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Safiri S, Noori M, Nejadghaderi SA, Shamekh A, Sullman MJM, Collins GS, Kolahi AA. The burden of schizophrenia in the Middle East and North Africa region, 1990-2019. Sci Rep 2024; 14:9720. [PMID: 38678101 PMCID: PMC11055947 DOI: 10.1038/s41598-024-59905-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2023] [Accepted: 04/16/2024] [Indexed: 04/29/2024] Open
Abstract
Schizophrenia ranks as the third-most common cause of disability among mental disorders globally. This study presents findings on the prevalence, incidence and years lived with disability (YLDs) as a result of schizophrenia in the Middle East and North Africa (MENA), stratified by age, sex and sociodemographic index (SDI). We collected publicly accessible data from the Global Burden of Disease (GBD) study 2019. This study reports the burden of schizophrenia, from 1990 to 2019, for the 21 countries that comprise MENA. In 2019, MENA exhibited an age-standardised point prevalence of 248.2, an incidence rate of 14.7 and an YLD rate of 158.7 per 100,000, which have not changed substantially between 1990 and 2019. In 2019, the age-standardised YLD rate was highest in Qatar and lowest in Afghanistan. No MENA countries demonstrated noteworthy changes in the burden of schizophrenia from 1990 to 2019. Furthermore, in 2019, the highest number of prevalent cases and the point prevalence were observed among those aged 35-39, with a higher prevalence among males in almost all age categories. Additionally, in 2019, the age-standardised YLD rates in MENA were below the worldwide average. Finally, there was a positive correlation between the burden of schizophrenia and the SDI from 1990 to 2019. The disease burden of schizophrenia has remained relatively stable over the past thirty years. Nevertheless, as the regional life-expectancy continues to increase, the burden of schizophrenia is also expected to rise. Therefore, early planning for the increase in the burden of the disease is urgently needed in the region.
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Affiliation(s)
- Saeid Safiri
- Neurosciences Research Center, Aging Research Institute, Tabriz University of Medical Sciences, Tabriz, Iran.
- Clinical Research Development Unit of Tabriz Valiasr Hospital, Tabriz University of Medical Sciences, Tabriz, Iran.
| | - Maryam Noori
- Student Research Committee, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Aria Nejadghaderi
- HIV/STI Surveillance Research Center, WHO Collaborating Center for HIV Surveillance, Institute for Futures Studies in Health, Kerman University of Medical Sciences, Kerman, Iran
- Systematic Review and Meta-analysis Expert Group (SRMEG), Universal Scientific Education and Research Network (USERN), Tehran, Iran
| | - Ali Shamekh
- Student Research Committee, Tabriz University of Medical Sciences, Tabriz, Iran
| | - Mark J M Sullman
- Department of Life and Health Sciences, University of Nicosia, Nicosia, Cyprus
- Department of Social Sciences, University of Nicosia, Nicosia, Cyprus
| | - Gary S Collins
- Centre for Statistics in Medicine, NDORMS, Botnar Research Centre, University of Oxford, Oxford, UK
- NIHR Oxford Biomedical Research Centre, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Ali-Asghar Kolahi
- Social Determinants of Health Research Center, Shahid Beheshti University of Medical Sciences, Tehran, Iran.
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Cuesta MJ, García de Jalón E, Sánchez-Torres AM, Gil-Berrozpe GJ, Aranguren L, Gutierrez G, Corrales A, Zarzuela A, Ibañez B, Peralta V. Additive effects of a family history of schizophrenia spectrum disorders and an environmental risk score for the outcome of patients with non-affective first-episode psychosis. Psychol Med 2024:1-9. [PMID: 38505954 DOI: 10.1017/s0033291724000576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/21/2024]
Abstract
BACKGROUND First-episode psychotic disorders comprise a heterogeneous phenotype with a complex etiology involving numerous common small-effect genetic variations and a wide range of environmental exposures. We examined whether a family of schizophrenia spectrum disorder (FH-Sz) interacts with an environmental risk score (ERS-Sz) regarding the outcome of patients with non-affective first episode psychosis (NAFEP). METHODS We included 288 patients with NAFEP who were evaluated after discharge from an intensive 2-year program. We evaluated three outcome measures: symptomatic remission, psychosocial functioning, and personal recovery. We analyzed the main and joint associations of a FH-Sz and the ERS-Sz on the outcomes by using the relative excess risk due to interaction (RERI) approach. RESULTS A FH-Sz showed a significant association with poor symptomatic remission and psychosocial functioning outcomes, although there was no significant interaction between a FH-Sz and the ERS-Sz on these outcomes. The ERS-Sz did not show a significant association with poor symptomatic remission and psychosocial functioning outcomes, even though the magnitude of the interaction between ERS-Sz and FH-Sz with the later outcome was moderate (RERI = 6.89, 95% confidence interval -16.03 to 29.81). There was no association between a FH-Sz and the ERS-Sz and personal recovery. CONCLUSIONS Our results provide further empirical support regarding the contribution of FH-Sz to poor symptomatic remission and poor psychosocial functioning outcomes in patients with NAFEP.
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Affiliation(s)
- Manuel J Cuesta
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Elena García de Jalón
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- Mental Health Department, Servicio Navarro de Salud - Osasunbidea, Pamplona, Spain
| | - Ana M Sánchez-Torres
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- Departament of Health Sciences, Universidad Pública de Navarra (UPNA), Pamplona, Spain
| | - Gustavo J Gil-Berrozpe
- Department of Psychiatry, Hospital Universitario de Navarra, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Lidia Aranguren
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- Mental Health Department, Servicio Navarro de Salud - Osasunbidea, Pamplona, Spain
| | - Gerardo Gutierrez
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- Mental Health Department, Servicio Navarro de Salud - Osasunbidea, Pamplona, Spain
| | - Asier Corrales
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- Mental Health Department, Servicio Navarro de Salud - Osasunbidea, Pamplona, Spain
| | - Amalia Zarzuela
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- Mental Health Department, Servicio Navarro de Salud - Osasunbidea, Pamplona, Spain
| | - Berta Ibañez
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- Methodology Unit, Navarrabiomed - HUN - UPNA, RICAPPS, Pamplona, Spain
| | - Víctor Peralta
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
- Mental Health Department, Servicio Navarro de Salud - Osasunbidea, Pamplona, Spain
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Ku BS, Ren J, Compton MT, Druss BG, Guo S, Walker EF. The association between neighborhood-level social fragmentation and distressing psychotic-like experiences in early adolescence: the moderating role of close friends. Psychol Med 2024:1-9. [PMID: 38362835 PMCID: PMC11327384 DOI: 10.1017/s0033291724000278] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
BACKGROUND Early exposure to neighborhood social fragmentation has been shown to be associated with schizophrenia. The impact of social fragmentation and friendships on distressing psychotic-like experiences (PLE) remains unknown. We investigate the relationships between neighborhood social fragmentation, number of friends, and distressing PLE among early adolescents. METHODS Data were collected from the Adolescent Brain Cognitive Development Study. Generalized linear mixed models tested associations between social fragmentation and distressing PLE, as well as the moderating role of the number of total and close friends. RESULTS Participants included 11 133 adolescents aged 9 to 10, with 52.3% being males. Greater neighborhood social fragmentation was associated with higher levels of distressing PLE (adjusted β = 0.05; 95% CI: 0.01-0.09). The number of close but not total friends significantly interacted with social fragmentation to predict distressing PLE (adjusted β = -0.02; 95% CI: -0.04 to <-0.01). Among those with fewer close friends, the association between neighborhood social fragmentation and distressing PLE was significant (adjusted β = 0.07; 95% CI: 0.03-0.11). However, among those with more close friends, the association was non-significant (adjusted β = 0.03; 95% CI: -0.01 to 0.07). CONCLUSIONS Greater neighborhood social fragmentation is associated with higher levels of distressing PLE, particularly among those with fewer close friends. Further research is needed to disentangle aspects of the interaction between neighborhood characteristics and the quality of social interactions that may contribute to psychosis, which would have implications for developing effective interventions at the individual and community levels.
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Affiliation(s)
- Benson S Ku
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Jiyuan Ren
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Michael T Compton
- Department of Psychiatry, Columbia University Vagelos College of Physicians and Surgeons, and New York State Psychiatric Institute, New York, NY, USA
| | - Benjamin G Druss
- Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Shuyi Guo
- Department of Biostatistics, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Elaine F Walker
- Department of Psychology, Emory University, Atlanta, GA, USA
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Hurtado H, Hansen M, Strack J, Vainik U, Decker AL, Khundrakpam B, Duncan K, Finn AS, Mabbott DJ, Merz EC. Polygenic risk for depression and anterior and posterior hippocampal volume in children and adolescents. J Affect Disord 2024; 344:619-627. [PMID: 37858734 PMCID: PMC10842073 DOI: 10.1016/j.jad.2023.10.068] [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: 04/07/2023] [Revised: 09/25/2023] [Accepted: 10/09/2023] [Indexed: 10/21/2023]
Abstract
BACKGROUND Depression has frequently been associated with smaller hippocampal volume. The hippocampus varies in function along its anterior-posterior axis, with the anterior hippocampus more strongly associated with stress and emotion processing. The goals of this study were to examine the associations among parental history of anxiety/depression, polygenic risk scores for depression (PGS-DEP), and anterior and posterior hippocampal volumes in children and adolescents. To examine specificity to PGS-DEP, we examined associations of educational attainment polygenic scores (PGS-EA) with anterior and posterior hippocampal volume. METHODS Participants were 350 3- to 21-year-olds (46 % female). PGS-DEP and PGS-EA were computed based on recent, large-scale genome-wide association studies. High-resolution, T1-weighted magnetic resonance imaging (MRI) data were acquired, and a semi-automated approach was used to segment the hippocampus into anterior and posterior subregions. RESULTS Children and adolescents with higher polygenic risk for depression were more likely to have a parent with a history of anxiety/depression. Higher polygenic risk for depression was significantly associated with smaller anterior but not posterior hippocampal volume. PGS-EA was not associated with anterior or posterior hippocampal volumes. LIMITATIONS Participants in these analyses were all of European ancestry. CONCLUSIONS Polygenic risk for depression may lead to smaller anterior but not posterior hippocampal volume in children and adolescents, and there may be specificity of these effects to PGS-DEP rather than PGS-EA. These findings may inform the earlier identification of those in need of support and the design of more effective, personalized treatment strategies. DECLARATIONS OF INTEREST none. DECLARATIONS OF INTEREST None.
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Affiliation(s)
- Hailee Hurtado
- Department of Psychology, Colorado State University, Fort Collins, CO, USA
| | - Melissa Hansen
- Department of Psychology, Colorado State University, Fort Collins, CO, USA
| | - Jordan Strack
- Department of Psychology, Colorado State University, Fort Collins, CO, USA
| | - Uku Vainik
- University of Tartu, Tartu, Estonia; Montreal Neurological Institute, McGill University, Montreal, QC, Canada
| | - Alexandra L Decker
- Department of Brain and Cognitive Sciences and McGovern Institute for Brain Research, Massachusetts Institute of Technology, Cambridge, MA, USA
| | | | - Katherine Duncan
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Amy S Finn
- Department of Psychology, University of Toronto, Toronto, ON, Canada
| | - Donald J Mabbott
- Department of Psychology, University of Toronto, Toronto, ON, Canada.; Neurosciences and Mental Health, Hospital for Sick Children, Toronto, ON, Canada.; Department of Psychology, Hospital for Sick Children, Toronto, ON, Canada
| | - Emily C Merz
- Department of Psychology, Colorado State University, Fort Collins, CO, USA.
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Zhang T, Xu L, Tang X, Wei Y, Hu Y, Cui H, Tang Y, Li C, Wang J. Comprehensive review of multidimensional biomarkers in the ShangHai At Risk for Psychosis (SHARP) program for early psychosis identification. PCN REPORTS : PSYCHIATRY AND CLINICAL NEUROSCIENCES 2023; 2:e152. [PMID: 38868725 PMCID: PMC11114265 DOI: 10.1002/pcn5.152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Revised: 09/28/2023] [Accepted: 10/20/2023] [Indexed: 06/14/2024]
Abstract
Psychosis is recognized as one of the largest contributors to nonfatal health loss, and early identification can largely improve routine clinical activity by predicting the psychotic course and guiding treatment. Clinicians have used the clinical high-risk for psychosis (CHR) paradigm to better understand the risk factors that contribute to the onset of psychotic disorders. Clinical factors have been widely applied to calculate the individualized risks for conversion to psychosis 1-2 years later. However, there is still a dearth of valid biomarkers to predict psychosis. Biomarkers, in the context of this paper, refer to measurable biological indicators that can provide valuable information about the early identification of individuals at risk for psychosis. The aim of this paper is to critically review studies assessing CHR and suggest possible biomarkers for application of prediction. We summarized the studies on biomarkers derived from the findings of the ShangHai at Risk for Psychosis (SHARP) program, including those that are considered to have the most potential. This comprehensive review was conducted based on expert opinions within the SHARP research team, and the selection of studies and results presented in this paper reflects the collective expertise of the team in the field of early psychosis identification. The three dimensions with potential candidates include neuroimaging dimension of brain structure and function, electrophysiological dimension of event-related potentials (ERPs), and immune dimension of inflammatory cytokines and complement proteins, which proved to be useful in supporting the prediction of psychosis from the CHR state. We suggest that these three dimensions could be useful as risk biomarkers for treatment optimization. In the future, when available for the integration of multiple dimensions, clinicians may be able to obtain a comprehensive report with detailed information of psychosis risk and specific indications about preferred prevention.
