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Scott K, Alda M. Integrating Polygenic Scores and Phenotypic Data to Understand Psychiatric Outcomes. Am J Psychiatry 2024; 181:572-574. [PMID: 38946280 DOI: 10.1176/appi.ajp.20240398] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/02/2024]
Affiliation(s)
- Katie Scott
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada (Scott, Alda); National Institute of Mental Health, Klecany, Czech Republic (Alda)
| | - Martin Alda
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada (Scott, Alda); National Institute of Mental Health, Klecany, Czech Republic (Alda)
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Scott J, Crouse JJ, Medland S, Byrne E, Iorfino F, Mitchell B, Gillespie NA, Martin N, Wray N, Hickie IB. Polygenic risk scores and the prediction of onset of mood and psychotic disorders in adolescents and young adults. Early Interv Psychiatry 2024; 18:397-405. [PMID: 37787636 PMCID: PMC11100301 DOI: 10.1111/eip.13472] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2023] [Revised: 09/02/2023] [Accepted: 09/25/2023] [Indexed: 10/04/2023]
Abstract
AIM To examine whether polygenic risk scores (PRS) for neuroticism, depression, bipolar disorder and schizophrenia are higher in individuals manifesting trans-diagnostic risk factors for the development of major mental disorders and whether PRS enhance prediction of early onset full-threshold disorders. METHODS Using data from the Brisbane Longitudinal Twin Study, we examined individual PRS for neuroticism, depression, bipolar disorder and schizophrenia, recorded evidence of subthreshold syndromes and family history of mood and/or psychotic disorders and noted progression to trans-diagnostic clinical caseness (onset of major mental disorders) at follow-up. We undertook multivariate, receiver operating curve and logistic regression analyses that were adjusted for known variables of influence (age, twin status, and so on). RESULTS Of 1473 eligible participants (female = 866, 59%; mean age 26.3 years), 28% (n = 409) met caseness criteria for a mood and/or psychotic disorder. All PRS were higher in cases versus non-cases but associations with different levels of risk were inconsistent. The prediction of caseness (reported as area under the curve with 95% confidence intervals [CI]) improved from 0.68 (95% CI: 0.65, 0.71) when estimated using clinical risk factors alone up to 0.71 (95% CI: 0.69, 0.73) when PRS were added to the model. Logistic regression identified five variables that optimally classified individuals according to caseness: age, sex, individual risk characteristics, PRS for depression and mental health case status of cotwins or siblings. CONCLUSIONS The findings need replication. However, this exploratory study suggests that combining PRS with other risk factors has the potential to improve outcome prediction in youth.
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Affiliation(s)
- Jan Scott
- Brain and Mind Centre, The University of Sydney, Sydney, Australia
- Institute of Neuroscience, Newcastle University, Newcastle, United Kingdom
| | - Jacob J Crouse
- Brain and Mind Centre, The University of Sydney, Sydney, Australia
| | - Sarah Medland
- QIMR Berghofer Institute of Medical Research, Brisbane, Australia
- Institute of Molecular Bioscience, The University of Queensland, Brisbane, Australia
| | - Enda Byrne
- QIMR Berghofer Institute of Medical Research, Brisbane, Australia
| | - Frank Iorfino
- Brain and Mind Centre, The University of Sydney, Sydney, Australia
| | | | - Nathan A. Gillespie
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond VA, USA
| | - Nicholas Martin
- QIMR Berghofer Institute of Medical Research, Brisbane, Australia
| | - Naomi Wray
- Institute of Molecular Bioscience, The University of Queensland, Brisbane, Australia
- Queensland Brain Institute, The University of Queensland, Brisbane, Queensland,Australia
| | - Ian B. Hickie
- Brain and Mind Centre, The University of Sydney, Sydney, Australia
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Besterman AD. A genetics-guided approach to the clinical management of schizophrenia. Schizophr Res 2024; 267:462-469. [PMID: 37813777 DOI: 10.1016/j.schres.2023.09.042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2023] [Revised: 09/27/2023] [Accepted: 09/29/2023] [Indexed: 10/11/2023]
Abstract
Schizophrenia is a highly heritable, severe mental illness characterized by hallucinations, delusions, social withdrawal, and cognitive dysfunction present in ∼1% of populations across cultures. There have been recent major advancements in our understanding of the genetic architecture of schizophrenia. Both rare, highly penetrant genetic variants as well as common, low-penetrant genetic variants can predispose individuals to schizophrenia and can impact the way people metabolize psychoactive medications used to treat schizophrenia. However, the impact of these findings on the clinical management of schizophrenia remains limited. This review highlights the few places where genetics currently informs schizophrenia management strategies, discusses major limitations, and reviews promising areas of genetics research that are most likely to impact future schizophrenia care. Specifically, I focuss on psychiatric genetic counseling, genetic testing strategies, pharmacogenetics, polygenic risk, and genetics-guided treatment. Lastly, I emphasize important ethical considerations in the clinical use of genetics for schizophrenia management, including the exacerbation of healthcare inequalities and unintended consequences of new genetic technologies.
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Affiliation(s)
- Aaron D Besterman
- University of California San Diego, Department of Psychiatry, San Diego, CA, USA; Rady Children's Hospital San Diego, Division of Behavioral Health Services, San Diego, CA, USA; Rady Children's Institute for Genomic Medicine, San Diego, CA, USA.
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4
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Wannan CMJ, Nelson B, Addington J, Allott K, Anticevic A, Arango C, Baker JT, Bearden CE, Billah T, Bouix S, Broome MR, Buccilli K, Cadenhead KS, Calkins ME, Cannon TD, Cecci G, Chen EYH, Cho KIK, Choi J, Clark SR, Coleman MJ, Conus P, Corcoran CM, Cornblatt BA, Diaz-Caneja CM, Dwyer D, Ebdrup BH, Ellman LM, Fusar-Poli P, Galindo L, Gaspar PA, Gerber C, Glenthøj LB, Glynn R, Harms MP, Horton LE, Kahn RS, Kambeitz J, Kambeitz-Ilankovic L, Kane JM, Kapur T, Keshavan MS, Kim SW, Koutsouleris N, Kubicki M, Kwon JS, Langbein K, Lewandowski KE, Light GA, Mamah D, Marcy PJ, Mathalon DH, McGorry PD, Mittal VA, Nordentoft M, Nunez A, Pasternak O, Pearlson GD, Perez J, Perkins DO, Powers AR, Roalf DR, Sabb FW, Schiffman J, Shah JL, Smesny S, Spark J, Stone WS, Strauss GP, Tamayo Z, Torous J, Upthegrove R, Vangel M, Verma S, Wang J, Rossum IWV, Wolf DH, Wolff P, Wood SJ, Yung AR, Agurto C, Alvarez-Jimenez M, Amminger P, Armando M, Asgari-Targhi A, Cahill J, Carrión RE, Castro E, Cetin-Karayumak S, Mallar Chakravarty M, Cho YT, Cotter D, D’Alfonso S, Ennis M, Fadnavis S, Fonteneau C, Gao C, Gupta T, Gur RE, Gur RC, Hamilton HK, Hoftman GD, Jacobs GR, Jarcho J, Ji JL, Kohler CG, Lalousis PA, Lavoie S, Lepage M, Liebenthal E, Mervis J, Murty V, Nicholas SC, Ning L, Penzel N, Poldrack R, Polosecki P, Pratt DN, Rabin R, Rahimi Eichi H, Rathi Y, Reichenberg A, Reinen J, Rogers J, Ruiz-Yu B, Scott I, Seitz-Holland J, Srihari VH, Srivastava A, Thompson A, Turetsky BI, Walsh BC, Whitford T, Wigman JTW, Yao B, Yuen HP, Ahmed U, Byun A(JS, Chung Y, Do K, Hendricks L, Huynh K, Jeffries C, Lane E, Langholm C, Lin E, Mantua V, Santorelli G, Ruparel K, Zoupou E, Adasme T, Addamo L, Adery L, Ali M, Auther A, Aversa S, Baek SH, Bates K, Bathery A, Bayer JMM, Beedham R, Bilgrami Z, Birch S, Bonoldi I, Borders O, Borgatti R, Brown L, Bruna A, Carrington H, Castillo-Passi RI, Chen J, Cheng N, Ching AE, Clifford C, Colton BL, Contreras P, Corral S, Damiani S, Done M, Estradé A, Etuka BA, Formica M, Furlan R, Geljic M, Germano C, Getachew R, Goncalves M, Haidar A, Hartmann J, Jo A, John O, Kerins S, Kerr M, Kesselring I, Kim H, Kim N, Kinney K, Krcmar M, Kotler E, Lafanechere M, Lee C, Llerena J, Markiewicz C, Matnejl P, Maturana A, Mavambu A, Mayol-Troncoso R, McDonnell A, McGowan A, McLaughlin D, McIlhenny R, McQueen B, Mebrahtu Y, Mensi M, Hui CLM, Suen YN, Wong SMY, Morrell N, Omar M, Partridge A, Phassouliotis C, Pichiecchio A, Politi P, Porter C, Provenzani U, Prunier N, Raj J, Ray S, Rayner V, Reyes M, Reynolds K, Rush S, Salinas C, Shetty J, Snowball C, Tod S, Turra-Fariña G, Valle D, Veale S, Whitson S, Wickham A, Youn S, Zamorano F, Zavaglia E, Zinberg J, Woods SW, Shenton ME. Accelerating Medicines Partnership® Schizophrenia (AMP® SCZ): Rationale and Study Design of the Largest Global Prospective Cohort Study of Clinical High Risk for Psychosis. Schizophr Bull 2024; 50:496-512. [PMID: 38451304 PMCID: PMC11059785 DOI: 10.1093/schbul/sbae011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/08/2024]
Abstract
This article describes the rationale, aims, and methodology of the Accelerating Medicines Partnership® Schizophrenia (AMP® SCZ). This is the largest international collaboration to date that will develop algorithms to predict trajectories and outcomes of individuals at clinical high risk (CHR) for psychosis and to advance the development and use of novel pharmacological interventions for CHR individuals. We present a description of the participating research networks and the data processing analysis and coordination center, their processes for data harmonization across 43 sites from 13 participating countries (recruitment across North America, Australia, Europe, Asia, and South America), data flow and quality assessment processes, data analyses, and the transfer of data to the National Institute of Mental Health (NIMH) Data Archive (NDA) for use by the research community. In an expected sample of approximately 2000 CHR individuals and 640 matched healthy controls, AMP SCZ will collect clinical, environmental, and cognitive data along with multimodal biomarkers, including neuroimaging, electrophysiology, fluid biospecimens, speech and facial expression samples, novel measures derived from digital health technologies including smartphone-based daily surveys, and passive sensing as well as actigraphy. The study will investigate a range of clinical outcomes over a 2-year period, including transition to psychosis, remission or persistence of CHR status, attenuated positive symptoms, persistent negative symptoms, mood and anxiety symptoms, and psychosocial functioning. The global reach of AMP SCZ and its harmonized innovative methods promise to catalyze the development of new treatments to address critical unmet clinical and public health needs in CHR individuals.
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Affiliation(s)
- Cassandra M J Wannan
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Barnaby Nelson
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Jean Addington
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, AB, Canada
| | - Kelly Allott
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Alan Anticevic
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, Instituto de Salud Carlos III, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Justin T Baker
- Department of Psychiatry, McLean Hospital and Harvard Medical School, Boston, MA, USA
| | - Carrie E Bearden
- Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
- Department Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Tashrif Billah
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Sylvain Bouix
- Department of Software Engineering and Information Technology, École de technologie supérieure, Montréal, Canada
| | - Matthew R Broome
- School of Psychology, Institute for Mental Health, University of Birmingham, Birmingham, UK
- Early Intervention for Psychosis Services, Birmingham Women’s and Children’s NHS Foundation Trust, Birmingham, UK
| | - Kate Buccilli
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | | | - Monica E Calkins
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Tyrone D Cannon
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Department of Psychology, Yale University, New Haven, CT, USA
| | | | - Eric Yu Hai Chen
- Department of Psychiatry, University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Kang Ik K Cho
- Department Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Jimmy Choi
- Olin Neuropsychiatry Research Center, Hartford Hospital, Hartford, CT, USA
| | - Scott R Clark
- Discipline of Psychiatry, University of Adelaide, Adelaide, SA, Australia
- Basil Hetzel Institute, Woodville, SA, Australia
| | - Michael J Coleman
- Department Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Philippe Conus
- General Psychiatry Service, Treatment and Early Intervention in Psychosis Program (TIPP–Lausanne), Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland
| | - Cheryl M Corcoran
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Barbara A Cornblatt
- Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Covadonga M Diaz-Caneja
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, IiSGM, CIBERSAM, Instituto de Salud Carlos III, School of Medicine, Universidad Complutense, Madrid, Spain
| | - Dominic Dwyer
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Bjørn H Ebdrup
- Centre for Neuropsychiatric Schizophrenia Research, CNSR Mental Health Centre, Glostrup, Copenhagen, Denmark
| | - Lauren M Ellman
- Department of Psychology and Neuroscience, Temple University, Philadelphia, PA, USA
| | - Paolo Fusar-Poli
- Department of Psychosis Studies, King’s College London, London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Liliana Galindo
- Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Pablo A Gaspar
- Department of Psychiatry, IMHAY, University of Chile, Santiago, Chile
| | - Carla Gerber
- Behavioral Health Services, PeaceHealth Medical Group, Eugene, OR, USA
| | - Louise Birkedal Glenthøj
- Copenhagen Research Centre for Mental Health, Mental Health Copenhagen, University of Copenhagen, Denmark
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - Robert Glynn
- Department of Medicine, Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA
- Department of Biostatistics, Harvard T.H. Chan School of Public Health and Harvard Medical School, Boston, MA, USA
| | - Michael P Harms
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Leslie E Horton
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - René S Kahn
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Joseph Kambeitz
- Department of Psychiatry, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - Lana Kambeitz-Ilankovic
- Department of Psychiatry, Faculty of Medicine and University Hospital Cologne, University of Cologne, Cologne, Germany
| | - John M Kane
- Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Tina Kapur
- Department of Radiology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Matcheri S Keshavan
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
- Mindlink, Gwangju Bukgu Mental Health Center, Gwangju, Korea
| | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig Maximilian University of Munich, Munich, Germany
| | - Marek Kubicki
- Department Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Jun Soo Kwon
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, Korea
- Department of Neuropsychiatry, Seoul National University Hospital, Seoul, Korea
| | - Kerstin Langbein
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Kathryn E Lewandowski
- Department of Psychiatry, McLean Hospital and Harvard Medical School, Boston, MA, USA
| | - Gregory A Light
- Department of Psychiatry, University of California, San Diego, CA, USA
- Veterans Affairs San Diego Health Care System, San Diego, CA, USA
| | - Daniel Mamah
- Department of Psychiatry, Washington University Medical School, St. Louis, MO, USA
| | | | - Daniel H Mathalon
- Department of Psychiatry and Behavioral Sciences and Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
- Mental Health Service 116D, Veterans Affairs San Francisco Health Care System, San Francisco, CA, USA
| | - Patrick D McGorry
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Vijay A Mittal
- Department of Psychology, Northwestern University, Evanston, IL, USA
| | - Merete Nordentoft
- Copenhagen Research Centre for Mental Health, Mental Health Copenhagen, University of Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - Angela Nunez
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - Ofer Pasternak
- Department Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Godfrey D Pearlson
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Olin Neuropsychiatry Research Center, Hartford Hospital, Hartford, CT, USA
| | - Jesus Perez
- CAMEO, Early Intervention in Psychosis Service, Cambridgeshire and Peterborough NHS Foundation Trust, Cambridge, UK
- Department of Medicine, Institute of Biomedical Research (IBSAL), Universidad de Salamanca, Salamanca, Spain
| | - Diana O Perkins
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Albert R Powers
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - David R Roalf
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Fred W Sabb
- Prevention Science Institute, University of Oregon, Eugene, OR, USA
| | - Jason Schiffman
- Department of Psychological Science, University of California, Irvine, Irvine, CA, USA
| | - Jai L Shah
- PEPP-Montreal, Douglas Research Centre, Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Stefan Smesny
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Jessica Spark
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - William S Stone
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | | | - Zailyn Tamayo
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - John Torous
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Rachel Upthegrove
- Department of Software Engineering and Information Technology, École de technologie supérieure, Montréal, Canada
- Birmingham Womens and Childrens, NHS Foundation Trust, Birmingham, UK
| | - Mark Vangel
- Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Swapna Verma
- Department of Psychosis, Institute of Mental Health, Singapore
| | - Jijun Wang
- Shanghai Mental Health Center, Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - Inge Winter-van Rossum
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Daniel H Wolf
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Phillip Wolff
- Department of Psychology, Emory University, Atlanta, GA, USA
| | - Stephen J Wood
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
- School of Psychology, University of Birmingham, Edgbaston, UK
| | - Alison R Yung
- Institute of Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Geelong, VIC, Australia
- School of Health Sciences, University of Manchester, Manchester, UK
| | - Carla Agurto
- IBM T.J. Watson Research Center, Yorktown Heights, NY, USA
| | - Mario Alvarez-Jimenez
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Paul Amminger
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Marco Armando
- Youth Early Detection/Intervention in Psychosis Platform (Plateforme ERA), Service of Child and Adolescent Psychiatry, Department of Psychiatry, Lausanne University Hospital and The University of Lausanne, Lausanne, Switzerland
| | | | - John Cahill
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - Ricardo E Carrión
- Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
- Institute of Behavioral Science, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Eduardo Castro
- IBM T.J. Watson Research Center, Yorktown Heights, NY, USA
| | - Suheyla Cetin-Karayumak
- Department Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | | | - Youngsun T Cho
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - David Cotter
- Department Psychiatry, Beaumont Hospital, Dublin 9, Ireland
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Simon D’Alfonso
- School of Computing and Information Systems, The University of Melbourne, Parkville, VIC, Australia
| | - Michaela Ennis
- Department of Psychiatry, McLean Hospital and Harvard Medical School, Boston, MA, USA
| | - Shreyas Fadnavis
- Department Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Clara Fonteneau
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - Caroline Gao
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Tina Gupta
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Raquel E Gur
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Ruben C Gur
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Holly K Hamilton
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Gil D Hoftman
- Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
- Department Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Grace R Jacobs
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Johanna Jarcho
- Department of Psychology and Neuroscience, Temple University, Philadelphia, PA, USA
| | - Jie Lisa Ji
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - Christian G Kohler
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Paris Alexandros Lalousis
- School of Psychology, Institute for Mental Health, University of Birmingham, Birmingham, UK
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Suzie Lavoie
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Martin Lepage
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Einat Liebenthal
- Program for Specialized Treatment Early in Psychosis (STEP), CMHC, New Haven, CT, USA
| | - Josh Mervis
- Department of Psychology and Neuroscience, Temple University, Philadelphia, PA, USA
| | - Vishnu Murty
- Department of Psychology and Neuroscience, Temple University, Philadelphia, PA, USA
| | - Spero C Nicholas
- Department of Psychiatry, Washington University Medical School, St. Louis, MO, USA
| | - Lipeng Ning
- Department Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Radiology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Nora Penzel
- Department Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Russell Poldrack
- Department of Psychology, Stanford University, Stanford, CA, USA
| | | | - Danielle N Pratt
- Department of Psychology, Northwestern University, Evanston, IL, USA
| | - Rachel Rabin
- PEPP-Montreal, Douglas Research Centre, Montreal, Quebec, Canada
| | | | - Yogesh Rathi
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- Department of Radiology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Avraham Reichenberg
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jenna Reinen
- IBM T.J. Watson Research Center, Yorktown Heights, NY, USA
| | - Jack Rogers
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Bernalyn Ruiz-Yu
- Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Isabelle Scott
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Johanna Seitz-Holland
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Vinod H Srihari
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Program for Specialized Treatment Early in Psychosis (STEP), CMHC, New Haven, CT, USA
| | - Agrima Srivastava
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Andrew Thompson
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Bruce I Turetsky
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Barbara C Walsh
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - Thomas Whitford
- Orygen, Parkville, VIC, Australia
- School of Psychology, University of New South Wales (UNSW), Kensington, NSW, Australia
| | - Johanna T W Wigman
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion Regulation, University of Groningen, University Medical Center,Groningen, Netherlands
| | - Beier Yao
- Department of Psychiatry, McLean Hospital and Harvard Medical School, Boston, MA, USA
| | - Hok Pan Yuen
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | | | - Andrew (Jin Soo) Byun
- Division of Digital Psychiatry, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, MA, USA
- John A. Paulson School of Engineering and Applied Sciences, Harvard University, Cambridge, MA, USA
| | - Yoonho Chung
- Department of Psychiatry, McLean Hospital and Harvard Medical School, Boston, MA, USA
| | - Kim Do
- Department of Psychiatry, Center for Psychiatric Neuroscience, Lausanne University Hospital and University of Lausanne (CHUV-UNIL), Lausanne, Switzerland
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience King’s College London, London, UK
| | - Larry Hendricks
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Kevin Huynh
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Clark Jeffries
- Renaissance Computing Institute, University of North Carolina, Chapel Hill, NC, USA
| | - Erlend Lane
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Carsten Langholm
- Department of Psychiatry, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston, MA, USA
| | - Eric Lin
- Department of Psychiatry, McLean Hospital and Harvard Medical School, Boston, MA, USA
- Medical Informatics Fellowship, Veteran Affairs Boston Healthcare System, Boston, MA, USA
- Food and Drug Administration, Silver Spring, MD, USA
| | - Valentina Mantua
- Department of Psychiatry, Neurodevelopment & Psychosis Section, University of Pennsylvania, Philadelphia, PA, USA
| | - Gennarina Santorelli
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Kosha Ruparel
- Department of Psychology, Yale University, New Haven, CT, USA
| | - Eirini Zoupou
- Department of Psychology, Yale University, New Haven, CT, USA
| | - Tatiana Adasme
- Department of Psychiatry, IMHAY, University of Chile, Santiago, Chile
| | - Lauren Addamo
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Laura Adery
- Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
- Department Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Munaza Ali
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - Andrea Auther
- Department of Psychiatry, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA
| | - Samantha Aversa
- PEPP-Montreal, Douglas Research Centre, Montreal, Quebec, Canada
| | - Seon-Hwa Baek
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
- Mindlink, Gwangju Bukgu Mental Health Center, Gwangju, Korea
| | - Kelly Bates
