, Republic of Korea
| | - Hyewon Jeong
- Samsung Biomedical Research Institute, Seoul, Republic of Korea
| | - Eun-Young Cho
- Samsung Biomedical Research Institute, Seoul, Republic of Korea
| | - Tae Hyon Ha
- Department of Neuropsychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Kyooseob Ha
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Psychiatry, Lions Gate Hospital - Vancouver Coastal Health Authority, British Columbia, Canada
| | - Kyung Sue Hong
- Department of Psychiatry, University of British Columbia, Vancouver, British Columbia, Canada
- Department of Psychiatry, Lions Gate Hospital - Vancouver Coastal Health Authority, British Columbia, Canada
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Au JS, Martinez de Andino A, Mekawi Y, Silverstein MW, Lamis DA. Latent class analysis of bipolar disorder symptoms and suicidal ideation and behaviors. Bipolar Disord 2021; 23:186-195. [PMID: 32579284 DOI: 10.1111/bdi.12967] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
UNLABELLED Individuals with bipolar disorder are at increased risk of dying by suicide compared to healthy controls and those with unipolar depression. Previous studies show that depressive symptoms and mixed episodes of mania and depression are related to suicide. However, most of these studies adopt a variable-centered approach to understanding how specific symptoms relate to suicidal ideation, without addressing how these symptoms and symptom profiles relate to suicidal behaviors. OBJECTIVES Using latent class analysis, this study adopts a person-centered approach to examine whether subtypes of patients with bipolar disorder differ in their levels of suicidal ideation and behaviors. METHODS A total of 150 patients from a behavioral health outpatient clinic were recruited. Latent classes were generated based on self reports of their depressive and manic symptoms. RESULTS Five classes of patients with bipolar disorder were identified, namely, a minimal symptom, mania, moderately depressed, severely depressed, and mixed depression-mania subtypes. Those in the severely depressed and mixed depression-mania groups reported significantly higher levels of suicidal ideation and behaviors compared to the other groups. CONCLUSIONS Our findings provide further support for the strong relationship between depressive symptoms and suicidality. These findings are significant as they shed light on the different suicide risk profiles among a heterogenous group of patients with bipolar disorder. Name of clinical trial: Suicidal Behavior in Patients Diagnosed with Bipolar Disorder: The Roles of Biological and Childhood and Adult Environmental Risk Factors. ClinicalTrials.gov Identifier: NCT02604277.
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Affiliation(s)
- Josephine S Au
- Child and Adolescent Psychiatry Division, McLean Hospital/Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Ana Martinez de Andino
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Emory University, Atlanta, GA, USA
| | - Yara Mekawi
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Emory University, Atlanta, GA, USA
| | - Madison W Silverstein
- Department of Psychological Sciences, Loyola University New Orleans, New Orleans, LA, USA
| | - Dorian A Lamis
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Emory University, Atlanta, GA, USA
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Baek JH, Ha K, Kim Y, Cho YA, Yang SY, Choi Y, Jang SL, Park T, Ha TH, Hong KS. Psychopathologic structure of bipolar disorders: exploring dimensional phenotypes, their relationships, and their associations with bipolar I and II disorders. Psychol Med 2019; 49:2177-2185. [PMID: 30326977 DOI: 10.1017/s003329171800301x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
BACKGROUND Given its diverse disease courses and symptom presentations, multiple phenotype dimensions with different biological underpinnings are expected with bipolar disorders (BPs). In this study, we aimed to identify lifetime BP psychopathology dimensions. We also explored the differing associations with bipolar I (BP-I) and bipolar II (BP-II) disorders. METHODS We included a total of 307 subjects with BPs in the analysis. For the factor analysis, we chose six variables related to clinical courses, 29 indicators covering lifetime symptoms of mood episodes, and 6 specific comorbid conditions. To determine the relationships among the identified phenotypic dimensions and their effects on differentiating BP subtypes, we applied structural equation modeling. RESULTS We selected a six-factor solution through scree plot, Velicer's minimum average partial test, and face validity evaluations; the six factors were cyclicity, depression, atypical vegetative symptoms, elation, psychotic/irritable mania, and comorbidity. In the path analysis, five factors excluding atypical vegetative symptoms were associated with one another. Cyclicity, depression, and comorbidity had positive associations, and they correlated negatively with psychotic/irritable mania; elation showed positive correlations with cyclicity and psychotic/irritable mania. Depression, cyclicity, and comorbidity were stronger in BP-II than in BP-I, and they contributed significantly to the distinction between the two disorders. CONCLUSIONS We identified six phenotype dimensions; in addition to symptom features of manic and depressive episodes, various comorbidities and high cyclicity constructed separate dimensions. Except for atypical vegetative symptoms, all factors showed a complex interdependency and played roles in discriminating BP-II from BP-I.