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Affiliation(s)
- TianHong Zhang
- Shanghai Engineering Research Center of Intelligent Psychological Evaluation and Intervention, Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health CenterShanghai Jiaotong University School of MedicineShanghaiChina
| | - LiHua Xu
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health CenterShanghai Jiaotong University School of MedicineShanghaiChina
| | - XiaoChen Tang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health CenterShanghai Jiaotong University School of MedicineShanghaiChina
| | - YanYan Wei
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health CenterShanghai Jiaotong University School of MedicineShanghaiChina
| | - YeGang Hu
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health CenterShanghai Jiaotong University School of MedicineShanghaiChina
| | - HuiRu Cui
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health CenterShanghai Jiaotong University School of MedicineShanghaiChina
| | - YingYing Tang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health CenterShanghai Jiaotong University School of MedicineShanghaiChina
| | - ChunBo Li
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health CenterShanghai Jiaotong University School of MedicineShanghaiChina
| | - JiJun Wang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health CenterShanghai Jiaotong University School of MedicineShanghaiChina
- CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT)Chinese Academy of SciencesShanghaiChina
- Institute of Psychology and Behavioral ScienceShanghai Jiaotong UniversityShanghaiChina
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Streit F, Völker MP, Klinger-König J, Zillich L, Frank J, Reinhard I, Foo JC, Witt SH, Sirignano L, Becher H, Obi N, Riedel O, Do S, Castell S, Hassenstein MJ, Karch A, Stang A, Schmidt B, Schikowski T, Stahl-Pehe A, Brenner H, Perna L, Greiser KH, Kaaks R, Michels KB, Franzke CW, Peters A, Fischer B, Konzok J, Mikolajczyk R, Führer A, Keil T, Fricke J, Willich SN, Pischon T, Völzke H, Meinke-Franze C, Loeffler M, Wirkner K, Berger K, Grabe HJ, Rietschel M. The interplay of family history of depression and early trauma: associations with lifetime and current depression in the German national cohort (NAKO). FRONTIERS IN EPIDEMIOLOGY 2023; 3:1099235. [PMID: 38523800 PMCID: PMC10959537 DOI: 10.3389/fepid.2023.1099235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 04/28/2023] [Indexed: 03/26/2024]
Abstract
Introduction Family history of depression and childhood maltreatment are established risk factors for depression. However, how these factors are interrelated and jointly influence depression risk is not well understood. The present study investigated (i) if childhood maltreatment is associated with a family history of depression (ii) if family history and childhood maltreatment are associated with increased lifetime and current depression, and whether both factors interact beyond their main effects, and (iii) if family history affects lifetime and current depression via childhood maltreatment. Methods Analyses were based on a subgroup of the first 100,000 participants of the German National Cohort (NAKO), with complete information (58,703 participants, mean age = 51.2 years, 53% female). Parental family history of depression was assessed via self-report, childhood maltreatment with the Childhood Trauma Screener (CTS), lifetime depression with self-reported physician's diagnosis and the Mini-International Neuropsychiatric Interview (MINI), and current depressive symptoms with the depression scale of the Patient Health Questionnaire (PHQ-9). Generalized linear models were used to test main and interaction effects. Mediation was tested using causal mediation analyses. Results Higher frequencies of the childhood maltreatment measures were found in subjects reporting a positive family history of depression. Family history and childhood maltreatment were independently associated with increased depression. No statistical interactions of family history and childhood maltreatment were found for the lifetime depression measures. For current depressive symptoms (PHQ-9 sum score), an interaction was found, with stronger associations of childhood maltreatment and depression in subjects with a positive family history. Childhood maltreatment was estimated to mediate 7%-12% of the effect of family history on depression, with higher mediated proportions in subjects whose parents had a depression onset below 40 years. Abuse showed stronger associations with family history and depression, and higher mediated proportions of family history effects on depression than neglect. Discussion The present study confirms the association of childhood maltreatment and family history with depression in a large population-based cohort. While analyses provide little evidence for the joint effects of both risk factors on depression beyond their individual effects, results are consistent with family history affecting depression via childhood maltreatment to a small extent.
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Affiliation(s)
- Fabian Streit
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Maja P. Völker
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Johanna Klinger-König
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Lea Zillich
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Josef Frank
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Iris Reinhard
- Department of Biostatistics, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Jerome C. Foo
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Stephanie H. Witt
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Lea Sirignano
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Heiko Becher
- Institute of Global Health, University Hospital Heidelberg, Heidelberg, Germany
| | - Nadia Obi
- Institute of Medical Biometry and Epidemiology, University Medical Centre Hamburg-Eppendorf, Hamburg, Germany
| | - Oliver Riedel
- Leibniz-Institut für Präventionsforschung und Epidemiologie – BIPS, Bremen, Deutschland
| | - Stefanie Do
- Leibniz-Institut für Präventionsforschung und Epidemiologie – BIPS, Bremen, Deutschland
| | - Stefanie Castell
- Department for Epidemiology, Helmholtz Centre for Infection Research (HZI), Braunschweig, Germany
| | - Max J. Hassenstein
- Department for Epidemiology, Helmholtz Centre for Infection Research (HZI), Braunschweig, Germany
- PhD Programme “Epidemiology”, Braunschweig-Hannover, Germany
| | - André Karch
- Institute of Epidemiology and Social Medicine, University of Muenster, Muenster, Germany
| | - Andreas Stang
- Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Essen, Germany
| | - Börge Schmidt
- Institute for Medical Informatics, Biometry and Epidemiology, University of Duisburg-Essen, Essen, Germany
| | - Tamara Schikowski
- IUF—Leibniz Institute for Environmental Medicine, Düsseldorf, Germany
| | - Anna Stahl-Pehe
- Institute for Biometrics and Epidemiology, German Diabetes Center, Leibniz Center for Diabetes Research, University of Düsseldorf, Düsseldorf, Germany
| | - Hermann Brenner
- Network Ageing Research (NAR), Heidelberg University, Heidelberg, Germany
- Division of Clinical Epidemiology & Ageing Research, German Cancer Research Centre (DKFZ), Heidelberg, Germany
| | - Laura Perna
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| | - Karin Halina Greiser
- German Cancer Research Centre (DKFZ) Heidelberg, Div. of Cancer Epidemiology, Heidelberg, Germany
| | - Rudolf Kaaks
- German Cancer Research Centre (DKFZ) Heidelberg, Div. of Cancer Epidemiology, Heidelberg, Germany
| | - Karin B. Michels
- Institute for Prevention and Cancer Epidemiology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Claus-Werner Franzke
- Institute for Prevention and Cancer Epidemiology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany
| | - Annette Peters
- Institute of Epidemiology, Helmholtz Zentrum Munchen, German Research Centre for Environmental Health, Neuherberg, Germany
- Chair of Epidemiology, Institute for Medical Information Processing, Biometry and Epidemiology, Medical Faculty, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Beate Fischer
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Julian Konzok
- Department of Epidemiology and Preventive Medicine, University of Regensburg, Regensburg, Germany
| | - Rafael Mikolajczyk
- Institute for Medical Epidemiology, Biometrics and Informatics (IMEBI), Interdisciplinary Centre for Health Sciences, Medical School of the Martin Luther University Halle-Wittenberg, Halle, Germany
- German Center for Mental Health, Site Jena-Magdeburg-Halle, Jena, Germany
| | - Amand Führer
- Institute for Medical Epidemiology, Biometrics and Informatics (IMEBI), Interdisciplinary Centre for Health Sciences, Medical School of the Martin Luther University Halle-Wittenberg, Halle, Germany
| | - Thomas Keil
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany
- Institute for Clinical Epidemiology and Biometry, University of Wuerzburg, Wuerzburg, Germany
- State Institute of Health, Bavarian Health and Food Safety Authority, Bad Kissingen, Germany
| | - Julia Fricke
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Stefan N. Willich
- Institute of Social Medicine, Epidemiology and Health Economics, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Tobias Pischon
- Max-Delbrueck-Centre for Molecular Medicine in the Helmholtz Association (MDC), Molecular Epidemiology Research Group, Berlin, Germany
- Charité – Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Berlin, Germany
- Max-Delbrueck-Centre for Molecular Medicine in the Helmholtz Association (MDC), Biobank Technology Platform, Berlin, Germany
| | - Henry Völzke
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Claudia Meinke-Franze
- Institute for Community Medicine, University Medicine Greifswald, Greifswald, Germany
| | - Markus Loeffler
- Institute for Medical Informatics, Statistics and Epidemiology (IMISE), University of Leipzig, Leipzig, Germany
- Leipzig Research Center for Civilization Diseases (LIFE), University of Leipzig, Leipzig, Germany
| | - Kerstin Wirkner
- Leipzig Research Center for Civilization Diseases (LIFE), University of Leipzig, Leipzig, Germany
| | - Klaus Berger
- Institute of Epidemiology & Social Medicine, University of Muenster, Muenster, Germany
| | - Hans J. Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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7
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Schick A, van Winkel R, Lin BD, Luykx JJ, de Zwarte SM, van Eijk KR, Myin-Germeys I, Reininghaus U. Polygenic risk, familial liability and stress reactivity in psychosis: an experience sampling study. Psychol Med 2023; 53:2798-2807. [PMID: 34991751 PMCID: PMC10235643 DOI: 10.1017/s0033291721004761] [Citation(s) in RCA: 4] [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: 02/19/2021] [Revised: 08/26/2021] [Accepted: 11/01/2021] [Indexed: 01/09/2023]
Abstract
BACKGROUND There is evidence for a polygenic contribution to psychosis. One targetable mechanism through which polygenic variation may impact on individuals and interact with the social environment is stress sensitization, characterized by elevated reactivity to minor stressors in daily life. The current study aimed to investigate whether stress reactivity is modified by polygenic risk score for schizophrenia (PRS) in cases with enduring non-affective psychotic disorder, first-degree relatives of cases, and controls. METHODS We used the experience sampling method to assess minor stressors, negative affect, positive affect and psychotic experiences in 96 cases, 79 first-degree relatives, i.e. siblings, and 73 controls at wave 3 of the Dutch Genetic Risk and Outcome of Psychosis (GROUP) study. Genome-wide data were collected at baseline to calculate PRS. RESULTS We found that associations of momentary stress with psychotic experiences, but not with negative and positive affect, were modified by PRS and group (all pFWE<0.001). In contrast to our hypotheses, siblings with high PRS reported less intense psychotic experiences in response to momentary stress compared to siblings with low PRS. No differences in magnitude of these associations were observed in cases with high v. low level of PRS. By contrast, controls with high PRS showed more intense psychotic experiences in response to stress compared to those with low PRS. CONCLUSIONS This tentatively suggests that polygenic risk may operate in different ways than previously assumed and amplify reactivity to stress in unaffected individuals but operate as a resilience factor in relatives by attenuating their stress reactivity.
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Affiliation(s)
- Anita Schick
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Ruud van Winkel
- KU Leuven, Department of Neuroscience, Research Group Psychiatry, Center for Clinical Psychiatry, Leuven, Belgium
| | - Bochao D. Lin
- Department of Translational Neuroscience, UMC Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Jurjen J. Luykx
- Department of Translational Neuroscience, UMC Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Department of Psychiatry, UMC Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Second Opinion Outpatient Clinic, GGNet, Warnsveld, The Netherlands
| | - Sonja M.C. de Zwarte
- Department of Psychiatry, UMC Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Kristel R. van Eijk
- Department of Neurology and Neurosurgery, University Medical Center Utrecht Brain Center, Utrecht University, Utrecht, The Netherlands
| | - GROUP Investigators
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Inez Myin-Germeys
- KU Leuven, Department of Neuroscience, Research Group Psychiatry, Center for Contextual Psychiatry, Leuven, Belgium
| | - Ulrich Reininghaus
- Department of Public Mental Health, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University, Maastricht, The Netherlands
- ESRC Centre for Society and Mental Health, King's College London, London, UK
- Center for Epidemiology and Public Health, Health Service and Population Research Department, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
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8
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Biernacka JM. Do Polygenic Scores Inform Psychiatric Disease Risk After Considering Family History? Am J Psychiatry 2023; 180:256-258. [PMID: 37002695 DOI: 10.1176/appi.ajp.20230116] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
Affiliation(s)
- Joanna M Biernacka
- Department of Psychiatry and Psychology and Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minn
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9
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Colbert SMC, Mullins N, Chan G, Meyers JL, Schulman J, Kuperman S, Lai D, Nurnberger J, Plawecki MH, Kamarajan C, Anokhin AP, Bucholz KK, Hesselbrock V, Edenberg HJ, Kramer J, Dick DM, Porjesz B, Agrawal A, Johnson EC. Polygenic Contributions to Suicidal Thoughts and Behaviors in a Sample Ascertained for Alcohol Use Disorders. Complex Psychiatry 2023; 9:11-23. [PMID: 38058956 PMCID: PMC10697665 DOI: 10.1159/000529164] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2022] [Accepted: 01/03/2023] [Indexed: 12/08/2023] Open
Abstract
Introduction Suicidal thoughts and behaviors have partially distinct genetic etiologies. Methods We used PRS-CS to create polygenic risk scores (PRSs) from GWAS of non-suicidal self-injury, broad-sense self-harm ideation, nonfatal suicide attempt, death by suicide, and depression. Using mixed-effect models, we estimated whether these PRSs were associated with a range of suicidal thoughts and behaviors in the Collaborative Study on the Genetics of Alcoholism (N = 7,526). Results All PRSs were significantly associated with suicidal ideation and suicide attempt (betas = 0.08-0.44, false discovery rate [FDR] <0.023). All PRSs except non-suicidal self-injury PRS were associated with active suicidal ideation (betas = 0.14-0.22, FDR <0.003). Several associations remained significant in models where all significant PRSs were included as simultaneous predictors, and when all PRSs predicted suicide attempt, the PRS together explained 6.2% of the variance in suicide attempt. Significant associations were also observed between some PRSs and persistent suicidal ideation, non-suicidal self-injury, compounded suicide attempt, and desire to die. Conclusion Our findings suggest that PRS for depression does not explain the entirety of the variance in suicidal thoughts and behaviors, with PRS specifically for suicidal thoughts and behaviors making additional and sometimes unique contributions.
