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Chakrabarti S, Singh N. Psychotic symptoms in bipolar disorder and their impact on the illness: A systematic review. World J Psychiatry 2022; 12:1204-1232. [PMID: 36186500 PMCID: PMC9521535 DOI: 10.5498/wjp.v12.i9.1204] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2022] [Revised: 05/02/2022] [Accepted: 08/26/2022] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Lifetime psychotic symptoms are present in over half of the patients with bipolar disorder (BD) and can have an adverse effect on its course, outcome, and treatment. However, despite a considerable amount of research, the impact of psychotic symptoms on BD remains unclear, and there are very few systematic reviews on the subject.
AIM To examine the extent of psychotic symptoms in BD and their impact on several aspects of the illness.
METHODS The Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines were followed. An electronic literature search of six English-language databases and a manual search was undertaken to identify published articles on psychotic symptoms in BD from January 1940 to December 2021. Combinations of the relevant Medical Subject Headings terms were used to search for these studies. Articles were selected after a screening phase, followed by a review of the full texts of the articles. Assessment of the methodological quality of the studies and the risk of bias was conducted using standard tools.
RESULTS This systematic review included 339 studies of patients with BD. Lifetime psychosis was found in more than a half to two-thirds of the patients, while current psychosis was found in a little less than half of them. Delusions were more common than hallucinations in all phases of BD. About a third of the patients reported first-rank symptoms or mood-incongruent psychotic symptoms, particularly during manic episodes. Psychotic symptoms were more frequent in bipolar type I compared to bipolar type II disorder and in mania or mixed episodes compared to bipolar depression. Although psychotic symptoms were not more severe in BD, the severity of the illness in psychotic BD was consistently greater. Psychosis was usually associated with poor insight and a higher frequency of agitation, anxiety, and hostility but not with psychiatric comorbidity. Psychosis was consistently linked with increased rates and the duration of hospitalizations, switching among patients with depression, and poorer outcomes with mood-incongruent symptoms. In contrast, psychosis was less likely to be accompanied by a rapid-cycling course, longer illness duration, and heightened suicidal risk. There was no significant impact of psychosis on the other parameters of course and outcome.
CONCLUSION Though psychotic symptoms are very common in BD, they are not always associated with an adverse impact on BD and its course and outcome.
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Affiliation(s)
- Subho Chakrabarti
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, UT, India
| | - Navdeep Singh
- Department of Psychiatry, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, UT, India
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2
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van Dellen E, Börner C, Schutte M, van Montfort S, Abramovic L, Boks MP, Cahn W, van Haren N, Mandl R, Stam CJ, Sommer I. Functional brain networks in the schizophrenia spectrum and bipolar disorder with psychosis. NPJ SCHIZOPHRENIA 2020; 6:22. [PMID: 32879316 PMCID: PMC7468123 DOI: 10.1038/s41537-020-00111-6] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Accepted: 06/23/2020] [Indexed: 12/22/2022]
Abstract
Psychotic experiences have been proposed to lie on a spectrum, ranging from subclinical experiences to treatment-resistant schizophrenia. We aimed to characterize functional connectivity and brain network characteristics in relation to the schizophrenia spectrum and bipolar disorder with psychosis to disentangle neural correlates to psychosis. Additionally, we studied antipsychotic medication and lithium effects on network characteristics. We analyzed functional connectivity strength and network topology in 487 resting-state functional MRI scans of individuals with schizophrenia spectrum disorder (SCZ), bipolar disorder with a history of psychotic experiences (BD), treatment-naïve subclinical psychosis (SCP), and healthy controls (HC). Since differences in connectivity strength may confound group comparisons of brain network topology, we analyzed characteristics of the minimum spanning tree (MST), a relatively unbiased backbone of the network. SCZ and SCP subjects had a lower connectivity strength than BD and HC individuals but showed no differences in network topology. In contrast, BD patients showed a less integrated network topology but no disturbances in connectivity strength. No differences in outcome measures were found between SCP and SCZ, or between BD patients that used antipsychotic medication or lithium and those that did not. We conclude that functional networks in patients prone to psychosis have different signatures for chronic SCZ patients and SCP compared to euthymic BD patients, with a limited role for medication. Connectivity strength effects may have confounded previous studies, as no functional network alterations were found in SCZ after strict correction for connectivity strength.
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Affiliation(s)
- Edwin van Dellen
- Department of Psychiatry, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands.
- Department of Intensive Care Medicine and UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
| | - Corinna Börner
- Department of Psychiatry, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Maya Schutte
- University of Groningen, Department of Neuroscience, University Medical Center Groningen, Groningen, The Netherlands
| | - Simone van Montfort
- Department of Intensive Care Medicine and UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
| | - Lucija Abramovic
- Department of Psychiatry, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Marco P Boks
- Department of Psychiatry, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Wiepke Cahn
- Department of Psychiatry, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Neeltje van Haren
- Department of Psychiatry, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center, Sophia Children's Hospital, Rotterdam, The Netherlands
| | - René Mandl
- Department of Psychiatry, Brain Center, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Cornelis J Stam
- Department of Clinical Neurophysiology and MEG Center, Amsterdam University Medical Center, Amsterdam, The Netherlands
| | - Iris Sommer
- University of Groningen, Department of Neuroscience, University Medical Center Groningen, Groningen, The Netherlands
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
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3
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Greenwood TA, Lazzeroni LC, Maihofer AX, Swerdlow NR, Calkins ME, Freedman R, Green MF, Light GA, Nievergelt CM, Nuechterlein KH, Radant AD, Siever LJ, Silverman JM, Stone WS, Sugar CA, Tsuang DW, Tsuang MT, Turetsky BI, Gur RC, Gur RE, Braff DL. Genome-wide Association of Endophenotypes for Schizophrenia From the Consortium on the Genetics of Schizophrenia (COGS) Study. JAMA Psychiatry 2019; 76:1274-1284. [PMID: 31596458 PMCID: PMC6802253 DOI: 10.1001/jamapsychiatry.2019.2850] [Citation(s) in RCA: 64] [Impact Index Per Article: 12.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
IMPORTANCE The Consortium on the Genetics of Schizophrenia (COGS) uses quantitative neurophysiological and neurocognitive endophenotypes with demonstrated deficits in schizophrenia as a platform from which to explore the underlying neural circuitry and genetic architecture. Many of these endophenotypes are associated with poor functional outcome in schizophrenia. Some are also endorsed as potential treatment targets by the US Food and Drug Administration. OBJECTIVE To build on prior assessments of heritability, association, and linkage in the COGS phase 1 (COGS-1) families by reporting a genome-wide association study (GWAS) of 11 schizophrenia-related endophenotypes in the independent phase 2 (COGS-2) cohort of patients with schizophrenia and healthy comparison participants (HCPs). DESIGN, SETTING, AND PARTICIPANTS A total of 1789 patients with schizophrenia and HCPs of self-reported European or Latino ancestry were recruited through a collaborative effort across the COGS sites and genotyped using the PsychChip. Standard quality control filters were applied, and more than 6.2 million variants with a genotyping call rate of greater than 0.99 were available after imputation. Association was performed for data sets stratified by diagnosis and ancestry using linear regression and adjusting for age, sex, and 5 principal components, with results combined through weighted meta-analysis. Data for COGS-1 were collected from January 6, 2003, to August 6, 2008; data for COGS-2, from June 30, 2010, to February 14, 2014. Data were analyzed from October 28, 2016, to May 4, 2018. MAIN OUTCOMES AND MEASURES A genome-wide association study was performed to evaluate association for 11 neurophysiological and neurocognitive endophenotypes targeting key domains of schizophrenia related to inhibition, attention, vigilance, learning, working memory, executive function, episodic memory, and social cognition. RESULTS The final sample of 1533 participants included 861 male participants (56.2%), and the mean (SD) age was 41.8 (13.6) years. In total, 7 genome-wide significant regions (P < 5 × 10-8) and 2 nearly significant regions (P < 9 × 10-8) containing several genes of interest, including NRG3 and HCN1, were identified for 7 endophenotypes. For each of the 11 endophenotypes, enrichment analyses performed at the level of P < 10-4 compared favorably with previous association results in the COGS-1 families and showed extensive overlap with regions identified for schizophrenia diagnosis. CONCLUSIONS AND RELEVANCE These analyses identified several genomic regions of interest that require further exploration and validation. These data seem to demonstrate the utility of endophenotypes for resolving the genetic architecture of schizophrenia and characterizing the underlying biological dysfunctions. Understanding the molecular basis of these endophenotypes may help to identify novel treatment targets and pave the way for precision-based medicine in schizophrenia and related psychotic disorders.