- Department of Psychology, Northwestern University, Evanston, IL, USA
| | - Alyssa Bathery
- Department of Psychiatry, Neurodevelopment & Psychosis Section, University of Pennsylvania, Philadelphia, PA, USA
| | - Johanna M M Bayer
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Rebecca Beedham
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Zarina Bilgrami
- Department of Psychology, Emory University, Atlanta, GA, USA
| | - Sonia Birch
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Ilaria Bonoldi
- Department of Psychosis Studies, King’s College London, London, UK
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Owen Borders
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Renato Borgatti
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- IRCCS Mondino Foundation, Pavia, Italy
| | - Lisa Brown
- Department of Radiology, Brigham and Women’s Hospital, Boston, MA, USA
| | - Alejandro Bruna
- Department of Psychiatry, IMHAY, University of Chile, Santiago, Chile
| | - Holly Carrington
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Rolando I Castillo-Passi
- Department of Psychiatry, IMHAY, University of Chile, Santiago, Chile
- Department of Neurology and Psychiatry, Clínica Alemana—Universidad del Desarrollo, Santiago, Chile
| | - Justine Chen
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Nicholas Cheng
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Ann Ee Ching
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Chloe Clifford
- School of Psychology, Institute for Mental Health, University of Birmingham, Birmingham, UK
| | - Beau-Luke Colton
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Pamela Contreras
- Department of Psychiatry, IMHAY, University of Chile, Santiago, Chile
| | - Sebastián Corral
- Department of Psychiatry, IMHAY, University of Chile, Santiago, Chile
| | - Stefano Damiani
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Monica Done
- Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
- Department Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Andrés Estradé
- Early Psychosis Detection and Clinical Intervention (EPIC) Lab, Department of Psychosis Studies, King’s College London, London, UK
| | - Brandon Asika Etuka
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | - Melanie Formica
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Rachel Furlan
- Department of Psychology and Neuroscience, Temple University, Philadelphia, PA, USA
| | - Mia Geljic
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Carmela Germano
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Ruth Getachew
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | | | - Anastasia Haidar
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Jessica Hartmann
- Department of Public Mental Health, Central Institute of Mental Health, Heidelberg Univeristy, Mannheim, Germany
| | - Anna Jo
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Omar John
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Sarah Kerins
- Early Psychosis Detection and Clinical Intervention (EPIC) Lab, Department of Psychosis Studies, King’s College London, London, UK
| | - Melissa Kerr
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Irena Kesselring
- Department of Psychiatry, Neurodevelopment & Psychosis Section, University of Pennsylvania, Philadelphia, PA, USA
| | - Honey Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Korea
| | - Nicholas Kim
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Kyle Kinney
- Department of Psychology and Neuroscience, Temple University, Philadelphia, PA, USA
| | - Marija Krcmar
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Elana Kotler
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Melanie Lafanechere
- School of Psychology, University of Birmingham, Edgbaston, UK
- Centre for Human Brain Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - Clarice Lee
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Joshua Llerena
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | | | | | | | - Aissata Mavambu
- School of Psychology, Institute for Mental Health, University of Birmingham, Birmingham, UK
| | | | - Amelia McDonnell
- Department of Psychology and Neuroscience, Temple University, Philadelphia, PA, USA
| | - Alessia McGowan
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Rebecca McIlhenny
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Brittany McQueen
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Yohannes Mebrahtu
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Martina Mensi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- IRCCS Mondino Foundation, Pavia, Italy
| | | | - Yi Nam Suen
- Department of Psychiatry, University of Hong Kong, Pok Fu Lam, Hong Kong
| | | | - Neal Morrell
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Mariam Omar
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Alice Partridge
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Christina Phassouliotis
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Anna Pichiecchio
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
- Neuroradiology Department, IRCCS Mondino Foundation, Pavia, Italy
| | - Pierluigi Politi
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Christian Porter
- Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA, USA
| | - Umberto Provenzani
- Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy
| | - Nicholas Prunier
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Jasmine Raj
- Department of Psychology, Northwestern University, Evanston, IL, USA
| | - Susan Ray
- Northwell Health, Glen Oaks, NY, USA
| | - Victoria Rayner
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Manuel Reyes
- Department of Psychiatry, IMHAY, University of Chile, Santiago, Chile
- Department of Neurology and Psychiatry, Clínica Alemana—Universidad del Desarrollo, Santiago, Chile
| | - Kate Reynolds
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Sage Rush
- Department of Psychiatry, Neurodevelopment & Psychosis Section, University of Pennsylvania, Philadelphia, PA, USA
| | - Cesar Salinas
- Department of Psychiatry, IMHAY, University of Chile, Santiago, Chile
| | - Jashmina Shetty
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Callum Snowball
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Sophie Tod
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | | | - Daniela Valle
- Department of Psychiatry, IMHAY, University of Chile, Santiago, Chile
| | - Simone Veale
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Sarah Whitson
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Alana Wickham
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
| | - Sarah Youn
- Centre for Youth Mental Health, The University of Melbourne, Parkville, VIC, Australia
- Orygen, Parkville, VIC, Australia
| | - Francisco Zamorano
- Unidad de imágenes cuantitativas avanzadas, departamento de imágenes, clínica alemana, universidad del Desarrollo, Santiago, Chile
- Facultad de ciencias para el cuidado de la salud, Universidad San Sebastián, Campus Los Leones, Santiago, Chile
| | - Elissa Zavaglia
- PEPP-Montreal, Douglas Research Centre, Montreal, Quebec, Canada
| | - Jamie Zinberg
- Department of Psychiatry, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
- Department Biobehavioral Sciences and Psychology, Semel Institute for Neuroscience and Human Behavior, University of California, Los Angeles, Los Angeles, CA, USA
| | - Scott W Woods
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Connecticut Mental Health Center, New Haven, CT, USA
| | - Martha E Shenton
- Department of Psychiatry, Brigham and Women’s Hospital and Harvard Medical School, Boston, MA, USA
- Department of Radiology, Brigham and Women’s Hospital, Boston, MA, USA
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
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5
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Byrne JF, Healy C, Föcking M, Susai SR, Mongan D, Wynne K, Kodosaki E, Heurich M, de Haan L, Hickie IB, Smesny S, Thompson A, Markulev C, Young AR, Schäfer MR, Riecher-Rössler A, Mossaheb N, Berger G, Schlögelhofer M, Nordentoft M, Chen EYH, Verma S, Nieman DH, Woods SW, Cornblatt BA, Stone WS, Mathalon DH, Bearden CE, Cadenhead KS, Addington J, Walker EF, Cannon TD, Cannon M, McGorry P, Amminger P, Cagney G, Nelson B, Jeffries C, Perkins D, Cotter DR. Proteomic Biomarkers for the Prediction of Transition to Psychosis in Individuals at Clinical High Risk: A Multi-cohort Model Development Study. Schizophr Bull 2024; 50:579-588. [PMID: 38243809 PMCID: PMC11059811 DOI: 10.1093/schbul/sbad184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/22/2024]
Abstract
Psychosis risk prediction is one of the leading challenges in psychiatry. Previous investigations have suggested that plasma proteomic data may be useful in accurately predicting transition to psychosis in individuals at clinical high risk (CHR). We hypothesized that an a priori-specified proteomic prediction model would have strong predictive accuracy for psychosis risk and aimed to replicate longitudinal associations between plasma proteins and transition to psychosis. This study used plasma samples from participants in 3 CHR cohorts: the North American Prodrome Longitudinal Studies 2 and 3, and the NEURAPRO randomized control trial (total n = 754). Plasma proteomic data were quantified using mass spectrometry. The primary outcome was transition to psychosis over the study follow-up period. Logistic regression models were internally validated, and optimism-corrected performance metrics derived with a bootstrap procedure. In the overall sample of CHR participants (age: 18.5, SD: 3.9; 51.9% male), 20.4% (n = 154) developed psychosis within 4.4 years. The a priori-specified model showed poor risk-prediction accuracy for the development of psychosis (C-statistic: 0.51 [95% CI: 0.50, 0.59], calibration slope: 0.45). At a group level, Complement C8B, C4B, C5, and leucine-rich α-2 glycoprotein 1 (LRG1) were associated with transition to psychosis but did not surpass correction for multiple comparisons. This study did not confirm the findings from a previous proteomic prediction model of transition from CHR to psychosis. Certain complement proteins may be weakly associated with transition at a group level. Previous findings, derived from small samples, should be interpreted with caution.
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Affiliation(s)
- Jonah F Byrne
- Department of Psychiatry, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
- SFI FutureNeuro Research Centre, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
| | - Colm Healy
- Department of Psychiatry, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
- Department of Psychology, Royal College of Surgeons in Ireland, Dublin 2, Ireland
| | - Melanie Föcking
- Department of Psychiatry, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
| | - Subash Raj Susai
- Department of Psychiatry, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
| | - David Mongan
- Department of Psychiatry, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
- Centre for Public Health, Queen’s University Belfast, Belfast, UK
| | - Kieran Wynne
- School of Biomolecular and Biomedical Science, Conway Institute, University College Dublin, Dublin, Ireland
| | - Eleftheria Kodosaki
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Wales, UK
| | - Meike Heurich
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Wales, UK
| | - Lieuwe de Haan
- Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands
| | - Ian B Hickie
- Brain and Mind Centre, The University of Sydney, Sydney, NSW, Australia
| | - Stefan Smesny
- Department of Psychiatry, Jena University Hospital, Jena, Germany
| | - Andrew Thompson
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia
| | - Connie Markulev
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia
| | - Alison Ruth Young
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- Institute for Mental and Physical Health and Clinical Translation (IMPACT), Deakin University, Geelong, VIC, Australia
- School of Health Sciences, University of Manchester, Manchester, UK
| | - Miriam R Schäfer
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia
| | | | - Nilufar Mossaheb
- Department of Psychiatry and Psychotherapy, Clinical Division of Social Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Gregor Berger
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric Hospital, University of Zurich, Zurich, Switzerland
| | - Monika Schlögelhofer
- BioPsyC—Biopsychosocial Corporation, Non-profit Association for Research Funding Ltd, Vienna, Austria
| | - Merete Nordentoft
- Mental Health Center Copenhagen, Research Unit (CORE), Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Eric Y H Chen
- Department of Psychiatry, School of Clinical Medicine, LKS Faculty of Medicine, The University of Hong Kong, 2/F New Clinical Building, Queen Mary Hospital, Pok Fu Lam, Hong Kong
- The State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Swapna Verma
- Office of Education, Duke-NUS Graduate Medical School, Singapore, Singapore
- Department of Psychosis & East Region, Institute of Mental Health, Singapore, Singapore
| | - Dorien H Nieman
- Department of Psychiatry, Academic Medical Center, Amsterdam, The Netherlands
| | - Scott W Woods
- Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
| | | | - William S Stone
- Department of Psychiatry, Harvard Medical School at Beth Israel Deaconess Medical Center and Massachusetts General Hospital, Boston, MA, USA
| | - Daniel H Mathalon
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, San Francisco, CA, USA
- Mental Health Service 116d, Veterans Affairs San Francisco Health Care System, San Francisco, CA, USA
| | - Carrie E Bearden
- Semel Institute for Neuroscience and Human Behavior, Departments of Psychiatry and Biobehavioral Sciences and Psychology, University of California, Los Angeles, CA, USA
| | | | - Jean Addington
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Canada
| | - Elaine F Walker
- Department of Psychology, Emory University, Atlanta, GA, USA
- Department of Psychiatry, Emory University, Atlanta, GA, USA
| | - Tyrone D Cannon
- Department of Psychology, Yale University, New Haven, CT, USA
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Mary Cannon
- Department of Psychiatry, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
- SFI FutureNeuro Research Centre, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
- Department of Psychiatry, Beaumont Hospital, Dublin 9, Ireland
| | - Pat McGorry
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia
| | - Paul Amminger
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia
| | - Gerard Cagney
- School of Biomolecular and Biomedical Science, Conway Institute, University College Dublin, Dublin, Ireland
| | - Barnaby Nelson
- Centre for Youth Mental Health, University of Melbourne, Parkville, VIC, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, Melbourne, VIC, Australia
| | - Clark Jeffries
- Renaissance Computing Institute, University of North Carolina, Chapel Hill, NC, USA
| | - Diana Perkins
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - David R Cotter
- Department of Psychiatry, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
- SFI FutureNeuro Research Centre, Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
- Department of Psychiatry, Beaumont Hospital, Dublin 9, Ireland
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6
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Jin J, Zhan J, Zhang J, Zhao R, O'Connell J, Jiang Y, Buyske S, Gignoux C, Haiman C, Kenny EE, Kooperberg C, North K, Koelsch BL, Wojcik G, Zhang H, Chatterjee N. MUSSEL: Enhanced Bayesian polygenic risk prediction leveraging information across multiple ancestry groups. CELL GENOMICS 2024; 4:100539. [PMID: 38604127 PMCID: PMC11019365 DOI: 10.1016/j.xgen.2024.100539] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/23/2023] [Revised: 09/07/2023] [Accepted: 03/14/2024] [Indexed: 04/13/2024]
Abstract
Polygenic risk scores (PRSs) are now showing promising predictive performance on a wide variety of complex traits and diseases, but there exists a substantial performance gap across populations. We propose MUSSEL, a method for ancestry-specific polygenic prediction that borrows information in summary statistics from genome-wide association studies (GWASs) across multiple ancestry groups via Bayesian hierarchical modeling and ensemble learning. In our simulation studies and data analyses across four distinct studies, totaling 5.7 million participants with a substantial ancestral diversity, MUSSEL shows promising performance compared to alternatives. For example, MUSSEL has an average gain in prediction R2 across 11 continuous traits of 40.2% and 49.3% compared to PRS-CSx and CT-SLEB, respectively, in the African ancestry population. The best-performing method, however, varies by GWAS sample size, target ancestry, trait architecture, and linkage disequilibrium reference samples; thus, ultimately a combination of methods may be needed to generate the most robust PRSs across diverse populations.
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Affiliation(s)
- Jin Jin
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, PA 19103, USA.
| | | | - Jingning Zhang
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Ruzhang Zhao
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | | | | | - Steven Buyske
- Department of Statistics, Rutgers University, New Brunswick, NJ 08854, USA
| | - Christopher Gignoux
- Colorado Center for Personalized Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Christopher Haiman
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA 90032, USA
| | - Eimear E Kenny
- Icahn Institute for Genomic Health, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Charles Kooperberg
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA 98109, USA
| | - Kari North
- Department of Epidemiology, University of North Carolina at Chapel Hill, Chapel Hill, NC 27516, USA
| | | | - Genevieve Wojcik
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Haoyu Zhang
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA; Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD 20892, USA
| | - Nilanjan Chatterjee
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA; Department of Oncology, School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA.
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7
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Hou Y, Xia H, He T, Zhang B, Qiu G, Chen A. N2 Responses in Youths With Psychosis Risk Syndrome and Their Association With Clinical Outcomes: A Cohort Follow-Up Study Based on the Three-Stimulus Visual Oddball Paradigm. Am J Psychiatry 2024; 181:330-341. [PMID: 38419496 DOI: 10.1176/appi.ajp.20221013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2024]
Abstract
OBJECTIVE Schizophrenia often occurs during youth, and psychosis risk syndrome occurs before the onset of psychosis. The aim of this study was to determine whether the visual event-related potential responses in youths with psychosis risk syndrome were defective in the presence of interference stimuli and associated with their clinical outcomes. METHODS A total of 223 participants, including 122 patients with psychosis risk syndrome, 50 patients with emotional disorders, and 51 healthy control subjects, were assessed. Baseline EEG was recorded during the three-stimulus visual oddball task. The event-related potentials induced by square pictures with different colors were measured. Almost all patients with psychosis risk syndrome were followed up for 12 months and were reclassified into three subgroups: conversion, symptomatic, and remission. The differences in baseline event-related potential responses were compared among the clinical outcome subgroups. RESULTS The average N2 amplitude of the psychosis risk syndrome group was significantly less negative than that in the healthy control group (d=0.53). The baseline average N2 amplitude in the conversion subgroup was significantly less negative than that in the symptomatic (d=0.58) and remission (d=0.50) subgroups and in the healthy control group (d=0.97). The average N2 amplitude did not differ significantly between the symptomatic and remission subgroups (d=0.02). However, it was significantly less negative in the symptomatic and remission subgroups than in the healthy control group (d=0.46 and d=0.38). No statistically significant results were found in the P3 response. CONCLUSIONS Youths with psychosis risk syndrome had significant N2 amplitude defects in attention processing with interference stimuli. N2 amplitude shows potential as a prognostic biomarker of clinical outcome in the psychosis risk syndrome.
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Affiliation(s)
- Yongqing Hou
- Key Laboratory of Cognition and Personality of the Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China (Hou, Xia, Zhang); Clinical Laboratory of Psychiatry, Mental Health Center of Guangyuan, Sichuan, China (Hou, He); College of Education, Psychology, and Social Work, Flinders University, Adelaide, Australia (Zhang); College of Teacher Education, Ningxia University, Yinchuan, China (Qiu); School of Psychology, Shanghai University of Sport, Shanghai, China (Chen)
| | - Haishuo Xia
- Key Laboratory of Cognition and Personality of the Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China (Hou, Xia, Zhang); Clinical Laboratory of Psychiatry, Mental Health Center of Guangyuan, Sichuan, China (Hou, He); College of Education, Psychology, and Social Work, Flinders University, Adelaide, Australia (Zhang); College of Teacher Education, Ningxia University, Yinchuan, China (Qiu); School of Psychology, Shanghai University of Sport, Shanghai, China (Chen)
| | - Tianbao He
- Key Laboratory of Cognition and Personality of the Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China (Hou, Xia, Zhang); Clinical Laboratory of Psychiatry, Mental Health Center of Guangyuan, Sichuan, China (Hou, He); College of Education, Psychology, and Social Work, Flinders University, Adelaide, Australia (Zhang); College of Teacher Education, Ningxia University, Yinchuan, China (Qiu); School of Psychology, Shanghai University of Sport, Shanghai, China (Chen)
| | - Bohua Zhang
- Key Laboratory of Cognition and Personality of the Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China (Hou, Xia, Zhang); Clinical Laboratory of Psychiatry, Mental Health Center of Guangyuan, Sichuan, China (Hou, He); College of Education, Psychology, and Social Work, Flinders University, Adelaide, Australia (Zhang); College of Teacher Education, Ningxia University, Yinchuan, China (Qiu); School of Psychology, Shanghai University of Sport, Shanghai, China (Chen)
| | - Guiping Qiu
- Key Laboratory of Cognition and Personality of the Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China (Hou, Xia, Zhang); Clinical Laboratory of Psychiatry, Mental Health Center of Guangyuan, Sichuan, China (Hou, He); College of Education, Psychology, and Social Work, Flinders University, Adelaide, Australia (Zhang); College of Teacher Education, Ningxia University, Yinchuan, China (Qiu); School of Psychology, Shanghai University of Sport, Shanghai, China (Chen)
| | - Antao Chen
- Key Laboratory of Cognition and Personality of the Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China (Hou, Xia, Zhang); Clinical Laboratory of Psychiatry, Mental Health Center of Guangyuan, Sichuan, China (Hou, He); College of Education, Psychology, and Social Work, Flinders University, Adelaide, Australia (Zhang); College of Teacher Education, Ningxia University, Yinchuan, China (Qiu); School of Psychology, Shanghai University of Sport, Shanghai, China (Chen)
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8
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Segura AG, Serna EDL, Sugranyes G, Baeza I, Valli I, Martínez-Serrano I, Díaz-Caneja CM, Andreu-Bernabeu Á, Moreno DM, Gassó P, Rodríguez N, Martínez-Pinteño A, Prohens L, Torrent C, García-Rizo C, Mas S, Castro-Fornieles J. Polygenic risk scores mediating functioning outcomes through cognitive and clinical features in youth at family risk and controls. Eur Neuropsychopharmacol 2024; 81:28-37. [PMID: 38310718 DOI: 10.1016/j.euroneuro.2024.01.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2023] [Revised: 01/23/2024] [Accepted: 01/26/2024] [Indexed: 02/06/2024]
Abstract
Schizophrenia and bipolar disorder exhibit substantial clinical overlap, particularly in individuals at familial high risk, who frequently present sub-threshold symptoms before the onset of illness. Severe mental disorders are highly polygenic traits, but their impact on the stages preceding the manifestation of mental disorders remains relatively unexplored. Our study aimed to examine the influence of polygenic risk scores (PRS) on sub-clinical outcomes over a 2-year period in youth at familial high risk for schizophrenia and bipolar disorder and controls. The sample included 222 children and adolescents, comprising offspring of parents with schizophrenia (n = 38), bipolar disorder (n = 80), and community controls (n = 104). We calculated PRS for psychiatric disorders, neuroticism and cognition using the PRS-CS method. Linear mixed-effects models were employed to investigate the association between PRS and cognition, symptom severity and functioning. Mediation analyses were conducted to explore whether clinical features acted as intermediaries in the impact of PRS on functioning outcomes. SZoff exhibited elevated PRS for schizophrenia. In the entire sample, PRS for depression, neuroticism, and cognitive traits showed associations with sub-clinical features. The effect of PRS for neuroticism and general intelligence on functioning outcomes were mediated by cognition and symptoms severity, respectively. This study delves into the interplay among genetics, the emergence of sub-clinical symptoms and functioning outcomes, providing novel evidence on mechanisms underpinning the continuum from sub-threshold features to the onset of mental disorders. The findings underscore the interplay of genetics, cognition, and clinical features, providing insights for personalized early interventions.