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Affiliation(s)
- Sarah M C Colbert
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Niamh Mullins
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Grace Chan
- Mount Sinai Clinical Intelligence Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jacquelyn L Meyers
- Department of Psychiatry, University of Connecticut, Farmington, CT, USA
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Jessica Schulman
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Samuel Kuperman
- Henri Begleiter Neurodynamics Lab, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Dongbing Lai
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - John Nurnberger
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA, USA
| | - Martin H Plawecki
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Chella Kamarajan
- Department of Psychiatry, University of Connecticut, Farmington, CT, USA
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Andrey P Anokhin
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Kathleen K Bucholz
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Victor Hesselbrock
- Mount Sinai Clinical Intelligence Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Howard J Edenberg
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA, USA
- Department of Psychiatry and Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, USA
| | - John Kramer
- Henri Begleiter Neurodynamics Lab, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Danielle M Dick
- Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Bernice Porjesz
- Department of Psychiatry, University of Connecticut, Farmington, CT, USA
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
| | - Arpana Agrawal
- Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
| | - Emma C Johnson
- Department of Psychiatry, Rutgers Robert Wood Johnson Medical School, New Brunswick, NJ, USA
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10
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Loughnan R, Palmer CE, Makowski C, Thompson WK, Barch DM, Jernigan TL, Dale AM, Fan CC. Unique prediction of developmental psychopathology from genetic and familial risk. J Child Psychol Psychiatry 2022; 63:1631-1643. [PMID: 35764363 PMCID: PMC9691563 DOI: 10.1111/jcpp.13649] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/23/2022] [Indexed: 12/30/2022]
Abstract
BACKGROUND Early detection is critical for easing the rising burden of psychiatric disorders. However, the specificity of psychopathological measurements and genetic predictors is unclear among youth. METHODS We measured associations between genetic risk for psychopathology (polygenic risk scores (PRS) and family history (FH) measures) and a wide range of behavioral measures in a large sample (n = 5,204) of early adolescent participants (9-11 years) from the Adolescent Brain and Cognitive Development StudySM . Associations were measured both with and without accounting for shared variance across measures of genetic risk. RESULTS When controlling for genetic risk for other psychiatric disorders, polygenic risk for problematic opioid use (POU) is uniquely associated with lower behavioral inhibition. Attention deficit hyperactivity disorder (ADHD), depression (DEP), and attempted suicide (SUIC) PRS shared many significant associations with externalizing, internalizing, and psychosis-related behaviors. However, when accounting for all measures of genetic and familial risk, these PRS also showed clear, unique patterns of association. Polygenic risk for ASD, BIP, and SCZ, and attempted suicide uniquely predicted variability in cognitive performance. FH accounted for unique variability in behavior above and beyond PRS and vice versa, with FH measures explaining a greater proportion of unique variability compared to the PRS. CONCLUSION Our results indicate that, among youth, many behaviors show shared genetic influences; however, there is also specificity in the profile of emerging psychopathologies for individuals with high genetic risk for particular disorders. This may be useful for quantifying early, differential risk for psychopathology in development.
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Affiliation(s)
- Robert Loughnan
- Population Neuroscience and Genetics, University of California San Diego, USA
| | - Clare E. Palmer
- Center for Human Development, University of California San Diego, USA
| | - Carolina Makowski
- Department of Radiology, University of California San Diego School of Medicine, USA
| | - Wesley K. Thompson
- Population Neuroscience and Genetics, University of California San Diego, USA
- Herbert Wertheim School of Public Health and Human Longevity Science, University of California, San Diego USA
| | - Deanna M. Barch
- Psychological & Brain Sciences, Psychiatry and Radiology, Washington University in St. Louis, St. Louis USA
| | - Terry L. Jernigan
- Center for Human Development, University of California San Diego, USA
- Department of Radiology, University of California San Diego School of Medicine, USA
| | - Anders M. Dale
- Department of Radiology, University of California San Diego School of Medicine, USA
| | - Chun Chieh Fan
- Population Neuroscience and Genetics, University of California San Diego, USA
- Department of Radiology, University of California San Diego School of Medicine, USA
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11
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Mohammed F, Geda B, Yadeta TA, Dessie Y. Profiles and factors associated with schizophrenia in eastern Ethiopia: A matched case-control study. Front Psychiatry 2022; 13:1016005. [PMID: 36311517 PMCID: PMC9606421 DOI: 10.3389/fpsyt.2022.1016005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/10/2022] [Accepted: 09/27/2022] [Indexed: 11/25/2022] Open
Abstract
Background Despite its strong hereditary and genetic connections, there are other factors reported to be linked to schizophrenia, but not well studied in eastern Ethiopia. Objective This study was aimed to investigating the potential profiles and factors associated with schizophrenia in eastern Ethiopia. Materials and methods A matched case-control study was conducted in two public hospitals from December 1, 2021, to January 30, 2022. Cases were patients with schizophrenia who visited the hospitals, and controls were healthy individuals without any mental illness who visited the same hospitals. A questionnaire was used to collect the data. Cases and controls were matched using age and sex. STATA-14 was used for analysis. A conditional logistic regression with an adjusted odds ratio (AOR) and a 95% confidence interval (CI) was applied to identify the determinants. P-values of <0.05 were used to build the final model as a measure of statistical significance. Results The mean age of the study participants group was 28.6 (±8.44) years, mean age for cases was 28.7(±8.5) ranging from 18 to 56 years and the mean age for the controls was 28.4 (±8.5), ranging from 18 to 60 years. About 181 (83.03%) of the participants were male. The odds of having schizophrenia was about 12.2 times higher among participants with family history of mental illness (AOR: 12.21; 95% CI: 4.83-30.00). The odds of having schizophrenia was 4.5 times higher among polysubstance users (AOR: 4.45; 95% CI: 1.28-5.45) and 2.8 times higher among khat consumers (AOR: 2.82; 95% CI: 1.23-6.45) compared to their counterparts. Conclusion Our findings show that genetic risk factors as well as some modifiable behaviors are associated to schizophrenia in eastern Ethiopia. At all levels, special attention should be given to those who are at risk.
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Affiliation(s)
- Fethia Mohammed
- Department of Psychiatry, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Biftu Geda
- Department of Nursing, School of Health Sciences, Madda Walabu University, Shashamane, Ethiopia
| | - Tesfaye Assebe Yadeta
- School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
| | - Yadeta Dessie
- School of Public Health, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
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12
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Jutla A, Donohue MR, Veenstra-VanderWeele J, Foss-Feig JH. Reported autism diagnosis is associated with psychotic-like symptoms in the Adolescent Brain Cognitive Development cohort. Eur Child Adolesc Psychiatry 2022; 31:1-10. [PMID: 33646417 PMCID: PMC8856839 DOI: 10.1007/s00787-021-01738-1] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/22/2020] [Accepted: 02/05/2021] [Indexed: 11/25/2022]
Abstract
Although the schizophrenia (SCZ) rate is increased in autism spectrum disorder (ASD), it is difficult to identify which ASD youth will develop psychosis. We explored the relationship between ASD and emerging psychotic-like experiences (PLS) in a sample of 9127 youth aged 9-11 from the Adolescent Brain Cognitive Development (ABCD) cohort. We predicted that parent-reported ASD would be associated with PLS severity, and that ASD youth with PLS (ASD+/PLS+) would differ from ASD youth without PLS (ASD+/PLS-) and youth with PLS but not ASD (ASD-/PLS+) in cognitive function. We fit regression models that included parent-reported ASD, family history of psychosis, lifetime trauma, executive function, processing speed, working memory, age, sex, race, ethnicity, and income-to-needs ratio as predictors of Prodromal Questionnaire-Brief Child (PQ-BC) distress score, a continuous index of PLS severity. We assessed cognitive differences using regression models with ASD/PLS status and relevant covariates as predictors of NIH Toolbox measures. ASD increased raw PQ-BC distress scores by 2.47 points (95% CI 1.33-3.61), an effect at least as large as Black race (1.27 points, 95% CI 0.75-1.78), family history of psychosis (1.05 points, 95% CI 0.56-1.54), and Latinx ethnicity (0.99 points, 95% CI 0.53-1.45. We did not identify differences in cognition for ASD+/PLS+ youth relative to other groups. Our finding of association between ASD and PLS in youth is consistent with previous literature and adds new information in suggesting that ASD may be a strong risk factor for PLS even compared to established SCZ risk factors.
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Affiliation(s)
- Amandeep Jutla
- Department of Psychiatry, Columbia University, New York, NY, USA.
| | - Meghan Rose Donohue
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | | | - Jennifer H Foss-Feig
- Seaver Autism Center for Research and Treatment, Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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13
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Santesteban-Echarri O, Sandel D, Liu L, Bearden CE, Cadenhead KS, Cannon TD, Cornblatt BA, Keshavan M, Mathalon DH, McGlashan TH, Perkins DO, Seidman LJ, Stone WS, Tsuang MT, Walker EF, Woods SW, Addington J. Family history of psychosis in youth at clinical high risk: A replication study. Psychiatry Res 2022; 311:114480. [PMID: 35245743 DOI: 10.1016/j.psychres.2022.114480] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 02/01/2022] [Accepted: 02/23/2022] [Indexed: 01/18/2023]
Abstract
Having a first-degree relative with a psychotic disorder increases an individual's risk for developing psychosis to 10% compared to 1% in the general population. The impact of being at family high-risk for psychosis (FHR) has been examined in samples of youth who are at clinical high-risk for psychosis (CHR). The second North American Prodrome Longitudinal Study (NAPLS-2) identified very few clinical differences between CHR individuals with and without FHR. This paper aims to confirm these results in a new CHR sample, NAPLS-3. The NAPLS-3 sample consisted of 703 CHR participants, of whom 82 were at FHR (CHR+FHR), and 621 were not (CHR+FHRneg). The Family Interview for Genetic Studies was used to determine the presence of a first-degree relative with a psychotic disorder. The groups were compared on social and role functioning, positive and negative symptoms, IQ, cannabis use, and trauma. At baseline, the CHR+FHR group reported a statistically significant increased severity of positive and negative symptoms, lower IQ scores, and increased reports of trauma, psychological and physical abuse. There were no differences in transition rates between the two groups. This study supports some of the already reported differences in trauma, physical and psychological abuse between CHR individuals with and without FHR.
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Affiliation(s)
- Olga Santesteban-Echarri
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Danah Sandel
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Lu Liu
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Carrie E Bearden
- Department of Psychiatry and Biobehavioral Sciences and Psychology, UCLA, Los Angeles, CA, United States
| | | | - Tyrone D Cannon
- Department of Psychology, Yale University, New Haven, CT, United States; Department of Psychiatry, Yale University, New Haven, CT, United States
| | - Barbara A Cornblatt
- Department of Psychiatry, Zucker Hillside Hospital, Long Island, NY, United States
| | - Matcheri Keshavan
- Department of Psychiatry, Harvard Medical School Department of Psychiatry at Beth Israel Deaconess Medical Center and Massachusetts Mental Health Center, Boston, MA, United States
| | - Daniel H Mathalon
- Department of Psychiatry, UCSF, and SFVA Medical Center, San Francisco, CA, United States
| | - Thomas H McGlashan
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, United States
| | - Diana O Perkins
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, United States
| | - Larry J Seidman
- Department of Psychiatry, Harvard Medical School Department of Psychiatry at Beth Israel Deaconess Medical Center and Massachusetts Mental Health Center, Boston, MA, United States
| | - William S Stone
- Department of Psychiatry, Harvard Medical School Department of Psychiatry at Beth Israel Deaconess Medical Center and Massachusetts Mental Health Center, Boston, MA, United States
| | - Ming T Tsuang
- Department of Psychiatry, UCSD, San Diego, CA, United States; Institute of Genomic Medicine, University of California, La Jolla, CA, United States
| | - Elaine F Walker
- Department of Psychology and Psychiatry, Emory University, Atlanta, GA, United States
| | - Scott W Woods
- Department of Psychiatry, Yale University, New Haven, CT, United States
| | - Jean Addington
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.