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Affiliation(s)
| | - Laura C. Lazzeroni
- Department of Psychiatry and Behavioral Sciences, Stanford University, Stanford, California,Sierra Pacific Mental Illness Research Education and Clinical Center, Department of Veterans Affairs (VA) Health Care System, Palo Alto, California
| | - Adam X. Maihofer
- Department of Psychiatry, University of California, San Diego, La Jolla
| | - Neal R. Swerdlow
- Department of Psychiatry, University of California, San Diego, La Jolla
| | | | - Robert Freedman
- Department of Psychiatry, University of Colorado Health Sciences Center, Denver
| | - Michael F. Green
- Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles, California,Desert Pacific Mental Illness Research Education and Clinical Center, VA Greater Los Angeles Healthcare System, Los Angeles, California
| | - Gregory A. Light
- Department of Psychiatry, University of California, San Diego, La Jolla,Desert Pacific Mental Illness Research Education and Clinical Center, VA San Diego Healthcare System, San Diego, California
| | | | | | - Allen D. Radant
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle,Northwest Geriatric Research Education and Clinical Center, VA Puget Sound Health Care System, Seattle, Washington
| | - Larry J. Siever
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York,Research & Development, James J. Peters VA Medical Center, New York, New York
| | - Jeremy M. Silverman
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York,Research & Development, James J. Peters VA Medical Center, New York, New York
| | - William S. Stone
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts,Massachusetts Mental Health Center Public Psychiatry Division of the Beth Israel Deaconess Medical Center, Boston
| | - Catherine A. Sugar
- Department of Psychiatry and Biobehavioral Sciences, UCLA, Los Angeles, California,Department of Biostatistics, UCLA School of Public Health
| | - Debby W. Tsuang
- Department of Psychiatry and Behavioral Sciences, University of Washington, Seattle,Northwest Geriatric Research Education and Clinical Center, VA Puget Sound Health Care System, Seattle, Washington
| | - Ming T. Tsuang
- Department of Psychiatry, University of California, San Diego, La Jolla
| | | | - Ruben C. Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia
| | - Raquel E. Gur
- Department of Psychiatry, University of Pennsylvania, Philadelphia
| | - David L. Braff
- Department of Psychiatry, University of California, San Diego, La Jolla
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Corponi F, Bonassi S, Vieta E, Albani D, Frustaci A, Ducci G, Landi S, Boccia S, Serretti A, Fabbri C. Genetic basis of psychopathological dimensions shared between schizophrenia and bipolar disorder. Prog Neuropsychopharmacol Biol Psychiatry 2019; 89:23-29. [PMID: 30149091 DOI: 10.1016/j.pnpbp.2018.08.023] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2018] [Revised: 08/22/2018] [Accepted: 08/23/2018] [Indexed: 12/25/2022]
Abstract
Shared genetic vulnerability between schizophrenia (SCZ) and bipolar disorder (BP) was demonstrated, but the genetic underpinnings of specific symptom domains are unclear. This study investigated which genes and gene sets may modulate specific psychopathological domains and if genome-wide significant loci previously associated with SCZ or BP may play a role. Genome-wide data were available in patients with SCZ (n = 226) or BP (n = 228). Phenotypes under investigation were depressive and positive symptoms severity, suicidal ideation, onset age and substance use disorder comorbidity. Genome-wide analyses were performed at gene and gene set level, while 148 genome-wide significant loci previously associated with SCZ and/or BP were investigated. Each sample was analyzed separately then a meta-analysis was performed. SH3GL2 and CLVS1 genes were associated with suicidal ideation in SCZ (p = 5.62e-08 and 0.01, respectively), the former also in the meta-analysis (p = .01). SHC4 gene was associated with depressive symptoms severity in BP (p = .003). A gene set involved in cellular differentiation (GO:0048661) was associated with substance disorder comorbidity in the meta-analysis (p = .03). Individual loci previously associated with SCZ or BP did not modulate the phenotypes of interest. This study provided confirmatory and new findings. SH3GL2 (endophilin A1) showed a role in suicidal ideation that may be due to its relevance to the glutamate system. SHC4 regulates BDNF-induced MAPK activation and was previously associated with depression. CLVS1 is involved in lysosome maturation and was for the first time associated with a psychiatric trait. GO:0048661 may mediate the risk of substance disorder through an effect on neurodevelopment/neuroplasticity.
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Affiliation(s)
- Filippo Corponi
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Italy
| | - Stefano Bonassi
- Unit of Clinical and Molecular Epidemiology, IRCCS San Raffaele Pisana, Rome, Italy; Department of Human Sciences and Quality of Life Promotion, San Raffaele University, Rome, Italy
| | - Eduard Vieta
- Bipolar Disorders Unit, Institute of Neuroscience, Hospital Clínic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Diego Albani
- Laboratory of Biology of Neurodegenerative Disorders, Neuroscience Department, IRCCS Istituto di Ricerche Farmacologiche "Mario Negri", Milan, Italy
| | - Alessandra Frustaci
- Barnet, Enfield and Haringey Mental Health NHS Trust, St.Ann's Hospital, St.Ann's Road, N15 3 TH London, UK
| | | | - Stefano Landi
- Dipartimento di Biologia, Universita' di Pisa, Pisa, Italy
| | - Stefania Boccia
- Section of Hygiene, Institute of Public Health, Universita' Cattolica del Sacro Cuore, Fondazione Policlinico "Agostino Gemelli" IRCCS, Rome, Italy
| | - Alessandro Serretti
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Italy.
| | - Chiara Fabbri
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Italy
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5
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Godwin D, Alpert KI, Wang L, Mamah D. Regional cortical thinning in young adults with schizophrenia but not psychotic or non-psychotic bipolar I disorder. Int J Bipolar Disord 2018; 6:16. [PMID: 29992455 PMCID: PMC6161965 DOI: 10.1186/s40345-018-0124-x] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2017] [Accepted: 06/06/2018] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Schizophrenia shares some genetic risk and clinical symptoms with bipolar disorder. Clinical heterogeneity across subjects is thought to contribute to variable structural imaging findings across studies. The current study investigates cortical thickness in young adults diagnosed with schizophrenia or bipolar I disorder with a history of hyperthymic mania. We hypothesize that cortical thickness will be most similar between SCZ and the psychotic bipolar 1 disorder subtype. METHODS Patients with schizophrenia (n = 52), psychotic bipolar I disorder (PBD; n = 49) and non-psychotic bipolar I disorder (NPBD; n = 24) and healthy controls (n = 40) were scanned in a 3T Trio MRI. The thickness of 34 cortical regions was estimated with FreeSurfer, and analyzed using univariate analyses of variance. Relationships to psychotic (SAPS) and negative (SANS) symptoms were investigated using linear regression. RESULTS Cortical thickness showed significant group effects, after covarying for sex, age, and intracranial volume (p = 0.001). SCZ subjects had thinner paracentral, inferior parietal, supramarginal and fusiform cortices compared to CON. Caudal anterior cingulate cortical thickness was increased in SCZ, PBD and NPBD. Cortical thickness in PBD and NPBD were not significantly different from controls. Significant partial correlations were observed for SAPS severity with middle temporal (r = - 0.26; p = 0.001) and fusiform (- 0.26; p = 0.001) cortical thickness. CONCLUSIONS Individuals with SCZ displayed significantly reduced cortical thickness in several cortical regions compared to both CON and bipolar. We found that SCZ participants had significant cortical thinning relative to CON and bipolar disorder most significantly in the frontal (i.e. paracentral), parietal (i.e. inferior parietal, supramarginal), and temporal (i.e. middle temporal, fusiform) cortices.
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Affiliation(s)
- Douglass Godwin
- Department of Psychiatry, Washington University Medical School, St. Louis, USA
| | - Kathryn I. Alpert
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Lei Wang
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Daniel Mamah
- Department of Psychiatry, Washington University Medical School, St. Louis, USA
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6
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Lencer R, Mills LJ, Alliey-Rodriguez N, Shafee R, Lee AM, Reilly JL, Sprenger A, McDowell JE, McCarroll SA, Keshavan MS, Pearlson GD, Tamminga CA, Clementz BA, Gershon ES, Sweeney JA, Bishop JR. Genome-wide association studies of smooth pursuit and antisaccade eye movements in psychotic disorders: findings from the B-SNIP study. Transl Psychiatry 2017; 7:e1249. [PMID: 29064472 PMCID: PMC5682604 DOI: 10.1038/tp.2017.210] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2017] [Accepted: 07/14/2017] [Indexed: 02/07/2023] Open
Abstract
Eye movement deviations, particularly deficits of initial sensorimotor processing and sustained pursuit maintenance, and antisaccade inhibition errors, are established intermediate phenotypes for psychotic disorders. We here studied eye movement measures of 849 participants from the Bipolar-Schizophrenia Network on Intermediate Phenotypes (B-SNIP) study (schizophrenia N=230, schizoaffective disorder N=155, psychotic bipolar disorder N=206 and healthy controls N=258) as quantitative phenotypes in relation to genetic data, while controlling for genetically derived ancestry measures, age and sex. A mixed-modeling genome-wide association studies approach was used including ~4.4 million genotypes (PsychChip and 1000 Genomes imputation). Across participants, sensorimotor processing at pursuit initiation was significantly associated with a single nucleotide polymorphism in IPO8 (12p11.21, P=8 × 10-11), whereas suggestive associations with sustained pursuit maintenance were identified with SNPs in SH3GL2 (9p22.2, P=3 × 10-8). In participants of predominantly African ancestry, sensorimotor processing was also significantly associated with SNPs in PCDH12 (5q31.3, P=1.6 × 10-10), and suggestive associations were observed with NRSN1 (6p22.3, P=5.4 × 10-8) and LMO7 (13q22.2, P=7.3x10-8), whereas antisaccade error rate was significantly associated with a non-coding region at chromosome 7 (P=6.5 × 10-9). Exploratory pathway analyses revealed associations with nervous system development and function for 40 top genes with sensorimotor processing and pursuit maintenance (P=4.9 × 10-2-9.8 × 10-4). Our findings suggest novel patterns of genetic variation relevant for brain systems subserving eye movement control known to be impaired in psychotic disorders. They include genes involved in nuclear trafficking and gene silencing (IPO8), fast axonal guidance and synaptic specificity (PCDH12), transduction of nerve signals (NRSN1), retinal degeneration (LMO7), synaptic glutamate release (SH3GL2), and broader nervous system development and function.