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Affiliation(s)
- Alex G Segura
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain
| | - Elena de la Serna
- Child and Adolescent Psychiatry and Psychology Department, 2021SGR01319, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain; Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Child and Adolescent Psychiatry and Psychology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Gisela Sugranyes
- Child and Adolescent Psychiatry and Psychology Department, 2021SGR01319, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain; Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Child and Adolescent Psychiatry and Psychology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Inmaculada Baeza
- Child and Adolescent Psychiatry and Psychology Department, 2021SGR01319, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain; Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Child and Adolescent Psychiatry and Psychology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Isabel Valli
- Child and Adolescent Psychiatry and Psychology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Irene Martínez-Serrano
- Child and Adolescent Psychiatry and Psychology Department, 2021SGR01319, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, 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, Madrid, Spain
| | - Álvaro Andreu-Bernabeu
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Department of Child and Adolescent Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain
| | - Dolores M Moreno
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Adolescent Inpatient Unit, Department of Psychiatry, Hospital General Universitario Gregorio Marañón, Madrid, Spain; Psychiatry Department, Universidad Complutense de Madrid, Madrid, Spain
| | - Patricia Gassó
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Child and Adolescent Psychiatry and Psychology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Natalia Rodríguez
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain
| | - Albert Martínez-Pinteño
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain
| | - Llucia Prohens
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain
| | - Carla Torrent
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Barcelona Bipolar Disorders Program, Clinical Institute of Neuroscience, Hospital Clinic, University of Barcelona, Fundació Clinic - Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
| | - Clemente García-Rizo
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Barcelona Clinic Schizophrenia Unit, Institute of Neuroscience, Hospital Clinic Barcelona, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), University of Barcelona, Barcelona, Spain
| | - Sergi Mas
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Child and Adolescent Psychiatry and Psychology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain.
| | - Josefina Castro-Fornieles
- Child and Adolescent Psychiatry and Psychology Department, 2021SGR01319, Institute of Neuroscience, Hospital Clínic de Barcelona, Barcelona, Spain; Department of Medicine, Institute of Neuroscience, University of Barcelona, Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain; Child and Adolescent Psychiatry and Psychology, Institut d'Investigacions Biomèdiques August Pi i Sunyer (IDIBAPS), Barcelona, Spain
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9
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Warren TL, Tubbs JD, Lesh TA, Corona MB, Pakzad SS, Albuquerque MD, Singh P, Zarubin V, Morse SJ, Sham PC, Carter CS, Nord AS. Association of neurotransmitter pathway polygenic risk with specific symptom profiles in psychosis. Mol Psychiatry 2024:10.1038/s41380-024-02457-0. [PMID: 38491343 DOI: 10.1038/s41380-024-02457-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2023] [Revised: 01/19/2024] [Accepted: 01/24/2024] [Indexed: 03/18/2024]
Abstract
A primary goal of psychiatry is to better understand the pathways that link genetic risk to psychiatric symptoms. Here, we tested association of diagnosis and endophenotypes with overall and neurotransmitter pathway-specific polygenic risk in patients with early-stage psychosis. Subjects included 205 demographically diverse cases with a psychotic disorder who underwent comprehensive psychiatric and neurological phenotyping and 115 matched controls. Following genotyping, we calculated polygenic scores (PGSs) for schizophrenia (SZ) and bipolar disorder (BP) using Psychiatric Genomics Consortium GWAS summary statistics. To test if overall genetic risk can be partitioned into affected neurotransmitter pathways, we calculated pathway PGSs (pPGSs) for SZ risk affecting each of four major neurotransmitter systems: glutamate, GABA, dopamine, and serotonin. Psychosis subjects had elevated SZ PGS versus controls; cases with SZ or BP diagnoses had stronger SZ or BP risk, respectively. There was no significant association within psychosis cases between individual symptom measures and overall PGS. However, neurotransmitter-specific pPGSs were moderately associated with specific endophenotypes; notably, glutamate was associated with SZ diagnosis and with deficits in cognitive control during task-based fMRI, while dopamine was associated with global functioning. Finally, unbiased endophenotype-driven clustering identified three diagnostically mixed case groups that separated on primary deficits of positive symptoms, negative symptoms, global functioning, and cognitive control. All clusters showed strong genome-wide risk. Cluster 2, characterized by deficits in cognitive control and negative symptoms, additionally showed specific risk concentrated in glutamatergic and GABAergic pathways. Due to the intensive characterization of our subjects, the present study was limited to a relatively small cohort. As such, results should be followed up with additional research at the population and mechanism level. Our study suggests pathway-based PGS analysis may be a powerful path forward to study genetic mechanisms driving psychiatric endophenotypes.
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Affiliation(s)
- Tracy L Warren
- Department of Neurobiology, Physiology and Behavior, University of California, Davis, CA, USA
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, CA, USA
- Center for Neuroscience, University of California, Davis, CA, USA
| | - Justin D Tubbs
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Tyler A Lesh
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, CA, USA
| | - Mylena B Corona
- Department of Neurobiology, Physiology and Behavior, University of California, Davis, CA, USA
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, CA, USA
- Center for Neuroscience, University of California, Davis, CA, USA
| | - Sarvenaz S Pakzad
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, CA, USA
| | - Marina D Albuquerque
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, CA, USA
| | - Praveena Singh
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, CA, USA
| | - Vanessa Zarubin
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, CA, USA
- Department of Psychology, Northwestern University, Evanston, IL, USA
| | - Sarah J Morse
- Department of Neurobiology, Physiology and Behavior, University of California, Davis, CA, USA
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, CA, USA
- Center for Neuroscience, University of California, Davis, CA, USA
- Department of Psychological and Brain Sciences, Washington University in St. Louis, St. Louis, MO, USA
| | - Pak Chung Sham
- Department of Psychiatry, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR.
- Centre for PanorOmic Sciences, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR.
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong, Pok Fu Lam, Hong Kong SAR.
| | - Cameron S Carter
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, CA, USA.
- Department of Psychiatry and Human Behavior, University of California, Irvine, CA, USA.
| | - Alex S Nord
- Department of Neurobiology, Physiology and Behavior, University of California, Davis, CA, USA.
- Department of Psychiatry and Behavioral Sciences, University of California, Davis, CA, USA.
- Center for Neuroscience, University of California, Davis, CA, USA.
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10
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Hou Y, Qiu G, Xia H, He T, Liu X, Chen A. The specificity of the auditory P300 responses and its association with clinical outcomes in youth with psychosis risk syndrome. Int J Clin Health Psychol 2024; 24:100437. [PMID: 38292829 PMCID: PMC10825643 DOI: 10.1016/j.ijchp.2024.100437] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2023] [Accepted: 01/02/2024] [Indexed: 02/01/2024] Open
Abstract
Background Schizophrenia often occurs in youth, and psychosis risk syndrome (PRS) occurs before the onset of psychosis. Assessing the neuropsychological abnormalities of PRS individuals can help in early identification and active intervention of mental illness. Auditory P300 amplitude defect is an important manifestation of attention processing abnormality in PRS, but it is still unclear whether there are abnormalities in the attention processing of rhythmic compound tone stimuli in PRS individuals, and whether the P300 amplitude induced by these stimuli is specific to PRS individuals and related to their clinical outcomes. Methods In total, 226 participants, including 122 patients with PRS, 51 patients with emotional disorders (ED), and 53 healthy controls (HC) were assessed. Baseline electroencephalography was recorded during the compound tone oddball task. The event-related potentials (ERPs) induced by rhythmic compound tone stimuli of two frequencies (20-Hz, 40-Hz) were measured. Almost all patients with PRS were followed up for 12 months and reclassified into four groups: PRS-conversion, PRS-symptomatic, PRS-emotional disorder, and PRS-complete remission. The differences in baseline ERPs were compared among the clinical outcome groups. Results Regardless of the stimulation frequency, the average P300 amplitude were significantly higher in patients with PRS than in those with ED (p = 0.003, d = 0.48) and in HC (p = 0.002, d = 0.44) group. The average P300 amplitude of PRS-conversion group was significantly higher than that of the PRS-complete remission (p = 0.016, d = 0.72) and HC group (p = 0.001, d = 0.76), and the average P300 amplitude of PRS-symptomatic group was significantly higher than that of the HC group (p = 0.006, d = 0.48). Regardless of the groups (PRS, ED, HC) or the PRS clinical outcome groups, the average P300 amplitude induced by 20-Hz tone stimulation was significantly higher than that induced by 40-Hz stimulation (ps < 0.001, Ƞ2 = 0.074-0.082). The average reaction times of PRS was significantly faster than that of ED (p = 0.01, d = 0.38), and the average reaction times of the participants to 20-Hz target stimulation was significantly faster than that to 40-Hz target stimulation (p < 0.001, d = 0.21). Conclusion The auditory P300 amplitude induced by rhythmic compound tone stimuli is a specific electrophysiological manifestation of PRS, and the auditory P300 amplitude induced by compound tone stimuli shows promise as a putative prognostic biomarker for PRS clinical outcomes, including conversion to psychosis and clinical complete remission.
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Affiliation(s)
- Yongqing Hou
- Key Laboratory of Cognition and Personality of Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
- Mental Health Center of Guangyuan, Sichuan, China
| | - Guiping Qiu
- College of Teacher Education, Ningxia University, Yinchuan, China
| | - Haishuo Xia
- Key Laboratory of Cognition and Personality of Ministry of Education, Faculty of Psychology, Southwest University, Chongqing, China
| | - Tianbao He
- Mental Health Center of Guangyuan, Sichuan, China
| | - Xiaoxian Liu
- Faculty of Education, Henan Normal University, Xinxiang, China
| | - Antao Chen
- School of Psychology, Research Center for Exercise and Brain Science, Shanghai University of Sport, Shanghai, China
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11
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Smith WR, Appelbaum PS, Lebowitz MS, Gülöksüz S, Calkins ME, Kohler CG, Gur RE, Barzilay R. The Ethics of Risk Prediction for Psychosis and Suicide Attempt in Youth Mental Health. J Pediatr 2023; 263:113583. [PMID: 37353146 PMCID: PMC10828819 DOI: 10.1016/j.jpeds.2023.113583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 06/01/2023] [Accepted: 06/16/2023] [Indexed: 06/25/2023]
Abstract
OBJECTIVE To identify potential clinical utility of polygenic risk scores (PRS) and exposomic risk scores (ERS) for psychosis and suicide attempt in youth and assess the ethical implications of these tools. STUDY DESIGN We conducted a narrative literature review of emerging findings on PRS and ERS for suicide and psychosis as well as a literature review on the ethics of PRS. We discuss the ethical implications of the emerging findings for the clinical potential of PRS and ERS. RESULTS Emerging evidence suggests that PRS and ERS may offer clinical utility in the relatively near future but that this utility will be limited to specific, narrow clinical questions, in contrast to the suggestion that population-level screening will have sweeping impact. Combining PRS and ERS might optimize prediction. This clinical utility would change the risk-benefit balance of PRS, and further empirical assessment of proposed risks would be necessary. Some concerns for PRS, such as those about counseling, privacy, and inequities, apply to ERS. ERS raise distinct ethical challenges as well, including some that involve informed consent and direct-to-consumer advertising. Both raise questions about the ethics of machine-learning/artificial intelligence approaches. CONCLUSIONS Predictive analytics using PRS and ERS may soon play a role in youth mental health settings. Our findings help educate clinicians about potential capabilities, limitations, and ethical implications of these tools. We suggest that a broader discussion with the public is needed to avoid overenthusiasm and determine regulations and guidelines for use of predictive scores.
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Affiliation(s)
- William R Smith
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA.
| | - Paul S Appelbaum
- Department of Psychiatry, Vagelos College of Physicians & Surgeons, Columbia University, New York, NY; New York State Psychiatric Institute, New York, NY
| | - Matthew S Lebowitz
- Department of Psychiatry, Vagelos College of Physicians & Surgeons, Columbia University, New York, NY
| | - Sinan Gülöksüz
- Department of Psychiatry, Yale School of Medicine, New Haven, CT; Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
| | - Monica E Calkins
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Christian G Kohler
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Raquel E Gur
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Lifespan Brain Institute, Children's Hospital of Philadelphia and Penn Medicine, University of Pennsylvania, Philadelphia, PA; Department of Child and Adolescent Psychiatry, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA
| | - Ran Barzilay
- Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA; Department of Child and Adolescent Psychiatry, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA; Department of Child and Adolescent Psychiatry, Children's Hospital of Philadelphia, University of Pennsylvania, Philadelphia, PA
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12
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Warren TL, Tubbs JD, Lesh TA, Corona MB, Pakzad S, Albuquerque M, Singh P, Zarubin V, Morse S, Sham PC, Carter CS, Nord AS. Association of neurotransmitter pathway polygenic risk with specific symptom profiles in psychosis. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.05.24.23290465. [PMID: 37292649 PMCID: PMC10246134 DOI: 10.1101/2023.05.24.23290465] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
A primary goal of psychiatry is to better understand the pathways that link genetic risk to psychiatric symptoms. Here, we tested association of diagnosis and endophenotypes with overall and neurotransmitter pathway-specific polygenic risk in patients with early-stage psychosis. Subjects included 206 demographically diverse cases with a psychotic disorder who underwent comprehensive psychiatric and neurological phenotyping and 115 matched controls. Following genotyping, we calculated polygenic scores (PGSs) for schizophrenia (SZ) and bipolar disorder (BP) using Psychiatric Genomics Consortium GWAS summary statistics. To test if overall genetic risk can be partitioned into affected neurotransmitter pathways, we calculated pathway PGSs (pPGSs) for SZ risk affecting each of four major neurotransmitter systems: glutamate, GABA, dopamine, and serotonin. Psychosis subjects had elevated SZ PGS versus controls; cases with SZ or BP diagnoses had stronger SZ or BP risk, respectively. There was no significant association within psychosis cases between individual symptom measures and overall PGS. However, neurotransmitter-specific pPGSs were moderately associated with specific endophenotypes; notably, glutamate was associated with SZ diagnosis and with deficits in cognitive control during task-based fMRI, while dopamine was associated with global functioning. Finally, unbiased endophenotype-driven clustering identified three diagnostically mixed case groups that separated on primary deficits of positive symptoms, negative symptoms, global functioning, and cognitive control. All clusters showed strong genome-wide risk. Cluster 2, characterized by deficits in cognitive control and negative symptoms, additionally showed specific risk concentrated in glutamatergic and GABAergic pathways. Due to the intensive characterization of our subjects, the present study was limited to a relatively small cohort. As such, results should be followed up with additional research at the population and mechanism level. Our study suggests pathway-based PGS analysis may be a powerful path forward to study genetic mechanisms driving psychiatric endophenotypes.
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Affiliation(s)
| | - Justin D. Tubbs
- Department of Psychiatry, The University of Hong Kong
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital
- Department of Psychiatry, Harvard Medical School
| | | | | | | | | | | | | | | | - Pak Chung Sham
- Department of Psychiatry, The University of Hong Kong
- Centre for PanorOmic Sciences, The University of Hong Kong
- State Key Laboratory of Brain and Cognitive Sciences, The University of Hong Kong
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13
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Forsyth JK, Bearden CE. Rethinking the First Episode of Schizophrenia: Identifying Convergent Mechanisms During Development and Moving Toward Prediction. Am J Psychiatry 2023; 180:792-804. [PMID: 37908094 DOI: 10.1176/appi.ajp.20230736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/02/2023]
Affiliation(s)
- Jennifer K Forsyth
- Department of Psychology, University of Washington, Seattle (Forsyth); Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Behavioral Sciences, and Department of Psychology, University of California, Los Angeles (Bearden)
| | - Carrie E Bearden
- Department of Psychology, University of Washington, Seattle (Forsyth); Semel Institute for Neuroscience and Human Behavior, Department of Psychiatry and Behavioral Sciences, and Department of Psychology, University of California, Los Angeles (Bearden)
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14
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Caballero N, Machiraju S, Diomino A, Kennedy L, Kadivar A, Cadenhead KS. Recent Updates on Predicting Conversion in Youth at Clinical High Risk for Psychosis. Curr Psychiatry Rep 2023; 25:683-698. [PMID: 37755654 PMCID: PMC10654175 DOI: 10.1007/s11920-023-01456-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/05/2023] [Indexed: 09/28/2023]
Abstract
PURPOSE OF REVIEW This review highlights recent advances in the prediction and treatment of psychotic conversion. Over the past 25 years, research into the prodromal phase of psychotic illness has expanded with the promise of early identification of individuals at clinical high risk (CHR) for psychosis who are likely to convert to psychosis. RECENT FINDINGS Meta-analyses highlight conversion rates between 20 and 30% within 2-3 years using existing clinical criteria while research into more specific risk factors, biomarkers, and refinement of psychosis risk calculators has exploded, improving our ability to predict psychotic conversion with greater accuracy. Recent studies highlight risk factors and biomarkers likely to contribute to earlier identification and provide insight into neurodevelopmental abnormalities, CHR subtypes, and interventions that can target specific risk profiles linked to neural mechanisms. Ongoing initiatives that assess longer-term (> 5-10 years) outcome of CHR participants can provide valuable information about predictors of later conversion and diagnostic outcomes while large-scale international biomarker studies provide hope for precision intervention that will alter the course of early psychosis globally.
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Affiliation(s)
- Noe Caballero
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr., La Jolla, CA, 92093-0810, USA
| | - Siddharth Machiraju
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr., La Jolla, CA, 92093-0810, USA
| | - Anthony Diomino
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr., La Jolla, CA, 92093-0810, USA
| | - Leda Kennedy
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr., La Jolla, CA, 92093-0810, USA
| | - Armita Kadivar
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr., La Jolla, CA, 92093-0810, USA
| | - Kristin S Cadenhead
- Department of Psychiatry, University of California San Diego, 9500 Gilman Dr., La Jolla, CA, 92093-0810, USA.
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15
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Byrne JF, Mongan D, Murphy J, Healy C, Fӧcking M, Cannon M, Cotter DR. Prognostic models predicting transition to psychotic disorder using blood-based biomarkers: a systematic review and critical appraisal. Transl Psychiatry 2023; 13:333. [PMID: 37898606 PMCID: PMC10613280 DOI: 10.1038/s41398-023-02623-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Revised: 09/15/2023] [Accepted: 10/06/2023] [Indexed: 10/30/2023] Open
Abstract
Accumulating evidence suggests individuals with psychotic disorder show abnormalities in metabolic and inflammatory processes. Recently, several studies have employed blood-based predictors in models predicting transition to psychotic disorder in risk-enriched populations. A systematic review of the performance and methodology of prognostic models using blood-based biomarkers in the prediction of psychotic disorder from risk-enriched populations is warranted. Databases (PubMed, EMBASE and PsycINFO) were searched for eligible texts from 1998 to 15/05/2023, which detailed model development or validation studies. The checklist for Critical Appraisal and Data Extraction for Systematic Reviews of Prediction Modelling Studies (CHARMS) was used to guide data extraction from eligible texts and the Prediction Model Risk of Bias Assessment Tool (PROBAST) was used to assess the risk of bias and applicability of the studies. A narrative synthesis of the included studies was performed. Seventeen eligible studies were identified: 16 eligible model development studies and one eligible model validation study. A wide range of biomarkers were assessed, including nucleic acids, proteins, metabolites, and lipids. The range of C-index (area under the curve) estimates reported for the models was 0.67-1.00. No studies assessed model calibration. According to PROBAST criteria, all studies were at high risk of bias in the analysis domain. While a wide range of potentially predictive biomarkers were identified in the included studies, most studies did not account for overfitting in model performance estimates, no studies assessed calibration, and all models were at high risk of bias according to PROBAST criteria. External validation of the models is needed to provide more accurate estimates of their performance. Future studies which follow the latest available methodological and reporting guidelines and adopt strategies to accommodate required sample sizes for model development or validation will clarify the value of including blood-based biomarkers in models predicting psychosis.
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Affiliation(s)
- Jonah F Byrne
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland.
- SFI FutureNeuro Research Centre, Royal College of Surgeons in Ireland, Dublin, Ireland.
| | - David Mongan
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
- Centre for Public Health, Queen's University Belfast, Belfast, United Kingdom
| | - Jennifer Murphy
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Colm Healy
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Melanie Fӧcking
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Mary Cannon
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
- SFI FutureNeuro Research Centre, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - David R Cotter
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
- SFI FutureNeuro Research Centre, Royal College of Surgeons in Ireland, Dublin, Ireland
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16
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Moorthy T, Nguyen H, Chen Y, Austin J, Smoller JW, Hercher L, Sabatello M. How do experts in psychiatric genetics view the clinical utility of polygenic risk scores for schizophrenia? Am J Med Genet B Neuropsychiatr Genet 2023; 192:161-170. [PMID: 37158703 PMCID: PMC10524148 DOI: 10.1002/ajmg.b.32939] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Revised: 03/02/2023] [Accepted: 04/15/2023] [Indexed: 05/10/2023]
Abstract
Polygenic risk scores (PRS) are promising for identifying common variant-related inheritance for psychiatric conditions but their integration into clinical practice depends on their clinical utility and psychiatrists' understanding of PRS. Our online survey explored these issues with 276 professionals working in psychiatric genetics (RR: 19%). Overall, participants demonstrated knowledge of how to interpret PRS results. Their performance on knowledge-based questions was positively correlated with participants' self-reported familiarity with PRS (r = 0.21, p = 0.0006) although differences were not statistically significant (Wald Chi-square = 3.29, df = 1, p = 0.07). However, only 48.9% of all participants answered all knowledge questions correctly. Many participants (56.5%), especially researchers (42%), indicated having at least occasional conversations about the role of genetics in psychiatric conditions with patients and/or family members. Most participants (62.7%) indicated that PRS are not yet sufficiently robust for assessment of susceptibility to schizophrenia; most significant obstacles were low predictive power and lack of population diversity in available PRS (selected, respectively, by 53.6% and 29.3% of participants). Nevertheless, 89.8% of participants were optimistic about the use of PRS in the next 10 years, suggesting a belief that current shortcomings could be addressed. Our findings inform about the perceptions of psychiatric professionals regarding PRS and the application of PRS in psychiatry.