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14
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Lai D, Johnson EC, Colbert S, Pandey G, Chan G, Bauer L, Francis MW, Hesselbrock V, Kamarajan C, Kramer J, Kuang W, Kuo S, Kuperman S, Liu Y, McCutcheon V, Pang Z, Plawecki MH, Schuckit M, Tischfield J, Wetherill L, Zang Y, Edenberg HJ, Porjesz B, Agrawal A, Foroud T. Evaluating risk for alcohol use disorder: Polygenic risk scores and family history. Alcohol Clin Exp Res 2022; 46:374-383. [PMID: 35267208 PMCID: PMC8928056 DOI: 10.1111/acer.14772] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2021] [Revised: 12/13/2021] [Accepted: 01/05/2022] [Indexed: 12/14/2022]
Abstract
BACKGROUND Early identification of individuals at high risk for alcohol use disorder (AUD) coupled with prompt interventions could reduce the incidence of AUD. In this study, we investigated whether Polygenic Risk Scores (PRS) can be used to evaluate the risk for AUD and AUD severity (as measured by the number of DSM-5 AUD diagnostic criteria met) and compared their performance with a measure of family history of AUD. METHODS We studied individuals of European ancestry from the Collaborative Study on the Genetics of Alcoholism (COGA). DSM-5 diagnostic criteria were available for 7203 individuals, of whom 3451 met criteria for DSM-IV alcohol dependence or DSM-5 AUD and 1616 were alcohol-exposed controls aged ≥21 years with no history of AUD or drug dependence. Further, 4842 individuals had a positive first-degree family history of AUD (FH+), 2722 had an unknown family history (FH?), and 336 had a negative family history (FH-). PRS were derived from a meta-analysis of a genome-wide association study of AUD from the Million Veteran Program and scores from the problem subscale of the Alcohol Use Disorders Identification Test in the UK Biobank. We used mixed models to test the association between PRS and risk for AUD and AUD severity. RESULTS AUD cases had higher PRS than controls with PRS increasing as the number of DSM-5 diagnostic criteria increased (p-values ≤ 1.85E-05 ) in the full COGA sample, the FH+ subsample, and the FH? subsample. Individuals in the top decile of PRS had odds ratios (OR) for developing AUD of 1.96 (95% CI: 1.54 to 2.51, p-value = 7.57E-08 ) and 1.86 (95% CI: 1.35 to 2.56, p-value = 1.32E-04 ) in the full sample and the FH+ subsample, respectively. These values are comparable to previously reported ORs for a first-degree family history (1.91 to 2.38) estimated from national surveys. PRS were also significantly associated with the DSM-5 AUD diagnostic criterion count in the full sample, the FH+ subsample, and the FH? subsample (p-values ≤6.7E-11 ). PRS remained significantly associated with AUD and AUD severity after accounting for a family history of AUD (p-values ≤6.8E-10 ). CONCLUSIONS Both PRS and family history were associated with AUD and AUD severity, indicating that these risk measures assess distinct aspects of liability to AUD traits.
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Affiliation(s)
- Dongbing Lai
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN
| | - Emma C. Johnson
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Sarah Colbert
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Gayathri Pandey
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry, State University of New York, Downstate Medical Center, Brooklyn, NY
| | - Grace Chan
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT
- Department of Psychiatry, University of Iowa Roy J and Lucille A Carver College of Medicine, Iowa City, IA
| | - Lance Bauer
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT
| | - Meredith W. Francis
- The Brown School of Social Work, Washington University School of Medicine, St. Louis, MO
| | - Victor Hesselbrock
- Department of Psychiatry, University of Connecticut School of Medicine, Farmington, CT
| | - Chella Kamarajan
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry, State University of New York, Downstate Medical Center, Brooklyn, NY
| | - John Kramer
- Department of Psychiatry, University of Iowa Roy J and Lucille A Carver College of Medicine, Iowa City, IA
| | - Weipeng Kuang
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry, State University of New York, Downstate Medical Center, Brooklyn, NY
| | - Sally Kuo
- Department of Psychology, Virginia Commonwealth University, Richmond, VA
| | - Samuel Kuperman
- Department of Psychiatry, University of Iowa Roy J and Lucille A Carver College of Medicine, Iowa City, IA
| | - Yunlong Liu
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN
| | - Vivia McCutcheon
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Zhiping Pang
- Department of Neuroscience and Cell Biology, Child Health Institute of New Jersey, Rutgers-Robert Wood Johnson Medical School, New Brunswick, NJ
| | - Martin H. Plawecki
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN
| | - Marc Schuckit
- Department of Psychiatry, University of California, San Diego Medical School, San Diego, CA
| | - Jay Tischfield
- Department of Genetics and the Human Genetics Institute of New Jersey, Rutgers University, Piscataway, NJ
| | - Leah Wetherill
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN
| | - Yong Zang
- Department of Biostatistics and Health Data Science, Indiana University School of Medicine, Indianapolis, IN
| | - Howard J. Edenberg
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN
- Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN
| | - Bernice Porjesz
- Henri Begleiter Neurodynamics Lab, Department of Psychiatry, State University of New York, Downstate Medical Center, Brooklyn, NY
| | - Arpana Agrawal
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO
| | - Tatiana Foroud
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN
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15
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Schendel D, Laursen TM, Albiñana C, Vilhjalmsson B, Ladd-Acosta C, Fallin MD, Benke K, Lee B, Grove J, Kalkbrenner A, Ejlskov L, Hougaard D, Bybjerg-Grauholm J, Bækvad-Hansen M, Børglum AD, Werge T, Nordentoft M, Mortensen PB, Agerbo E. Evaluating the interrelations between the autism polygenic score and psychiatric family history in risk for autism. Autism Res 2022; 15:171-182. [PMID: 34664785 PMCID: PMC11289736 DOI: 10.1002/aur.2629] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2021] [Revised: 09/19/2021] [Accepted: 10/01/2021] [Indexed: 01/25/2023]
Abstract
Psychiatric family history or a high autism polygenic risk score (PRS) have been separately linked to autism spectrum disorder (ASD) risk. The study aimed to simultaneously consider psychiatric family history and individual autism genetic liability (PRS) in autism risk. We performed a case-control study of all Denmark singleton births, May 1981-December 2005, in Denmark at their first birthday and a known mother. Cases were diagnosed with ASD before 2013 and controls comprised a random sample of 30,000 births without ASD, excluding persons with non-Denmark-born parents, missing ASD PRS, non-European ancestry. Adjusted odds ratios (aOR) were estimated for ASD by PRS decile and by psychiatric history in parents or full siblings (8 mutually-exclusive categories) using logistic regression. Adjusted ASD PRS z-score least-squares means were estimated by psychiatric family history category. ASD risk (11,339 ASD cases; 20,175 controls) from ASD PRS was not substantially altered after accounting for psychiatric family history (e.g., ASD PRS 10th decile aOR: 2.35 (95% CI 2.11-2.63) before vs 2.11 (95% CI 1.91-2.40) after adjustment) nor from psychiatric family history after accounting for ASD PRS (e.g., ASD family history aOR: 6.73 (95% CI 5.89-7.68) before vs 6.32 (95% CI 5.53-7.22) after adjustment). ASD risk from ASD PRS varied slightly by psychiatric family history. While ASD risk from psychiatric family history was not accounted for by ASD PRS and vice versa, risk overlap between the two factors will likely increase as measures of genetic risk improve. The two factors are best viewed as complementary measures of family-based autism risk. LAY SUMMARY: Autism risk from a history of mental disorders in the immediate family was not explained by a measure of individual genetic risk (autism polygenic risk score) and vice versa. That is, genetic risk did not appear to overlap family history risk. As genetic measures for autism improve then the overlap in autism risk from family history versus genetic factors will likely increase, but further study may be needed to fully determine the components of risk and how they are inter-related between these key family factors. Meanwhile, the two factors may be best viewed as complementary measures of autism family-based risk.
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Affiliation(s)
- Diana Schendel
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
- National Centre for Register-Based Research (NCRR), Department of Economics and Business, Aarhus University, Aarhus, Denmark
- A. J. Drexel Autism Institute, Drexel University, Philadelphia, USA
| | - Thomas Munk Laursen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- National Centre for Register-Based Research (NCRR), Department of Economics and Business, Aarhus University, Aarhus, Denmark
| | - Clara Albiñana
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- National Centre for Register-Based Research (NCRR), Department of Economics and Business, Aarhus University, Aarhus, Denmark
| | - Bjarni Vilhjalmsson
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- National Centre for Register-Based Research (NCRR), Department of Economics and Business, Aarhus University, Aarhus, Denmark
| | - Christine Ladd-Acosta
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - M Danielle Fallin
- Wendy Klag Center for Autism and Developmental Disabilities, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Kelly Benke
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Brian Lee
- A. J. Drexel Autism Institute, Drexel University, Philadelphia, USA
- Drexel University Dornsife School of Public Health, Philadelphia, USA
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Jakob Grove
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Centre for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark
- Department of Biomedicine – Human Genetics, Aarhus University, Aarhus, Denmark
- Bioinformatics Research Centre, Aarhus University, Aarhus, Denmark
- Centre for Genomics and Personalized Medicine, Aarhus, Denmark
| | - Amy Kalkbrenner
- University of Wisconsin Milwaukee, Joseph J Zilber School of Public Health, Milwaukee, WI
| | - Linda Ejlskov
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- National Centre for Register-Based Research (NCRR), Department of Economics and Business, Aarhus University, Aarhus, Denmark
| | - David Hougaard
- Center for Neonatal Screening, Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | - Jonas Bybjerg-Grauholm
- Center for Neonatal Screening, Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | - Marie Bækvad-Hansen
- Center for Neonatal Screening, Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | - Anders D Børglum
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Centre for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark
- Department of Biomedicine – Human Genetics, Aarhus University, Aarhus, Denmark
- Centre for Genomics and Personalized Medicine, Aarhus, Denmark
| | - Thomas Werge
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Institute of Biological Psychiatry, MHC Sct. Hans, Mental Health Services Copenhagen, Roskilde, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Merete Nordentoft
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Mental Health Center Copenhagen, Copenhagen, Denmark
| | - Preben Bo Mortensen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- National Centre for Register-Based Research (NCRR), Department of Economics and Business, Aarhus University, Aarhus, Denmark
- Centre for Integrated Register-based Research (CIRRAU), Aarhus University, Aarhus, Denmark
| | - Esben Agerbo
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- National Centre for Register-Based Research (NCRR), Department of Economics and Business, Aarhus University, Aarhus, Denmark
- Centre for Integrated Register-based Research (CIRRAU), Aarhus University, Aarhus, Denmark
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16
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Guan F, Ni T, Zhu W, Williams LK, Cui LB, Li M, Tubbs J, Sham PC, Gui H. Integrative omics of schizophrenia: from genetic determinants to clinical classification and risk prediction. Mol Psychiatry 2022; 27:113-126. [PMID: 34193973 PMCID: PMC11018294 DOI: 10.1038/s41380-021-01201-2] [Citation(s) in RCA: 27] [Impact Index Per Article: 13.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2021] [Revised: 06/15/2021] [Accepted: 06/17/2021] [Indexed: 02/06/2023]
Abstract
Schizophrenia (SCZ) is a debilitating neuropsychiatric disorder with high heritability and complex inheritance. In the past decade, successful identification of numerous susceptibility loci has provided useful insights into the molecular etiology of SCZ. However, applications of these findings to clinical classification and diagnosis, risk prediction, or intervention for SCZ have been limited, and elucidating the underlying genomic and molecular mechanisms of SCZ is still challenging. More recently, multiple Omics technologies - genomics, transcriptomics, epigenomics, proteomics, metabolomics, connectomics, and gut microbiomics - have all been applied to examine different aspects of SCZ pathogenesis. Integration of multi-Omics data has thus emerged as an approach to provide a more comprehensive view of biological complexity, which is vital to enable translation into assessments and interventions of clinical benefit to individuals with SCZ. In this review, we provide a broad survey of the single-omics studies of SCZ, summarize the advantages and challenges of different Omics technologies, and then focus on studies in which multiple omics data are integrated to unravel the complex pathophysiology of SCZ. We believe that integration of multi-Omics technologies would provide a roadmap to create a more comprehensive picture of interactions involved in the complex pathogenesis of SCZ, constitute a rich resource for elucidating the potential molecular mechanisms of the illness, and eventually improve clinical assessments and interventions of SCZ to address clinical translational questions from bench to bedside.
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Affiliation(s)
- Fanglin Guan
- Department of Forensic Psychiatry, School of Medicine & Forensics, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Tong Ni
- Department of Forensic Psychiatry, School of Medicine & Forensics, Xi'an Jiaotong University Health Science Center, Xi'an, Shaanxi, China
| | - Weili Zhu
- National Institute on Drug Dependence and Beijing Key Laboratory of Drug Dependence, Peking University, Beijing, China
| | - L Keoki Williams
- Center for Individualized and Genomic Medicine Research, Department of Internal Medicine, Henry Ford Health System, Detroit, MI, USA
| | - Long-Biao Cui
- Department of Clinical Psychology, School of Medical Psychology, Air Force Medical University, Xi'an, Shaanxi, China
| | - Ming Li
- Key Laboratory of Animal Models and Human Disease Mechanisms of the Chinese Academy of Sciences and Yunnan Province, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, Yunnan, China
| | - Justin Tubbs
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China
- Centre for PanorOmic Sciences, The University of Hong Kong, Hong Kong SAR, China
| | - Pak-Chung Sham
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, China.
- Centre for PanorOmic Sciences, The University of Hong Kong, Hong Kong SAR, China.
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong SAR, China.
| | - Hongsheng Gui
- Center for Individualized and Genomic Medicine Research, Department of Internal Medicine, Henry Ford Health System, Detroit, MI, USA.
- Behavioral Health Services, Henry Ford Health System, Detroit, MI, USA.