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Affiliation(s)
- R Lencer
- Department of Psychiatry and Psychotherapy, Otto Creutzfeldt Center for Cognitive and Behavioral Neuroscience, University of Muenster, Muenster, Germany
| | - L J Mills
- Minnesota Supercomputing Institute, University of Minnesota, Minneapolis, MN, USA
| | - N Alliey-Rodriguez
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - R Shafee
- Department of Genetics, Harvard Medical School, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - A M Lee
- Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, Minneapolis, MN, USA
| | - J L Reilly
- Department of Psychiatry and Behavioral Sciences, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - A Sprenger
- Department of Neurology, University of Luebeck, Luebeck, Germany
| | - J E McDowell
- Department of Psychology and Neuroscience, BioImaging Research Center, University of Georgia, Athens, GA, USA
| | - S A McCarroll
- Department of Genetics, Harvard Medical School, Boston, MA, USA
| | - M S Keshavan
- Department of Psychiatry, Harvard Medical School, Beth Israel Deacones Medical Center, Boston, MA, USA
| | - G D Pearlson
- Departments of Psychiatry and Neurobiology, Yale University School of Medicine, New Haven, CT, USA
- Institute of Living, Hartford Hospital, Hartford, CT, USA
| | - C A Tamminga
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - B A Clementz
- Department of Psychology and Neuroscience, BioImaging Research Center, University of Georgia, Athens, GA, USA
| | - E S Gershon
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - J A Sweeney
- Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Psychiatry and Behavioral Neuroscience, University of Cincinnati, Cincinnati, OH, USA
| | - J R Bishop
- Department of Experimental and Clinical Pharmacology, College of Pharmacy, University of Minnesota, Minneapolis, MN, USA
- Department of Psychiatry, University of Minnesota College of Medicine, Minneapolis, MN, USA
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7
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Sugranyes G, de la Serna E, Borras R, Sanchez-Gistau V, Pariente JC, Romero S, Baeza I, Díaz-Caneja CM, Rodriguez-Toscano E, Moreno C, Bernardo M, Moreno D, Vieta E, Castro-Fornieles J. Clinical, Cognitive, and Neuroimaging Evidence of a Neurodevelopmental Continuum in Offspring of Probands With Schizophrenia and Bipolar Disorder. Schizophr Bull 2017; 43:1208-1219. [PMID: 28180904 PMCID: PMC5737486 DOI: 10.1093/schbul/sbx002] [Citation(s) in RCA: 35] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Studies in child and adolescent offspring of patients with schizophrenia or bipolar disorders may help understand the influence of neurodevelopmental factors on the premorbid phenotype of these disorders. AIMS To assess whether a combination of neurodevelopmental factors discriminates between young offspring of patients with schizophrenia (SzO) or bipolar disorder (BpO) and community controls (CcO). To assess the association between these factors and rates of psychiatric diagnoses in high risk (HR) youth. METHODS One hundred thirty-three HR offspring (47 SzO and 86 BpO) and 84 CcO, aged 6-17, underwent cross-sectional clinical, neurocognitive, and structural neuroimaging assessment. Information on perinatal events and early childhood development was also obtained. General linear mixed models were performed to assess group discrimination and association with lifetime axis I psychiatric disorders. RESULTS Multivariate analyses revealed that greater neurological soft signs (NSS), less total grey matter volume (GMV) and a higher frequency of obstetric complications discriminated HR offspring from CcO. When comparing each group individually, greater NSS and a higher frequency of obstetric complications discriminated SzO from CcO, and BpO from CcO, while lower intelligence also discriminated SzO from CcO and from BpO. Within HR offspring, lower intelligence and less total GMV were associated with lifetime incidence of psychiatric disorders. CONCLUSIONS Both SzO and BpO showed evidence of neurodevelopmental insult, although this may have a greater impact in SzO. Lower intelligence and less total GMV hold potential as biomarkers of risk for psychiatric disorders in HR youth.
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Affiliation(s)
- Gisela Sugranyes
- Department of Child and Adolescent Psychiatry and Psychology, 2014SGR489, Institut Clinic de Neurociències, Hospital Clínic i Provincial, Barcelona, Spain,Institut d′Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Barcelona, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain,To whom correspondence should be addressed; Department of Child and Adolescent Psychiatry and Psychology, 2014SGR489, Institut Clinic de Neurociències, Hospital Clínic i Provincial, c. Villarroel 170, 08036 Barcelona, Spain; tel: +34-93-227-9974/9970, fax: +34-93-227-9974, e-mail:
| | - Elena de la Serna
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Roger Borras
- Institut d′Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Vanessa Sanchez-Gistau
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain,Early Intervention Team, Pere Mata Institute of Reus, Health Research Institute Pere Virgili (IISPV), Reus, Spain
| | - Jose C Pariente
- Institut d′Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Soledad Romero
- Institut d′Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Barcelona, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Inmaculada Baeza
- Department of Child and Adolescent Psychiatry and Psychology, 2014SGR489, Institut Clinic de Neurociències, Hospital Clínic i Provincial, Barcelona, Spain,Institut d′Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Barcelona, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
| | - Covadonga M Díaz-Caneja
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain,Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Elisa Rodriguez-Toscano
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain,Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Carmen Moreno
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain,Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Miguel Bernardo
- Department of Child and Adolescent Psychiatry and Psychology, 2014SGR489, Institut Clinic de Neurociències, Hospital Clínic i Provincial, Barcelona, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain,Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain,Department of Psychiatry and Psychology, Hospital Clinic, Barcelona, Spain
| | - Dolores Moreno
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain,Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, IiSGM, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Eduard Vieta
- Department of Child and Adolescent Psychiatry and Psychology, 2014SGR489, Institut Clinic de Neurociències, Hospital Clínic i Provincial, Barcelona, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain,Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain,Department of Psychiatry and Psychology, Hospital Clinic, Barcelona, Spain
| | - Josefina Castro-Fornieles
- Department of Child and Adolescent Psychiatry and Psychology, 2014SGR489, Institut Clinic de Neurociències, Hospital Clínic i Provincial, Barcelona, Spain,Institut d′Investigació Biomèdica August Pi i Sunyer (IDIBAPS), Barcelona, Spain,Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain,Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain
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Greenwood TA. Positive Traits in the Bipolar Spectrum: The Space between Madness and Genius. MOLECULAR NEUROPSYCHIATRY 2017; 2:198-212. [PMID: 28277566 PMCID: PMC5318923 DOI: 10.1159/000452416] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/18/2016] [Accepted: 10/10/2016] [Indexed: 01/25/2023]
Abstract
Bipolar disorder is a severe, lifelong mood disorder for which little is currently understood of the genetic mechanisms underlying risk. By examining related dimensional phenotypes, we may further our understanding of the disorder. Creativity has a historical connection with the bipolar spectrum and is particularly enhanced among unaffected first-degree relatives and those with bipolar spectrum traits. This suggests that some aspects of the bipolar spectrum may confer advantages, while more severe expressions of symptoms negatively influence creative accomplishment. Creativity is a complex, multidimensional construct with both cognitive and affective components, many of which appear to reflect a shared genetic vulnerability with bipolar disorder. It is suggested that a subset of bipolar risk variants confer advantages as positive traits according to an inverted-U-shaped curve with clinically unaffected allele carriers benefitting from the positive traits and serving to maintain the risk alleles in the population. The association of risk genes with creativity in healthy individuals (e.g., NRG1), as well as an overall sharing of common genetic variation between bipolar patients and creative individuals, provides support for this model. Current findings are summarized from a multidisciplinary perspective to demonstrate the feasibility of research in this area to reveal the mechanisms underlying illness.
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Zanini MA, Castro J, Cunha GR, Asevedo E, Pan PM, Bittencourt L, Coelho FM, Tufik S, Gadelha A, Bressan RA, Brietzke E. Abnormalities in sleep patterns in individuals at risk for psychosis and bipolar disorder. Schizophr Res 2015; 169:262-267. [PMID: 26391284 DOI: 10.1016/j.schres.2015.08.023] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/01/2015] [Revised: 08/12/2015] [Accepted: 08/17/2015] [Indexed: 10/23/2022]
Abstract
AIM To compare patterns of sleep and the presence of sleep disturbances in individuals in at-risk mental states (ARMS) for psychosis and bipolar disorder (BD) with a healthy control (HC) group. METHODS This was a comparative study involving 20 individuals in ARMS for psychosis or BD, according to the Comprehensive Assessment of At-Risk Mental States, and 20 age- and sex-matched healthy controls. Quality of sleep in the previous month was assessed using the Pittsburgh Sleep Quality Index, diurnal somnolence was evaluated using The Epworth Sleepiness Scale, and chronotype was determined using the Questionnaire of Morningness/Eveningness (QME). All of the participants underwent polysomnography (PSG) during the entire night for two consecutive nights. The first night aimed to adapt the subject to the environment, and only the data from the second night were used for the analysis. RESULTS Compared with the HC group, individuals in the ARMS group reported significantly worse sleep quality, as measured by the Pittsburgh Sleep Quality Index. Both groups had scores consistent with daytime sleepiness on the Epworth Sleepiness Scale, and there were no differences with regard to chronotype between the groups, with a predominance of the indifferent type in both groups. In the PSG assessment, we observed increased Sleep Latency (SL) and increased Rapid Eye Movement Sleep Onset Latency (REMOL) in the ARMS group, compared to the HC group. CONCLUSION The results of this study indicated that sleep abnormalities could be found early in the course of mental diseases, even in at-risk stages, and support the further investigation of their predictive value in the transition to psychosis and BD.