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Affiliation(s)
- Tiahna Moorthy
- NYC Health + Hospitals/Jacobi Medical Center, Bronx, NY, USA
| | | | - Ying Chen
- New York State Psychiatric Institute, New York City, NY, USA
| | - Jehannine Austin
- Psychiatry and Medical Genetics, University of British Columbia, Vancouver, British Columbia, Canada
| | - Jordan W Smoller
- Psychiatry, Harvard Medical School, Boston, MA, USA
- Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Center for Precision Psychiatry and Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Laura Hercher
- Sarah Lawrence College Joan H. Marks Graduate Program in Human Genetics, Bronxville, NY, USA
| | - Maya Sabatello
- Medical Sciences (in Medicine), Center for Precision Medicine and Genomics, Department of Medicine, Columbia University, New York City, NY, USA
- Medical Sciences (in Medical Humanities and Ethics), Division of Ethics, Department of Medical Humanities and Ethics, Columbia University, New York City, NY, USA
- Precision Medicine: Ethics, Politics and Culture Project, Columbia University, New York City, NY, USA
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17
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Jin J, Zhan J, Zhang J, Zhao R, O’Connell J, Jiang Y, Buyske S, Gignoux C, Haiman C, Kenny EE, Kooperberg C, North K, Koelsch BL, Wojcik G, Zhang H, Chatterjee N. MUSSEL: Enhanced Bayesian Polygenic Risk Prediction Leveraging Information across Multiple Ancestry Groups. BIORXIV : THE PREPRINT SERVER FOR BIOLOGY 2023:2023.04.12.536510. [PMID: 37090648 PMCID: PMC10120638 DOI: 10.1101/2023.04.12.536510] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/25/2023]
Abstract
Polygenic risk scores (PRS) are now showing promising predictive performance on a wide variety of complex traits and diseases, but there exists a substantial performance gap across different populations. We propose MUSSEL, a method for ancestry-specific polygenic prediction that borrows information in the summary statistics from genome-wide association studies (GWAS) across multiple ancestry groups. MUSSEL conducts Bayesian hierarchical modeling under a MUltivariate Spike-and-Slab model for effect-size distribution and incorporates an Ensemble Learning step using super learner to combine information across different tuning parameter settings and ancestry groups. In our simulation studies and data analyses of 16 traits across four distinct studies, totaling 5.7 million participants with a substantial ancestral diversity, MUSSEL shows promising performance compared to alternatives. The method, for example, has an average gain in prediction R2 across 11 continuous traits of 40.2% and 49.3% compared to PRS-CSx and CT-SLEB, respectively, in the African Ancestry population. The best-performing method, however, varies by GWAS sample size, target ancestry, underlying trait architecture, and the choice of reference samples for LD estimation, and thus ultimately, a combination of methods may be needed to generate the most robust PRS across diverse populations.
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Affiliation(s)
- Jin Jin
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Biostatistics, Epidemiology and Informatics, University of Pennsylvania, Philadelphia, PA, USA
| | | | - Jingning Zhang
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ruzhang Zhao
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | | | | | - Steven Buyske
- Department of Statistics, Rutgers University, New Brunswick, NJ, USA
| | - Christopher Gignoux
- Colorado Center for Personalized Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Christopher Haiman
- Department of Preventive Medicine, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Eimear E. Kenny
- Icahn Institute for Genomic Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Charles Kooperberg
- Division of Public Health Sciences, Fred Hutchinson Cancer Center, Seattle, WA, USA
| | - Kari North
- Department of Epidemiology, University of North Carolina Chapel Hill, Chapel Hill, NC, USA
| | | | - Genevieve Wojcik
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Haoyu Zhang
- Department of Biostatistics, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Division of Cancer Epidemiology and Genetics, National Cancer Institute, Bethesda, MD, USA
| | - Nilanjan Chatterjee
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Oncology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
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18
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Als TD, Kurki MI, Grove J, Voloudakis G, Therrien K, Tasanko E, Nielsen TT, Naamanka J, Veerapen K, Levey DF, Bendl J, Bybjerg-Grauholm J, Zeng B, Demontis D, Rosengren A, Athanasiadis G, Bækved-Hansen M, Qvist P, Bragi Walters G, Thorgeirsson T, Stefánsson H, Musliner KL, Rajagopal VM, Farajzadeh L, Thirstrup J, Vilhjálmsson BJ, McGrath JJ, Mattheisen M, Meier S, Agerbo E, Stefánsson K, Nordentoft M, Werge T, Hougaard DM, Mortensen PB, Stein MB, Gelernter J, Hovatta I, Roussos P, Daly MJ, Mors O, Palotie A, Børglum AD. Depression pathophysiology, risk prediction of recurrence and comorbid psychiatric disorders using genome-wide analyses. Nat Med 2023; 29:1832-1844. [PMID: 37464041 PMCID: PMC10839245 DOI: 10.1038/s41591-023-02352-1] [Citation(s) in RCA: 44] [Impact Index Per Article: 44.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2022] [Accepted: 04/17/2023] [Indexed: 07/20/2023]
Abstract
Depression is a common psychiatric disorder and a leading cause of disability worldwide. Here we conducted a genome-wide association study meta-analysis of six datasets, including >1.3 million individuals (371,184 with depression) and identified 243 risk loci. Overall, 64 loci were new, including genes encoding glutamate and GABA receptors, which are targets for antidepressant drugs. Intersection with functional genomics data prioritized likely causal genes and revealed new enrichment of prenatal GABAergic neurons, astrocytes and oligodendrocyte lineages. We found depression to be highly polygenic, with ~11,700 variants explaining 90% of the single-nucleotide polymorphism heritability, estimating that >95% of risk variants for other psychiatric disorders (anxiety, schizophrenia, bipolar disorder and attention deficit hyperactivity disorder) were influencing depression risk when both concordant and discordant variants were considered, and nearly all depression risk variants influenced educational attainment. Additionally, depression genetic risk was associated with impaired complex cognition domains. We dissected the genetic and clinical heterogeneity, revealing distinct polygenic architectures across subgroups of depression and demonstrating significantly increased absolute risks for recurrence and psychiatric comorbidity among cases of depression with the highest polygenic burden, with considerable sex differences. The risks were up to 5- and 32-fold higher than cases with the lowest polygenic burden and the background population, respectively. These results deepen the understanding of the biology underlying depression, its disease progression and inform precision medicine approaches to treatment.
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Affiliation(s)
- Thomas D Als
- Department of Biomedicine, Aarhus University, Aarhus, Denmark.
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark.
- Center for Genomics and Personalized Medicine, Aarhus, Denmark.
| | - Mitja I Kurki
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
- Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Jakob Grove
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Center for Genomics and Personalized Medicine, Aarhus, Denmark
- Bioinformatics Research Centre, Aarhus University, Aarhus, Denmark
| | - Georgios Voloudakis
- Center for Disease Neurogenomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Icahn Institute for Data Science and Genomic Technology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mental Illness Research, Education, and Clinical Center (VISN 2 South), James J Peters VA Medical Center, Bronx, NY, USA
| | - Karen Therrien
- Center for Disease Neurogenomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Icahn Institute for Data Science and Genomic Technology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mental Illness Research, Education, and Clinical Center (VISN 2 South), James J Peters VA Medical Center, Bronx, NY, USA
- Nash Family Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Elisa Tasanko
- Department of Psychology and Logopedics, SleepWell Research Program, University of Helsinki, Helsinki, Finland
| | - Trine Tollerup Nielsen
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Center for Genomics and Personalized Medicine, Aarhus, Denmark
| | - Joonas Naamanka
- Department of Psychology and Logopedics, SleepWell Research Program, University of Helsinki, Helsinki, Finland
| | - Kumar Veerapen
- Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Daniel F Levey
- Division of Human Genetics, Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Department of Psychiatry, Veterans Affairs Connecticut Healthcare Center, West Haven, CT, USA
| | - Jaroslav Bendl
- Center for Disease Neurogenomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Icahn Institute for Data Science and Genomic Technology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jonas Bybjerg-Grauholm
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Center for Neonatal Screening, Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | - Biao Zeng
- Center for Disease Neurogenomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Icahn Institute for Data Science and Genomic Technology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ditte Demontis
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Center for Genomics and Personalized Medicine, Aarhus, Denmark
| | - Anders Rosengren
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Mental Health Centre Sct. Hans, Capital Region of Denmark, Institute of Biological Psychiatry, Copenhagen University Hospital, Copenhagen, Denmark
| | - Georgios Athanasiadis
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Mental Health Centre Sct. Hans, Capital Region of Denmark, Institute of Biological Psychiatry, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Evolutionary Biology, Ecology and Environmental Sciences, University of Barcelona, Barcelona, Spain
| | - Marie Bækved-Hansen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Center for Neonatal Screening, Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | - Per Qvist
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Center for Genomics and Personalized Medicine, Aarhus, Denmark
| | | | | | | | - Katherine L Musliner
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- National Centre for Register-Based Research (NCRR), Business and Social Sciences, Aarhus University, Aarhus, Denmark
- Department of Affective Disorders, Aarhus University Hospital-Psychiatry, Aarhus, Denmark
- The Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - Veera M Rajagopal
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Center for Genomics and Personalized Medicine, Aarhus, Denmark
| | - Leila Farajzadeh
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Center for Genomics and Personalized Medicine, Aarhus, Denmark
| | - Janne Thirstrup
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Center for Genomics and Personalized Medicine, Aarhus, Denmark
| | - Bjarni J Vilhjálmsson
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Bioinformatics Research Centre, Aarhus University, Aarhus, Denmark
- National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
| | - John J McGrath
- National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark
- Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Brisbane, Queensland, Australia
- Queensland Brain Institute, University of Queensland, Brisbane, Queensland, Australia
| | - Manuel Mattheisen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
- Faculty of Computer Science, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Sandra Meier
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Department of Community Health and Epidemiology, Dalhousie University, Halifax, Nova Scotia, Canada
- Faculty of Computer Science, Dalhousie University, Halifax, Nova Scotia, Canada
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Esben Agerbo
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- National Centre for Register-Based Research (NCRR), Business and Social Sciences, Aarhus University, Aarhus, Denmark
- Centre for Integrated Register-based Research, CIRRAU, Aarhus University, Aarhus, Denmark
| | | | - Merete Nordentoft
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Mental Health Centre Copenhagen, Capital Region of Denmark, Copenhagen University Hospital, Copenhagen, Denmark
| | - Thomas Werge
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Mental Health Centre Sct. Hans, Capital Region of Denmark, Institute of Biological Psychiatry, Copenhagen University Hospital, Copenhagen, Denmark
- Institute of Clinical Sciences and GLOBE Institute, LF Center for GeoGenetics, University of Copenhagen, Copenhagen, Denmark
| | - David M Hougaard
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Center for Neonatal Screening, Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | - Preben B Mortensen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- National Centre for Register-Based Research (NCRR), Business and Social Sciences, Aarhus University, Aarhus, Denmark
- Centre for Integrated Register-based Research, CIRRAU, Aarhus University, Aarhus, Denmark
| | - Murray B Stein
- Psychiatry Service, VA San Diego Healthcare System, San Diego, CA, USA
- Departments of Psychiatry and Herbert Wertheim School of Public Health, University of California, San Diego, La Jolla, CA, USA
| | - Joel Gelernter
- Division of Human Genetics, Department of Psychiatry, Yale University School of Medicine, New Haven, CT, USA
- Department of Psychiatry, Veterans Affairs Connecticut Healthcare Center, West Haven, CT, USA
| | - Iiris Hovatta
- Department of Psychology and Logopedics, SleepWell Research Program, University of Helsinki, Helsinki, Finland
| | - Panos Roussos
- Center for Disease Neurogenomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Icahn Institute for Data Science and Genomic Technology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Friedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mental Illness Research, Education, and Clinical Center (VISN 2 South), James J Peters VA Medical Center, Bronx, NY, USA
- Center for Dementia Research, Nathan Kline Institute for Psychiatric Research, Orangeburg, NY, USA
| | - Mark J Daly
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
- Analytic and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Ole Mors
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Psychosis Research Unit, Aarhus University Hospital-Psychiatry, Aarhus, Denmark
| | - Aarno Palotie
- Institute for Molecular Medicine Finland, University of Helsinki, Helsinki, Finland
| | - Anders D Børglum
- Department of Biomedicine, Aarhus University, Aarhus, Denmark.
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark.
- Center for Genomics and Personalized Medicine, Aarhus, Denmark.
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19
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Segura AG, Mezquida G, Martínez-Pinteño A, Gassó P, Rodriguez N, Moreno-Izco L, Amoretti S, Bioque M, Lobo A, González-Pinto A, García-Alcon A, Roldán-Bejarano A, Vieta E, de la Serna E, Toll A, Cuesta MJ, Mas S, Bernardo M. Link between cognitive polygenic risk scores and clinical progression after a first-psychotic episode. Psychol Med 2023; 53:4634-4647. [PMID: 35678455 PMCID: PMC10388335 DOI: 10.1017/s0033291722001544] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Revised: 05/05/2022] [Accepted: 05/09/2022] [Indexed: 11/05/2022]
Abstract
BACKGROUND Clinical intervention in early stages of psychotic disorders is crucial for the prevention of severe symptomatology trajectories and poor outcomes. Genetic variability is studied as a promising modulator of prognosis, thus novel approaches considering the polygenic nature of these complex phenotypes are required to unravel the mechanisms underlying the early progression of the disorder. METHODS The sample comprised of 233 first-episode psychosis (FEP) subjects with clinical and cognitive data assessed periodically for a 2-year period and 150 matched controls. Polygenic risk scores (PRSs) for schizophrenia, bipolar disorder, depression, education attainment and cognitive performance were used to assess the genetic risk of FEP and to characterize their association with premorbid, baseline and progression of clinical and cognitive status. RESULTS Schizophrenia, bipolar disorder and cognitive performance PRSs were associated with an increased risk of FEP [false discovery rate (FDR) ⩽ 0.027]. In FEP patients, increased cognitive PRSs were found for FEP patients with more cognitive reserve (FDR ⩽ 0.037). PRSs reflecting a genetic liability for improved cognition were associated with a better course of symptoms, functionality and working memory (FDR ⩽ 0.039). Moreover, the PRS of depression was associated with a worse trajectory of the executive function and the general cognitive status (FDR ⩽ 0.001). CONCLUSIONS Our study provides novel evidence of the polygenic bases of psychosis and its clinical manifestation in its first stage. The consistent effect of cognitive PRSs on the early clinical progression suggests that the mechanisms underlying the psychotic episode and its severity could be partially independent.
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Affiliation(s)
- Alex G. Segura
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain
| | - Gisela Mezquida
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain
- Barcelona Clínic Schizophrenia Unit, Neuroscience Institute Hospital Clínic de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain
| | - Albert Martínez-Pinteño
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain
| | - Patricia Gassó
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain
| | - Natalia Rodriguez
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain
| | - Lucía Moreno-Izco
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Silvia Amoretti
- Barcelona Clínic Schizophrenia Unit, Neuroscience Institute Hospital Clínic de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Group of Psychiatry, Mental Health and Addictions, Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Barcelona, Spain
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, Barcelona, Spain
| | - Miquel Bioque
- Barcelona Clínic Schizophrenia Unit, Neuroscience Institute Hospital Clínic de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Antonio Lobo
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Department of Medicine and Psychiatry, Universidad de Zaragoza, Zaragoza, Spain
- Instituto de Investigación Sanitaria Aragón (IIS Aragón), Zaragoza, Spain
| | - Ana González-Pinto
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Hospital Universitario de Alava, Vitoria-Gasteiz, Spain
- Instituto de Investigación Sanitaria Bioaraba, Vitoria-Gasteiz, Spain
- University of the Basque Country, Vizcaya, Spain
| | - Alicia García-Alcon
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain
| | - Alexandra Roldán-Bejarano
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Psychiatry Department, Institut d'Investigació Biomèdica-SantPau (IIB-SANTPAU), Hospital de la Santa Creu i Sant Pau, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Eduard Vieta
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
| | - Elena de la Serna
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
- Department of Child and Adolescent Psychiatry and Psychology, Clínic Institute of Neurosciences, University of Barcelona, Barcelona, Spain
| | - Alba Toll
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Institute of Neuropsychiatry and Addiction, Parc de Salut Mar, Barcelona, Spain
- Hospital del Mar Medical Research Institute, Barcelona, Spain
| | - Manuel J. Cuesta
- Department of Psychiatry, Complejo Hospitalario de Navarra, Pamplona, Spain
- Navarra Institute for Health Research (IdiSNA), Pamplona, Spain
| | - Sergi Mas
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain
| | - Miquel Bernardo
- Barcelona Clínic Schizophrenia Unit, Neuroscience Institute Hospital Clínic de Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
- Institut d'investigacions Biomèdiques August Pi i Sunyer (IDIBAPs), Barcelona, Spain
- Department of Medicine, University of Barcelona, Barcelona, Spain
| | - PEPs Group
- Department of Clinical Foundations, Pharmacology Unit, University of Barcelona, Barcelona, Spain
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20
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Deng W, Addington J, Bearden CE, Cadenhead KS, Cornblatt BA, Mathalon DH, Perkins DO, Seidman LJ, Tsuang MT, Woods SW, Walker EF, Cannon TD. Characterizing sustained social anxiety in individuals at clinical high risk for psychosis: trajectory, risk factors, and functional outcomes. Psychol Med 2023; 53:3644-3651. [PMID: 35144716 PMCID: PMC10277760 DOI: 10.1017/s0033291722000277] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2021] [Revised: 01/07/2022] [Accepted: 01/20/2022] [Indexed: 11/06/2022]
Abstract
BACKGROUND While comorbidity of clinical high-risk for psychosis (CHR-P) status and social anxiety is well-established, it remains unclear how social anxiety and positive symptoms covary over time in this population. The present study aimed to determine whether there are more than one covariant trajectory of social anxiety and positive symptoms in the North American Prodrome Longitudinal Study cohort (NAPLS 2) and, if so, to test whether the different trajectory subgroups differ in terms of genetic and environmental risk factors for psychotic disorders and general functional outcome. METHODS In total, 764 CHR individuals were evaluated at baseline for social anxiety and psychosis risk symptom severity and followed up every 6 months for 2 years. Application of group-based multi-trajectory modeling discerned three subgroups based on the covariant trajectories of social anxiety and positive symptoms over 2 years. RESULTS One of the subgroups showed sustained social anxiety over time despite moderate recovery in positive symptoms, while the other two showed recovery of social anxiety below clinically significant thresholds, along with modest to moderate recovery in positive symptom severity. The trajectory group with sustained social anxiety had poorer long-term global functional outcomes than the other trajectory groups. In addition, compared with the other two trajectory groups, membership in the group with sustained social anxiety was predicted by higher levels of polygenic risk for schizophrenia and environmental stress exposures. CONCLUSIONS Together, these analyses indicate differential relevance of sustained v. remitting social anxiety symptoms in the CHR-P population, which in turn may carry implications for differential intervention strategies.
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Affiliation(s)
- Wisteria Deng
- Department of Psychology, Yale University, New Haven, CT, USA
| | - Jean Addington
- Department of Psychiatry, Hotchkiss Brain Institute, Calgary, Canada
| | - Carrie E. Bearden
- Department of Psychiatry and Biobehavioral Sciences and Psychology, UCLA, Los Angeles, USA
| | | | | | | | - Diana O. Perkins
- Department of Psychiatry, University of North Carolina, Chapel Hill, USA
| | - Larry J. Seidman
- Department of Psychiatry, Harvard Medical School, Boston, USA
- Massachusetts General Hospital, Boston, USA
| | | | - Scott W. Woods
- Department of Psychiatry, Yale University, New Haven, CT, USA
| | - Elaine F. Walker
- Department of Psychology and Psychiatry, Emory University, Atlanta, USA
| | - Tyrone D. Cannon
- Department of Psychology, Yale University, New Haven, CT, USA
- Department of Psychiatry, Yale University, New Haven, CT, USA
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21
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Abi-Dargham A, Moeller SJ, Ali F, DeLorenzo C, Domschke K, Horga G, Jutla A, Kotov R, Paulus MP, Rubio JM, Sanacora G, Veenstra-VanderWeele J, Krystal JH. Candidate biomarkers in psychiatric disorders: state of the field. World Psychiatry 2023; 22:236-262. [PMID: 37159365 PMCID: PMC10168176 DOI: 10.1002/wps.21078] [Citation(s) in RCA: 51] [Impact Index Per Article: 51.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/08/2023] [Indexed: 05/11/2023] Open
Abstract
The field of psychiatry is hampered by a lack of robust, reliable and valid biomarkers that can aid in objectively diagnosing patients and providing individualized treatment recommendations. Here we review and critically evaluate the evidence for the most promising biomarkers in the psychiatric neuroscience literature for autism spectrum disorder, schizophrenia, anxiety disorders and post-traumatic stress disorder, major depression and bipolar disorder, and substance use disorders. Candidate biomarkers reviewed include various neuroimaging, genetic, molecular and peripheral assays, for the purposes of determining susceptibility or presence of illness, and predicting treatment response or safety. This review highlights a critical gap in the biomarker validation process. An enormous societal investment over the past 50 years has identified numerous candidate biomarkers. However, to date, the overwhelming majority of these measures have not been proven sufficiently reliable, valid and useful to be adopted clinically. It is time to consider whether strategic investments might break this impasse, focusing on a limited number of promising candidates to advance through a process of definitive testing for a specific indication. Some promising candidates for definitive testing include the N170 signal, an event-related brain potential measured using electroencephalography, for subgroup identification within autism spectrum disorder; striatal resting-state functional magnetic resonance imaging (fMRI) measures, such as the striatal connectivity index (SCI) and the functional striatal abnormalities (FSA) index, for prediction of treatment response in schizophrenia; error-related negativity (ERN), an electrophysiological index, for prediction of first onset of generalized anxiety disorder, and resting-state and structural brain connectomic measures for prediction of treatment response in social anxiety disorder. Alternate forms of classification may be useful for conceptualizing and testing potential biomarkers. Collaborative efforts allowing the inclusion of biosystems beyond genetics and neuroimaging are needed, and online remote acquisition of selected measures in a naturalistic setting using mobile health tools may significantly advance the field. Setting specific benchmarks for well-defined target application, along with development of appropriate funding and partnership mechanisms, would also be crucial. Finally, it should never be forgotten that, for a biomarker to be actionable, it will need to be clinically predictive at the individual level and viable in clinical settings.