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Affiliation(s)
- Ji Hyun Baek
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Kyooseob Ha
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
- Institute of Human Behavioral Medicine, Seoul National University College of Medicine, Seoul, Korea
| | - Yongkang Kim
- Department of Statistics, Seoul National University, Seoul, Korea
| | - Young-Ah Cho
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - So Yung Yang
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yujin Choi
- Samsung Biomedical Research Institute, Seoul, Korea
| | | | - Taesung Park
- Department of Statistics, Seoul National University, Seoul, Korea
| | - Tae Hyon Ha
- Department of Psychiatry, Seoul National University Bundang Hospital, Gyeonggi-do, Korea
| | - Kyung Sue Hong
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
- Samsung Biomedical Research Institute, Seoul, Korea
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McInnis MG, Assari S, Kamali M, Ryan K, Langenecker SA, Saunders EFH, Versha K, Evans S, O’Shea KS, Mower Provost E, Marshall D, Forger D, Deldin P, Zoellner S. Cohort Profile: The Heinz C. Prechter Longitudinal Study of Bipolar Disorder. Int J Epidemiol 2018; 47:28-28n. [PMID: 29211851 PMCID: PMC5837550 DOI: 10.1093/ije/dyx229] [Citation(s) in RCA: 41] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Revised: 10/09/2017] [Accepted: 10/16/2017] [Indexed: 12/13/2022] Open
Affiliation(s)
- Melvin G McInnis
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Shervin Assari
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Masoud Kamali
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Kelly Ryan
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Scott A Langenecker
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - Erika FH Saunders
- Department of Psychiatry, Penn State Hershey Medical Group, Hershey, PA, USA
| | - Kritika Versha
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Simon Evans
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - K Sue O’Shea
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
- Department of Cell and Developmental Biology
| | | | - David Marshall
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | | | | | - Sebastian Zoellner
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
- Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
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Zai G, Alberry B, Arloth J, Bánlaki Z, Bares C, Boot E, Camilo C, Chadha K, Chen Q, Cole CB, Cost KT, Crow M, Ekpor I, Fischer SB, Flatau L, Gagliano S, Kirli U, Kukshal P, Labrie V, Lang M, Lett TA, Maffioletti E, Maier R, Mihaljevic M, Mittal K, Monson ET, O'Brien NL, Østergaard SD, Ovenden E, Patel S, Peterson RE, Pouget JG, Rovaris DL, Seaman L, Shankarappa B, Tsetsos F, Vereczkei A, Wang C, Xulu K, Yuen RKC, Zhao J, Zai CC, Kennedy JL. Rapporteur summaries of plenary, symposia, and oral sessions from the XXIIIrd World Congress of Psychiatric Genetics Meeting in Toronto, Canada, 16-20 October 2015. Psychiatr Genet 2016; 26:229-257. [PMID: 27606929 PMCID: PMC5134913 DOI: 10.1097/ypg.0000000000000148] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
The XXIIIrd World Congress of Psychiatric Genetics meeting, sponsored by the International Society of Psychiatric Genetics, was held in Toronto, ON, Canada, on 16-20 October 2015. Approximately 700 participants attended to discuss the latest state-of-the-art findings in this rapidly advancing and evolving field. The following report was written by trainee travel awardees. Each was assigned one session as a rapporteur. This manuscript represents the highlights and topics that were covered in the plenary sessions, symposia, and oral sessions during the conference, and contains major notable and new findings.