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Affiliation(s)
- Marcio A Zanini
- Program for Recognition and Intervention in Individuals in At-Risk Mental States (PRISMA), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil; Interdisciplinary Laboratory of Clinical Neuroscience (LINC), Universidade Federal de São Paulo, São Paulo, Brazil; Sleep Institute, Department of Psychobiology, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Juliana Castro
- Sleep Institute, Department of Psychobiology, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Graccielle R Cunha
- Program for Recognition and Intervention in Individuals in At-Risk Mental States (PRISMA), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil; Interdisciplinary Laboratory of Clinical Neuroscience (LINC), Universidade Federal de São Paulo, São Paulo, Brazil
| | - Elson Asevedo
- Program for Recognition and Intervention in Individuals in At-Risk Mental States (PRISMA), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil; Interdisciplinary Laboratory of Clinical Neuroscience (LINC), Universidade Federal de São Paulo, São Paulo, Brazil
| | - Pedro M Pan
- Program for Recognition and Intervention in Individuals in At-Risk Mental States (PRISMA), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil; Interdisciplinary Laboratory of Clinical Neuroscience (LINC), Universidade Federal de São Paulo, São Paulo, Brazil
| | - Lia Bittencourt
- Sleep Institute, Department of Psychobiology, Universidade Federal de São Paulo, São Paulo, Brazil
| | | | - Sergio Tufik
- Sleep Institute, Department of Psychobiology, Universidade Federal de São Paulo, São Paulo, Brazil
| | - Ary Gadelha
- Program for Recognition and Intervention in Individuals in At-Risk Mental States (PRISMA), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil; Interdisciplinary Laboratory of Clinical Neuroscience (LINC), Universidade Federal de São Paulo, São Paulo, Brazil
| | - Rodrigo A Bressan
- Program for Recognition and Intervention in Individuals in At-Risk Mental States (PRISMA), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil; Interdisciplinary Laboratory of Clinical Neuroscience (LINC), Universidade Federal de São Paulo, São Paulo, Brazil
| | - Elisa Brietzke
- Program for Recognition and Intervention in Individuals in At-Risk Mental States (PRISMA), Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil; Interdisciplinary Laboratory of Clinical Neuroscience (LINC), Universidade Federal de São Paulo, São Paulo, Brazil.
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Common Polymorphisms Within QPCT Gene Are Associated with the Susceptibility of Schizophrenia in a Han Chinese Population. Mol Neurobiol 2015; 53:6362-6366. [DOI: 10.1007/s12035-015-9541-3] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2015] [Accepted: 11/11/2015] [Indexed: 01/09/2023]
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11
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Castro J, Zanini M, Gonçalves BDSB, Coelho FMS, Bressan R, Bittencourt L, Gadelha A, Brietzke E, Tufik S. Circadian rest-activity rhythm in individuals at risk for psychosis and bipolar disorder. Schizophr Res 2015. [PMID: 26220853 DOI: 10.1016/j.schres.2015.07.024] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND At-risk mental states (ARMS) are clinical syndromes that are associated with higher risk, compared with the general population, for developing psychosis and bipolar disorder. Circadian rhythm misalignments have been proposed to be part of this early phase of the clinical course. OBJECTIVE To compare circadian rhythm of activity and rest changes between ARMS individuals and a healthy control group. METHODS Forty volunteers of both genders, aged between 13 and 27years old, participated in this study (n=20 ARMS group, and n=20 healthy controls). The ARMS individuals were classified as ultra-high risk for psychosis according to the CAARMS (Comprehensive Assessment of At-risk Mental State) or at high risk for bipolar disorder according to criteria proposed by Bechdolf and colleagues. Participants used an actigraph for fifteen days, kept a sleep diary, and completed the Epworth Sleepiness Scale, the Pittsburgh Sleep Quality Index, and a Morningness-Eveningness Questionnaire. RESULTS Compared with healthy volunteers, the ARMS group presented worse sleep quality (P=0.010); longer nap durations (P=0.038), shorter wake times (P=0.001), higher total sleep times (P=0.011), and shorter activity duration (P=0.021), sleep rhythms were more fragmented, the circadian rest-activity rhythms were less synchronized with the dark-light cycle and had lower amplitudes of motor activity. CONCLUSION The results suggest alterations in the circadian rest-activity rhythms (and likely in sleep-wake cycle patterns) in ARMS individuals compared with healthy controls. It is possible that circadian rhythms of activity and rest changes are one of the prodromal clinical and behavioral expressions of the brain changes that underlie ARMS individuals.
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Affiliation(s)
- Juliana Castro
- Departamento de Psicobiologia, Universidade Federal de Sao Paulo, Sao Paulo, Brazil.
| | - Marcio Zanini
- PRISMA/PROESQ - Departamento de Psiquiatria, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | | | - Fernando Morgadinho Santos Coelho
- Departamento de Psicobiologia, Universidade Federal de Sao Paulo, Sao Paulo, Brazil; Departamento de Neurologia e Neurocirurgia, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Rodrigo Bressan
- PRISMA/PROESQ - Departamento de Psiquiatria, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Lia Bittencourt
- Departamento de Psicobiologia, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Ary Gadelha
- PRISMA/PROESQ - Departamento de Psiquiatria, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Elisa Brietzke
- PRISMA/PROESQ - Departamento de Psiquiatria, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
| | - Sergio Tufik
- Departamento de Psicobiologia, Universidade Federal de Sao Paulo, Sao Paulo, Brazil
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Toh WL, Thomas N, Rossell SL. Auditory verbal hallucinations in bipolar disorder (BD) and major depressive disorder (MDD): A systematic review. J Affect Disord 2015; 184:18-28. [PMID: 26066781 DOI: 10.1016/j.jad.2015.05.040] [Citation(s) in RCA: 65] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2015] [Revised: 05/20/2015] [Accepted: 05/20/2015] [Indexed: 01/09/2023]
Abstract
BACKGROUND Auditory verbal hallucinations (AVHs) are not uncommon in bipolar disorder (BD) and major depressive disorder (MDD), but there has been scant research in the area. The current paper aims to draw together and provide a critical overview of existing studies of AVHs in BD and MDD. METHODS A systematic review was undertaken using the search terms 'hallucinations' or 'hearing voices' in conjunction with 'bipolar disorder', 'mania' or 'manic-depressive' or 'major depressive disorder' or 'depression' or 'affective disorder' or 'mood disorder'. After applying a pre-defined set of inclusion criteria, 14 eligible peer-reviewed publications were accepted for further analysis. RESULTS Prevalence rates of AVHs in BD (11.3-62.8%) and MDD (5.4-40.6%) varied. When psychotic features were examined, persecutory and grandiose delusions were especially common in BD (though the latter did not necessarily occur in conjunction with AVHs). A single known neuroimaging study has suggested increased fronto-temporal connectivity relating to AVHs in BD. LIMITATIONS Methodological challenges relating to fluctuations in mood states and limited use of validated instruments, coupled with post-episode recall bias, pose as specific barriers to the collection of meaningful phenomenological information. CONCLUSIONS AVHs remains a central but largely understudied symptom in BD and MDD. Future research examining its phenomenology and clinical/neural correlates could bring about positive clinical implications as well as adapted therapeutic applications.
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Affiliation(s)
- Wei Lin Toh
- Brain and Psychological Sciences Research Centre (BPsyC), Swinburne University of Technology, Melbourne, VIC, Australia; Monash Alfred Psychiatry Research Centre (MAPrc), The Alfred Hospital and Monash University School of Psychology and Psychiatry, Melbourne, VIC, Australia.
| | - Neil Thomas
- Brain and Psychological Sciences Research Centre (BPsyC), Swinburne University of Technology, Melbourne, VIC, Australia; Monash Alfred Psychiatry Research Centre (MAPrc), The Alfred Hospital and Monash University School of Psychology and Psychiatry, Melbourne, VIC, Australia
| | - Susan L Rossell
- Brain and Psychological Sciences Research Centre (BPsyC), Swinburne University of Technology, Melbourne, VIC, Australia; Monash Alfred Psychiatry Research Centre (MAPrc), The Alfred Hospital and Monash University School of Psychology and Psychiatry, Melbourne, VIC, Australia; Psychiatry, St Vincent's Hospital, Melbourne, VIC, Australia
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Simeonova DI, Lee FJ, Walker EF. Longitudinal investigation of the relationship between family history of psychosis and affective disorders and Child Behavior Checklist ratings in clinical high-risk adolescents. Schizophr Res 2015; 166:24-30. [PMID: 25982810 PMCID: PMC4512880 DOI: 10.1016/j.schres.2015.04.027] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2015] [Revised: 04/20/2015] [Accepted: 04/23/2015] [Indexed: 12/15/2022]
Abstract
This is the first study to investigate whether positive family history (FH) of psychosis and affective disorders moderates the relationship between child diagnostic status and parent-reported social and behavioral problems on the Child Behavior Checklist (CBCL) in clinical high-risk adolescents. This longitudinal investigation assessed 122 participants (mean age=14.25±1.8years) from three groups (at-risk, other personality disorders, non-psychiatric controls) at baseline and one year follow-up. As predicted, there was a main effect of FH for a number of CBCL scales indicating higher scores for adolescents with positive FH. The findings also demonstrate a significant Diagnostic Status×Family History interaction for several behavioral scales providing support for FH as a concurrent and longitudinal moderator of the relationship between diagnostic status and CBCL scales. The moderating effect is present for areas of functioning associated with depression, anxiety, social adjustment, thought problems, attention problems, and aggressive behavior. The findings also indicate that both positive and negative symptoms are related to the genetic vulnerability for developing psychosis in clinical high-risk individuals, particularly those symptoms reflective of emotional, attentional, and interpersonal functioning. The present findings are novel and have significant clinical and research implications. This investigation provides a platform for future studies to clarify further the role of FH in clinical high-risk individuals and contributes to integration of this knowledge in the development of early intervention and prevention approaches in at-risk populations for the emergence of severe mental illness.