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Affiliation(s)
- Anissa Abi-Dargham
- Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Scott J Moeller
- Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Farzana Ali
- Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Christine DeLorenzo
- Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | - Katharina Domschke
- Department of Psychiatry and Psychotherapy, Faculty of Medicine, University of Freiburg, Freiburg, Germany
- Centre for Basics in Neuromodulation, Faculty of Medicine, University of Freiburg, Freiburg, Germany
| | - Guillermo Horga
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Amandeep Jutla
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - Roman Kotov
- Renaissance School of Medicine at Stony Brook University, Stony Brook, NY, USA
| | | | - Jose M Rubio
- Zucker School of Medicine at Hofstra-Northwell, Hempstead, NY, USA
- Feinstein Institute for Medical Research - Northwell, Manhasset, NY, USA
- Zucker Hillside Hospital - Northwell Health, Glen Oaks, NY, USA
| | - Gerard Sanacora
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
| | - Jeremy Veenstra-VanderWeele
- Department of Psychiatry, Columbia University, New York, NY, USA
- New York State Psychiatric Institute, New York, NY, USA
| | - John H Krystal
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
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22
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Ding Y, Hou K, Xu Z, Pimplaskar A, Petter E, Boulier K, Privé F, Vilhjálmsson BJ, Olde Loohuis LM, Pasaniuc B. Polygenic scoring accuracy varies across the genetic ancestry continuum. Nature 2023; 618:774-781. [PMID: 37198491 PMCID: PMC10284707 DOI: 10.1038/s41586-023-06079-4] [Citation(s) in RCA: 51] [Impact Index Per Article: 51.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2022] [Accepted: 04/12/2023] [Indexed: 05/19/2023]
Abstract
Polygenic scores (PGSs) have limited portability across different groupings of individuals (for example, by genetic ancestries and/or social determinants of health), preventing their equitable use1-3. PGS portability has typically been assessed using a single aggregate population-level statistic (for example, R2)4, ignoring inter-individual variation within the population. Here, using a large and diverse Los Angeles biobank5 (ATLAS, n = 36,778) along with the UK Biobank6 (UKBB, n = 487,409), we show that PGS accuracy decreases individual-to-individual along the continuum of genetic ancestries7 in all considered populations, even within traditionally labelled 'homogeneous' genetic ancestries. The decreasing trend is well captured by a continuous measure of genetic distance (GD) from the PGS training data: Pearson correlation of -0.95 between GD and PGS accuracy averaged across 84 traits. When applying PGS models trained on individuals labelled as white British in the UKBB to individuals with European ancestries in ATLAS, individuals in the furthest GD decile have 14% lower accuracy relative to the closest decile; notably, the closest GD decile of individuals with Hispanic Latino American ancestries show similar PGS performance to the furthest GD decile of individuals with European ancestries. GD is significantly correlated with PGS estimates themselves for 82 of 84 traits, further emphasizing the importance of incorporating the continuum of genetic ancestries in PGS interpretation. Our results highlight the need to move away from discrete genetic ancestry clusters towards the continuum of genetic ancestries when considering PGSs.
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Affiliation(s)
- Yi Ding
- Bioinformatics Interdepartmental Program, UCLA, Los Angeles, CA, USA.
| | - Kangcheng Hou
- Bioinformatics Interdepartmental Program, UCLA, Los Angeles, CA, USA
| | - Ziqi Xu
- Department of Computer Science, UCLA, Los Angeles, CA, USA
| | - Aditya Pimplaskar
- Bioinformatics Interdepartmental Program, UCLA, Los Angeles, CA, USA
| | - Ella Petter
- Department of Computer Science, UCLA, Los Angeles, CA, USA
| | - Kristin Boulier
- Bioinformatics Interdepartmental Program, UCLA, Los Angeles, CA, USA
| | - Florian Privé
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
| | - Bjarni J Vilhjálmsson
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
- Bioinformatics Research Centre, Aarhus University, Aarhus, Denmark
- Novo Nordisk Foundation Center for Genomic Mechanisms of Disease, Broad Institute, Cambridge, MA, USA
| | - Loes M Olde Loohuis
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
- Department of Human Genetics, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA
| | - Bogdan Pasaniuc
- Bioinformatics Interdepartmental Program, UCLA, Los Angeles, CA, USA.
- Department of Human Genetics, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
- Department of Computational Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
- Department of Pathology and Laboratory Medicine, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
- Institute for Precision Health, UCLA, Los Angeles, CA, USA.
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23
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Wang FL, Bountress KE, Lemery-Chalfant K, Wilson MN, Shaw DS. A Polygenic Risk Score Enhances Risk Prediction for Adolescents' Antisocial Behavior over the Combined Effect of 22 Extra-familial, Familial, and Individual Risk Factors in the Context of the Family Check-Up. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2023; 24:739-751. [PMID: 36515774 PMCID: PMC10226895 DOI: 10.1007/s11121-022-01474-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/28/2022] [Indexed: 12/15/2022]
Abstract
Possessing informative tools to predict who is most at risk for antisocial behavior in adolescence is important to help identify families most in need of early intervention. Polygenic risk scores (PRSs) have been shown to predict antisocial behavior, but it remains unclear whether PRSs provide additional benefit above more conventional tools to early risk detection for antisocial behavior. This study examined the utility of a PRS in predicting adolescents' antisocial behavior after accounting for a broad index of children's contextual and individual risk factors for antisocial behavior. Participants were drawn from a longitudinal family-based prevention study (N = 463; Ncontrol = 224; 48.8% girls; 45.1% White; 30.2% Black; 12.7% Hispanic/Latino, 10.4% biracial; 0.2% Native American). Participants were recruited from US-based Women, Infants, and Children Nutritional Supplement programs. A risk tolerance PRS was created from a genome-wide association study. We created a robust measure capturing additive effects of 22 conventional measures of a risk of antisocial behavior assessed at child age 2 (before intervention). A latent variable capturing antisocial behavior (ages 10.5-16) was created. After accounting for intervention status and the conventional risk index, the risk tolerance PRS predicted independent variance in antisocial behavior. A PRS-by-conventional risk interaction showed that the conventional risk measure only predicted antisocial behavior at high levels of the PRS. Thus, the risk tolerance PRS provides unique predictive information above conventional screening tools and, when combined with them, identified a higher-risk subgroup of children. Integrating PRSs could facilitate risk identification and, ultimately, prevention screening, particularly in settings unable to serve all individuals in need.
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Affiliation(s)
- Frances L Wang
- Department of Psychiatry, University of Pittsburgh, 3811 O'Hara St, Pittsburgh, PA, 15213, USA.
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24
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Mondelli V, Blackman G, Kempton MJ, Pollak TA, Iyegbe C, Valmaggia LR, Amminger P, Barrantes-Vidal N, Bressan R, van der Gaag M, de Haan L, Krebs MO, Nordentoft M, Ruhrmann S, Riecher-Rössler A, Rutten BPF, Sachs G, Koutsouleris N, McGuire P. Serum immune markers and transition to psychosis in individuals at clinical high risk. Brain Behav Immun 2023; 110:290-296. [PMID: 36940754 DOI: 10.1016/j.bbi.2023.03.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2022] [Revised: 03/10/2023] [Accepted: 03/16/2023] [Indexed: 03/23/2023] Open
Abstract
Individuals at clinical high risk (CHR) for psychosis have been found to have altered cytokine levels, but whether these changes are related to clinical outcomes remains unclear. We addressed this issue by measuring serum levels of 20 immune markers in 325 participants (n = 269 CHR, n = 56 healthy controls) using multiplex immunoassays, and then followed up the CHR sample to determine their clinical outcomes. Among 269 CHR individuals, 50 (18.6 %) developed psychosis by two years. Univariate and machine learning techniques were used to compare levels of inflammatory markers in CHR subjects and healthy controls, and in CHR subjects who had (CHR-t), or had not (CHR-nt) transitioned to psychosis. An ANCOVA identified significant group differences (CHR-t, CHR-nt and controls) and post-hoc tests indicated that VEGF levels and the IL-10/IL-6 ratio were significantly higher in CHR-t than CHR-nt, after adjusting for multiple comparisons. Using a penalised logistic regression classifier, CHR participants were distinguished from controls with an area-under the curve (AUC) of 0.82, with IL-6 and IL-4 levels the most important discriminating features. Transition to psychosis was predicted with an AUC of 0.57, with higher VEGF level and IL-10/IL-6 ratio the most important discriminating features. These data suggest that alterations in the levels of peripheral immune markers are associated with the subsequent onset of psychosis. The association with increased VEGF levels could reflect altered blood-brain-barrier (BBB) permeability, while the link with an elevated IL-10/IL-6 ratio points to an imbalance between anti- and pro-inflammatory cytokines.
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Affiliation(s)
- Valeria Mondelli
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychological Medicine, London, UK; National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, UK.
| | - Graham Blackman
- National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, UK; King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, London, UK
| | - Matthew J Kempton
- National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, UK; King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, London, UK
| | - Thomas A Pollak
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, London, UK
| | - Conrad Iyegbe
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, London, UK
| | - Lucia R Valmaggia
- National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, UK; King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychology, London, UK
| | - Paul Amminger
- Centre for Youth Mental Health, University of Melbourne, 35 Poplar Road (Locked Bag 10), Parkville, Victoria 485 3052, Australia
| | - Neus Barrantes-Vidal
- Departament de Psicologia Clínica i de la Salut (Universitat Autònoma de Barcelona), Fundació Sanitària Sant Pere Claver (Spain), Spanish Mental Health Research Network (CIBERSAM), Australia
| | - Rodrigo Bressan
- LiNC - Lab Interdisciplinar Neurociências Clínicas, Depto Psiquiatria, Escola Paulista de Medicina, Universidade Federal de São Paulo - UNIFESP), Australia
| | - Mark van der Gaag
- VU University, Department of Clinical Psychology and Amsterdam Public Health Research Institute, van der Boechorststraat 7, 1081 BT Amsterdam, The Netherlands; Parnassia Psychiatric Institute, Department of Psychosis Research, Zoutkeetsingel 40, 2512 HN The Hague, The Netherlands
| | - Lieuwe de Haan
- AMC, Academic Psychiatric Centre, Department Early Psychosis, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands; Arkin Amsterdam, The Netherlands
| | - Marie-Odile Krebs
- University Paris Descartes, Hôpital Sainte-Anne, C'JAAD, Service Hospitalo-Universitaire, Inserm U894, Institut de Psychiatrie (CNRS 3557), Paris, France
| | - Merete Nordentoft
- Mental Health Center Copenhagen and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, CINS, Mental Health Center Glostrup, Mental Health Services in the Capital Region of Copenhagen, University of Copenhagen, Germany
| | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | | | - Bart P F Rutten
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, P.O. Box 616, 6200 MD 464 Maastricht, The Netherlands; Max-Planck Institute of Psychiatry, Munich, Germany
| | - Gabriele Sachs
- Medical University of Vienna, Department of Psychiatry and Psychotherapy, The Netherlands
| | - Nikolaos Koutsouleris
- King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, London, UK; Medical University of Vienna, Department of Psychiatry and Psychotherapy, The Netherlands; Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
| | - Philip McGuire
- National Institute for Health and Care Research (NIHR) Maudsley Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King's College London, UK; King's College London, Institute of Psychiatry, Psychology and Neuroscience, Department of Psychosis Studies, London, UK
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25
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Zwicker A, Fullerton JM, Mullins N, Rice F, Hafeman DM, van Haren NEM, Setiaman N, Merranko JA, Goldstein BI, Ferrera AG, Stapp EK, de la Serna E, Moreno D, Sugranyes G, Herrero SM, Roberts G, Toma C, Schofield PR, Edenberg HJ, Wilcox HC, McInnis MG, Powell V, Propper L, Denovan-Wright E, Rouleau G, Castro-Fornieles J, Hillegers MHJ, Birmaher B, Thapar A, Mitchell PB, Lewis CM, Alda M, Nurnberger JI, Uher R. Polygenic Scores and Onset of Major Mood or Psychotic Disorders Among Offspring of Affected Parents. Am J Psychiatry 2023; 180:285-293. [PMID: 36856707 DOI: 10.1176/appi.ajp.20220476] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/02/2023]
Abstract
OBJECTIVE Family history is an established risk factor for mental illness. The authors sought to investigate whether polygenic scores (PGSs) can complement family history to improve identification of risk for major mood and psychotic disorders. METHODS Eight cohorts were combined to create a sample of 1,884 participants ages 2-36 years, including 1,339 offspring of parents with mood or psychotic disorders, who were prospectively assessed with diagnostic interviews over an average of 5.1 years. PGSs were constructed for depression, bipolar disorder, anxiety, attention deficit hyperactivity disorder (ADHD), schizophrenia, neuroticism, subjective well-being, p factor, and height (as a negative control). Cox regression was used to test associations between PGSs, family history of major mental illness, and onsets of major mood and psychotic disorders. RESULTS There were 435 onsets of major mood and psychotic disorders across follow-up. PGSs for neuroticism (hazard ratio=1.23, 95% CI=1.12-1.36), schizophrenia (hazard ratio=1.15, 95% CI=1.04-1.26), depression (hazard ratio=1.11, 95% CI=1.01-1.22), ADHD (hazard ratio=1.10, 95% CI=1.00-1.21), subjective well-being (hazard ratio=0.90, 95% CI=0.82-0.99), and p factor (hazard ratio=1.14, 95% CI=1.04-1.26) were associated with onsets. After controlling for family history, neuroticism PGS remained significantly positively associated (hazard ratio=1.19, 95% CI=1.08-1.31) and subjective well-being PGS remained significantly negatively associated (hazard ratio=0.89, 95% CI=0.81-0.98) with onsets. CONCLUSIONS Neuroticism and subjective well-being PGSs capture risk of major mood and psychotic disorders that is independent of family history, whereas PGSs for psychiatric illness provide limited predictive power when family history is known. Neuroticism and subjective well-being PGSs may complement family history in the early identification of persons at elevated risk.
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Affiliation(s)
- Alyson Zwicker
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Janice M Fullerton
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Niamh Mullins
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Frances Rice
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Danella M Hafeman
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Neeltje E M van Haren
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Nikita Setiaman
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - John A Merranko
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Benjamin I Goldstein
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Alessandra G Ferrera
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Emma K Stapp
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Elena de la Serna
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Dolores Moreno
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Gisela Sugranyes
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Sergio Mas Herrero
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Gloria Roberts
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Claudio Toma
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Peter R Schofield
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Howard J Edenberg
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Holly C Wilcox
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Melvin G McInnis
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Victoria Powell
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Lukas Propper
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Eileen Denovan-Wright
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Guy Rouleau
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Josefina Castro-Fornieles
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Manon H J Hillegers
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Boris Birmaher
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Anita Thapar
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Philip B Mitchell
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Cathryn M Lewis
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Martin Alda
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - John I Nurnberger
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
| | - Rudolf Uher
- Department of Psychiatry (Zwicker, Propper, Denovan-Wright, Alda, Uher) and Department of Pharmacology (Denovan-Wright), Dalhousie University, Halifax, Nova Scotia, Canada; Nova Scotia Health, Halifax (Zwicker, Alda, Uher); Dalhousie Medicine New Brunswick, Saint John, New Brunswick, Canada (Zwicker); Neuroscience Research Australia, Randwick, New South Wales, Australia (Fullerton, Toma, Schofield); School of Medical Sciences, University of New South Wales, Kensington, Australia (Fullerton, Toma, Schofield); Department of Genetics and Genomic Sciences and Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York (Mullins); Wolfson Centre for Young People's Mental Health, Section of Child and Adolescent Psychiatry, Division of Psychological Medicine and Clinical Neurosciences, and MRC Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, U.K. (Rice, Powell, Thapar); Western Psychiatric Hospital, University of Pittsburgh School of Medicine, Pittsburgh (Hafeman, Merranko, Birmaher); Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Center, Sophia Children's Hospital, Rotterdam, the Netherlands (van Haren, Setiaman, Hillegers); Department of Psychiatry, University Medical Center Utrecht Brain Center, Utrecht, the Netherlands (van Haren, Setiaman, Hillegers); Center for Addiction and Mental Health, University of Toronto Faculty of Medicine, Ontario (Goldstein); Department of Psychiatry (Ferrera, Nurnberger) and Stark Neurosciences Research Institute (Nurnberger), Indiana University School of Medicine, Indianapolis; NIMH, Bethesda, Md. (Stapp); Institut d'Investigacions Biomèdiques Agustí Pi i Sunyer (IDIBAPS), Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Spain (de la Serna, Moreno, Sugranyes, Castro-Fornieles); Department of Child and Adolescent Psychiatry and Psychology, Institute of Neuroscience, Hospital Clinic of Barcelona, Spain (de la Serna, Sugranyes, Castro-Fornieles); Child and Adolescent Psychiatry Department, Hospital General Universitario Gregorio Marañón, Madrid (Moreno); Department of Psychiatry, Universitat de Barcelona, Spain (Herrero); School of Psychiatry, University of New South Wales, Randwick, New South Wales, Australia (Roberts, Mitchell); Centro de Biología Molecular "Severo Ochoa," Universidad Autónoma de Madrid/CSIC, Madrid (Toma); Department of Biochemistry and Molecular Biology, Indiana University, Indianapolis (Edenberg); Department of Psychiatry and Behavioral Sciences, Division of Child Psychiatry and Public Health, Johns Hopkins Medicine, and Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Wilcox); Department of Psychiatry, University of Michigan, Ann Arbor (McInnis); IWK Health Centre, Halifax (Propper); Montreal Neurological Institute and Department of Neurology, McGill University, Montreal (Rouleau); Department of Medicine, University of Barcelona, Barcelona, Spain (Castro-Fornieles); Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis)
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Biernacka JM. Do Polygenic Scores Inform Psychiatric Disease Risk After Considering Family History? Am J Psychiatry 2023; 180:256-258. [PMID: 37002695 DOI: 10.1176/appi.ajp.20230116] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/04/2023]
Affiliation(s)
- Joanna M Biernacka
- Department of Psychiatry and Psychology and Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minn
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27
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Andreassen OA, Hindley GFL, Frei O, Smeland OB. New insights from the last decade of research in psychiatric genetics: discoveries, challenges and clinical implications. World Psychiatry 2023; 22:4-24. [PMID: 36640404 PMCID: PMC9840515 DOI: 10.1002/wps.21034] [Citation(s) in RCA: 43] [Impact Index Per Article: 43.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/07/2022] [Indexed: 01/15/2023] Open
Abstract
Psychiatric genetics has made substantial progress in the last decade, providing new insights into the genetic etiology of psychiatric disorders, and paving the way for precision psychiatry, in which individual genetic profiles may be used to personalize risk assessment and inform clinical decision-making. Long recognized to be heritable, recent evidence shows that psychiatric disorders are influenced by thousands of genetic variants acting together. Most of these variants are commonly occurring, meaning that every individual has a genetic risk to each psychiatric disorder, from low to high. A series of large-scale genetic studies have discovered an increasing number of common and rare genetic variants robustly associated with major psychiatric disorders. The most convincing biological interpretation of the genetic findings implicates altered synaptic function in autism spectrum disorder and schizophrenia. However, the mechanistic understanding is still incomplete. In line with their extensive clinical and epidemiological overlap, psychiatric disorders appear to exist on genetic continua and share a large degree of genetic risk with one another. This provides further support to the notion that current psychiatric diagnoses do not represent distinct pathogenic entities, which may inform ongoing attempts to reconceptualize psychiatric nosology. Psychiatric disorders also share genetic influences with a range of behavioral and somatic traits and diseases, including brain structures, cognitive function, immunological phenotypes and cardiovascular disease, suggesting shared genetic etiology of potential clinical importance. Current polygenic risk score tools, which predict individual genetic susceptibility to illness, do not yet provide clinically actionable information. However, their precision is likely to improve in the coming years, and they may eventually become part of clinical practice, stressing the need to educate clinicians and patients about their potential use and misuse. This review discusses key recent insights from psychiatric genetics and their possible clinical applications, and suggests future directions.