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17
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Rao WW, Zhang YS, Ng CH, Cui LJ, Li JF, Li L, Ungvari GS, Li KQ, Xiang YT. Prevalence of schizophrenia and its association with socio-demographic correlates in an agricultural region of China. Asian J Psychiatr 2021; 64:102743. [PMID: 34400109 DOI: 10.1016/j.ajp.2021.102743] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Revised: 06/03/2021] [Accepted: 06/24/2021] [Indexed: 10/21/2022]
Abstract
Little is known about the epidemiology of schizophrenia in the agricultural regions of China. This study examined the 1-month and lifetime prevalence of schizophrenia and their association with socio-demographic factors in Hebei province which is an important agricultural region of China. A multi-stage, stratified, cluster random sampling method was adopted. The diagnosis of schizophrenia was ascertained with the validated Structured Clinical Interview for DSM-IV Axis I Disorders-Patient Edition (SCID-I/P/C). Altogether, 23,675 subjects were screened, of whom, 20,884 were included for analyses. The weighted 1-month and lifetime prevalence of schizophrenia were 0.5 % [95 % confidence interval (CI): 0.4-0.5 %] and 0.6 % (95 %CI: 0.5-0.7 %), respectively. Multiple logistic regression analyses found that unmarried marital status [P < 0.001, Odd Ratio(OR)=2.670, 95 %CI:1.767-4.036], lower education level (primary school or below: P = 0.042, OR=2.447, 95 % CI: 1.034-5.933; secondary school: P = 0.002, OR = 4.261, 95 % CI:1.692-10.730), unemployment (P = 0.006, OR=1.870, 95 % CI:1.198-2.920), lower income (P < 0.001, OR=4.017, 95 % CI:2.207-7.310) and family history of psychiatric disorders (P < 0.001, OR=16.278, 95 % CI:10.435-25.393) were independently associated with a higher risk of schizophrenia, while age above 60 years (P = 0.004, OR=0.440, 95 % CI:0.253-0.765) was associated with a lower risk of schizophrenia. The prevalence of schizophrenia appeared to be lower in Hebei province compared to other regions of China or other countries. Socioeconomic factors should be further examined to inform the public health surveillance and policies relevant to schizophrenia in the agricultural regions of China.
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Affiliation(s)
- Wen-Wang Rao
- Institute of Mental Health, Hebei Mental Health Centre, Hebei Province, China; Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China
| | - Yun-Shu Zhang
- Institute of Mental Health, Hebei Mental Health Centre, Hebei Province, China; Department of Sleep Medicine, Hebei Psychiatric Hospital, Hebei Province, China
| | - Chee H Ng
- Department of Psychiatry, The Melbourne Clinic and St Vincent's Hospital, University of Melbourne, Richmond, Victoria, Australia
| | - Li-Jun Cui
- Department of Sleep Medicine, Hebei Psychiatric Hospital, Hebei Province, China
| | - Jian-Feng Li
- Department of Sleep Medicine, Hebei Psychiatric Hospital, Hebei Province, China
| | - Lin Li
- Department of Sleep Medicine, Hebei Psychiatric Hospital, Hebei Province, China
| | - Gabor S Ungvari
- University of Notre Dame, Australia, Perth, Australia; Division of Psychiatry, School of Medicine, University of Western Australia / Graylands Hospital, Perth, Australia
| | - Ke-Qing Li
- Institute of Mental Health, Hebei Mental Health Centre, Hebei Province, China; Department of Sleep Medicine, Hebei Psychiatric Hospital, Hebei Province, China.
| | - Yu-Tao Xiang
- Unit of Psychiatry, Department of Public Health and Medicinal Administration, & Institute of Translational Medicine, Faculty of Health Sciences, University of Macau, Macao SAR, China; Centre for Cognitive and Brain Science, University of Macau, Macao SAR, China; Institute of Advanced Studies in Humanities and Social Sciences, University of Macau, Macao SAR, China.
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18
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Verdolini N, Amoretti S, Mezquida G, Cuesta MJ, Pina-Camacho L, García-Rizo C, Lobo A, González-Pinto A, Merchán-Naranjo J, Corripio I, Salagre E, Baeza I, Bergé D, Garriga M, Bioque M, Vallespir C, Serra M, Vieta E, Bernardo M. The effect of family environment and psychiatric family history on psychosocial functioning in first-episode psychosis at baseline and after 2 years. Eur Neuropsychopharmacol 2021; 49:54-68. [PMID: 33857739 DOI: 10.1016/j.euroneuro.2021.03.015] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 03/01/2021] [Accepted: 03/15/2021] [Indexed: 01/13/2023]
Abstract
The aim of the present study was to evaluate the contribution of family environment styles and psychiatric family history on functioning of patients presenting first-episode psychosis (FEP). Patients with FEP and healthy controls (HC) were assessed at baseline and after 2 years. The Functional Assessment Short Test (FAST) was used to assess functional outcome and the Family Environment Scale (FES) to evaluate family environment. Linear regressions evaluated the effect that family environment exerts on functioning at baseline and at 2-year follow-up, when FEP patients were diagnosed according to non-affective (NA-PSYCH) or affective psychoses (A-PSYCH). The influence of a positive parents' psychiatric history on functioning was evaluated through one-way between-groups analysis of covariance (ANCOVA) models, after controlling for family environmental styles. At baseline, FEP patients presented moderate functioning impairment, significantly worse than HC (28.65±16.17 versus 3.25±7.92; p<0.001, g = 1.91). At 2-year follow-up, the functioning of NA-PSYCH patients was significantly worse than in A-PSYCH (19.92±14.83 versus 12.46±14.86; p = 0.020, g = 0.50). No specific family environment style was associated with functioning in FEP patients and HC. On the contrary, a positive psychiatric father's history influenced functioning of FEP patients. After 2 years, worse functioning in NA-PSYCH patients was associated with lower rates of active-recreational and achievement orientated family environment and with higher rates of moral-religious emphasis and control. In A-PSYCH, worse functioning was associated with higher rates of conflict in the family. Both family environment and psychiatric history influence psychosocial functioning, with important implications for early interventions, that should involve both patients and caregivers.
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Affiliation(s)
- Norma Verdolini
- Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, Institute of Neuroscience, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Silvia Amoretti
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Barcelona, Spain; Department of Medicine, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Gisela Mezquida
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Barcelona, Spain; Department of Medicine, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Manuel J Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain; Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Laura Pina-Camacho
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; Department of Child and Adolescent Psychiatry, Institute of Psychatry and Mental Health, Hospital General Universitario Gregorio Marañon, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Clemente García-Rizo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Barcelona, Spain; Department of Medicine, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Antonio Lobo
- Department of Medicine and Psychiatry. Universidad de Zaragoza, Spain; Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - Ana González-Pinto
- Hospital Universitario de Alava, UPV/EHU, BIOARABA, CIBERSAM, Vitoria, Spain
| | - Jessica Merchán-Naranjo
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; Department of Child and Adolescent Psychiatry, Institute of Psychatry and Mental Health, Hospital General Universitario Gregorio Marañon, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Iluminada Corripio
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; Psychiatry Department, Institut d'Investigació Biomèdica-Sant Pau (IIB-SANT PAU), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Estela Salagre
- Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, Institute of Neuroscience, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Immaculada Baeza
- Department of Child and Adolescent Psychiatry and Psychology, Clínic Institute of Neurosciences, Hospital Clínic de Barcelona, 2017SGR881, University of Barcelona, CIBERSAM, IDIBAPS, Barcelona, Spain
| | - Daniel Bergé
- Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; Hospital del Mar Medical Research Institute (IMIM), Spain; Autonomous University of Barcelona (UAB), Spain
| | - Marina Garriga
- Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, Institute of Neuroscience, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Miquel Bioque
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Barcelona, Spain; Department of Medicine, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
| | - Catalina Vallespir
- Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, Institute of Neuroscience, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Maria Serra
- Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, Institute of Neuroscience, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Hospital Clinic, University of Barcelona, Institute of Neuroscience, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain.
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, Neuroscience Institute, Barcelona, Spain; Department of Medicine, Institut de Neurociències, Universitat de Barcelona, Barcelona, Spain; Biomedical Research Networking Center for Mental Health Network (CIBERSAM), Barcelona, Spain; August Pi I Sunyer Biomedical Research Institute (IDIBAPS), Barcelona, Spain
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19
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Perkins DO, Olde Loohuis L, Barbee J, Ford J, Jeffries CD, Addington J, Bearden CE, Cadenhead KS, Cannon TD, Cornblatt BA, Mathalon DH, McGlashan TH, Seidman LJ, Tsuang M, Walker EF, Woods SW. Polygenic Risk Score Contribution to Psychosis Prediction in a Target Population of Persons at Clinical High Risk. Am J Psychiatry 2020; 177:155-163. [PMID: 31711302 PMCID: PMC7202227 DOI: 10.1176/appi.ajp.2019.18060721] [Citation(s) in RCA: 80] [Impact Index Per Article: 20.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE The 2-year risk of psychosis in persons who meet research criteria for a high-risk syndrome is about 15%-25%; improvements in risk prediction accuracy would benefit the development and implementation of preventive interventions. The authors sought to assess polygenic risk score (PRS) prediction of subsequent psychosis in persons at high risk and to determine the impact of adding the PRS to a previously validated psychosis risk calculator. METHODS Persons meeting research criteria for psychosis high risk (N=764) and unaffected individuals (N=279) were followed for up to 2 years. The PRS was based on the latest schizophrenia and bipolar genome-wide association studies. Variables in the psychosis risk calculator included stressful life events, trauma, disordered thought content, verbal learning, information processing speed, and family history of psychosis. RESULTS For Europeans, the PRS varied significantly by group and was higher in the psychosis converter group compared with both the nonconverter and unaffected groups, but was similar for the nonconverter group compared with the unaffected group. For non-Europeans, the PRS varied significantly by group; the difference between the converters and nonconverters was not significant, but the PRS was significantly higher in converters than in unaffected individuals, and it did not differ between nonconverters and unaffected individuals. The R2liability (R2 adjusted for the rate of disease risk in the population being studied, here assuming a 2-year psychosis risk between 10% and 30%) for Europeans varied between 9.2% and 12.3% and for non-Europeans between 3.5% and 4.8%. The amount of risk prediction information contributed by the addition of the PRS to the risk calculator was less than severity of disordered thoughts and similar to or greater than for other variables. For Europeans, the PRS was correlated with risk calculator variables of information processing speed and verbal memory. CONCLUSIONS The PRS discriminates psychosis converters from nonconverters and modestly improves individualized psychosis risk prediction when added to a psychosis risk calculator. The schizophrenia PRS shows promise in enhancing risk prediction in persons at high risk for psychosis, although its potential utility is limited by poor performance in persons of non-European ancestry.