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Affiliation(s)
- Diana I Simeonova
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States.
| | - Frances J Lee
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, United States
| | - Elaine F Walker
- Department of Psychology, Emory University, Atlanta, GA, United States
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14
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Kret ME, Ploeger A. Emotion processing deficits: A liability spectrum providing insight into comorbidity of mental disorders. Neurosci Biobehav Rev 2015; 52:153-71. [DOI: 10.1016/j.neubiorev.2015.02.011] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/31/2014] [Revised: 02/11/2015] [Accepted: 02/17/2015] [Indexed: 12/13/2022]
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15
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Liang SG, Greenwood TA. The impact of clinical heterogeneity in schizophrenia on genomic analyses. Schizophr Res 2015; 161:490-5. [PMID: 25496659 PMCID: PMC4308487 DOI: 10.1016/j.schres.2014.11.019] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2014] [Revised: 11/12/2014] [Accepted: 11/17/2014] [Indexed: 02/05/2023]
Abstract
Though clinically useful, the diagnostic systems currently employed are not well equipped to capture the substantial clinical heterogeneity observed for most psychiatric disorders, as exemplified by the complex psychotic disorder(s) that Bleuler aptly labeled the "Group of Schizophrenias". The clinical heterogeneity associated with schizophrenia has likely frustrated decades of attempts to illuminate the underlying genetic architecture, although recent genome-wide association studies have begun to provide valuable insight into the role of common genetic risk variants. Here we demonstrate the importance of using diagnostic information to identify a core form of the disorder and to eliminate potential comorbidities in genetic studies. We also demonstrate why applying a diagnostic screening procedure to the control dataset to remove individuals with potentially related disorders is critical. Additionally, subjects may participate in multiple studies at different institutions or may have genotype data released by more than one research group. It is thus good practice to verify that no identical subjects exist within or between samples prior to conducting any type of genetic analysis to avoid potential confounding of results. While the availability of genomic data for large collections of subjects has facilitated many investigations that would otherwise not have been possible, we clearly show why one must use caution when acquiring data from publicly available sources. Although the broad vs. narrow debate in terms of phenotype definition in genetic analyses will remain, it is likely that both approaches will yield different results and that both will have utility in resolving the genetic architecture of schizophrenia.
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Affiliation(s)
- Sherri G Liang
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States
| | - Tiffany A Greenwood
- Department of Psychiatry, University of California San Diego, La Jolla, CA, United States.
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Wang Z, Meda SA, Keshavan MS, Tamminga CA, Sweeney JA, Clementz BA, Schretlen DJ, Calhoun VD, Lui S, Pearlson GD. Large-Scale Fusion of Gray Matter and Resting-State Functional MRI Reveals Common and Distinct Biological Markers across the Psychosis Spectrum in the B-SNIP Cohort. Front Psychiatry 2015; 6:174. [PMID: 26732139 PMCID: PMC4685049 DOI: 10.3389/fpsyt.2015.00174] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/19/2015] [Accepted: 11/27/2015] [Indexed: 02/05/2023] Open
Abstract
To investigate whether aberrant interactions between brain structure and function present similarly or differently across probands with psychotic illnesses [schizophrenia (SZ), schizoaffective disorder (SAD), and bipolar I disorder with psychosis (BP)] and whether these deficits are shared with their first-degree non-psychotic relatives. A total of 1199 subjects were assessed, including 220 SZ, 147 SAD, 180 psychotic BP, 150 first-degree relatives of SZ, 126 SAD relatives, 134 BP relatives, and 242 healthy controls (1). All subjects underwent structural MRI (sMRI) and resting-state functional MRI (rs-fMRI) scanning. Joint-independent component analysis (jICA) was used to fuse sMRI gray matter and rs-fMRI amplitude of low-frequency fluctuations data to identify the relationship between the two modalities. jICA revealed two significantly fused components. The association between functional brain alteration in a prefrontal-striatal-thalamic-cerebellar network and structural abnormalities in the default mode network was found to be common across psychotic diagnoses and correlated with cognitive function, social function, and schizo-bipolar scale scores. The fused alteration in the temporal lobe was unique to SZ and SAD. The above effects were not seen in any relative group (including those with cluster-A personality). Using a multivariate-fused approach involving two widely used imaging markers, we demonstrate both shared and distinct biological traits across the psychosis spectrum. Furthermore, our results suggest that the above traits are psychosis biomarkers rather than endophenotypes.
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Affiliation(s)
- Zheng Wang
- Mental Health Institute of the Second Xiangya Hospital, Central South University , Changsha , China
| | - Shashwath A Meda
- Olin Neuropsychiatry Research Center, Institute of Living at Hartford Hospital , Hartford, CT , USA
| | - Matcheri S Keshavan
- Department of Psychiatry, Beth Israel Deaconess Hospital, Harvard Medical School , Boston, MA , USA
| | - Carol A Tamminga
- Department of Psychiatry, University of Texas Southwestern Medical Center , Dallas, TX , USA
| | - John A Sweeney
- Department of Psychiatry, University of Texas Southwestern Medical Center , Dallas, TX , USA
| | - Brett A Clementz
- Department of Psychology, University of Georgia , Athens, GA , USA
| | - David J Schretlen
- Department of Psychiatry, Johns Hopkins University , Baltimore, MD , USA
| | - Vince D Calhoun
- Department of Psychiatry, Johns Hopkins University, Baltimore, MD, USA; The Mind Research Network, Albuquerque, NM, USA; Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Su Lui
- Department of Radiology, Huaxi MR Research Center, West China Hospital of Sichuan University , Chengdu , China
| | - Godfrey D Pearlson
- Olin Neuropsychiatry Research Center, Institute of Living at Hartford Hospital, Hartford, CT, USA; Department of Psychiatry, Yale University, New Haven, CT, USA
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Gu LZ, Jiang T, Cheng ZH, Zhang YC, Ou MM, Chen MC, Ling WM. TSNARE1 polymorphisms are associated with schizophrenia susceptibility in Han Chinese. J Neural Transm (Vienna) 2014; 122:929-32. [PMID: 25471352 DOI: 10.1007/s00702-014-1348-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2014] [Accepted: 11/30/2014] [Indexed: 12/27/2022]
Abstract
t-SNARE domain containing 1 gene (TSNARE1) is located at human chromosome 8q24.3, and may play a crucial role in intracellular protein transport and synaptic transmission. Recently, a large-scale meta-analysis of genome-wide association study dataset identified that rs10098073 and rs4129585, two single nucleotide polymorphisms (SNPs) within TSNARE1, were closely associated with the risk of schizophrenia in Caucasians. However, this finding has not been validated in other populations or ethnic groups thus far. In the current study, we conducted a case-control study to confirm the association of these two SNPs with the schizophrenia risk in a Han Chinese population comprising 440 schizophrenia patients and 450 control subjects. According to the genotype data of Han Chinese from Beijing in 1,000 Genomes Project database, rs10098073 and rs4129585 were located in one haplotype block and were in almost complete linkage disequilibrium (D' = 1, r (2) ≥ 0.952). Therefore, only rs10098073 was selected for the subsequent analysis. We showed for the first time that the minor allele (A) of rs10098073 was associated with a reduced risk of schizophrenia (OR = 0.753; 95 % CI 0.613-0.924; P = 0.007). Furthermore, we found that the A allele of rs10098073 reduced the schizophrenia risk through a recessive manner (A/A vs. A/C + C/C, OR = 0.563; 95 % CI 0.357-0.89; P = 0.013, P Bonferroni corrected = 0.026) rather than a dominant manner (A/A + A/C vs. C/C, OR = 0.762; 95 % CI 0.586-0.992; P = 0.043, P Bonferroni corrected = 0.086). Taken together, these findings demonstrate a significant association between TSNARE1 polymorphisms and schizophrenia risk in a Han Chinese population, suggesting TSNARE1 may represent a susceptibility gene for this disease.
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Affiliation(s)
- Li-Ze Gu
- Department of Laboratory Medicine, Wuxi Mental Health Center, Nanjing Medical University, No. 156, Qian Rong Road, Wuxi, China
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Gu LZ, Jiang T, Cheng ZH, Zhang YC, Ou MM, Chen MC, Zhou ZH, Ling WM. rs11098403 polymorphism near NDST3 is associated with a reduced risk of schizophrenia in a Han Chinese population. Neurosci Lett 2014; 581:42-5. [DOI: 10.1016/j.neulet.2014.08.018] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2014] [Revised: 08/02/2014] [Accepted: 08/08/2014] [Indexed: 11/27/2022]
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Finseth PI, Sønderby IE, Djurovic S, Agartz I, Malt UF, Melle I, Morken G, Andreassen OA, Vaaler AE, Tesli M. Association analysis between suicidal behaviour and candidate genes of bipolar disorder and schizophrenia. J Affect Disord 2014; 163:110-4. [PMID: 24461634 DOI: 10.1016/j.jad.2013.12.018] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/05/2013] [Revised: 12/17/2013] [Accepted: 12/18/2013] [Indexed: 10/25/2022]
Abstract
BACKGROUND The present study investigated associations between the strongest joint genetic risk variants for bipolar disorder (BD) and schizophrenia (SCZ) and a history of suicide attempt in patients with BD, SCZ and related psychiatric disorders. METHODS A history of suicide attempt was assessed in a sample of 1009 patients with BD, SCZ and related psychosis spectrum disorders, and associations with the joint genetic risk variants for BD and SCZ (rs2239547 (ITIH3/4-region), rs10994359 (ANK3) and rs4765905 (CACNA1C)) were investigated. Previously reported susceptibility loci for suicide attempt in BD were also investigated. Associations were tested by logistic regression with Bonferroni correction for multiple testing. RESULTS The risk allele in rs2239547 (ITIH3/4-region) was significantly associated with a history of suicide attempt (p=0.01) after multiple testing correction (p threshold<0.017). The previous suicide attempt susceptibility loci were only nominally associated, but had the same direction of risk in the replication sample (sign test, p=0.02). LIMITATIONS Relatively small sample size and retrospective clinical assessment. CONCLUSIONS We detected a novel association between suicide attempt and the ITIH3/4-region in a combined group of patients with BD, SCZ and related psychosis spectrum disorders. This may be useful in understanding molecular mechanisms of suicidal behaviour in severe mental disorders, although replication is warranted.