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Affiliation(s)
- Ole A Andreassen
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Guy F L Hindley
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Oleksandr Frei
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Centre for Bioinformatics, Department of Informatics, University of Oslo, Oslo, Norway
| | - Olav B Smeland
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
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Affiliation(s)
- Cathryn M Lewis
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis, Vassos); Department of Medical and Molecular Genetics, Faculty of Life Sciences and Medicine, King's College London (Lewis)
| | - Evangelos Vassos
- Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London (Lewis, Vassos); Department of Medical and Molecular Genetics, Faculty of Life Sciences and Medicine, King's College London (Lewis)
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29
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Clapcote SJ. How can we obtain truly translational mouse models to improve clinical outcomes in schizophrenia? Dis Model Mech 2022; 15:dmm049970. [PMID: 36441105 PMCID: PMC10655820 DOI: 10.1242/dmm.049970] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2023] Open
Abstract
Schizophrenia is a serious mental illness affecting 0.7% of the world's population. Despite over 50 years of schizophrenia drug identification and development, there have been no fundamental advances in the treatment of schizophrenia since the 1980s. Complex genetic aetiology and elusive pathomechanisms have made it difficult for researchers to develop models that sufficiently reflect pathophysiology to support effective drug discovery. However, recent large-scale, well-powered genomic studies have identified risk genes that represent tractable entry points to decipher disease mechanisms in heterogeneous patient populations and develop targeted treatments. Replicating schizophrenia-associated gene variants in mouse models is an important strategy to start understanding their pathogenicity and role in disease biology. Furthermore, longitudinal studies in a wide range of genetic mouse models from early postnatal life are required to assess the progression of this disease through developmental stages to improve early diagnostic strategies and enable preventative measures. By expanding and refining our approach to schizophrenia research, we can improve prevention strategies and treatment of this debilitating disease.
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Lencz T, Sabatello M, Docherty A, Peterson RE, Soda T, Austin J, Bierut L, Crepaz-Keay D, Curtis D, Degenhardt F, Huckins L, Lazaro-Munoz G, Mattheisen M, Meiser B, Peay H, Rietschel M, Walss-Bass C, Davis LK. Concerns about the use of polygenic embryo screening for psychiatric and cognitive traits. Lancet Psychiatry 2022; 9:838-844. [PMID: 35931093 PMCID: PMC9930635 DOI: 10.1016/s2215-0366(22)00157-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 04/01/2022] [Accepted: 04/23/2022] [Indexed: 12/19/2022]
Abstract
Private companies have begun offering services to allow parents undergoing in-vitro fertilisation to screen embryos for genetic risk of complex diseases, including psychiatric disorders. This procedure, called polygenic embryo screening, raises several difficult scientific and ethical issues, as discussed in this Personal View. Polygenic embryo screening depends on the statistical properties of polygenic risk scores, which are complex and not well studied in the context of this proposed clinical application. The clinical, social, and ethical implications of polygenic embryo screening have barely been discussed among relevant stakeholders. To our knowledge, the International Society of Psychiatric Genetics is the first professional biomedical organisation to issue a statement regarding polygenic embryo screening. For the reasons discussed in this Personal View, the Society urges caution and calls for additional research and oversight on the use of polygenic embryo screening.
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Affiliation(s)
- Todd Lencz
- Divison of Psychiatry Research, Zucker Hillside Hospital, Glen Oaks, NY, USA; Department of Psychiatry, Division of Research, The Zucker Hillside Hospital Division of Northwell Health, Glen Oaks, NY, USA; Institute for Behavioral Science, The Feinstein Institutes for Medical Research, Manhasset, NY, USA.
| | - Maya Sabatello
- Division of Ethics, Department of Medical Humanities and Ethics, Columbia University, New York, NY, USA
| | - Anna Docherty
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Roseann E Peterson
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Takahiro Soda
- Department of Psychiatry, University of Florida College of Medicine, Gainesville, FL, USA
| | - Jehannine Austin
- Departments of Psychiatry and Medical Genetics, University of British Columbia, Vancouver, BC, Canada
| | - Laura Bierut
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
| | | | - David Curtis
- UCL Genetics Institute, University College London, London, United Kingdom
| | - Franziska Degenhardt
- Department of Child and Adolescent Psychiatry, Psychosomatics, and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Duisburg, Germany
| | - Laura Huckins
- Departments of Psychiatry and Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Manuel Mattheisen
- Department of Psychiatry, Dalhousie Medical School, Halifax, NS, Canada
| | - Bettina Meiser
- Prince of Wales Clinical School, University of New South Wales, NSW, Australia
| | - Holly Peay
- Genomics, Bioinformatics, and Translational Research Center, RTI International, Raleigh, NC, USA
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Consuelo Walss-Bass
- Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Science Center at Houston, Houston, TX, USA
| | - Lea K Davis
- Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN, USA
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Perceptions of causal attribution and attitudes to genetic testing among people with schizophrenia and their first-degree relatives. Eur J Hum Genet 2022; 30:1147-1154. [PMID: 35577937 PMCID: PMC9553941 DOI: 10.1038/s41431-022-01116-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2021] [Revised: 12/28/2021] [Accepted: 04/28/2022] [Indexed: 12/15/2022] Open
Abstract
Rapid advances in the genetics of psychiatric disorders mean that diagnostic and predictive genetic testing for schizophrenia risk may one day be a reality. This study examined how causal attributions for schizophrenia contribute to interest in a hypothetical genetic test. People with schizophrenia and first-degree relatives of people with schizophrenia were recruited through a schizophrenia research bank and mental health organisation. Semi-structured telephone interviews were conducted with 13 individuals with schizophrenia and 8 first-degree relatives. Transcripts were subjected to a qualitative analysis using the thematic analysis framework. Five themes were developed: (i) "It is like a cocktail", with most participants aware that both genetic and environmental factors contributed to causation, and many mentioning the positive impact of genetic causal explanations; (ii) "Knowledge is power" (i.e., in favour of genetic testing); (iii) Genetic testing provides opportunities for early intervention and avoiding triggers, with participants citing a wide range of perceived benefits of genetic testing but few risks; (iv) Views on reproductive genetic testing for schizophrenia risk with a few participants viewing it as "playing God" but not necessarily being against it; and (v) "It snowballs", whereby participants' understanding of genetics was sophisticated with most believing that multiple rather than single genes contributed to schizophrenia. In conclusion, many individuals had a sound understanding of the role of genetic testing if it were to become available, with evidence of insight into the role of multiple genes and the contribution of other risk factors that may interact with any inherited genetic risk.
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Novel functional genomics approaches bridging neuroscience and psychiatry. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2022. [PMID: 37519472 PMCID: PMC10382709 DOI: 10.1016/j.bpsgos.2022.07.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
The possibility of establishing a metric of individual genetic risk for a particular disease or trait has sparked the interest of the clinical and research communities, with many groups developing and validating genomic profiling methodologies for their potential application in clinical care. Current approaches for calculating genetic risk to specific psychiatric conditions consist of aggregating genome-wide association studies-derived estimates into polygenic risk scores, which broadly represent the number of inherited risk alleles for an individual. While the traditional approach for polygenic risk score calculation aggregates estimates of gene-disease associations, novel alternative approaches have started to consider functional molecular phenotypes that are closer to genetic variation and are less penalized by the multiple testing required in genome-wide association studies. Moving the focus from genotype-disease to genotype-gene regulation frameworks, these novel approaches incorporate prior knowledge regarding biological processes involved in disease and aggregate estimates for the association of genotypes and phenotypes using multi-omics data modalities. In this review, we discuss and list different functional genomics tools that can be used and integrated to inform researchers and clinicians for a better understanding and diagnosis of psychopathology. We suggest that these novel approaches can help generate biologically driven hypotheses for polygenic signals that can ultimately serve the clinical community as potential biomarkers of psychiatric disease susceptibility.
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Sullivan SA, Kounali D, Morris R, Kessler D, Hamilton W, Lewis G, Lilford P, Nazareth I. Developing and internally validating a prognostic model (P Risk) to improve the prediction of psychosis in a primary care population using electronic health records: The MAPPED study. Schizophr Res 2022; 246:241-249. [PMID: 35843156 DOI: 10.1016/j.schres.2022.06.031] [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: 10/05/2021] [Revised: 05/17/2022] [Accepted: 06/25/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND An accurate risk prediction algorithm could improve psychosis outcomes by reducing duration of untreated psychosis. OBJECTIVE To develop and validate a risk prediction model for psychosis, for use by family doctors, using linked electronic health records. METHODS A prospective prediction study. Records from family practices were used between 1/1/2010 to 31/12/2017 of 300,000 patients who had consulted their family doctor for any nonpsychotic mental health problem. Records were selected from Clinical Practice Research Datalink Gold, a routine database of UK family doctor records linked to Hospital Episode Statistics, a routine database of UK secondary care records. Each patient had 5-8 years of follow up data. Study predictors were consultations, diagnoses and/or prescribed medications, during the study period or historically, for 13 nonpsychotic mental health problems and behaviours, age, gender, number of mental health consultations, social deprivation, geographical location, and ethnicity. The outcome was time to an ICD10 psychosis diagnosis. FINDINGS 830 diagnoses of psychosis were made. Patients were from 216 family practices; mean age was 45.3 years and 43.5 % were male. Median follow-up was 6.5 years (IQR 5.6, 7.8). Overall 8-year psychosis incidence was 45.8 (95 % CI 42.8, 49.0)/100,000 person years at risk. A risk prediction model including age, sex, ethnicity, social deprivation, consultations for suicidal behaviour, depression/anxiety, substance abuse, history of consultations for suicidal behaviour, smoking history and prescribed medications for depression/anxiety/PTSD/OCD and total number of consultations had good discrimination (Harrell's C = 0.774). Identifying patients aged 17-100 years with predicted risk exceeding 1.0 % over 6 years had sensitivity of 71 % and specificity of 84 %. FUNDING NIHR, School for Primary Care Research, Biomedical Research Centre.
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Affiliation(s)
- Sarah A Sullivan
- Centre for Academic Mental Health, Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK; National Institute for Health Research, Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol, UK.
| | - Daphne Kounali
- Centre for Academic Mental Health, Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK; National Institute for Health Research, Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol, UK.
| | - Richard Morris
- National Institute for Health Research, Bristol Biomedical Research Centre, University Hospitals Bristol NHS Foundation Trust, University of Bristol, Bristol, UK; Centre for Academic Primary Care, Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK.
| | - David Kessler
- Centre for Academic Mental Health, Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK.
| | | | - Glyn Lewis
- UCL Division of Psychiatry, Maple House, Tottenham Court Rd, London W1T 7NF, UK.
| | - Philippa Lilford
- Centre for Academic Mental Health, Bristol Medical School, Population Health Sciences, University of Bristol, Bristol, UK.
| | - Irwin Nazareth
- UCL Division of Psychiatry, Maple House, Tottenham Court Rd, London W1T 7NF, UK.
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Zhang D, Xu L, Xie Y, Tang X, Hu Y, Liu X, Wu G, Qian Z, Tang Y, Liu Z, Chen T, Liu H, Zhang T, Wang J. Eye movement indices as predictors of conversion to psychosis in individuals at clinical high risk. Eur Arch Psychiatry Clin Neurosci 2022; 273:553-563. [PMID: 35857090 DOI: 10.1007/s00406-022-01463-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 06/27/2022] [Indexed: 12/17/2022]
Abstract
Eye movement abnormalities have been established as an "endophenotype" of schizophrenia. However, less is known about the possibility of these abnormalities as biomarkers for psychosis conversion among clinical high risk (CHR) populations. In the present study, 108 CHR individuals and 70 healthy controls (HC) underwent clinical assessments and eye-tracking tests, comprising fixation stability and free-viewing tasks. According to three-year follow-up outcomes, CHR participants were further stratified into CHR-converter (CHR-C; n = 21) and CHR-nonconverter (CHR-NC; n = 87) subgroups. Prediction models were constructed using Cox regression and logistic regression. The CHR-C group showed more saccades of the fixation stability test (no distractor) and a reduced saccade amplitude of the free-viewing test than HC. Moreover, the CHR-NC group exhibited excessive saccades and an increased saccade amplitude of the fixation stability test (no distractor; with distractor) compared with HC. Furthermore, two indices could effectively discriminate CHR-C from CHR-NC with an area under the receiver-operating characteristic (ROC) curve of 0.80, including the saccade number of the fixation stability test (no distractor) and the saccade amplitude of the free-viewing test. Combined with negative symptom scores of the Scale of Prodromal Symptoms, the area was 0.81. These findings support that eye movement alterations might emerge before the onset of clinically overt psychosis and could assist in predicting psychosis transition among CHR populations.
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Affiliation(s)
- Dan Zhang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, People's Republic of China
| | - Lihua Xu
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, People's Republic of China
| | - Yuou Xie
- First Clinical Medical College of Nanjing Medical University, Nanjing, 211103, People's Republic of China
| | - Xiaochen Tang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, People's Republic of China
| | - Yegang Hu
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, People's Republic of China
| | - Xu Liu
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, People's Republic of China
| | - Guisen Wu
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, People's Republic of China
| | - Zhenying Qian
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, People's Republic of China
| | - Yingying Tang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, People's Republic of China
| | - Zhi Liu
- Shanghai Institute for Advanced Communication and Data Science, Shanghai University, Shanghai, 200444, People's Republic of China.,School of Communication and Information Engineering, Shanghai University, Shanghai, 200444, People's Republic of China
| | - Tao Chen
- Senior Research Fellow, Labor and Worklife Program, Harvard University, Cambridge, MA, USA.,Big Data Research Lab, University of Waterloo, Waterloo, ON, Canada.,Niacin (Shanghai) Technology Co., Ltd., Shanghai, People's Republic of China
| | - HaiChun Liu
- Department of Automation, Shanghai Jiao Tong University, Shanghai, 200240, People's Republic of China
| | - Tianhong Zhang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, People's Republic of China.
| | - Jijun Wang
- Shanghai Key Laboratory of Psychotic Disorders, Shanghai Mental Health Center, Shanghai Jiao Tong University School of Medicine, Shanghai, 200030, People's Republic of China. .,CAS Center for Excellence in Brain Science and Intelligence Technology (CEBSIT), Chinese Academy of Science, Shanghai, People's Republic of China. .,Institute of Psychology and Behavioral Science, Shanghai Jiao Tong University, Shanghai, People's Republic of China.
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35
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Dwyer DB, Buciuman MO, Ruef A, Kambeitz J, Sen Dong M, Stinson C, Kambeitz-Ilankovic L, Degenhardt F, Sanfelici R, Antonucci LA, Lalousis PA, Wenzel J, Urquijo-Castro MF, Popovic D, Oeztuerk OF, Haas SS, Weiske J, Hauke D, Neufang S, Schmidt-Kraepelin C, Ruhrmann S, Penzel N, Lichtenstein T, Rosen M, Chisholm K, Riecher-Rössler A, Egloff L, Schmidt A, Andreou C, Hietala J, Schirmer T, Romer G, Michel C, Rössler W, Maj C, Borisov O, Krawitz PM, Falkai P, Pantelis C, Lencer R, Bertolino A, Borgwardt S, Noethen M, Brambilla P, Schultze-Lutter F, Meisenzahl E, Wood SJ, Davatzikos C, Upthegrove R, Salokangas RKR, Koutsouleris N. Clinical, Brain, and Multilevel Clustering in Early Psychosis and Affective Stages. JAMA Psychiatry 2022; 79:677-689. [PMID: 35583903 PMCID: PMC9118078 DOI: 10.1001/jamapsychiatry.2022.1163] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Importance Approaches are needed to stratify individuals in early psychosis stages beyond positive symptom severity to investigate specificity related to affective and normative variation and to validate solutions with premorbid, longitudinal, and genetic risk measures. Objective To use machine learning techniques to cluster, compare, and combine subgroup solutions using clinical and brain structural imaging data from early psychosis and depression stages. Design, Setting, and Participants A multisite, naturalistic, longitudinal cohort study (10 sites in 5 European countries; including major follow-up intervals at 9 and 18 months) with a referred patient sample of those with clinical high risk for psychosis (CHR-P), recent-onset psychosis (ROP), recent-onset depression (ROD), and healthy controls were recruited between February 1, 2014, to July 1, 2019. Data were analyzed between January 2020 and January 2022. Main Outcomes and Measures A nonnegative matrix factorization technique separately decomposed clinical (287 variables) and parcellated brain structural volume (204 gray, white, and cerebrospinal fluid regions) data across CHR-P, ROP, ROD, and healthy controls study groups. Stability criteria determined cluster number using nested cross-validation. Validation targets were compared across subgroup solutions (premorbid, longitudinal, and schizophrenia polygenic risk scores). Multiclass supervised machine learning produced a transferable solution to the validation sample. Results There were a total of 749 individuals in the discovery group and 610 individuals in the validation group. Individuals included those with CHR-P (n = 287), ROP (n = 323), ROD (n = 285), and healthy controls (n = 464), The mean (SD) age was 25.1 (5.9) years, and 702 (51.7%) were female. A clinical 4-dimensional solution separated individuals based on positive symptoms, negative symptoms, depression, and functioning, demonstrating associations with all validation targets. Brain clustering revealed a subgroup with distributed brain volume reductions associated with negative symptoms, reduced performance IQ, and increased schizophrenia polygenic risk scores. Multilevel results distinguished between normative and illness-related brain differences. Subgroup results were largely validated in the external sample. Conclusions and Relevance The results of this longitudinal cohort study provide stratifications beyond the expression of positive symptoms that cut across illness stages and diagnoses. Clinical results suggest the importance of negative symptoms, depression, and functioning. Brain results suggest substantial overlap across illness stages and normative variation, which may highlight a vulnerability signature independent from specific presentations. Premorbid, longitudinal, and genetic risk validation suggested clinical importance of the subgroups to preventive treatments.
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Affiliation(s)
- Dominic B Dwyer
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany.,Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia
| | - Madalina-Octavia Buciuman
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany.,International Max-Planck Research School for Translational Psychiatry, Munich, Germany
| | - Anne Ruef
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
| | - Joseph Kambeitz
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Mark Sen Dong
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
| | - Caedyn Stinson
- Max-Planck School of Cognition, Leipzig, Germany.,Center for Adaptive Rationality, Max Planck Institute for Human Development, Berlin, Germany
| | - Lana Kambeitz-Ilankovic
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany.,Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Franziska Degenhardt
- Institute of Human Genetics, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany.,Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Essen, Germany
| | - Rachele Sanfelici
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany.,Max-Planck Institute of Psychiatry, Munich, Germany
| | - Linda A Antonucci
- Department of Education, Psychology, Communication, University of Bari Aldo Moro, Bari, Italy
| | - Paris Alexandros Lalousis
- Institute for Mental Health and Centre for Brain Health, University of Birmingham, Birmingham, United Kingdom
| | - Julian Wenzel
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | | | - David Popovic
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany.,International Max-Planck Research School for Translational Psychiatry, Munich, Germany
| | - Oemer Faruk Oeztuerk
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany.,International Max-Planck Research School for Translational Psychiatry, Munich, Germany
| | - Shalaila S Haas
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York
| | - Johanna Weiske
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany
| | - Daniel Hauke
- Department of Psychiatry (Psychiatric University Hospital, UPK), University of Basel, Basel, Switzerland.,Early Intervention Service, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, United Kingdom.,Department of Mathematics and Computer Science, University of Basel, Basel, Switzerland
| | - Susanne Neufang
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany
| | | | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Nora Penzel
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Theresa Lichtenstein
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Marlene Rosen
- Department of Psychiatry and Psychotherapy, Faculty of Medicine and University Hospital, University of Cologne, Cologne, Germany
| | - Katharine Chisholm
- Institute for Mental Health and Centre for Brain Health, University of Birmingham, Birmingham, United Kingdom.,Department of Psychology, Aston University, Birmingham, United Kingdom
| | | | - Laura Egloff
- Department of Psychiatry (Psychiatric University Hospital, UPK), University of Basel, Basel, Switzerland
| | - André Schmidt
- Department of Psychiatry (Psychiatric University Hospital, UPK), University of Basel, Basel, Switzerland
| | - Christina Andreou
- Department of Psychiatry (Psychiatric University Hospital, UPK), University of Basel, Basel, Switzerland
| | - Jarmo Hietala
- Department of Psychiatry, University of Turku, Turku, Finland
| | - Timo Schirmer
- GE Healthcare GmbH (previously GE Global Research GmbH), Munich, Germany
| | - Georg Romer
- Department of Child and Adolescent Psychiatry, University of Münster, Münster, Germany
| | - Chantal Michel
- University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland
| | - Wulf Rössler
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Psychiatry Zurich, Zurich, Switzerland
| | - Carlo Maj
- Institute of Genomic Statistics and Bioinformatics, University of Bonn, Bonn, Germany
| | - Oleg Borisov
- Institute of Genomic Statistics and Bioinformatics, University of Bonn, Bonn, Germany
| | - Peter M Krawitz
- Institute of Genomic Statistics and Bioinformatics, University of Bonn, Bonn, Germany
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany.,Max-Planck Institute of Psychiatry, Munich, Germany
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, University of Melbourne & Melbourne Health, Melbourne, Victoria, Australia
| | - Rebekka Lencer
- Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany.,Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Alessandro Bertolino
- Department of Basic Medical Science, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy
| | - Stefan Borgwardt
- Department of Psychiatry (Psychiatric University Hospital, UPK), University of Basel, Basel, Switzerland.,Department of Psychiatry and Psychotherapy, University of Lübeck, Lübeck, Germany
| | - Markus Noethen
- Institute of Human Genetics, Rheinische Friedrich-Wilhelms-Universität Bonn, Bonn, Germany
| | - Paolo Brambilla
- Department of Neurosciences and Mental Health, Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico, Milano, Italy.,Department of Pathophysiology and Transplantation, University of Milan, Milan, Italy
| | - Frauke Schultze-Lutter
- Department of Psychiatry and Psychotherapy, Medical Faculty, Heinrich-Heine University, Düsseldorf, Germany.,University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Bern, Switzerland.,Department of Psychology, Faculty of Psychology, Airlangga University, Surabaya, Indonesia
| | | | - Stephen J Wood
- Centre for Youth Mental Health, University of Melbourne, Melbourne, Victoria, Australia.,Orygen, the National Centre of Excellence for Youth Mental Health, Melbourne, Victoria, Australia
| | - Christos Davatzikos
- Department of Radiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia.,Center for Biomedical Image Computing and Analytics, Perelman School of Medicine, University of Pennsylvania, Philadelphia
| | - Rachel Upthegrove
- Institute for Mental Health and Centre for Brain Health, University of Birmingham, Birmingham, United Kingdom.,Early Intervention Service, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, United Kingdom
| | | | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany.,Max-Planck Institute of Psychiatry, Munich, Germany.,Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
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Metabolic polygenic risk scores effect on antipsychotic-induced metabolic dysregulation: A longitudinal study in a first episode psychosis cohort. Schizophr Res 2022; 244:101-110. [PMID: 35659654 DOI: 10.1016/j.schres.2022.05.021] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2021] [Revised: 03/18/2022] [Accepted: 05/21/2022] [Indexed: 11/20/2022]
Abstract
OBJECTIVE Metabolic syndrome is a health-threatening condition suffered by approximately one third of schizophrenia patients and largely attributed to antipsychotic medication. Previous evidence reports a common genetic background of psychotic and metabolic disorders. In this study, we aimed to assess the role of polygenic risk scores (PRSs) on the progression of the metabolic profile in a first-episode psychosis (FEP) cohort. METHOD Of the 231 FEP individuals included in the study, 192-220 participants were included in basal analysis and 118-179 in longitudinal 6-month models. Eleven psychopathologic and metabolic PRSs were constructed. Basal and longitudinal PRSs association with metabolic measurements was assessed by statistical analyses. RESULTS No major association of psychopathological PRSs with the metabolic progression was found. However, high risk individuals for depression and cholesterol-related PRSs reported a higher increase of cholesterol levels during the follow-up (FDR ≤ 0.023 for all analyses). Their effect was comparable to other well-established pharmacological and environmental risk factors (explaining at least 1.2% of total variance). CONCLUSION Our findings provide new evidence of the effects of metabolic genetic risk on the development of metabolic dysregulation. The future establishment of genetic profiling tools in clinical procedures could enable practitioners to better personalize antipsychotic treatment selection and dosage.
