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Zhan N, Sham PC, So HC, Lui SSY. The genetic basis of onset age in schizophrenia: evidence and models. Front Genet 2023; 14:1163361. [PMID: 37441552 PMCID: PMC10333597 DOI: 10.3389/fgene.2023.1163361] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Accepted: 06/16/2023] [Indexed: 07/15/2023] Open
Abstract
Schizophrenia is a heritable neurocognitive disorder affecting about 1% of the population, and usually has an onset age at around 21-25 in males and 25-30 in females. Recent advances in genetics have helped to identify many common and rare variants for the liability to schizophrenia. Earlier evidence appeared to suggest that younger onset age is associated with higher genetic liability to schizophrenia. Clinical longitudinal research also found that early and very-early onset schizophrenia are associated with poor clinical, neurocognitive, and functional profiles. A recent study reported a heritability of 0.33 for schizophrenia onset age, but the genetic basis of this trait in schizophrenia remains elusive. In the pre-Genome-Wide Association Study (GWAS) era, genetic loci found to be associated with onset age were seldom replicated. In the post-Genome-Wide Association Study era, new conceptual frameworks are needed to clarify the role of onset age in genetic research in schizophrenia, and to identify its genetic basis. In this review, we first discussed the potential of onset age as a characterizing/subtyping feature for psychosis, and as an important phenotypic dimension of schizophrenia. Second, we reviewed the methods, samples, findings and limitations of previous genetic research on onset age in schizophrenia. Third, we discussed a potential conceptual framework for studying the genetic basis of onset age, as well as the concepts of susceptibility, modifier, and "mixed" genes. Fourth, we discussed the limitations of this review. Lastly, we discussed the potential clinical implications for genetic research of onset age of schizophrenia, and how future research can unveil the potential mechanisms for this trait.
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Affiliation(s)
- Na Zhan
- Department of Psychiatry, School of Clinical Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Pak C. Sham
- Department of Psychiatry, School of Clinical Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- Centre of PanorOmic Sciences, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
| | - Hon-Cheong So
- School of Biomedical Sciences, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
- KIZ-CUHK Joint Laboratory of Bioresources and Molecular Research of Common Diseases, Kunming Institute of Zoology and the Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
- Department of Psychiatry, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
- CUHK Shenzhen Research Institute, Shenzhen, China
- Margaret K. L. Cheung Research Centre for Management of Parkinsonism, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
- Brain and Mind Institute, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
- Hong Kong Branch of the Chinese Academy of Sciences Center for Excellence in Animal Evolution and Genetics, The Chinese University of Hong Kong, Shatin, Hong Kong SAR, China
| | - Simon S. Y. Lui
- Department of Psychiatry, School of Clinical Medicine, The University of Hong Kong, Hong Kong, Hong Kong SAR, China
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Hui L, Hu WM, Zhu ZH, Gao ST, Han M, Fan Y, Tian Q, Yin XY, Yuan Y, Jiang CX, Yin GZ, Jia QF, Zhang XY. Association between dopamine beta-hydroxylase polymorphism and attention function in suicide attempters with chronic schizophrenia. Hum Psychopharmacol 2020; 35:1-8. [PMID: 32896003 DOI: 10.1002/hup.2755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 07/13/2020] [Accepted: 08/03/2020] [Indexed: 11/11/2022]
Abstract
BACKGROUND Patients with schizophrenia are at a higher risk for suicide compared with the general population. Dopamine beta-hydroxylase (DβH) plays a key role in the conversion of dopamine to norepinephrine, which is related to suicidal behavior and cognitive regulation. OBJECTIVE To examine whether there is the effect of DβH 5'-insertion/deletion (Ins/Del) polymorphism on cognitive performance in suicide attempters with chronic schizophrenia. METHODS This polymorphism was detected in 114 suicide attempters and 617 non-suicide attempters with chronic schizophrenia. Cognitive performance was assessed by the Repeatable Battery for the Assessment of Neuropsychological Status (RBANS). RESULTS The allelic and genotypic frequencies of this polymorphism between two groups did not differ after controlling for covariates (both, p > .05). There were no differences in RBANS scores between two groups after adjusting for covariates (all, p > .05). However, based on the genotype grouping in suicide attempters and non-attempters, the attention score significantly differed after adjusting for covariates (both, p < .05). Further analysis indicated that this polymorphism was associated with attention score in suicide attempters (p < .05), but not in non-suicide attempters (p > .05). CONCLUSIONS DβH 5'-Ins/Del polymorphism was not a risk locus of suicide attempters, but it was implicated in attention regulation in suicide attempters with chronic schizophrenia.
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Affiliation(s)
- Li Hui
- Research Center of Biological Psychiatry, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Wei Ming Hu
- Mental Health Center of Yanqing District, Beijing, China
| | - Zhen Hua Zhu
- Research Center of Biological Psychiatry, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | | | - Mei Han
- School of Medicine, University of Wollongong, Wollongong, New South Wales, Australia
| | - Yu Fan
- Research Center of Biological Psychiatry, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Qing Tian
- Research Center of Biological Psychiatry, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Xu Yuan Yin
- Research Center of Biological Psychiatry, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Ying Yuan
- Research Center of Biological Psychiatry, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Cai Xia Jiang
- Research Center of Biological Psychiatry, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Guang Zhong Yin
- Research Center of Biological Psychiatry, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Qiu Fang Jia
- Research Center of Biological Psychiatry, The Affiliated Guangji Hospital of Soochow University, Suzhou, China
| | - Xiang Yang Zhang
- Research Center of Biological Psychiatry, The Affiliated Guangji Hospital of Soochow University, Suzhou, China.,Institute of Psychology, Chinese Academy of Sciences, Beijing, China
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Abstract
Since its earliest conceptualization, schizophrenia has been considered a disorder of "young men." Contemporary research suggests that there are sex differences in schizophrenia that are both transdiagnostic and representative of general sex/gender differences across the psychopathology spectrum. This chapter selectively summarizes representative sex/gender differences in clinical expression, epidemiology, risk factors, treatment, as well as course and outcome in schizophrenia. The consistent sex differences found, such as onset age, generic brain anomalies, and hormonal involvement, are not specific to schizophrenia or necessarily to psychopathology. It is suggested that in working with those diagnosed as meeting the current criteria for schizophrenia, clinicians adopt a transdiagnostic framework informed by sex and gender role processes.
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Affiliation(s)
- Richard Lewine
- Department of Psychological and Brain Sciences, University of Louisville, Louisville, KY, United States.
| | - Mara Hart
- Department of Psychiatry, Worcester Recovery Center and Hospital, Worcester, MA, United States
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Gonzalez‐Lopez E, Vrana KE. Dopamine beta‐hydroxylase and its genetic variants in human health and disease. J Neurochem 2019; 152:157-181. [DOI: 10.1111/jnc.14893] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2019] [Revised: 09/18/2019] [Accepted: 09/26/2019] [Indexed: 12/12/2022]
Affiliation(s)
| | - Kent E. Vrana
- Department of Pharmacology Penn State College of Medicine Hershey PA USA
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