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Affiliation(s)
- Per Ivar Finseth
- Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Østmarka Psychiatric Department, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway.
| | - Ida Elken Sønderby
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway; K. G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Srdjan Djurovic
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway; K. G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Ingrid Agartz
- K. G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway; Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Ulrik Fredrik Malt
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway; Department of Neuropsychiatry and Psychosomatic Medicine, Division of Surgery and Neuroscience, Oslo University Hospital, Oslo, Norway
| | - Ingrid Melle
- K. G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; K. G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Gunnar Morken
- Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Department of Research and Development, Psychiatry, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Ole Andreas Andreassen
- K. G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; K. G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Arne Einar Vaaler
- Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology (NTNU), Trondheim, Norway; Østmarka Psychiatric Department, St. Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Martin Tesli
- K. G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway; K. G. Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
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Cuesta MJ, Basterra V, Sanchez-Torres A, Peralta V. Controversies surrounding the diagnosis of schizophrenia and other psychoses. Expert Rev Neurother 2014; 9:1475-86. [DOI: 10.1586/ern.09.102] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
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21
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Zanini M, Castro J, Coelho FM, Bittencourt L, Bressan RA, Tufik S, Brietzke E. Do sleep abnormalities and misaligned sleep/circadian rhythm patterns represent early clinical characteristics for developing psychosis in high risk populations? Neurosci Biobehav Rev 2013; 37:2631-7. [PMID: 24096189 DOI: 10.1016/j.neubiorev.2013.08.012] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2013] [Revised: 08/24/2013] [Accepted: 08/28/2013] [Indexed: 02/04/2023]
Abstract
Sleep architecture changes, such as slow-wave sleep (SWS) percentage variations and reductions in latency and density of rapid eye movement (REM), are found in most patients with schizophrenia and are considered to be an important part of the pathophysiology of the disorder. In addition to these sleep parameters changes, disruptions in sleep homeostasis and the sleep/circadian rhythm also occur in these patients. Sleep/circadian rhythm abnormalities negatively affect neocortical plasticity and cognition and often precede the diagnosis of the illness. Thus, it has been suggested that the sleep/circadian rhythm might be involved in the pathophysiology of psychosis. Recent advances in the identification of individuals at a high risk for developing schizophrenia allow us to investigate several neurobiological processes involved in the development of psychosis. In this article, we review the current evidence of the effects of sleep parameter abnormalities, disruptions in sleep homeostasis and misalignments of sleep circadian rhythm on the early stages of schizophrenia. In addition, we discuss the preliminary evidence of sleep and circadian rhythm abnormalities during the prodromal stages of psychosis and propose that these abnormalities can be explored as potential predictors, as an adjunct to clinical diagnosis, of developing a psychotic disorder in at risk populations.
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Affiliation(s)
- Marcio Zanini
- Programa de Reconhecimento e Intervencao em Indivíduos em Estados Mentais de Risco (PRISMA), Departamento de Psiquiatria, Universidade Federal de Sao Paulo, Sao Paulo, Brazil.
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Jung YE, Jun TY. Association between FAT Gene and Schizophrenia in the Korean Population. CLINICAL PSYCHOPHARMACOLOGY AND NEUROSCIENCE 2013; 11:67-71. [PMID: 24023550 PMCID: PMC3766757 DOI: 10.9758/cpn.2013.11.2.67] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/09/2012] [Revised: 11/27/2012] [Accepted: 03/15/2013] [Indexed: 01/27/2023]
Abstract
OBJECTIVE The aim of this study was to investigate the genetic association of the FAT gene with schizophrenia in the Korean population, as well as analyzing the association of FAT gene with clinical variables. METHODS Four variants within the FAT gene were investigated in 189 patients with schizophrenia and 119 healthy controls (rs2306987 A/C, rs2306990 T/C, rs2637777 G/T, and rs2304865 G/C). RESULTS Significant association at the rs273777 with schizophrenia was observed; however, rs2306987, rs2306990, and rs2304865 were not associated with schizophrenia. Haplotype analyses revealed that the haplotype A/T/T/G was associated with a significantly protective effect. Sliding window analysis (rs2637777 G/T and rs2304865 G/C) revealed the more common T/G haplotype, included in the A/T/T/G protective combination, showed a small protective effect, in particular the effect was due to the rs273777 T variant (minor allele). CONCLUSION The present finding suggests that FAT polymorphism may play a putative role in the susceptibility to schizophrenia in the Korean population. Further studies using a larger number of subjects should be performed to determine whether the FAT gene polymorphism may be truly involved in the development of schizophrenia.
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Affiliation(s)
- Young-Eun Jung
- Department of Psychiatry, College of Medicine, The Catholic University of Korea, Seoul, Korea. ; Department of Psychiatry, College of Medicine, Chonbuk National University, Jeonju, Korea
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Bambole V, Johnston M, Shah N, Sonavane S, Desouza A, Shrivastava A. Symptom overlap between schizophrenia and bipolar mood disorder: Diagnostic issues. ACTA ACUST UNITED AC 2013. [DOI: 10.4236/ojpsych.2013.34a002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Trouble bipolaire et comorbidités somatiques : diabète et troubles cardiométaboliques Données physiopathologiques. L'ENCEPHALE 2012; 38 Suppl 4:S167-72. [DOI: 10.1016/s0013-7006(12)70095-7] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Mansur RB, Brietzke E. The "selfish brain" hypothesis for metabolic abnormalities in bipolar disorder and schizophrenia. TRENDS IN PSYCHIATRY AND PSYCHOTHERAPY 2012; 34:121-8. [DOI: 10.1590/s2237-60892012000300003] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/21/2012] [Accepted: 06/13/2012] [Indexed: 11/22/2022]
Abstract
Metabolic abnormalities are frequent in patients with schizophrenia and bipolar disorder (BD), leading to a high prevalence of diabetes and metabolic syndrome in this population. Moreover, mortality rates among patients are higher than in the general population, especially due to cardiovascular diseases. Several neurobiological systems involved in energy metabolism have been shown to be altered in both illnesses; however, the cause of metabolic abnormalities and how they relate to schizophrenia and BD pathophysiology are still largely unknown. The "selfish brain" theory is a recent paradigm postulating that, in order to maintain its own energy supply stable, the brain modulates energy metabolism in the periphery by regulation of both allocation and intake of nutrients. We hypothesize that the metabolic alterations observed in these disorders are a result of an inefficient regulation of the brain energy supply and its compensatory mechanisms. The selfish brain theory can also expand our understanding of stress adaptation and neuroprogression in schizophrenia and BD, and, overall, can have important clinical implications for both illnesses.
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Lee SA, Tsao TTH, Yang KC, Lin H, Kuo YL, Hsu CH, Lee WK, Huang KC, Kao CY. Construction and analysis of the protein-protein interaction networks for schizophrenia, bipolar disorder, and major depression. BMC Bioinformatics 2011; 12 Suppl 13:S20. [PMID: 22373040 PMCID: PMC3278837 DOI: 10.1186/1471-2105-12-s13-s20] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Schizophrenia, bipolar disorder, and major depression are devastating mental diseases, each with distinctive yet overlapping epidemiologic characteristics. Microarray and proteomics data have revealed genes which expressed abnormally in patients. Several single nucleotide polymorphisms (SNPs) and mutations are associated with one or more of the three diseases. Nevertheless, there are few studies on the interactions among the disease-associated genes and proteins. RESULTS This study, for the first time, incorporated microarray and protein-protein interaction (PPI) databases to construct the PPI network of abnormally expressed genes in postmortem brain samples of schizophrenia, bipolar disorder, and major depression patients. The samples were collected from Brodmann area (BA) 10 of the prefrontal cortex. Abnormally expressed disease genes were selected by t-tests comparing the disease and control samples. These genes were involved in housekeeping functions (e.g. translation, transcription, energy conversion, and metabolism), in brain specific functions (e.g. signal transduction, neuron cell differentiation, and cytoskeleton), or in stress responses (e.g. heat shocks and biotic stress).The diseases were interconnected through several "switchboard"-like nodes in the PPI network or shared abnormally expressed genes. A "core" functional module which consisted of a tightly knitted sub-network of clique-5 and -4s was also observed. These cliques were formed by 12 genes highly expressed in both disease and control samples. CONCLUSIONS Several previously unidentified disease marker genes and drug targets, such as SBNO2 (schizophrenia), SEC24C (bipolar disorder), and SRRT (major depression), were identified based on statistical and topological analyses of the PPI network. The shared or interconnecting marker genes may explain the shared symptoms of the studied diseases. Furthermore, the "switchboard" genes, such as APP, UBC, and YWHAZ, are proposed as potential targets for developing new treatments due to their functional and topological significance.
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Affiliation(s)
- Sheng-An Lee
- Department of Information Management, Kainan University, Taoyuan, Taiwan
| | - Theresa Tsun-Hui Tsao
- Department of Computer Science and Information Engineering, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan
| | - Ko-Chun Yang
- Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan
| | - Han Lin
- Graduate Institute of Electronics Engineering, National Taiwan University, Taipei, Taiwan
| | - Yu-Lun Kuo
- Department of Computer Science and Information Engineering, National Taiwan University, Taipei, Taiwan
| | - Chien-Hsiang Hsu
- Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan
| | - Wen-Kuei Lee
- Department of Psychiatry, Armed Forces Beitou Hospital, Taipei, Taiwan
| | - Kuo-Chuan Huang
- Department of Computer Science and Information Engineering, National Taiwan University, Taipei, Taiwan
- Department of Psychiatry, Armed Forces Beitou Hospital, Taipei, Taiwan
| | - Cheng-Yan Kao
- Department of Computer Science and Information Engineering, National Taiwan University, Taipei, Taiwan
- Graduate Institute of Biomedical Electronics and Bioinformatics, National Taiwan University, Taipei, Taiwan
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The contribution of epidemiology to defining the most appropriate approach to genetic research on schizophrenia. ACTA ACUST UNITED AC 2011. [DOI: 10.1017/s1121189x00000932] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
AbstractPsychosis is thought to have a strong genetic component, but many efforts to discover the underlying putative schizophrenia genes have yielded disappointing results. In fact, no strong associations emerged in the first genome-wide association studies in psychiatry and weakly observed associations were not related to the candidate genes identified in previous studies. These partially successful findings may be explained by the fact that genetic research in psychiatry suffers from confounding issues related to phenotype definition, the considerable degree of phenotypic variability and diagnostic uncertainty, absence of specific neuropathological features and environmental influences. To make progress it is first necessary to deconstruct psychosis based on symptomatology, and then to correlate particular phenotypes with genetic variants. Moreover, it is time to conduct studies that define persistent aspects of the schizophrenic profile that are more likely to represent an underlying biological pathogenesis, as opposed to fluctuating symptoms that are possibly environmentally mediated. In fact, progress in understanding the etiology of schizophrenia will depend upon the availability of good measures of genetic liability as well as relevant environmental exposures during critical periods of an individual's life. If environmental and/or genetic factors are not precisely measured, it is impossible to study their independent effects or interactions.