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Affiliation(s)
- Diana O Perkins
- Department of Psychiatry (Perkins, Barbee), Lineberger Bioinformatics Core (Ford), Renaissance Computing Institute (Jeffries), University of North Carolina, Chapel Hill; Center for Neurobehavioral Genetics (Olde Loohuis) and Departments of Psychiatry and Biobehavioral Sciences and Psychology (Bearden), University of California, Los Angeles; Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Alberta, Canada (Addington); Department of Psychiatry (Cadenhead) and Center for Behavioral Genomics, Department of Psychiatry (Tsuang), University of California, San Diego; Department of Psychology, Yale University, New Haven, Conn. (Cannon); Department of Psychiatry, Zucker Hillside Hospital, Glen Oaks, N.Y. (Cornblatt); Department of Psychiatry, University of California, San Francisco (Mathalon); Department of Psychiatry, Yale University, New Haven, Conn. (McGlashan, Woods); Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston (Seidman); and Departments of Psychology and Psychiatry, Emory University, Atlanta (Walker)
| | - Loes Olde Loohuis
- Department of Psychiatry (Perkins, Barbee), Lineberger Bioinformatics Core (Ford), Renaissance Computing Institute (Jeffries), University of North Carolina, Chapel Hill; Center for Neurobehavioral Genetics (Olde Loohuis) and Departments of Psychiatry and Biobehavioral Sciences and Psychology (Bearden), University of California, Los Angeles; Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Alberta, Canada (Addington); Department of Psychiatry (Cadenhead) and Center for Behavioral Genomics, Department of Psychiatry (Tsuang), University of California, San Diego; Department of Psychology, Yale University, New Haven, Conn. (Cannon); Department of Psychiatry, Zucker Hillside Hospital, Glen Oaks, N.Y. (Cornblatt); Department of Psychiatry, University of California, San Francisco (Mathalon); Department of Psychiatry, Yale University, New Haven, Conn. (McGlashan, Woods); Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston (Seidman); and Departments of Psychology and Psychiatry, Emory University, Atlanta (Walker)
| | - Jenna Barbee
- Department of Psychiatry (Perkins, Barbee), Lineberger Bioinformatics Core (Ford), Renaissance Computing Institute (Jeffries), University of North Carolina, Chapel Hill; Center for Neurobehavioral Genetics (Olde Loohuis) and Departments of Psychiatry and Biobehavioral Sciences and Psychology (Bearden), University of California, Los Angeles; Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Alberta, Canada (Addington); Department of Psychiatry (Cadenhead) and Center for Behavioral Genomics, Department of Psychiatry (Tsuang), University of California, San Diego; Department of Psychology, Yale University, New Haven, Conn. (Cannon); Department of Psychiatry, Zucker Hillside Hospital, Glen Oaks, N.Y. (Cornblatt); Department of Psychiatry, University of California, San Francisco (Mathalon); Department of Psychiatry, Yale University, New Haven, Conn. (McGlashan, Woods); Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston (Seidman); and Departments of Psychology and Psychiatry, Emory University, Atlanta (Walker)
| | - John Ford
- Department of Psychiatry (Perkins, Barbee), Lineberger Bioinformatics Core (Ford), Renaissance Computing Institute (Jeffries), University of North Carolina, Chapel Hill; Center for Neurobehavioral Genetics (Olde Loohuis) and Departments of Psychiatry and Biobehavioral Sciences and Psychology (Bearden), University of California, Los Angeles; Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Alberta, Canada (Addington); Department of Psychiatry (Cadenhead) and Center for Behavioral Genomics, Department of Psychiatry (Tsuang), University of California, San Diego; Department of Psychology, Yale University, New Haven, Conn. (Cannon); Department of Psychiatry, Zucker Hillside Hospital, Glen Oaks, N.Y. (Cornblatt); Department of Psychiatry, University of California, San Francisco (Mathalon); Department of Psychiatry, Yale University, New Haven, Conn. (McGlashan, Woods); Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston (Seidman); and Departments of Psychology and Psychiatry, Emory University, Atlanta (Walker)
| | - Clark D Jeffries
- Department of Psychiatry (Perkins, Barbee), Lineberger Bioinformatics Core (Ford), Renaissance Computing Institute (Jeffries), University of North Carolina, Chapel Hill; Center for Neurobehavioral Genetics (Olde Loohuis) and Departments of Psychiatry and Biobehavioral Sciences and Psychology (Bearden), University of California, Los Angeles; Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Alberta, Canada (Addington); Department of Psychiatry (Cadenhead) and Center for Behavioral Genomics, Department of Psychiatry (Tsuang), University of California, San Diego; Department of Psychology, Yale University, New Haven, Conn. (Cannon); Department of Psychiatry, Zucker Hillside Hospital, Glen Oaks, N.Y. (Cornblatt); Department of Psychiatry, University of California, San Francisco (Mathalon); Department of Psychiatry, Yale University, New Haven, Conn. (McGlashan, Woods); Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston (Seidman); and Departments of Psychology and Psychiatry, Emory University, Atlanta (Walker)
| | - Jean Addington
- Department of Psychiatry (Perkins, Barbee), Lineberger Bioinformatics Core (Ford), Renaissance Computing Institute (Jeffries), University of North Carolina, Chapel Hill; Center for Neurobehavioral Genetics (Olde Loohuis) and Departments of Psychiatry and Biobehavioral Sciences and Psychology (Bearden), University of California, Los Angeles; Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Alberta, Canada (Addington); Department of Psychiatry (Cadenhead) and Center for Behavioral Genomics, Department of Psychiatry (Tsuang), University of California, San Diego; Department of Psychology, Yale University, New Haven, Conn. (Cannon); Department of Psychiatry, Zucker Hillside Hospital, Glen Oaks, N.Y. (Cornblatt); Department of Psychiatry, University of California, San Francisco (Mathalon); Department of Psychiatry, Yale University, New Haven, Conn. (McGlashan, Woods); Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston (Seidman); and Departments of Psychology and Psychiatry, Emory University, Atlanta (Walker)
| | - Carrie E Bearden
- Department of Psychiatry (Perkins, Barbee), Lineberger Bioinformatics Core (Ford), Renaissance Computing Institute (Jeffries), University of North Carolina, Chapel Hill; Center for Neurobehavioral Genetics (Olde Loohuis) and Departments of Psychiatry and Biobehavioral Sciences and Psychology (Bearden), University of California, Los Angeles; Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Alberta, Canada (Addington); Department of Psychiatry (Cadenhead) and Center for Behavioral Genomics, Department of Psychiatry (Tsuang), University of California, San Diego; Department of Psychology, Yale University, New Haven, Conn. (Cannon); Department of Psychiatry, Zucker Hillside Hospital, Glen Oaks, N.Y. (Cornblatt); Department of Psychiatry, University of California, San Francisco (Mathalon); Department of Psychiatry, Yale University, New Haven, Conn. (McGlashan, Woods); Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston (Seidman); and Departments of Psychology and Psychiatry, Emory University, Atlanta (Walker)
| | - Kristin S Cadenhead
- Department of Psychiatry (Perkins, Barbee), Lineberger Bioinformatics Core (Ford), Renaissance Computing Institute (Jeffries), University of North Carolina, Chapel Hill; Center for Neurobehavioral Genetics (Olde Loohuis) and Departments of Psychiatry and Biobehavioral Sciences and Psychology (Bearden), University of California, Los Angeles; Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Alberta, Canada (Addington); Department of Psychiatry (Cadenhead) and Center for Behavioral Genomics, Department of Psychiatry (Tsuang), University of California, San Diego; Department of Psychology, Yale University, New Haven, Conn. (Cannon); Department of Psychiatry, Zucker Hillside Hospital, Glen Oaks, N.Y. (Cornblatt); Department of Psychiatry, University of California, San Francisco (Mathalon); Department of Psychiatry, Yale University, New Haven, Conn. (McGlashan, Woods); Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston (Seidman); and Departments of Psychology and Psychiatry, Emory University, Atlanta (Walker)
| | - Tyrone D Cannon
- Department of Psychiatry (Perkins, Barbee), Lineberger Bioinformatics Core (Ford), Renaissance Computing Institute (Jeffries), University of North Carolina, Chapel Hill; Center for Neurobehavioral Genetics (Olde Loohuis) and Departments of Psychiatry and Biobehavioral Sciences and Psychology (Bearden), University of California, Los Angeles; Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Alberta, Canada (Addington); Department of Psychiatry (Cadenhead) and Center for Behavioral Genomics, Department of Psychiatry (Tsuang), University of California, San Diego; Department of Psychology, Yale University, New Haven, Conn. (Cannon); Department of Psychiatry, Zucker Hillside Hospital, Glen Oaks, N.Y. (Cornblatt); Department of Psychiatry, University of California, San Francisco (Mathalon); Department of Psychiatry, Yale University, New Haven, Conn. (McGlashan, Woods); Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston (Seidman); and Departments of Psychology and Psychiatry, Emory University, Atlanta (Walker)
| | - Barbara A Cornblatt
- Department of Psychiatry (Perkins, Barbee), Lineberger Bioinformatics Core (Ford), Renaissance Computing Institute (Jeffries), University of North Carolina, Chapel Hill; Center for Neurobehavioral Genetics (Olde Loohuis) and Departments of Psychiatry and Biobehavioral Sciences and Psychology (Bearden), University of California, Los Angeles; Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Alberta, Canada (Addington); Department of Psychiatry (Cadenhead) and Center for Behavioral Genomics, Department of Psychiatry (Tsuang), University of California, San Diego; Department of Psychology, Yale University, New Haven, Conn. (Cannon); Department of Psychiatry, Zucker Hillside Hospital, Glen Oaks, N.Y. (Cornblatt); Department of Psychiatry, University of California, San Francisco (Mathalon); Department of Psychiatry, Yale University, New Haven, Conn. (McGlashan, Woods); Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston (Seidman); and Departments of Psychology and Psychiatry, Emory University, Atlanta (Walker)
| | - Daniel H Mathalon
- Department of Psychiatry (Perkins, Barbee), Lineberger Bioinformatics Core (Ford), Renaissance Computing Institute (Jeffries), University of North Carolina, Chapel Hill; Center for Neurobehavioral Genetics (Olde Loohuis) and Departments of Psychiatry and Biobehavioral Sciences and Psychology (Bearden), University of California, Los Angeles; Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Alberta, Canada (Addington); Department of Psychiatry (Cadenhead) and Center for Behavioral Genomics, Department of Psychiatry (Tsuang), University of California, San Diego; Department of Psychology, Yale University, New Haven, Conn. (Cannon); Department of Psychiatry, Zucker Hillside Hospital, Glen Oaks, N.Y. (Cornblatt); Department of Psychiatry, University of California, San Francisco (Mathalon); Department of Psychiatry, Yale University, New Haven, Conn. (McGlashan, Woods); Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston (Seidman); and Departments of Psychology and Psychiatry, Emory University, Atlanta (Walker)
| | - Thomas H McGlashan
- Department of Psychiatry (Perkins, Barbee), Lineberger Bioinformatics Core (Ford), Renaissance Computing Institute (Jeffries), University of North Carolina, Chapel Hill; Center for Neurobehavioral Genetics (Olde Loohuis) and Departments of Psychiatry and Biobehavioral Sciences and Psychology (Bearden), University of California, Los Angeles; Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Alberta, Canada (Addington); Department of Psychiatry (Cadenhead) and Center for Behavioral Genomics, Department of Psychiatry (Tsuang), University of California, San Diego; Department of Psychology, Yale University, New Haven, Conn. (Cannon); Department of Psychiatry, Zucker Hillside Hospital, Glen Oaks, N.Y. (Cornblatt); Department of Psychiatry, University of California, San Francisco (Mathalon); Department of Psychiatry, Yale University, New Haven, Conn. (McGlashan, Woods); Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston (Seidman); and Departments of Psychology and Psychiatry, Emory University, Atlanta (Walker)
| | - Larry J Seidman
- Department of Psychiatry (Perkins, Barbee), Lineberger Bioinformatics Core (Ford), Renaissance Computing Institute (Jeffries), University of North Carolina, Chapel Hill; Center for Neurobehavioral Genetics (Olde Loohuis) and Departments of Psychiatry and Biobehavioral Sciences and Psychology (Bearden), University of California, Los Angeles; Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Alberta, Canada (Addington); Department of Psychiatry (Cadenhead) and Center for Behavioral Genomics, Department of Psychiatry (Tsuang), University of California, San Diego; Department of Psychology, Yale University, New Haven, Conn. (Cannon); Department of Psychiatry, Zucker Hillside Hospital, Glen Oaks, N.Y. (Cornblatt); Department of Psychiatry, University of California, San Francisco (Mathalon); Department of Psychiatry, Yale University, New Haven, Conn. (McGlashan, Woods); Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston (Seidman); and Departments of Psychology and Psychiatry, Emory University, Atlanta (Walker)
| | - Ming Tsuang
- Department of Psychiatry (Perkins, Barbee), Lineberger Bioinformatics Core (Ford), Renaissance Computing Institute (Jeffries), University of North Carolina, Chapel Hill; Center for Neurobehavioral Genetics (Olde Loohuis) and Departments of Psychiatry and Biobehavioral Sciences and Psychology (Bearden), University of California, Los Angeles; Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Alberta, Canada (Addington); Department of Psychiatry (Cadenhead) and Center for Behavioral Genomics, Department of Psychiatry (Tsuang), University of California, San Diego; Department of Psychology, Yale University, New Haven, Conn. (Cannon); Department of Psychiatry, Zucker Hillside Hospital, Glen Oaks, N.Y. (Cornblatt); Department of Psychiatry, University of California, San Francisco (Mathalon); Department of Psychiatry, Yale University, New Haven, Conn. (McGlashan, Woods); Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston (Seidman); and Departments of Psychology and Psychiatry, Emory University, Atlanta (Walker)
| | - Elaine F Walker
- Department of Psychiatry (Perkins, Barbee), Lineberger Bioinformatics Core (Ford), Renaissance Computing Institute (Jeffries), University of North Carolina, Chapel Hill; Center for Neurobehavioral Genetics (Olde Loohuis) and Departments of Psychiatry and Biobehavioral Sciences and Psychology (Bearden), University of California, Los Angeles; Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Alberta, Canada (Addington); Department of Psychiatry (Cadenhead) and Center for Behavioral Genomics, Department of Psychiatry (Tsuang), University of California, San Diego; Department of Psychology, Yale University, New Haven, Conn. (Cannon); Department of Psychiatry, Zucker Hillside Hospital, Glen Oaks, N.Y. (Cornblatt); Department of Psychiatry, University of California, San Francisco (Mathalon); Department of Psychiatry, Yale University, New Haven, Conn. (McGlashan, Woods); Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston (Seidman); and Departments of Psychology and Psychiatry, Emory University, Atlanta (Walker)
| | - Scott W Woods
- Department of Psychiatry (Perkins, Barbee), Lineberger Bioinformatics Core (Ford), Renaissance Computing Institute (Jeffries), University of North Carolina, Chapel Hill; Center for Neurobehavioral Genetics (Olde Loohuis) and Departments of Psychiatry and Biobehavioral Sciences and Psychology (Bearden), University of California, Los Angeles; Hotchkiss Brain Institute, Department of Psychiatry, University of Calgary, Alberta, Canada (Addington); Department of Psychiatry (Cadenhead) and Center for Behavioral Genomics, Department of Psychiatry (Tsuang), University of California, San Diego; Department of Psychology, Yale University, New Haven, Conn. (Cannon); Department of Psychiatry, Zucker Hillside Hospital, Glen Oaks, N.Y. (Cornblatt); Department of Psychiatry, University of California, San Francisco (Mathalon); Department of Psychiatry, Yale University, New Haven, Conn. (McGlashan, Woods); Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston (Seidman); and Departments of Psychology and Psychiatry, Emory University, Atlanta (Walker)
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20
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Mataix-Cols D, Hansen B, Mattheisen M, Karlsson EK, Addington AM, Boberg J, Djurfeldt DR, Halvorsen M, Lichtenstein P, Solem S, Lindblad-Toh K, Haavik J, Kvale G, Rück C, Crowley JJ. Nordic OCD & Related Disorders Consortium: Rationale, design, and methods. Am J Med Genet B Neuropsychiatr Genet 2020; 183:38-50. [PMID: 31424634 PMCID: PMC6898732 DOI: 10.1002/ajmg.b.32756] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2019] [Revised: 07/19/2019] [Accepted: 07/29/2019] [Indexed: 12/23/2022]
Abstract
Obsessive-compulsive disorder (OCD) is a debilitating psychiatric disorder, yet its etiology is unknown and treatment outcomes could be improved if biological targets could be identified. Unfortunately, genetic findings for OCD are lagging behind other psychiatric disorders. Thus, there is a pressing need to understand the causal mechanisms implicated in OCD in order to improve clinical outcomes and to reduce morbidity and societal costs. Specifically, there is a need for a large-scale, etiologically informative genetic study integrating genetic and environmental factors that presumably interact to cause the condition. The Nordic countries provide fertile ground for such a study, given their detailed population registers, national healthcare systems and active specialist clinics for OCD. We thus formed the Nordic OCD and Related Disorders Consortium (NORDiC, www.crowleylab.org/nordic), and with the support of NIMH and the Swedish Research Council, have begun to collect a large, richly phenotyped and genotyped sample of OCD cases. Our specific aims are geared toward answering a number of key questions regarding the biology, etiology, and treatment of OCD. This article describes and discusses the rationale, design, and methodology of NORDiC, including details on clinical measures and planned genomic analyses.