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Fabbri C. Genetics in psychiatry: Methods, clinical applications and future perspectives. PCN REPORTS : PSYCHIATRY AND CLINICAL NEUROSCIENCES 2022; 1:e6. [PMID: 38868637 PMCID: PMC11114394 DOI: 10.1002/pcn5.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/18/2021] [Revised: 01/18/2022] [Accepted: 03/02/2022] [Indexed: 06/14/2024]
Abstract
Psychiatric disorders and related traits have a demonstrated genetic component, with heritability estimated by twin studies generally between 80% and 40%. Their pathogenesis is complex and multi-determined: environmental factors interact with a polygenic architecture, making difficult the development of models able to stratify patients or predict mental health outcomes. Despite this difficult challenge, relevant progress has been made in the field of psychiatric genetics in recent years. This review aims to present the main current methods in psychiatric genetics, their output, limitations, clinical applications, and possible future developments. Genome-wide association studies (GWASs) performed in increasingly large samples have led to the identification of replicated genetic loci associated with the risk of major psychiatric disorders, including schizophrenia and mood disorders. Statistical and biological approaches have been developed to improve our understanding of the etiopathogenetic mechanisms behind genome-wide significant associations, as well as for estimating the cumulative effect of risk variants at the individual level and the genetic overlap between different disorders, as pleiotropy is the rule rather than the exception. Clinical applications are available in the pharmacogenetics field. The main issues that remain to be addressed include improving ethnic diversity in genetic studies and the optimization of statistical power through methodological improvements, such as the definition of dimensional phenotypes with specific biological correlates and the integration of different types of omics data.
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Affiliation(s)
- Chiara Fabbri
- Department of Biomedical and Neuromotor SciencesUniversity of BolognaBolognaItaly
- Institute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
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Is it possible to stage schizophrenia? A systematic review. Transl Psychiatry 2022; 12:197. [PMID: 35545617 PMCID: PMC9095725 DOI: 10.1038/s41398-022-01889-y] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2021] [Revised: 02/07/2022] [Accepted: 03/09/2022] [Indexed: 11/09/2022] Open
Abstract
INTRODUCTION A staging model is a clinical tool used to define the development of a disease over time. In schizophrenia, authors have proposed different theoretical staging models of increasing complexity. Therefore, the aims of our study were to provide an updated and critical view of the proposed clinical staging models for schizophrenia and to review the empirical data that support them. METHODS Systematic literature review following PRISMA guidelines. From the PubMed database and backward reference search, a total of 141 records were retrieved, but only 20 were selected according to the inclusion criteria: (a) available in English; (b) participants with schizophrenia ≥ 18 years; and (c) theoretical and empirical research studies intended to develop, validate, and/or improve staging models of schizophrenia. RESULTS Different clinical staging models for schizophrenia were identified, information about the proposed stages was tabulated and presented in the Results section (Tables 1, 2). Most of which include neuroimaging, functioning, and psychopathology, but only two models add objective biomarkers and none include patient point of view. However, few models have been psychometrically tested or used small samples and thus have been validated only partially. In addition, five studies proposed therapeutic interventions according to the stage of the disorder from a theoretical point of view. DISCUSSION In conclusion, it is possible to stage schizophrenia, but the models developed have several limitations. Empirical validation and inclusion of more specific biomarkers and measures of other life areas affected by schizophrenia could help in the development of more valid models.
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Santesteban-Echarri O, Sandel D, Liu L, Bearden CE, Cadenhead KS, Cannon TD, Cornblatt BA, Keshavan M, Mathalon DH, McGlashan TH, Perkins DO, Seidman LJ, Stone WS, Tsuang MT, Walker EF, Woods SW, Addington J. Family history of psychosis in youth at clinical high risk: A replication study. Psychiatry Res 2022; 311:114480. [PMID: 35245743 DOI: 10.1016/j.psychres.2022.114480] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/19/2021] [Revised: 02/01/2022] [Accepted: 02/23/2022] [Indexed: 01/18/2023]
Abstract
Having a first-degree relative with a psychotic disorder increases an individual's risk for developing psychosis to 10% compared to 1% in the general population. The impact of being at family high-risk for psychosis (FHR) has been examined in samples of youth who are at clinical high-risk for psychosis (CHR). The second North American Prodrome Longitudinal Study (NAPLS-2) identified very few clinical differences between CHR individuals with and without FHR. This paper aims to confirm these results in a new CHR sample, NAPLS-3. The NAPLS-3 sample consisted of 703 CHR participants, of whom 82 were at FHR (CHR+FHR), and 621 were not (CHR+FHRneg). The Family Interview for Genetic Studies was used to determine the presence of a first-degree relative with a psychotic disorder. The groups were compared on social and role functioning, positive and negative symptoms, IQ, cannabis use, and trauma. At baseline, the CHR+FHR group reported a statistically significant increased severity of positive and negative symptoms, lower IQ scores, and increased reports of trauma, psychological and physical abuse. There were no differences in transition rates between the two groups. This study supports some of the already reported differences in trauma, physical and psychological abuse between CHR individuals with and without FHR.
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Affiliation(s)
- Olga Santesteban-Echarri
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Danah Sandel
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Lu Liu
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada
| | - Carrie E Bearden
- Department of Psychiatry and Biobehavioral Sciences and Psychology, UCLA, Los Angeles, CA, United States
| | | | - Tyrone D Cannon
- Department of Psychology, Yale University, New Haven, CT, United States; Department of Psychiatry, Yale University, New Haven, CT, United States
| | - Barbara A Cornblatt
- Department of Psychiatry, Zucker Hillside Hospital, Long Island, NY, United States
| | - Matcheri Keshavan
- Department of Psychiatry, Harvard Medical School Department of Psychiatry at Beth Israel Deaconess Medical Center and Massachusetts Mental Health Center, Boston, MA, United States
| | - Daniel H Mathalon
- Department of Psychiatry, UCSF, and SFVA Medical Center, San Francisco, CA, United States
| | - Thomas H McGlashan
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, United States
| | - Diana O Perkins
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, United States
| | - Larry J Seidman
- Department of Psychiatry, Harvard Medical School Department of Psychiatry at Beth Israel Deaconess Medical Center and Massachusetts Mental Health Center, Boston, MA, United States
| | - William S Stone
- Department of Psychiatry, Harvard Medical School Department of Psychiatry at Beth Israel Deaconess Medical Center and Massachusetts Mental Health Center, Boston, MA, United States
| | - Ming T Tsuang
- Department of Psychiatry, UCSD, San Diego, CA, United States; Institute of Genomic Medicine, University of California, La Jolla, CA, United States
| | - Elaine F Walker
- Department of Psychology and Psychiatry, Emory University, Atlanta, GA, United States
| | - Scott W Woods
- Department of Psychiatry, Yale University, New Haven, CT, United States
| | - Jean Addington
- Department of Psychiatry, Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.
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Gershon ES, Lee SH, Zhou X, Sweeney JA, Tamminga C, Pearlson GA, Clementz BA, Keshavan MS, Alliey-Rodriguez N, Hudgens-Haney M, Keedy SK, Glahn DC, Asif H, Lencer R, Hill SK. An opportunity for primary prevention research in psychotic disorders. Schizophr Res 2022; 243:433-439. [PMID: 34315649 PMCID: PMC8784565 DOI: 10.1016/j.schres.2021.07.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 04/29/2021] [Accepted: 07/01/2021] [Indexed: 10/20/2022]
Abstract
An opportunity has opened for research into primary prevention of psychotic disorders, based on progress in endophenotypes, genetics, and genomics. Primary prevention requires reliable prediction of susceptibility before any symptoms are present. We studied a battery of measures where published data supports abnormalities of these measurements prior to appearance of initial psychosis symptoms. These neurobiological and behavioral measurements included cognition, eye movement tracking, Event Related Potentials, and polygenic risk scores. They generated an acceptably precise separation of healthy controls from outpatients with a psychotic disorder. METHODS: The Bipolar and Schizophrenia Network on Intermediate Phenotypes (B-SNIP) measured this battery in an ancestry-diverse series of consecutively recruited adult outpatients with a psychotic disorder and healthy controls. Participants include all genders, 16 to 50 years of age, 261 with psychotic disorders (Schizophrenia (SZ) 109, Bipolar with psychosis (BPP) 92, Schizoaffective disorder (SAD) 60), 110 healthy controls. Logistic Regression, and an extension of the Linear Mixed Model to include analysis of pairwise interactions between measures (Environmental kernel Relationship Matrices (ERM)) with multiple iterations, were performed to predict case-control status. Each regression analysis was validated with four-fold cross-validation. RESULTS AND CONCLUSIONS: Sensitivity, specificity, and Area Under the Curve of Receiver Operating Characteristic of 85%, 62%, and 86%, respectively, were obtained for both analytic methods. These prediction metrics demonstrate a promising diagnostic distinction based on premorbid risk variables. There were also statistically significant pairwise interactions between measures in the ERM model. The strong prediction metrics of both types of analytic model provide proof-of-principle for biologically-based laboratory tests as a first step toward primary prevention studies. Prospective studies of adolescents at elevated risk, vs. healthy adolescent controls, would be a next step toward development of primary prevention strategies.
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Affiliation(s)
- Elliot S Gershon
- University of Chicago, Department of Psychiatry, United States of America; University of Chicago, Department of Human Genetics, United States of America.
| | - S Hong Lee
- Australian Centre for Precision Health, University of South Australia Cancer Research Institute, University of South Australia, Adelaide, SA 5000, Australia; UniSA: Allied Health and Human Performance, University of South Australia, Adelaide, SA 5000, Australia; South Australian Health and Medical Research Institute, Adelaide, South Australia 5000, Australia.
| | - Xuan Zhou
- Australian Centre for Precision Health, University of South Australia Cancer Research Institute, University of South Australia, Adelaide, SA 5000, Australia; UniSA: Allied Health and Human Performance, University of South Australia, Adelaide, SA 5000, Australia; South Australian Health and Medical Research Institute, Adelaide, South Australia 5000, Australia.
| | - John A Sweeney
- University of Cincinnati, Department of Psychiatry United States of America, Sichuan University, Hauxi Center for MR Research, China.
| | - Carol Tamminga
- University of Texas Southwestern, United States of America.
| | | | | | | | | | | | | | - David C Glahn
- Harvard Medical School, Boston Children's Hospital, United States of America.
| | - Huma Asif
- University of Chicago, United States of America.
| | - Rebekka Lencer
- University of Muenster, Muenster, Germany; Department of Psychiatry and Psychotherapy, University of Luebeck, Luebeck, Germany.
| | - S Kristian Hill
- Rosalind Franklin University of Medicine and Science, United States of America.
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Jeon EJ, Kang SH, Piao YH, Kim SW, Kim JJ, Lee BJ, Yu JC, Lee KY, Won SH, Lee SH, Kim SH, Kim ET, Kim CT, Oliver D, Fusar-Poli P, Rami FZ, Chung YC. Development of the Korea-Polyenvironmental Risk Score for Psychosis. Psychiatry Investig 2022; 19:197-206. [PMID: 35196829 PMCID: PMC8958209 DOI: 10.30773/pi.2021.0328] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2021] [Accepted: 12/26/2021] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE Comprehensive understanding of polyenvironmental risk factors for the development of psychosis is important. Based on a review of related evidence, we developed the Korea Polyenvironmental Risk Score (K-PERS) for psychosis. We investigated whether the K-PERS can differentiate patients with schizophrenia spectrum disorders (SSDs) from healthy controls (HCs). METHODS We reviewed existing tools for measuring polyenvironmental risk factors for psychosis, including the Maudsley Environmental Risk Score (ERS), polyenviromic risk score (PERS), and Psychosis Polyrisk Score (PPS). Using odds ratios and relative risks for Western studies and the "population proportion" (PP) of risk factors for Korean data, we developed the K-PERS, and compared the scores thereon between patients with SSDs and HCs. In addition, correlation was performed between the K-PERS and Positive and Negative Syndrome Scale (PANSS). RESULTS We first constructed the "K-PERS-I," comprising five factors based on the PPS, and then the "K-PERS-II" comprising six factors based on the ERS. The instruments accurately predicted participants' status (case vs. control). In addition, the K-PERS-I and -II scores exhibited significant negative correlations with the negative symptom factor score of the PANSS. CONCLUSION The K-PERS is the first comprehensive tool developed based on PP data obtained from Korean studies that measures polyenvironmental risk factors for psychosis. Using pilot data, the K-PERS predicted patient status (SSD vs. HC). Further research is warranted to examine the relationship of K-PERS scores with clinical outcomes of psychosis and schizophrenia.
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Affiliation(s)
- Eun-Jin Jeon
- Department of Psychiatry, Jeonbuk National University Hospital, Jeonju, Republic of Korea
| | - Shi-Hyun Kang
- Department of Social Psychiatry and Rehabilitation, National Center for Mental Health, Seoul, Republic of Korea
| | - Yan-Hong Piao
- Department of Psychiatry, Jeonbuk National University Medical School, Jeonju, Republic of Korea
| | - Sung-Wan Kim
- Department of Psychiatry, Chonnam National University Medical School, Gwangju, Republic of Korea
| | - Jung-Jin Kim
- Department of Psychiatry, The Catholic University of Korea, Seoul St. Mary's Hospital, Seoul, Republic of Korea
| | - Bong-Ju Lee
- Department of Psychiatry, Inje University Haeundae Paik Hospital, Inje University College of Medicine, Busan, Republic of Korea
| | - Je-Chun Yu
- Department of Psychiatry, Eulji University School of Medicine, Eulji University Hospital, Daejeon, Republic of Korea
| | - Kyu-Young Lee
- Department of Psychiatry, Nowon Eulji Medical Center, Eulji University, Seoul, Republic of Korea
| | - Seung-Hee Won
- Department of Psychiatry, School of Medicine, Kyungpook National University, Daegu, Republic of Korea
| | - Seung-Hwan Lee
- Department of Psychiatry, Inje University Ilsan Paik Hospital, Goyang, Republic of Korea
| | - Seung-Hyun Kim
- Department of Psychiatry, Korea University College of Medicine, Guro Hospital, Seoul, Republic of Korea
| | - Eui-Tae Kim
- Department of Psychiatry, Seoul National University Bundang Hospital, Seongnam, Republic of Korea
| | - Clara Tammy Kim
- Institute of Life and Death Studies, Hallym University, Chuncheon, Republic of Korea
| | - Dominic Oliver
- Early Psychosis: Interventions and Clinical Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,OASIS Service, South London and the Maudsley NHS Foundation Trust, London, United Kingdom
| | - Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,OASIS Service, South London and the Maudsley NHS Foundation Trust, London, United Kingdom.,Department of Brain and Behavioural Sciences, University of Pavia, Pavia, Italy
| | - Fatima Zahra Rami
- Department of Psychiatry, Jeonbuk National University Medical School, Jeonju, Republic of Korea
| | - Young-Chul Chung
- Department of Psychiatry, Jeonbuk National University Hospital, Jeonju, Republic of Korea.,Department of Psychiatry, Jeonbuk National University Medical School, Jeonju, Republic of Korea.,Research Institute of Clinical Medicine of Jeonbuk National University-Biomedical Research Institute of Jeonbuk National University Hospital, Jeonju, Republic of Korea
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Yang S, Zhou X. PGS-server: accuracy, robustness and transferability of polygenic score methods for biobank scale studies. Brief Bioinform 2022; 23:6534383. [PMID: 35193147 DOI: 10.1093/bib/bbac039] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2021] [Revised: 12/29/2021] [Accepted: 01/26/2022] [Indexed: 01/02/2023] Open
Abstract
Polygenic scores (PGS) are important tools for carrying out genetic prediction of common diseases and disease related complex traits, facilitating the development of precision medicine. Unfortunately, despite the critical importance of PGS and the vast number of PGS methods recently developed, few comprehensive comparison studies have been performed to evaluate the effectiveness of PGS methods. To fill this critical knowledge gap, we performed a comprehensive comparison study on 12 different PGS methods through internal evaluations on 25 quantitative and 25 binary traits within the UK Biobank with sample sizes ranging from 147 408 to 336 573, and through external evaluations via 25 cross-study and 112 cross-ancestry analyses on summary statistics from multiple genome-wide association studies with sample sizes ranging from 1415 to 329 345. We evaluate the prediction accuracy, computational scalability, as well as robustness and transferability of different PGS methods across datasets and/or genetic ancestries, providing important guidelines for practitioners in choosing PGS methods. Besides method comparison, we present a simple aggregation strategy that combines multiple PGS from different methods to take advantage of their distinct benefits to achieve stable and superior prediction performance. To facilitate future applications of PGS, we also develop a PGS webserver (http://www.pgs-server.com/) that allows users to upload summary statistics and choose different PGS methods to fit the data directly. We hope that our results, method and webserver will facilitate the routine application of PGS across different research areas.
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Affiliation(s)
- Sheng Yang
- Department of Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, Jiangsu 211166, China
| | - Xiang Zhou
- Department of Biostatistics, School of Public Health, University of Michigan, Ann Arbor, MI 48109, USA.,Center for Statistical Genetics, University of Michigan, Ann Arbor, MI 48109, USA
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Akingbuwa WA, Hammerschlag AR, Bartels M, Middeldorp CM. Systematic Review: Molecular Studies of Common Genetic Variation in Child and Adolescent Psychiatric Disorders. J Am Acad Child Adolesc Psychiatry 2022; 61:227-242. [PMID: 33932494 DOI: 10.1016/j.jaac.2021.03.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 03/08/2021] [Accepted: 03/19/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE A systematic review of studies using molecular genetics and statistical approaches to investigate the role of common genetic variation in the development, persistence, and comorbidity of childhood psychiatric traits was conducted. METHOD A literature review was performed using the PubMed database, following PRISMA guidelines. There were 131 studies meeting inclusion criteria, having investigated at least one type of childhood-onset or childhood-measured psychiatric disorder or trait with the aim of identifying trait-associated common genetic variants, estimating the contribution of single nucleotide polymorphisms (SNPs) to the amount of variance explained (SNP-based heritability), investigating genetic overlap between psychiatric traits, or investigating whether the stability in traits or the association with adult traits is explained by genetic factors. RESULTS The first robustly associated genetic variants have started to be identified for childhood psychiatric traits. There were substantial contributions of common genetic variants to many traits, with variation in single nucleotide polymorphism heritability estimates depending on age and raters. Moreover, genetic variants also appeared to explain comorbidity as well as stability across a range of psychiatric traits in childhood and across the life span. CONCLUSION Common genetic variation plays a substantial role in childhood psychiatric traits. Increased sample sizes will lead to increased power to identify genetic variants and to understand genetic architecture, which will ultimately be beneficial to targeted and prevention strategies. This can be achieved by harmonizing phenotype measurements, as is already proposed by large international consortia and by including the collection of genetic material in every study.