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Varghese D, Scott J, Welham J, Bor W, Najman J, O'Callaghan M, Williams G, McGrath J. Psychotic-like experiences in major depression and anxiety disorders: a population-based survey in young adults. Schizophr Bull 2011; 37:389-93. [PMID: 19687152 PMCID: PMC3044630 DOI: 10.1093/schbul/sbp083] [Citation(s) in RCA: 200] [Impact Index Per Article: 15.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Population-based surveys have confirmed that psychotic-like experiences are prevalent in the community. However, it is unclear if these experiences are associated with common mental disorders. The aim of this study was to examine the prevalence of psychotic-like experiences in those with affective and anxiety disorders. METHODS Subjects were drawn from the Mater-University of Queensland Study of Pregnancy. Delusion-like experiences were assessed with the Peters Delusional Inventory (PDI). The Composite International Diagnostic Interview (CIDI) was used to identify individuals with Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) lifetime diagnoses of major depression, anxiety disorder, substance use/dependence, and psychotic disorders. The influence of affective and anxiety disorders on PDI and CIDI psychosis-related items' scores were assessed with logistic regression, with adjustments for age, sex, and the presence of the other comorbid psychiatric diagnoses. RESULTS Having either a lifetime diagnosis of major depressive disorder or an anxiety disorder was associated with significantly higher PDI total scores (highest vs lowest quartile adjusted odds ratios [ORs] and 95% confidence intervals [CIs] = 4.43, 3.09-6.36; 3.08, 2.26-4.20, respectively). The odds of endorsing any CIDI hallucination or delusion item was increased in those with a major depressive or anxiety disorder. The presence of current anxiety disorder symptoms was significantly associated with PDI score (OR = 5.81, 95% CI = 3.68-9.16). CONCLUSION While psychotic-like experiences are usually associated with psychotic disorders, individuals with depression and anxiety are also more likely to report these symptoms compared with well individuals. Psychotic-like experiences are associated with a range of common mental disorders.
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Affiliation(s)
- Daniel Varghese
- Department of Psychiatry, Princess Alexandra Hospital, Woolloongabba, Queensland 4102, Australia,Department of Psychiatry, University of Queensland, St Lucia, Queensland 4072, Australia
| | - James Scott
- Child and Youth Mental Health Service, Royal Children's Hospital, Herston, Queensland 4029, Australia
| | - Joy Welham
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Queensland 4076, Australia
| | - William Bor
- Mater Children's Hospital, South Brisbane, Queensland 4101, Australia
| | - Jake Najman
- School of Population Health, University of Queensland, Herston, Queensland 4029, Australia
| | | | - Gail Williams
- School of Population Health, University of Queensland, Herston, Queensland 4029, Australia
| | - John McGrath
- Department of Psychiatry, University of Queensland, St Lucia, Queensland 4072, Australia,Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, Queensland 4076, Australia,Queensland Brain Institute, University of Queensland, St Lucia, Queensland 4076, Australia,To whom correspondence should be addressed; tel: +61-7-3271-8694, fax: +61-7-3271-8698, e-mail:
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Hennessy RJ, Baldwin PA, Browne DJ, Kinsella A, Waddington JL. Frontonasal dysmorphology in bipolar disorder by 3D laser surface imaging and geometric morphometrics: comparisons with schizophrenia. Schizophr Res 2010; 122:63-71. [PMID: 20554158 PMCID: PMC2941027 DOI: 10.1016/j.schres.2010.05.001] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/22/2010] [Revised: 04/22/2010] [Accepted: 05/05/2010] [Indexed: 11/22/2022]
Abstract
Any developmental relationship between bipolar disorder and schizophrenia engenders continuing debate. As the brain and face emerge in embryological intimacy, brain dysmorphogenesis is accompanied by facial dysmorphogenesis. 3D laser surface imaging was used to capture the facial surface of 13 male and 14 female patients with bipolar disorder in comparison with 61 male and 75 female control subjects and with 37 male and 32 female patients with schizophrenia. Surface images were analysed using geometric morphometrics and 3D visualisations to identify domains of facial shape that distinguish bipolar patients from controls and bipolar patients from those with schizophrenia. Both male and female bipolar patients evidenced significant facial dysmorphology: common to male and female patients was overall facial widening, increased width of nose, narrowing of mouth and upward displacement of the chin; dysmorphology differed between male and female patients for nose length, lip thickness and tragion height. There were few morphological differences in comparison with schizophrenia patients. That dysmorphology of the frontonasal prominences and related facial regions in bipolar disorder is more similar to than different from that found in schizophrenia indicates some common dysmorphogenesis. Bipolar disorder and schizophrenia might reflect similar insult(s) acting over slightly differing time-frames or slightly differing insult(s) acting over a similar time-frame.
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Affiliation(s)
- Robin J. Hennessy
- Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, St. Stephen's Green, Dublin 2, Ireland
| | - Patrizia A. Baldwin
- Cavan-Monaghan Mental Health Service, St. Davnet's Hospital, Monaghan, Ireland
| | - David J. Browne
- Cavan-Monaghan Mental Health Service, St. Davnet's Hospital, Monaghan, Ireland
| | - Anthony Kinsella
- Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, St. Stephen's Green, Dublin 2, Ireland
| | - John L. Waddington
- Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, St. Stephen's Green, Dublin 2, Ireland,Cavan-Monaghan Mental Health Service, St. Davnet's Hospital, Monaghan, Ireland,Corresponding author. Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, St. Stephen's Green, Dublin 2, Ireland. Tel.: + 353 1 402 2129; fax: + 353 1 402 2453.
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Ringen PA, Vaskinn A, Sundet K, Engh JA, Jónsdóttir H, Simonsen C, Friis S, Opjordsmoen S, Melle I, Andreassen OA. Opposite relationships between cannabis use and neurocognitive functioning in bipolar disorder and schizophrenia. Psychol Med 2010; 40:1337-1347. [PMID: 19891810 DOI: 10.1017/s0033291709991620] [Citation(s) in RCA: 54] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Cannabis use is associated with altered neurocognitive functioning in severe mental disorders, but data are still inconclusive and there are no studies of bipolar disorder. The aim of this study was to investigate the association between cannabis use and neurocognition in bipolar disorder compared with schizophrenia in a naturalistic setting. METHOD A total of 133 patients with bipolar disorder and 140 patients with schizophrenia underwent neuropsychological assessments and clinical characterization including measures of substance use. Relationships between cannabis users and neurocognitive function were explored in the two diagnostic groups. Possible interactions between diagnosis and cannabis use were investigated, and findings were controlled for possible confounders. RESULTS In bipolar disorder subjects, cannabis use was associated with better neurocognitive function, but the opposite was the case for the schizophrenia subjects. There was a statistically significant interaction effect of diagnosis and cannabis use on focused attention (p=0.019), executive functioning (verbal fluency--set shifting) (p=0.009), logical memory-learning (p=0.007) and on logical memory-recall (p=0.004). These differences in neurocognitive function could not be explained by putative confounders. CONCLUSIONS The findings suggest that cannabis use may be related to improved neurocognition in bipolar disorder and compromised neurocognition in schizophrenia. The results need to be replicated in independent samples, and may suggest different underlying disease mechanisms in the two disorders.
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Affiliation(s)
- P A Ringen
- Institute of Psychiatry, University of Oslo, N-0318 Oslo, Norway
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Quantifying over-activity in bipolar and schizophrenia patients in a human open field paradigm. Psychiatry Res 2010; 178:84-91. [PMID: 20471103 PMCID: PMC2914139 DOI: 10.1016/j.psychres.2010.04.032] [Citation(s) in RCA: 63] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/14/2010] [Revised: 04/07/2010] [Accepted: 04/19/2010] [Indexed: 11/22/2022]
Abstract
It has been suggested that a cardinal symptom of mania is over-activity and exaggerated goal-directed behavior. Nevertheless, few attempts have been made to quantify this behavior objectively in a laboratory environment. Having a methodology to assess over-activity reliably might be useful in distinguishing manic bipolar disorder (BD) from schizophrenia (SCZ) during highly activated states. In the current study, quantifiable measures of object interaction were assessed using a multivariate approach. Additionally, symptom correlates of over-activity were assessed. Patients admitted to an acute care psychiatric hospital for either BD with mania or SCZ (paranoid and non-paranoid subtypes) as well as non-patient comparison (NC) participants were assessed in an open field setting referred to as the human Behavioral Pattern Monitor (hBPM). Activity and interactions with novel and engaging objects were recorded for 15min via a concealed video camera and rated for exploratory behavior. Both BD and SCZ patients spent more time near the objects and exhibited more overall walking compared to NC. In contrast, BD patients exhibited greater physical contact with objects (number of object interactions and time spent with objects) relative to SCZ patients or NC participants, as well as more perseverative and socially disinhibited behaviors, indicating a unique pattern of over-activity and goal-directed behavior. Further analyses revealed a distinction between SCZ patients according to their subtype. The current study extends our methodology for quantifying exploration and over-activity in a controlled laboratory setting and aids in assessing the overlap and distinguishing characteristics of BD and SCZ.