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Affiliation(s)
- David Mataix-Cols
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden,Stockholm Health Care Services, Stockholm, Sweden
| | - Bjarne Hansen
- Haukeland University Hospital, OCD-team, Bergen, Norway,Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | - Manuel Mattheisen
- Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany,Institute of Human Genetics, University of Bonn, Bonn, Germany,Center for Integrative Sequencing, iSEQ, Department of Biomedicine, Aarhus University, Denmark,Department of Psychiatry, Psychosomatics, and Psychotherapy, University of Würzburg, Germany
| | - Elinor K. Karlsson
- Broad Institute of MIT and Harvard, Cambridge, MA, USA,Program in Bioinformatics & Integrative Biology and Program in Molecular Medicine, University of Massachusetts Medical School, Worcester, MA, USA
| | - Anjené M. Addington
- Genomics Research Branch, National Institute of Mental Health in Bethesda, Bethesda, Maryland, USA
| | - Julia Boberg
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden,Stockholm Health Care Services, Stockholm, Sweden
| | - Diana R. Djurfeldt
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden,Stockholm Health Care Services, Stockholm, Sweden
| | - Matthew Halvorsen
- Department of Genetics, University of North Carolina at Chapel Hill, NC, USA
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Stian Solem
- Haukeland University Hospital, OCD-team, Bergen, Norway,Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Kerstin Lindblad-Toh
- Broad Institute of MIT and Harvard, Cambridge, MA, USA,Science for Life Laboratory, IMBIM, Uppsala University, Uppsala, Sweden
| | | | - Jan Haavik
- Department of Biomedicine, University of Bergen, Bergen, Norway,Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Gerd Kvale
- Haukeland University Hospital, OCD-team, Bergen, Norway,Department of Clinical Psychology, University of Bergen, Bergen, Norway
| | - Christian Rück
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden,Stockholm Health Care Services, Stockholm, Sweden
| | - James J. Crowley
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden,Department of Genetics, University of North Carolina at Chapel Hill, NC, USA,Department of Psychiatry, University of North Carolina at Chapel Hill, NC, USA
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21
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Horsdal HT, Agerbo E, McGrath JJ, Vilhjálmsson BJ, Antonsen S, Closter AM, Timmermann A, Grove J, Mok PLH, Webb RT, Sabel CE, Hertel O, Sigsgaard T, Erikstrup C, Hougaard DM, Werge T, Nordentoft M, Børglum AD, Mors O, Mortensen PB, Brandt J, Geels C, Pedersen CB. Association of Childhood Exposure to Nitrogen Dioxide and Polygenic Risk Score for Schizophrenia With the Risk of Developing Schizophrenia. JAMA Netw Open 2019; 2:e1914401. [PMID: 31675084 PMCID: PMC6827271 DOI: 10.1001/jamanetworkopen.2019.14401] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023] Open
Abstract
IMPORTANCE Schizophrenia is a highly heritable psychiatric disorder, and recent studies have suggested that exposure to nitrogen dioxide (NO2) during childhood is associated with an elevated risk of subsequently developing schizophrenia. However, it is not known whether the increased risk associated with NO2 exposure is owing to a greater genetic liability among those exposed to highest NO2 levels. OBJECTIVE To examine the associations between childhood NO2 exposure and genetic liability for schizophrenia (as measured by a polygenic risk score), and risk of developing schizophrenia. DESIGN, SETTING, AND PARTICIPANTS Population-based cohort study including individuals with schizophrenia (International Statistical Classification of Diseases and Related Health Problems, Tenth Revision code F20) and a randomly selected subcohort. Using national registry data, all individuals born in Denmark between May 1, 1981, and December 31, 2002, were followed up from their 10th birthday until the first occurrence of schizophrenia, emigration, death, or December 31, 2012, whichever came first. Statistical analyses were conducted between October 24, 2018, and June 17, 2019. EXPOSURES Individual exposure to NO2 during childhood estimated as mean daily exposure to NO2 at residential addresses from birth to the 10th birthday. Polygenic risk scores were calculated as the weighted sum of risk alleles at selected single-nucleotide polymorphisms based on genetic material obtained from dried blood spot samples from the Danish Newborn Screening Biobank and on the Psychiatric Genomics Consortium genome-wide association study summary statistics file. MAIN OUTCOMES AND MEASURES The main outcome was schizophrenia. Weighted Cox proportional hazards regression models were fitted to estimate adjusted hazard ratios (AHRs) for schizophrenia with 95% CIs according to the exposures. RESULTS Of a total of 23 355 individuals, 11 976 (51.3%) were male and all had Danish-born parents. During the period of the study, 3531 were diagnosed with schizophrenia. Higher polygenic risk scores were correlated with higher childhood NO2 exposure (ρ = 0.0782; 95% CI, 0.065-0.091; P < .001). A 10-μg/m3 increase in childhood daily NO2 exposure (AHR, 1.23; 95% CI, 1.15-1.32) and a 1-SD increase in polygenic risk score (AHR, 1.29; 95% CI, 1.23-1.35) were independently associated with increased schizophrenia risk. CONCLUSIONS AND RELEVANCE These findings suggest that the apparent association between NO2 exposure and schizophrenia is only slightly confounded by a higher polygenic risk score for schizophrenia among individuals living in areas with greater NO2. The findings demonstrate the utility of including polygenic risk scores in epidemiologic studies.
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Affiliation(s)
- Henriette Thisted Horsdal
- Department of Economics and Business Economics, National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Big Data Centre for Environment and Health (BERTHA), Aarhus University, Roskilde, Denmark
| | - Esben Agerbo
- Department of Economics and Business Economics, National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Centre for Integrated Register-based Research, CIRRAU, Aarhus University, Aarhus, Denmark
| | - John Joseph McGrath
- Department of Economics and Business Economics, National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
- Queensland Brain Institute, The University of Queensland, St Lucia, Queensland, Australia
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Queensland, Australia
| | - Bjarni Jóhann Vilhjálmsson
- Department of Economics and Business Economics, National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
| | - Sussie Antonsen
- Department of Economics and Business Economics, National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
- Centre for Integrated Register-based Research, CIRRAU, Aarhus University, Aarhus, Denmark
| | - Ane Marie Closter
- Department of Economics and Business Economics, National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
- Big Data Centre for Environment and Health (BERTHA), Aarhus University, Roskilde, Denmark
- Centre for Integrated Register-based Research, CIRRAU, Aarhus University, Aarhus, Denmark
| | - Allan Timmermann
- Department of Economics and Business Economics, National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
- Big Data Centre for Environment and Health (BERTHA), Aarhus University, Roskilde, Denmark
- Centre for Integrated Register-based Research, CIRRAU, Aarhus University, Aarhus, Denmark
| | - Jakob Grove
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Department of Biomedicine and Center for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark
- Center for Genomics and Personalized Medicine, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | - Pearl L. H. Mok
- Centre for Mental Health and Safety, Division of Psychology and Mental Health, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, United Kingdom
| | - Roger T. Webb
- Centre for Mental Health and Safety, Division of Psychology and Mental Health, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, United Kingdom
| | - Clive Eric Sabel
- Big Data Centre for Environment and Health (BERTHA), Aarhus University, Roskilde, Denmark
- Department of Environmental Science, Aarhus University, Aarhus, Denmark
| | - Ole Hertel
- Big Data Centre for Environment and Health (BERTHA), Aarhus University, Roskilde, Denmark
- Department of Environmental Science, Aarhus University, Aarhus, Denmark
| | - Torben Sigsgaard
- Big Data Centre for Environment and Health (BERTHA), Aarhus University, Roskilde, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Christian Erikstrup
- Big Data Centre for Environment and Health (BERTHA), Aarhus University, Roskilde, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - David Michael Hougaard
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | - Thomas Werge
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Institute of Biological Psychiatry, Copenhagen Mental Health Services, Copenhagen, Denmark
| | - Merete Nordentoft
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Mental Health Centre Copenhagen, Capital Region of Denmark, Copenhagen University Hospital, Copenhagen, Denmark
| | - Anders Dupont Børglum
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Department of Biomedicine and Center for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark
- Center for Genomics and Personalized Medicine, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | - Ole Mors
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Psychosis Research Unit, Aarhus University Hospital Psychiatry, Aarhus, Denmark
| | - Preben Bo Mortensen
- Department of Economics and Business Economics, National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Centre for Integrated Register-based Research, CIRRAU, Aarhus University, Aarhus, Denmark
| | - Jørgen Brandt
- Department of Environmental Science, Aarhus University, Aarhus, Denmark
| | - Camilla Geels
- Department of Environmental Science, Aarhus University, Aarhus, Denmark
| | - Carsten Bøcker Pedersen
- Department of Economics and Business Economics, National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Big Data Centre for Environment and Health (BERTHA), Aarhus University, Roskilde, Denmark
- Centre for Integrated Register-based Research, CIRRAU, Aarhus University, Aarhus, Denmark
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22
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Horsdal HT, Agerbo E, McGrath JJ, Vilhjálmsson BJ, Antonsen S, Closter AM, Timmermann A, Grove J, Mok PLH, Webb RT, Sabel CE, Hertel O, Sigsgaard T, Erikstrup C, Hougaard DM, Werge T, Nordentoft M, Børglum AD, Mors O, Mortensen PB, Brandt J, Geels C, Pedersen CB. Association of Childhood Exposure to Nitrogen Dioxide and Polygenic Risk Score for Schizophrenia With the Risk of Developing Schizophrenia. JAMA Netw Open 2019; 2:e1914401. [PMID: 31675084 DOI: 10.1001/jamanetworkopen.201914401] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 05/22/2023] Open
Abstract
IMPORTANCE Schizophrenia is a highly heritable psychiatric disorder, and recent studies have suggested that exposure to nitrogen dioxide (NO2) during childhood is associated with an elevated risk of subsequently developing schizophrenia. However, it is not known whether the increased risk associated with NO2 exposure is owing to a greater genetic liability among those exposed to highest NO2 levels. OBJECTIVE To examine the associations between childhood NO2 exposure and genetic liability for schizophrenia (as measured by a polygenic risk score), and risk of developing schizophrenia. DESIGN, SETTING, AND PARTICIPANTS Population-based cohort study including individuals with schizophrenia (International Statistical Classification of Diseases and Related Health Problems, Tenth Revision code F20) and a randomly selected subcohort. Using national registry data, all individuals born in Denmark between May 1, 1981, and December 31, 2002, were followed up from their 10th birthday until the first occurrence of schizophrenia, emigration, death, or December 31, 2012, whichever came first. Statistical analyses were conducted between October 24, 2018, and June 17, 2019. EXPOSURES Individual exposure to NO2 during childhood estimated as mean daily exposure to NO2 at residential addresses from birth to the 10th birthday. Polygenic risk scores were calculated as the weighted sum of risk alleles at selected single-nucleotide polymorphisms based on genetic material obtained from dried blood spot samples from the Danish Newborn Screening Biobank and on the Psychiatric Genomics Consortium genome-wide association study summary statistics file. MAIN OUTCOMES AND MEASURES The main outcome was schizophrenia. Weighted Cox proportional hazards regression models were fitted to estimate adjusted hazard ratios (AHRs) for schizophrenia with 95% CIs according to the exposures. RESULTS Of a total of 23 355 individuals, 11 976 (51.3%) were male and all had Danish-born parents. During the period of the study, 3531 were diagnosed with schizophrenia. Higher polygenic risk scores were correlated with higher childhood NO2 exposure (ρ = 0.0782; 95% CI, 0.065-0.091; P < .001). A 10-μg/m3 increase in childhood daily NO2 exposure (AHR, 1.23; 95% CI, 1.15-1.32) and a 1-SD increase in polygenic risk score (AHR, 1.29; 95% CI, 1.23-1.35) were independently associated with increased schizophrenia risk. CONCLUSIONS AND RELEVANCE These findings suggest that the apparent association between NO2 exposure and schizophrenia is only slightly confounded by a higher polygenic risk score for schizophrenia among individuals living in areas with greater NO2. The findings demonstrate the utility of including polygenic risk scores in epidemiologic studies.