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Affiliation(s)
- Gwyneth Zai
- Neurogenetics Section, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, ON, Canada
- Frederick W. Thompson Anxiety Disorders Centre, Department of Psychiatry, Sunnybrook Health Sciences Centre
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Bonnie Alberry
- Molecular Genetics Unit, Department of Biology, University of Western Ontario, London, ON, Canada
| | - Janine Arloth
- Max Planck Institute of Psychiatry, Munich, Germany
- Department of Translational Research in Psychiatry, Institute of Computational Biology, Helmholtz Zentrum München, Germany
| | - Zsófia Bánlaki
- Department of Medical Chemistry, Molecular Biology and Pathobiochemistry, Semmelweis University, Budapest, Hungary
| | - Cristina Bares
- School of Social Work, University of Michigan, Ann Arbor, MI, USA
| | - Erik Boot
- Department of Psychiatry, University of Toronto, ON, Canada
- The Dalglish Family 22q Clinic, Toronto, ON, Canada
- University Health Network, Toronto, ON, Canada
- Clinical Genetics Research Program, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Nuclear Medicine, Academic Medical Centre, Amsterdam, The Netherlands
| | - Caroline Camilo
- Institute and Department of Psychiatry, University of São Paulo Medical School, São Paulo, Brazil
| | - Kartikay Chadha
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Qi Chen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Christopher B. Cole
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
- Biomedical Sciences Division, Department of Biology, University of Ottawa, Ottawa, ON, Canada
| | - Katherine Tombeau Cost
- Neurogenetics Section, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Megan Crow
- Stanley Institute for Cognitive Genomics, Cold Spring Harbor Laboratory, Woodbury, NY, USA
| | - Ibene Ekpor
- Department of Psychiatry, University of Calabar Teaching Hospital, Calabar, Nigeria
| | - Sascha B. Fischer
- Human Genomics Research Group, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Laura Flatau
- Institute of Psychiatric Phenomics and Genomics, University of Munich, Munich, Germany
| | - Sarah Gagliano
- Department of Biostatistics and Center for Statistical Genetics, University of Michigan, Ann Arbor, Michigan, USA
| | - Umut Kirli
- Department of Psychiatry, Ege University School of Medicine, Izmir, Turkey
| | - Prachi Kukshal
- Department of Genetics, University of Delhi, South Campus, New Delhi, India
| | - Viviane Labrie
- Department of Psychiatry, University of Toronto, ON, Canada
- Krembil Family Epigenetics Laboratory, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Maren Lang
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Heidelberg, Germany
| | | | | | - Robert Maier
- Queensland Brain Institute, University of Queensland, St. Lucia, Australia
| | | | - Kirti Mittal
- Neurogenetics Section, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Eric T. Monson
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
| | - Niamh L. O'Brien
- Molecular Psychiatric Laboratory, Division of Psychiatry, University College London, London, UK
| | - Søren Dinesen Østergaard
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Psychosis Research Unit, Aarhus University Hospital, Risskov, Denmark
| | - Ellen Ovenden
- Human Genetics Lab, Department of Genetics, Stellenbosch University, South Africa
| | - Sejal Patel
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Roseann E. Peterson
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, Virginia, USA
| | - Jennie G. Pouget
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Diego Luiz Rovaris
- Department of Genetics, Instituto de Biociências, Federal University of Rio Grande do Sul, Brazil
- ADHD Outpatient Clinic, Hospital de Clínicas de Porto Alegre, Federal University of Rio Grande do Sul, Brazil
| | - Lauren Seaman
- Department of Chemistry and Biochemistry, Department of Psychiatry and Biobehavioral Sciences, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Bhagya Shankarappa
- Molecular Genetics Lab, Department of Psychiatry, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
| | - Fotis Tsetsos
- Department of Molecular Biology and Genetics, Democritus University of Thrace, Alexandroupolis, Greece
| | - Andrea Vereczkei
- Department of Medical Chemistry, Molecular Biology and Pathobiochemistry, Semmelweis University, Budapest, Hungary
| | | | - Khethelo Xulu
- Department of Psychiatry, Stellenbosch University, South Africa
| | - Ryan K. C. Yuen
- The Centre for Applied Genomics, Genetics and Genome Biology, The Hospital for Sick Children, Toronto, ON, Canada
| | - Jingjing Zhao
- School of Psychology, Shaanxi Normal University, Xi'an, China
- School of Psychology, National University of Ireland, Galway, Ireland
| | - Clement C. Zai
- Neurogenetics Section, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, ON, Canada
| | - James L. Kennedy
- Neurogenetics Section, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, ON, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON, Canada
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