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32
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Ivleva EI, Morris DW, Moates AF, Suppes T, Thaker GK, Tamminga CA. Genetics and intermediate phenotypes of the schizophrenia--bipolar disorder boundary. Neurosci Biobehav Rev 2010; 34:897-921. [PMID: 19954751 DOI: 10.1016/j.neubiorev.2009.11.022] [Citation(s) in RCA: 115] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2009] [Revised: 11/20/2009] [Accepted: 11/23/2009] [Indexed: 12/20/2022]
Abstract
Categorization of psychotic illnesses into schizophrenic and affective psychoses remains an ongoing controversy. Although Kraepelinian subtyping of psychosis was historically beneficial, modern genetic and neurophysiological studies do not support dichotomous conceptualization of psychosis. Evidence suggests that schizophrenia and bipolar disorder rather present a clinical continuum with partially overlapping symptom dimensions, neurophysiology, genetics and treatment responses. Recent large scale genetic studies have produced inconsistent findings and exposed an urgent need for re-thinking phenomenology-based approach in psychiatric research. Epidemiological, linkage and molecular genetic studies, as well as studies in intermediate phenotypes (neurocognitive, neurophysiological and anatomical imaging) in schizophrenia and bipolar disorders are reviewed in order to support a dimensional conceptualization of psychosis. Overlapping and unique genetic and intermediate phenotypic signatures of the two psychoses are comprehensively recapitulated. Alternative strategies which may be implicated into genetic research are discussed.
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Affiliation(s)
- Elena I Ivleva
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX 75235, USA.
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Abstract
Psychiatric diseases place a tremendous burden on affected individuals, their caregivers, and the health care system. Although evidence exists for a strong inherited component to many of these conditions, dedicated efforts to identify DNA sequence-based causes have not been exceptionally productive, and very few pharmacologic treatment options are clinically available. Many features of psychiatric diseases are consistent with an epigenetic dysregulation, such as discordance of monozygotic twins, late age of onset, parent-of-origin and sex effects, and fluctuating disease course. In recent years, experimental technologies have significantly advanced, permitting indepth studies of the epigenome and its role in maintenance of normal genomic functions, as well as disease etiopathogenesis. Here, we present an epigenetic explanation for many characteristics of psychiatric disease, review the current literature on the epigenetic mechanisms involved in major psychosis, Alzheimer's disease, and autism spectrum disorders, and describe some future directions in the field of psychiatric epigenomics.
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Affiliation(s)
- Carolyn Ptak
- The Krembil Family Epigenetics Laboratory, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
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Affiliation(s)
- B Millet
- CHU, Service de psychiatrie, 108 avenue du Général Leclerc, 35703 Rennes Cedex 7, France.
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35
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Pae CU, Chiesa A, Mandelli L, De Ronchi D, Serretti A. No influence of FAT polymorphisms in response to aripiprazole. J Hum Genet 2009; 55:32-6. [DOI: 10.1038/jhg.2009.117] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Kirby BP, Waddington JL, O'Tuathaigh CMP. Advancing a functional genomics for schizophrenia: psychopathological and cognitive phenotypes in mutants with gene disruption. Brain Res Bull 2009; 83:162-76. [PMID: 19800398 DOI: 10.1016/j.brainresbull.2009.09.010] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2009] [Revised: 08/18/2009] [Accepted: 09/21/2009] [Indexed: 12/19/2022]
Abstract
Schizophrenia is a complex, heritable psychotic disorder in which numerous genes and environmental adversities appear to interact in determining disease phenotype. In addition to genes regulating putative pathophysiological mechanisms, a new generation of molecular studies has indicated numerous candidate genes to be associated with risk for schizophrenia. The present review focuses on studies in mice mutant for genes associated with putative pathophysiological mechanisms and candidate risk genes for the disorder. It seeks to evaluate the extent to which each mutation of a schizophrenia-related gene accurately models multiple aspects of the schizophrenia phenotype or more circumscribed, distinct endophenotypes in terms of psychopathology and pathobiology; in doing so, it places particular emphasis on positive symptoms, negative symptoms and cognitive dysfunction. To further this goal, it juxtaposes continually evolving mutant genomics with emergent clinical genomic studies. Opportunities and challenges associated with the use of such mutants, including diagnostic specificity and the translational barrier associated with modelling schizophrenia, are discussed. The potential value of genetic models for exploring gene-gene and gene-environment interactions relating to schizophrenia is highlighted. Elucidation of the contribution of genetic variation to specific symptom clusters and underlying aspects of pathobiology will have important implications for identifying treatments that target distinct domains of psychopathology and dysfunction on an individual patient basis.
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Affiliation(s)
- Brian P Kirby
- School of Pharmacy, Royal College of Surgeons in Ireland, Dublin 2, Ireland
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A comparison of neuropsychological dysfunction in first-episode psychosis patients with unipolar depression, bipolar disorder, and schizophrenia. Schizophr Res 2009; 113:167-75. [PMID: 19450952 PMCID: PMC2773205 DOI: 10.1016/j.schres.2009.04.020] [Citation(s) in RCA: 107] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2008] [Revised: 04/06/2009] [Accepted: 04/09/2009] [Indexed: 01/29/2023]
Abstract
The severity and profile of cognitive dysfunction in first episode schizophrenia and psychotic affective disorders were compared before and after antipsychotic treatment. Parallel recruitment of consecutively admitted study-eligible first-episode psychotic patients (30 schizophrenia, 22 bipolar with psychosis, and 21 psychotic depression) reduced confounds of acute and chronic disease/medication effects as well as differential treatment and course. Patient groups completed a neuropsychological battery and were demographically similar to healthy controls (n=41) studied in parallel. Prior to treatment, schizophrenia patients displayed significant deficits in all cognitive domains. The two psychotic affective groups were also impaired overall, generally performing intermediate between the schizophrenia and healthy comparison groups. No profile differences in neuropsychological deficits were observed across patient groups. Following 6 weeks of treatment, no patient group improved more than practice effects seen in healthy individuals, and level of performance improvement was similar for affective psychosis and schizophrenia groups. Although less severe in psychotic affective disorders, similar profiles of generalized neuropsychological deficits were observed across patient groups. Recovery of cognitive function after clinical stabilization was similar in mood disorders and schizophrenia. To the extent that these findings are generalizable, neuropsychological deficits in psychotic affective disorders, like schizophrenia, may be trait-like deficits with persistent functional implications.
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Abstract
Kraepelin proposed dementia praecox and manic-depressive illness as the two major psychotic disorders. This paradigm is still prevalent, but observations of overlapping boundaries between bipolar disorder and schizophrenia challenge this dichotomy. However, the concept of schizophrenia has been radically altered from the original Kraepelinian proposal. We defend the two psychoses positions, but suggest two flaws in the heuristic application: (1) overlapping features, such as psychotic symptoms, are not decisive in differential diagnosis; and (2) each disorder is a syndrome, not a disease entity. An alternative paradigm based on domains of pathology is more powerful for studies of etiology, pathophysiology, and therapeutic discovery.
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Choi KH, Elashoff M, Higgs BW, Song J, Kim S, Sabunciyan S, Diglisic S, Yolken RH, Knable MB, Torrey EF, Webster MJ. Putative psychosis genes in the prefrontal cortex: combined analysis of gene expression microarrays. BMC Psychiatry 2008; 8:87. [PMID: 18992145 PMCID: PMC2585075 DOI: 10.1186/1471-244x-8-87] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2008] [Accepted: 11/07/2008] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND Recent studies have shown similarities between schizophrenia and bipolar disorder in phenotypes and in genotypes, and those studies have contributed to an ongoing re-evaluation of the traditional dichotomy between schizophrenia and bipolar disorder. Bipolar disorder with psychotic features may be closely related to schizophrenia and therefore, psychosis may be an alternative phenotype compared to the traditional diagnosis categories. METHODS We performed a cross-study analysis of 7 gene expression microarrays that include both psychosis and non-psychosis subjects. These studies include over 400 microarray samples (163 individual subjects) on 3 different Affymetrix microarray platforms. RESULTS We found that 110 transcripts are differentially regulated (p < 0.001) in psychosis after adjusting for confounding variables with a multiple regression model. Using a quantitative PCR, we validated a set of genes such as up-regulated metallothioneins (MT1E, MT1F, MT1H, MT1K, MT1X, MT2A and MT3) and down-regulated neuropeptides (SST, TAC1 and NPY) in the dorsolateral prefrontal cortex of psychosis patients. CONCLUSION This study demonstrates the advantages of cross-study analysis in detecting consensus changes in gene expression across multiple microarray studies. Differential gene expression between individuals with and without psychosis suggests that psychosis may be a useful phenotypic variable to complement the traditional diagnosis categories.
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Affiliation(s)
- Kwang Ho Choi
- Stanley Laboratory of Brain Research, 9800 Medical Center Dr. Bldg 2C, Rockville, MD 20850, USA.
| | | | | | - Jonathan Song
- Stanley Laboratory of Brain Research, 9800 Medical Center Dr. Bldg 2C, Rockville, MD 20850, USA
| | - Sanghyeon Kim
- Stanley Laboratory of Brain Research, 9800 Medical Center Dr. Bldg 2C, Rockville, MD 20850, USA
| | - Sarven Sabunciyan
- Stanley Laboratory of Developmental Neurovirology, Johns Hopkins University, School of Medicine, 600 North Wolfe Street, Blalock 1105, Baltimore, MD 21287, USA
| | - Suad Diglisic
- Stanley Laboratory of Brain Research, 9800 Medical Center Dr. Bldg 2C, Rockville, MD 20850, USA
| | - Robert H Yolken
- Stanley Laboratory of Developmental Neurovirology, Johns Hopkins University, School of Medicine, 600 North Wolfe Street, Blalock 1105, Baltimore, MD 21287, USA
| | - Michael B Knable
- Stanley Medical Research Institute, 8401 Connecticut Ave, Suite 200, Chevy Chase, MD 20815, USA
| | - E Fuller Torrey
- Stanley Medical Research Institute, 8401 Connecticut Ave, Suite 200, Chevy Chase, MD 20815, USA
| | - Maree J Webster
- Stanley Laboratory of Brain Research, 9800 Medical Center Dr. Bldg 2C, Rockville, MD 20850, USA
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