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Affiliation(s)
- Henriette Thisted Horsdal
- Department of Economics and Business Economics, National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Big Data Centre for Environment and Health (BERTHA), Aarhus University, Roskilde, Denmark
| | - Esben Agerbo
- Department of Economics and Business Economics, National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Centre for Integrated Register-based Research, CIRRAU, Aarhus University, Aarhus, Denmark
| | - John Joseph McGrath
- Department of Economics and Business Economics, National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
- Queensland Brain Institute, The University of Queensland, St Lucia, Queensland, Australia
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Queensland, Australia
| | - Bjarni Jóhann Vilhjálmsson
- Department of Economics and Business Economics, National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
| | - Sussie Antonsen
- Department of Economics and Business Economics, National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
- Centre for Integrated Register-based Research, CIRRAU, Aarhus University, Aarhus, Denmark
| | - Ane Marie Closter
- Department of Economics and Business Economics, National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
- Big Data Centre for Environment and Health (BERTHA), Aarhus University, Roskilde, Denmark
- Centre for Integrated Register-based Research, CIRRAU, Aarhus University, Aarhus, Denmark
| | - Allan Timmermann
- Department of Economics and Business Economics, National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
- Big Data Centre for Environment and Health (BERTHA), Aarhus University, Roskilde, Denmark
- Centre for Integrated Register-based Research, CIRRAU, Aarhus University, Aarhus, Denmark
| | - Jakob Grove
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Department of Biomedicine and Center for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark
- Center for Genomics and Personalized Medicine, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | - Pearl L H Mok
- Centre for Mental Health and Safety, Division of Psychology and Mental Health, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, United Kingdom
| | - Roger T Webb
- Centre for Mental Health and Safety, Division of Psychology and Mental Health, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, United Kingdom
| | - Clive Eric Sabel
- Big Data Centre for Environment and Health (BERTHA), Aarhus University, Roskilde, Denmark
- Department of Environmental Science, Aarhus University, Aarhus, Denmark
| | - Ole Hertel
- Big Data Centre for Environment and Health (BERTHA), Aarhus University, Roskilde, Denmark
- Department of Environmental Science, Aarhus University, Aarhus, Denmark
| | - Torben Sigsgaard
- Big Data Centre for Environment and Health (BERTHA), Aarhus University, Roskilde, Denmark
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Christian Erikstrup
- Big Data Centre for Environment and Health (BERTHA), Aarhus University, Roskilde, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - David Michael Hougaard
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | - Thomas Werge
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Institute of Biological Psychiatry, Copenhagen Mental Health Services, Copenhagen, Denmark
| | - Merete Nordentoft
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Mental Health Centre Copenhagen, Capital Region of Denmark, Copenhagen University Hospital, Copenhagen, Denmark
| | - Anders Dupont Børglum
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Department of Biomedicine and Center for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark
- Center for Genomics and Personalized Medicine, Aarhus University and Aarhus University Hospital, Aarhus, Denmark
| | - Ole Mors
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Psychosis Research Unit, Aarhus University Hospital Psychiatry, Aarhus, Denmark
| | - Preben Bo Mortensen
- Department of Economics and Business Economics, National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Centre for Integrated Register-based Research, CIRRAU, Aarhus University, Aarhus, Denmark
| | - Jørgen Brandt
- Department of Environmental Science, Aarhus University, Aarhus, Denmark
| | - Camilla Geels
- Department of Environmental Science, Aarhus University, Aarhus, Denmark
| | - Carsten Bøcker Pedersen
- Department of Economics and Business Economics, National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Big Data Centre for Environment and Health (BERTHA), Aarhus University, Roskilde, Denmark
- Centre for Integrated Register-based Research, CIRRAU, Aarhus University, Aarhus, Denmark
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23
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Brannan C, Foulkes AL, Lázaro-Muñoz G. Preventing discrimination based on psychiatric risk biomarkers. Am J Med Genet B Neuropsychiatr Genet 2019; 180:159-171. [PMID: 29633550 PMCID: PMC6173986 DOI: 10.1002/ajmg.b.32629] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Revised: 02/17/2018] [Accepted: 03/01/2018] [Indexed: 01/09/2023]
Abstract
Recent studies have identified genomic and nongenomic psychiatric risk biomarkers (PRBs; e.g., genomic variants, blood analytes, gray matter volume). PRBs may soon become a powerful tool for improving psychiatric care and prevention. PRB research and its translation to clinical care, however, may prove to be a double-edged sword. Mental health stigma and discrimination are already widespread, and data caution that biological explanations of psychiatric disorders can exacerbate these stigmatizing attitudes, increasing the desire for social distance and heightening the perceived dangerousness of the patient. As a reaction to the Human Genome Project and historical concerns about eugenics, the international community mobilized to establish legislation to prevent genomic discrimination. But in most countries, these laws are limited to few contexts (e.g., employment, health insurance), and very few countries protect against discrimination based on nongenomic risk biomarkers. Like genomic PRBs, nongenomic PRBs provide information regarding risk for stigmatized psychiatric disorders and have similar-and in some cases greater-predictive value. Numerous large-scale neuroscience and neurogenomics projects are advancing the identification and translation of PRBs. The prospect of PRB-based stigma however, threatens to undermine the potential benefits of this research. Unbridaled by nonexistent or limited PRB anti-discrimination protections, the threat of PRB-based stigma and discrimination may lead many to forego PRB testing, even if shown to have clinical utility. To maximize the clinical and social benefits of PRB-based technologies, educational campaigns should address mental health and PRB stigma, and lawmakers should carefully consider expanding legislation that prohibits PRB-based discrimination.
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Affiliation(s)
- Cody Brannan
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, USA
- Department of Biosciences, Rice University, Houston, TX, USA
| | - Alexandra L. Foulkes
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, USA
- University of Houston Law Center, Houston, TX, USA
| | - Gabriel Lázaro-Muñoz
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, USA
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24
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Szatkiewicz J, Crowley JJ, Adolfsson AN, Åberg KA, Alaerts M, Genovese G, McCarroll S, Del-Favero J, Adolfsson R, Sullivan PF. The genomics of major psychiatric disorders in a large pedigree from Northern Sweden. Transl Psychiatry 2019; 9:60. [PMID: 30718465 PMCID: PMC6362018 DOI: 10.1038/s41398-019-0414-9] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/12/2018] [Revised: 01/15/2019] [Accepted: 01/17/2019] [Indexed: 11/08/2022] Open
Abstract
We searched for genetic causes of major psychiatric disorders (bipolar disorder, schizoaffective disorder, and schizophrenia) in a large, densely affected pedigree from Northern Sweden that originated with three pairs of founders born around 1650. We applied a systematic genomic approach to the pedigree via karyotyping (N = 9), genome-wide SNP arrays (N = 418), whole-exome sequencing (N = 26), and whole-genome sequencing (N = 10). Comprehensive analysis did not identify plausible variants of strong effect. Rather, pedigree cases had significantly higher genetic risk scores compared to pedigree and community controls.
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Affiliation(s)
- Jin Szatkiewicz
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - James J Crowley
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Karolina A Åberg
- Center for Biomarker Research and Precision Medicine, Virginia Commonwealth University, Richmond, VA, USA
| | - Maaike Alaerts
- Center of Medical Genetics, University of Antwerp and Antwerp University Hospital, Antwerp, Belgium
| | | | | | - Jurgen Del-Favero
- VIB Center for Molecular Neurology, Universiteitsplein 1, Antwerp, Belgium and Multiplicom N.V., Galileilaan 18, Niel, Belgium
| | - Rolf Adolfsson
- Department of Clinical Sciences and Psychiatry, University of Umeå, Umeå, Sweden.
| | - Patrick F Sullivan
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA.
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.
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25
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Fan CC, McGrath JJ, Appadurai V, Buil A, Gandal MJ, Schork AJ, Mortensen PB, Agerbo E, Geschwind SA, Geschwind D, Werge T, Thompson WK, Pedersen CB. Spatial fine-mapping for gene-by-environment effects identifies risk hot spots for schizophrenia. Nat Commun 2018; 9:5296. [PMID: 30546018 PMCID: PMC6294340 DOI: 10.1038/s41467-018-07708-7] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2018] [Accepted: 11/16/2018] [Indexed: 12/12/2022] Open
Abstract
Spatial mapping is a promising strategy to investigate the mechanisms underlying the incidence of psychosis. We analyzed a case-cohort study (n = 24,028), drawn from the 1.47 million Danish persons born between 1981 and 2005, using a novel framework for decomposing the geospatial risk for schizophrenia based on locale of upbringing and polygenic scores. Upbringing in a high environmental risk locale increases the risk for schizophrenia by 122%. Individuals living in a high gene-by-environmental risk locale have a 78% increased risk compared to those who have the same genetic liability but live in a low-risk locale. Effects of specific locales vary substantially within the most densely populated city of Denmark, with hazard ratios ranging from 0.26 to 9.26 for environment and from 0.20 to 5.95 for gene-by-environment. These findings indicate the critical synergism of gene and environment on the etiology of schizophrenia and demonstrate the potential of incorporating geolocation in genetic studies.
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Affiliation(s)
- Chun Chieh Fan
- Center for Human Development, University of California, San Diego, CA, 92093, USA
- Mental Health Center Sct. Hans, Capital Region of Denmark, Roskilde, 4000, Denmark
| | - John J McGrath
- National Centre for Register-based Research, Aarhus University, Aarhus, 8210, Denmark
- Queensland Brain Institute, University of Queensland, St. Lucia, QLD, 4072, Australia
- Queensland Centre for Mental Health Research, Wacol, QLD, 4076, Australia
| | - Vivek Appadurai
- Mental Health Center Sct. Hans, Capital Region of Denmark, Roskilde, 4000, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus and Copenhagen, Denmark
| | - Alfonso Buil
- Mental Health Center Sct. Hans, Capital Region of Denmark, Roskilde, 4000, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus and Copenhagen, Denmark
| | - Michael J Gandal
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, 90095, USA
| | - Andrew J Schork
- Mental Health Center Sct. Hans, Capital Region of Denmark, Roskilde, 4000, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus and Copenhagen, Denmark
| | - Preben Bo Mortensen
- National Centre for Register-based Research, Aarhus University, Aarhus, 8210, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus and Copenhagen, Denmark
- Centre for Integrated Register-based Research, CIRRAU, Aarhus University, Aarhus, 8210, Denmark
| | - Esben Agerbo
- National Centre for Register-based Research, Aarhus University, Aarhus, 8210, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus and Copenhagen, Denmark
- Centre for Integrated Register-based Research, CIRRAU, Aarhus University, Aarhus, 8210, Denmark
| | | | - Daniel Geschwind
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, CA, 90095, USA
- Department of Neurology, University of California, Los Angeles, CA, 90095, USA
| | - Thomas Werge
- Mental Health Center Sct. Hans, Capital Region of Denmark, Roskilde, 4000, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus and Copenhagen, Denmark
- Department of Clinical Sciences, University of Copenhagen, Copenhagen, 2200, Denmark
- Institute of Biological Psychiatry, Mental Health Services of Copenhagen, Copenhagen, 4000, Denmark
| | - Wesley K Thompson
- Mental Health Center Sct. Hans, Capital Region of Denmark, Roskilde, 4000, Denmark.
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus and Copenhagen, Denmark.
- Family Medicine and Public Health Division of Biostatistics, University of California, San Diego, CA, 92093, USA.
| | - Carsten Bøcker Pedersen
- National Centre for Register-based Research, Aarhus University, Aarhus, 8210, Denmark.
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus and Copenhagen, Denmark.
- Centre for Integrated Register-based Research, CIRRAU, Aarhus University, Aarhus, 8210, Denmark.
- Big data Centre for Environment and Health, Aarhus University, Aarhus, 8210, Denmark.
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26
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Seeman MV. Women who suffer from schizophrenia: Critical issues. World J Psychiatry 2018; 8:125-136. [PMID: 30425943 PMCID: PMC6230925 DOI: 10.5498/wjp.v8.i5.125] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/18/2018] [Revised: 08/24/2018] [Accepted: 10/11/2018] [Indexed: 02/05/2023] Open
Abstract
Many brain diseases, including schizophrenia, affect men and women unequally - either more or less frequently, or at different times in the life cycle, or to varied degrees of severity. With updates from recent findings, this paper reviews the work of my research group over the last 40 years and underscores issues that remain critical to the optimal care of women with schizophrenia, issues that overlap with, but are not identical to, the cares and concerns of men with the same diagnosis. Clinicians need to be alert not only to the overarching needs of diagnostic groups, but also to the often unique needs of women and men.
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Affiliation(s)
- Mary V Seeman
- Department of Psychiatry, University of Toronto, Institute of Medical Science, Toronto, ON M5P 3L6, Canada
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27
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Lázaro-Muñoz G, Farrell MS, Crowley JJ, Filmyer DM, Shaughnessy RA, Josiassen RC, Sullivan PF. Improved ethical guidance for the return of results from psychiatric genomics research. Mol Psychiatry 2018; 23:15-23. [PMID: 29158581 PMCID: PMC5752587 DOI: 10.1038/mp.2017.228] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2017] [Revised: 09/27/2017] [Accepted: 10/02/2017] [Indexed: 12/21/2022]
Abstract
There is an emerging consensus that genomic researchers should, at a minimum, offer to return to individual participants clinically valid, medically important and medically actionable genomic findings (for example, pathogenic variants in BRCA1) identified in the course of research. However, this is not a common practice in psychiatric genetics research. Furthermore, psychiatry researchers often generate findings that do not meet all of these criteria, yet there may be ethically compelling arguments to offer selected results. Here, we review the return of results debate in genomics research and propose that, as for genomic studies of other medical conditions, psychiatric genomics researchers should offer findings that meet the minimum criteria stated above. Additionally, if resources allow, psychiatry researchers could consider offering to return pre-specified 'clinically valuable' findings even if not medically actionable-for instance, findings that help corroborate a psychiatric diagnosis, and findings that indicate important health risks. Similarly, we propose offering 'likely clinically valuable' findings, specifically, variants of uncertain significance potentially related to a participant's symptoms. The goal of this Perspective is to initiate a discussion that can help identify optimal ways of managing the return of results from psychiatric genomics research.
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Affiliation(s)
- G Lázaro-Muñoz
- Center for Medical Ethics and Health Policy, Baylor College of Medicine, Houston, TX, USA
| | - M S Farrell
- Department of Genetics, University of North Carolina, Chapel Hill, NC, USA
| | - J J Crowley
- Department of Genetics, University of North Carolina, Chapel Hill, NC, USA
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweeden
| | - D M Filmyer
- Translational Neuroscience LLC, Conshohocken, PA, USA
| | - R A Shaughnessy
- Translational Neuroscience LLC, Conshohocken, PA, USA
- Department of Psychiatry, Drexel University College of Medicine, Philadelphia, PA, USA
| | - R C Josiassen
- Translational Neuroscience LLC, Conshohocken, PA, USA
| | - P F Sullivan
- Department of Genetics, University of North Carolina, Chapel Hill, NC, USA
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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