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Affiliation(s)
- Wonuola A Akingbuwa
- Ms. Akingbuwa, Dr. Hammerschlag, and Profs. Bartels and Middeldorp are with Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Ms. Akingbuwa, Dr. Hammerschlag, and Prof. Bartels are also with Amsterdam Public Health Research Institute, Amsterdam University Medical Centres, Amsterdam, The Netherlands.
| | - Anke R Hammerschlag
- Ms. Akingbuwa, Dr. Hammerschlag, and Profs. Bartels and Middeldorp are with Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Ms. Akingbuwa, Dr. Hammerschlag, and Prof. Bartels are also with Amsterdam Public Health Research Institute, Amsterdam University Medical Centres, Amsterdam, The Netherlands; Dr. Hammerschlag and Prof. Middeldorp are also with the Child Health Research Centre, the University of Queensland, Brisbane, Queensland, Australia
| | - Meike Bartels
- Ms. Akingbuwa, Dr. Hammerschlag, and Profs. Bartels and Middeldorp are with Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Ms. Akingbuwa, Dr. Hammerschlag, and Prof. Bartels are also with Amsterdam Public Health Research Institute, Amsterdam University Medical Centres, Amsterdam, The Netherlands
| | - Christel M Middeldorp
- Ms. Akingbuwa, Dr. Hammerschlag, and Profs. Bartels and Middeldorp are with Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Dr. Hammerschlag and Prof. Middeldorp are also with the Child Health Research Centre, the University of Queensland, Brisbane, Queensland, Australia; Prof. Middeldorp is also with the Child and Youth Mental Health Service, Children's Health Queensland Hospital and Health Services, Brisbane, Queensland, Australia
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Aberizk K, Collins MA, Addington J, Bearden CE, Cadenhead KS, Cornblatt BA, Mathalon DH, McGlashan TH, Perkins DO, Tsuang MT, Woods SW, Cannon TD, Walker EF. Life Event Stress and Reduced Cortical Thickness in Youth at Clinical High Risk for Psychosis and Healthy Control Subjects. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2022; 7:171-179. [PMID: 33930604 PMCID: PMC8551305 DOI: 10.1016/j.bpsc.2021.04.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 03/21/2021] [Accepted: 04/20/2021] [Indexed: 02/03/2023]
Abstract
BACKGROUND A decline in cortical thickness during early life appears to be a normal neuromaturational process. Accelerated cortical thinning has been linked with conversion to psychosis among individuals at clinical high risk for psychosis (CHR-P). Previous research indicates that exposure to life event stress (LES) is associated with exaggerated cortical thinning in both healthy and clinical populations, and LES is also linked with conversion to psychosis in CHR-P. To date, there are no reports on the relationship of LES with cortical thickness in CHR-P. This study examines this relationship and whether LES is linked with cortical thinning to a greater degree in individuals at CHR-P who convert to psychosis compared with individuals at CHR-P who do not convert and healthy control subjects. METHODS Controlling for age and gender (364 male, 262 female), this study examined associations between LES and baseline cortical thickness in 436 individuals at CHR-P (375 nonconverters and 61 converters) and 190 comparison subjects in the North American Prodrome Longitudinal Study. RESULTS Findings indicate that prebaseline cumulative LES is associated with reduced baseline cortical thickness in several regions among the CHR-P and control groups. Evidence suggests that LES is a risk factor for thinner cortex to the same extent across diagnostic groups, while CHR-P status is linked with thinner cortex in select regions after accounting for LES. CONCLUSIONS This research provides additional evidence to support the role of LES in cortical thinning in both healthy youth and those at CHR-P. Potential underlying mechanisms of the findings and implications for future research are discussed.
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Affiliation(s)
- Katrina Aberizk
- Department of Psychology, Emory University, Atlanta, Georgia.
| | - Meghan A Collins
- Department of Psychology, Yale University, New Haven, Connecticut
| | - Jean Addington
- Department of Psychiatry, University of Calgary, Calgary, Alberta, Canada
| | - Carrie E Bearden
- Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, California; Department of Psychology, University of California Los Angeles, Los Angeles, California
| | - Kristin S Cadenhead
- Department of Psychiatry, University of California San Diego, San Diego, California
| | | | - Daniel H Mathalon
- Department of Psychiatry, University of California San Francisco, San Francisco, California; San Francisco VA Medical Center, San Francisco, California
| | | | - Diana O Perkins
- Department of Psychiatry, University of North Carolina, Chapel Hill, North Carolina
| | - Ming T Tsuang
- Department of Psychiatry, University of California San Diego, San Diego, California
| | - Scott W Woods
- Department of Psychiatry, Yale University, New Haven, Connecticut
| | - Tyrone D Cannon
- Department of Psychology, Yale University, New Haven, Connecticut; Department of Psychiatry, Yale University, New Haven, Connecticut
| | - Elaine F Walker
- Department of Psychology, Emory University, Atlanta, Georgia
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Giangrande EJ, Weber RS, Turkheimer E. What Do We Know About the Genetic Architecture of Psychopathology? Annu Rev Clin Psychol 2022; 18:19-42. [DOI: 10.1146/annurev-clinpsy-081219-091234] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
In the second half of the twentieth century, twin and family studies established beyond a reasonable doubt that all forms of psychopathology are substantially heritable and highly polygenic. These conclusions were simultaneously an important theoretical advance and a difficult methodological obstacle, as it became clear that heritability is universal and undifferentiated across forms of psychopathology, and the radical polygenicity of genetic effects limits the biological insight provided by genetically informed studies at the phenotypic level. The paradigm-shifting revolution brought on by the Human Genome Project has recapitulated the great methodological promise and the profound theoretical difficulties of the twin study era. We review these issues using the rubric of genetic architecture, which we define as a search for specific genetic insight that adds to the general conclusion that psychopathology is heritable and polygenic. Although significant problems remain, we see many promising avenues for progress. Expected final online publication date for the Annual Review of Clinical Psychology, Volume 18 is May 2022. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.
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Affiliation(s)
- Evan J. Giangrande
- Department of Psychology, University of Virginia, Charlottesville, Virginia, USA
| | - Ramona S. Weber
- Department of Psychology, University of Virginia, Charlottesville, Virginia, USA
| | - Eric Turkheimer
- Department of Psychology, University of Virginia, Charlottesville, Virginia, USA
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46
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Karcher NR, Paul SE, Johnson EC, Hatoum AS, Baranger DAA, Agrawal A, Thompson WK, Barch DM, Bogdan R. Psychotic-like Experiences and Polygenic Liability in the Adolescent Brain Cognitive Development Study. BIOLOGICAL PSYCHIATRY. COGNITIVE NEUROSCIENCE AND NEUROIMAGING 2022; 7:45-55. [PMID: 34271214 PMCID: PMC8786267 DOI: 10.1016/j.bpsc.2021.06.012] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/02/2021] [Revised: 06/01/2021] [Accepted: 06/28/2021] [Indexed: 01/26/2023]
Abstract
BACKGROUND Childhood psychotic-like experiences (PLEs) often precede the development of later severe psychopathology. This study examined whether childhood PLEs are associated with several psychopathology-related polygenic scores (PGSs) and additionally examined possible neural and behavioral mechanisms. METHODS Adolescent Brain Cognitive Development Study baseline data from children with European ancestry (n = 4650, ages 9-10 years, 46.8% female) were used to estimate associations between PLEs (i.e., both total and presence of significantly distressing) and PGSs for psychopathology (i.e., schizophrenia, psychiatric cross-disorder risk, PLEs) and related phenotypes (i.e., educational attainment [EDU], birth weight, inflammation). We also assessed whether variability in brain structure indices (i.e., volume, cortical thickness, surface area) and behaviors proximal to PGSs (e.g., cognition for EDU) indirectly linked PGSs to PLEs using mediational models. RESULTS Total and significantly distressing PLEs were associated with EDU and cross-disorder PGSs (all %ΔR2s = 0.202%-0.660%; false discovery rate-corrected ps < .006). Significantly distressing PLEs were also associated with higher schizophrenia and PLE PGSs (both %ΔR2 = 0.120%-0.216%; false discovery rate-corrected ps < .03). There was evidence that global brain volume metrics and cognitive performance indirectly linked EDU PGS to PLEs (estimated proportion mediated = 3.33%-32.22%). CONCLUSIONS Total and significantly distressing PLEs were associated with genomic risk indices of broad-spectrum psychopathology risk (i.e., EDU and cross-disorder PGSs). Significantly distressing PLEs were also associated with genomic risk for psychosis (i.e., schizophrenia, PLEs). Global brain volume metrics and PGS-proximal behaviors represent promising putative intermediary phenotypes that may indirectly link genomic risk to psychopathology. Broadly, polygenic scores derived from genome-wide association studies of adult samples generalize to indices of psychopathology risk among children.
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Affiliation(s)
- Nicole R Karcher
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri.
| | - Sarah E Paul
- Department of Psychological and Brain Sciences, Washington University, St. Louis, Missouri
| | - Emma C Johnson
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Alexander S Hatoum
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - David A A Baranger
- Department of Psychiatry, University of Pittsburgh, Pittsburgh, Pennsylvania
| | - Arpana Agrawal
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri
| | - Wesley K Thompson
- Population Neuroscience and Genetics Laboratory, University of California San Diego, San Diego, California
| | - Deanna M Barch
- Department of Psychiatry, Washington University School of Medicine, St. Louis, Missouri; Department of Psychological and Brain Sciences, Washington University, St. Louis, Missouri
| | - Ryan Bogdan
- Department of Psychological and Brain Sciences, Washington University, St. Louis, Missouri
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Golimbet V, Kostyuk G. Genotype — phenotype relationships in view of recent advances in the understanding of genetic causes of schizophrenia. Zh Nevrol Psikhiatr Im S S Korsakova 2022; 122:20-25. [DOI: 10.17116/jnevro202212201220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
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Tavares V, Vassos E, Marquand A, Stone J, Valli I, Barker GJ, Ferreira H, Prata D. Prediction of transition to psychosis from an at-risk mental state using structural neuroimaging, genetic, and environmental data. Front Psychiatry 2022; 13:1086038. [PMID: 36741573 PMCID: PMC9892839 DOI: 10.3389/fpsyt.2022.1086038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/31/2022] [Accepted: 12/29/2022] [Indexed: 01/20/2023] Open
Abstract
INTRODUCTION Psychosis is usually preceded by a prodromal phase in which patients are clinically identified as being at in an "At Risk Mental State" (ARMS). A few studies have demonstrated the feasibility of predicting psychosis transition from an ARMS using structural magnetic resonance imaging (sMRI) data and machine learning (ML) methods. However, the reliability of these findings is unclear due to possible sampling bias. Moreover, the value of genetic and environmental data in predicting transition to psychosis from an ARMS is yet to be explored. METHODS In this study we aimed to predict transition to psychosis from an ARMS using a combination of ML, sMRI, genome-wide genotypes, and environmental risk factors as predictors, in a sample drawn from a pool of 246 ARMS subjects (60 of whom later transitioned to psychosis). First, the modality-specific values in predicting transition to psychosis were evaluated using several: (a) feature types; (b) feature manipulation strategies; (c) ML algorithms; (d) cross-validation strategies, as well as sample balancing and bootstrapping. Subsequently, the modalities whose at least 60% of the classification models showed an balanced accuracy (BAC) statistically better than chance level were included in a multimodal classification model. RESULTS AND DISCUSSION Results showed that none of the modalities alone, i.e., neuroimaging, genetic or environmental data, could predict psychosis from an ARMS statistically better than chance and, as such, no multimodal classification model was trained/tested. These results suggest that the value of structural MRI data and genome-wide genotypes in predicting psychosis from an ARMS, which has been fostered by previous evidence, should be reconsidered.
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Affiliation(s)
- Vânia Tavares
- Instituto de Biofísica e Engenharia Biomédica, Faculdade de Ciências, Universidade de Lisboa, Lisbon, Portugal.,Faculdade de Medicina, Universidade de Lisboa, Lisbon, Portugal
| | - Evangelos Vassos
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,National Institute for Health Research Maudsley Biomedical Research Centre, South London and Maudsley National Health System Trust, London, United Kingdom
| | - Andre Marquand
- Donders Centre for Cognitive Neuroimaging, Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, Netherlands.,Department of Cognitive Neuroscience, Radboud University Medical Centre, Nijmegen, Netherlands
| | - James Stone
- Brighton and Sussex Medical School, University of Sussex, Brighton, United Kingdom
| | - Isabel Valli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom.,Institut d'Investigacions Biomèdiques August Pi i Sunyer, University of Barcelona, Barcelona, Spain
| | - Gareth J Barker
- Department of Neuroimaging, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Hugo Ferreira
- Instituto de Biofísica e Engenharia Biomédica, Faculdade de Ciências, Universidade de Lisboa, Lisbon, Portugal
| | - Diana Prata
- Instituto de Biofísica e Engenharia Biomédica, Faculdade de Ciências, Universidade de Lisboa, Lisbon, Portugal.,Department of Old Age Psychiatry, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
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49
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Weiser M, Davidson M. Identifying an elusive target with the help of an unproven technique. Mol Psychiatry 2021; 26:7074-7075. [PMID: 34244619 DOI: 10.1038/s41380-021-01213-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Affiliation(s)
- Mark Weiser
- Department of Psychiatry, Sheba Medical Center, Tel Hashomer, Israel. .,Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel.
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50
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Smigielski L, Papiol S, Theodoridou A, Heekeren K, Gerstenberg M, Wotruba D, Buechler R, Hoffmann P, Herms S, Adorjan K, Anderson-Schmidt H, Budde M, Comes AL, Gade K, Heilbronner M, Heilbronner U, Kalman JL, Klöhn-Saghatolislam F, Reich-Erkelenz D, Schaupp SK, Schulte EC, Senner F, Anghelescu IG, Arolt V, Baune BT, Dannlowski U, Dietrich DE, Fallgatter AJ, Figge C, Jäger M, Juckel G, Konrad C, Nieratschker V, Reimer J, Reininghaus E, Schmauß M, Spitzer C, von Hagen M, Wiltfang J, Zimmermann J, Gryaznova A, Flatau-Nagel L, Reitt M, Meyers M, Emons B, Haußleiter IS, Lang FU, Becker T, Wigand ME, Witt SH, Degenhardt F, Forstner AJ, Rietschel M, Nöthen MM, Andlauer TFM, Rössler W, Walitza S, Falkai P, Schulze TG, Grünblatt E. Polygenic risk scores across the extended psychosis spectrum. Transl Psychiatry 2021; 11:600. [PMID: 34836939 PMCID: PMC8626446 DOI: 10.1038/s41398-021-01720-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 10/24/2021] [Accepted: 10/29/2021] [Indexed: 12/23/2022] Open
Abstract
As early detection of symptoms in the subclinical to clinical psychosis spectrum may improve health outcomes, knowing the probabilistic susceptibility of developing a disorder could guide mitigation measures and clinical intervention. In this context, polygenic risk scores (PRSs) quantifying the additive effects of multiple common genetic variants hold the potential to predict complex diseases and index severity gradients. PRSs for schizophrenia (SZ) and bipolar disorder (BD) were computed using Bayesian regression and continuous shrinkage priors based on the latest SZ and BD genome-wide association studies (Psychiatric Genomics Consortium, third release). Eight well-phenotyped groups (n = 1580; 56% males) were assessed: control (n = 305), lower (n = 117) and higher (n = 113) schizotypy (both groups of healthy individuals), at-risk for psychosis (n = 120), BD type-I (n = 359), BD type-II (n = 96), schizoaffective disorder (n = 86), and SZ groups (n = 384). PRS differences were investigated for binary traits and the quantitative Positive and Negative Syndrome Scale. Both BD-PRS and SZ-PRS significantly differentiated controls from at-risk and clinical groups (Nagelkerke's pseudo-R2: 1.3-7.7%), except for BD type-II for SZ-PRS. Out of 28 pairwise comparisons for SZ-PRS and BD-PRS, 9 and 12, respectively, reached the Bonferroni-corrected significance. BD-PRS differed between control and at-risk groups, but not between at-risk and BD type-I groups. There was no difference between controls and schizotypy. SZ-PRSs, but not BD-PRSs, were positively associated with transdiagnostic symptomology. Overall, PRSs support the continuum model across the psychosis spectrum at the genomic level with possible irregularities for schizotypy. The at-risk state demands heightened clinical attention and research addressing symptom course specifiers. Continued efforts are needed to refine the diagnostic and prognostic accuracy of PRSs in mental healthcare.
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Affiliation(s)
- Lukasz Smigielski
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland.
- The Zurich Program for Sustainable Development of Mental Health Services (ZInEP), Psychiatric University Hospital Zurich, Zurich, Switzerland.
| | - Sergi Papiol
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Anastasia Theodoridou
- The Zurich Program for Sustainable Development of Mental Health Services (ZInEP), Psychiatric University Hospital Zurich, Zurich, Switzerland
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
| | - Karsten Heekeren
- The Zurich Program for Sustainable Development of Mental Health Services (ZInEP), Psychiatric University Hospital Zurich, Zurich, Switzerland
- Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Department of Psychiatry and Psychotherapy I, LVR-Hospital, Cologne, Germany
| | - Miriam Gerstenberg
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
- The Zurich Program for Sustainable Development of Mental Health Services (ZInEP), Psychiatric University Hospital Zurich, Zurich, Switzerland
| | - Diana Wotruba
- The Zurich Program for Sustainable Development of Mental Health Services (ZInEP), Psychiatric University Hospital Zurich, Zurich, Switzerland
| | - Roman Buechler
- The Zurich Program for Sustainable Development of Mental Health Services (ZInEP), Psychiatric University Hospital Zurich, Zurich, Switzerland
- Department of Neuroradiology, University Hospital Zurich, Zurich, Switzerland
| | - Per Hoffmann
- Department of Biomedicine, Human Genomics Research Group, University Hospital and University of Basel, Basel, Switzerland
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Stefan Herms
- Department of Biomedicine, Human Genomics Research Group, University Hospital and University of Basel, Basel, Switzerland
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Kristina Adorjan
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Heike Anderson-Schmidt
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Monika Budde
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
| | - Ashley L Comes
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- International Max Planck Research School for Translational Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| | - Katrin Gade
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Maria Heilbronner
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
| | - Urs Heilbronner
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
| | - Janos L Kalman
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- International Max Planck Research School for Translational Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| | | | - Daniela Reich-Erkelenz
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Sabrina K Schaupp
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
| | - Eva C Schulte
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Fanny Senner
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Ion-George Anghelescu
- Department of Psychiatry and Psychotherapy, Mental Health Institute, Berlin, Germany
| | - Volker Arolt
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Bernhard T Baune
- Department of Psychiatry, University of Münster, Münster, Germany
- Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Melbourne, VIC, Australia
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Detlef E Dietrich
- AMEOS Clinical Center Hildesheim, Hildesheim, Germany
- Center for Systems Neuroscience (ZSN), Hannover, Germany
| | - Andreas J Fallgatter
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University of Tübingen, Tübingen, Germany
| | - Christian Figge
- Karl-Jaspers Clinic, European Medical School Oldenburg-Groningen, Oldenburg, Germany
| | - Markus Jäger
- Department of Psychiatry II, Ulm University, Bezirkskrankenhaus Günzburg, Günzburg, Germany
| | - Georg Juckel
- Department of Psychiatry, Ruhr University Bochum, LWL University Hospital, Bochum, Germany
| | - Carsten Konrad
- Department of Psychiatry and Psychotherapy, Agaplesion Diakonieklinikum, Rotenburg, Germany
| | - Vanessa Nieratschker
- Department of Psychiatry and Psychotherapy, Tübingen Center for Mental Health (TüCMH), University of Tübingen, Tübingen, Germany
| | - Jens Reimer
- Department of Psychiatry, Klinikum Bremen-Ost, Bremen, Germany
- Department of Psychiatry, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Eva Reininghaus
- Department of Psychiatry and Psychotherapeutic Medicine, Research Unit for Bipolar Affective Disorder, Medical University of Graz, Graz, Austria
| | - Max Schmauß
- Clinic for Psychiatry, Psychotherapy and Psychosomatics, Augsburg University, Medical Faculty, Bezirkskrankenhaus Augsburg, Augsburg, Germany
| | - Carsten Spitzer
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Rostock, Rostock, Germany
| | - Martin von Hagen
- Clinic for Psychiatry and Psychotherapy, Clinical Center Werra-Meißner, Eschwege, Germany
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
- iBiMED, Medical Sciences Department, University of Aveiro, Aveiro, Portugal
| | - Jörg Zimmermann
- Psychiatrieverbund Oldenburger Land gGmbH, Karl-Jaspers-Klinik, Bad Zwischenahn, Germany
| | - Anna Gryaznova
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
| | - Laura Flatau-Nagel
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
| | - Markus Reitt
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Milena Meyers
- Department of Psychiatry, Ruhr University Bochum, LWL University Hospital, Bochum, Germany
| | - Barbara Emons
- Department of Psychiatry, Ruhr University Bochum, LWL University Hospital, Bochum, Germany
| | - Ida Sybille Haußleiter
- Department of Psychiatry, Ruhr University Bochum, LWL University Hospital, Bochum, Germany
| | - Fabian U Lang
- Department of Psychiatry II, Ulm University, Bezirkskrankenhaus Günzburg, Günzburg, Germany
| | - Thomas Becker
- Department of Psychiatry II, Ulm University, Bezirkskrankenhaus Günzburg, Günzburg, Germany
| | - Moritz E Wigand
- Department of Psychiatry II, Ulm University, Bezirkskrankenhaus Günzburg, Günzburg, Germany
| | - Stephanie H Witt
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Franziska Degenhardt
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Andreas J Forstner
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
- Centre for Human Genetics, University of Marburg, Marburg, Germany
- Institute of Neuroscience and Medicine (INM-1), Research Center Jülich, Jülich, Germany
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Markus M Nöthen
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Till F M Andlauer
- Department of Neurology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Wulf Rössler
- The Zurich Program for Sustainable Development of Mental Health Services (ZInEP), Psychiatric University Hospital Zurich, Zurich, Switzerland
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin, Berlin, Germany
- Laboratory of Neuroscience (LIM 27), Institute of Psychiatry, Universidade de São Paulo, São Paulo, Brazil
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland
- Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Thomas G Schulze
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, Syracuse, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Edna Grünblatt
- Department of Child and Adolescent Psychiatry and Psychotherapy, Psychiatric University Hospital Zurich, University of Zurich, Zurich, Switzerland
- Neuroscience Center Zurich, University of Zurich and ETH Zurich, Zurich, Switzerland
- Zurich Center for Integrative Human Physiology, University of Zurich, Zurich, Switzerland
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