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Seegan PL, Miller L, Young AS, Parrish C, Cullen B, Reynolds EK. Enhancing Quality of Care Through Evidence-Based Practice: Training and Supervision Experiences. Am J Psychother 2023; 76:100-106. [PMID: 37026189 DOI: 10.1176/appi.psychotherapy.20220015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/08/2023]
Abstract
OBJECTIVE Evidence-based practice (EBP) is the preferred approach to treatment in mental health settings because it involves the integration of the best available research, clinical expertise, and patient values to optimize patient outcomes. Training on empirically supported treatments (ESTs) in mental health settings is an important component of EBP, and supervision of therapists' implementation of ESTs is critical for therapists to develop and maintain a strong EBP skill set. This study aimed to evaluate training and supervision histories of therapists in outpatient and inpatient psychiatric care settings as an essential first step in improving patient outcomes. METHODS Electronic surveys were completed by 69 therapists, most of whom had a master's degree, within a psychiatry and behavioral sciences department at an academic institution. Participating therapists were recruited from several outpatient and inpatient mental health settings serving children, adolescents, and adults. RESULTS Although most therapists reported completing some form of EST-related coursework, a majority did not receive any supervision related to implementation of ESTs (51% for cognitive-behavioral therapy cases, 76% for dialectical behavior therapy cases, and 52% for other EST cases) during graduate and postgraduate training. CONCLUSIONS Although research from the past decade has supported the need for improvements in training on ESTs, and especially in supervision, problems related to limited exposure to training and supervision among therapists still exist. These findings have implications for how mental health centers can evaluate staff members' EST training and supervision experiences, training needs, and associated training targets to improve the quality of routine care.
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Affiliation(s)
- Paige L Seegan
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (all authors); Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore (Cullen)
| | - Leslie Miller
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (all authors); Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore (Cullen)
| | - Andrea S Young
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (all authors); Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore (Cullen)
| | - Carisa Parrish
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (all authors); Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore (Cullen)
| | - Bernadette Cullen
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (all authors); Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore (Cullen)
| | - Elizabeth K Reynolds
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (all authors); Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore (Cullen)
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Dickerson F, Goldsholl S, Yuan CT, Dalcin A, Eidman B, Minahan E, Gennusa III JV, Mace E, Cullen B, Evins AE, Cather C, Wang NY, McGinty EM, Daumit GL. Promoting Evidence-Based Tobacco Cessation Treatment in Community Mental Health Clinics: Protocol for a Pilot Study (Preprint). JMIR Res Protoc 2022; 12:e44787. [PMID: 37171851 DOI: 10.2196/44787] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2022] [Revised: 03/25/2023] [Accepted: 03/27/2023] [Indexed: 03/29/2023] Open
Abstract
BACKGROUND Tobacco smoking is highly prevalent among persons with serious mental illness (SMI) and is the largest contributor to premature mortality in this population. Evidence-based smoking cessation therapy with medications and behavioral counseling is effective for persons with SMI, but few receive this treatment. Mental health providers have extensive experience working with clients with SMI and frequent treatment contacts, making them well positioned to deliver smoking cessation treatment. However, few mental health providers feel adequately trained to deliver this treatment, and many providers believe that smokers with SMI are not interested in quitting or have concerns about the safety of smoking cessation pharmacotherapy, despite substantial evidence to the contrary. OBJECTIVE We present the protocol for the pilot "IMPACT" (Implementing Action for Tobacco Smoking Cessation Treatment) study, which aims to pilot test a multicomponent implementation intervention to increase the delivery of evidence-based tobacco smoking cessation treatment in community mental health clinics. METHODS We are using a prepost observational design to examine the effects of an implementation intervention designed to improve mental health providers' delivery of the following four evidence-based practices related to smoking cessation treatment: (1) assessment of smoking status, (2) assessment of willingness to quit, (3) behavioral counseling, and (4) pharmacotherapy prescribing. To overcome key barriers related to providers' knowledge and self-efficacy of smoking cessation treatment, the study will leverage implementation strategies including (1) real-time and web-based training for mental health providers about evidence-based smoking cessation treatment and motivational interviewing, including an avatar practice module; (2) a tobacco smoking treatment protocol; (3) expert consultation; (4) coaching; and (5) organizational strategy meetings. We will use surveys and in-depth interviews to assess the implementation intervention's effects on providers' knowledge and self-efficacy, the mechanisms of change targeted by the intervention, as well as providers' perceptions of the acceptability, appropriateness, and feasibility of both the evidence-based practices and implementation strategies. We will use data on care delivery to assess providers' implementation of evidence-based smoking cessation practices. RESULTS The IMPACT study is being conducted at 5 clinic sites. More than 50 providers have been enrolled, exceeding our recruitment target. The study is ongoing. CONCLUSIONS In order for persons with SMI to realize the benefits of smoking cessation treatment, it is important for clinicians to implement evidence-based practices successfully. This pilot study will result in a set of training modules, implementation tools, and resources for clinicians working in community mental health clinics to address tobacco smoking with their clients. Trial Registration: ClinicalTrials.gov NCT04796961; https://clinicaltrials.gov/ct2/show/NCT04796961. TRIAL REGISTRATION ClinicalTrials.gov NCT04796961; https://clinicaltrials.gov/ct2/show/NCT04796961. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/44787.
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Van Hoye A, Regan C, Lane A, Cullen B, Vuillemin A, Woods C. Sport federation investment in health promotion: program implementation and viability. Eur J Public Health 2022. [DOI: 10.1093/eurpub/ckac131.341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
Researchers have called for a better recognition of the potential of sports clubs for health promotion (HP), but less is known on the support provided by sports federation. The present study analyses the the implementation of the Gaelic Athletics Association (GAA) Healthy Club Project, to investigate its organization’s viability.
Methods
A single case study was realized, based on observation, document analysis and interviews, to document the viable system model.
Results
Results have identified a three-level structure, where 6 employees at national level support the work of 28 volunteer’s county health and well-being officers and 439 clubs implicated. Strengths of the organization are the identification of a single national referent for clubs or county, the learning process and openness to novelty, as well as the enhanced workforce through county implication as role model. Challenges are the financial and human resources provision, the ability to implicate county and club board and the training in HP of volunteers. Interlevel relationship are supported by the creation of a community of practice and the centralization of the project at national level, but hindered by a clear definition of county tasks. The strengths of the controlling system include a steering committee implicating partners completing each other and the proper use of evaluation to build evidence on the project, where challenges remains in wider collaboration within the GAA.
Conclusions
The present work has underlined key scaling up factors of the HCP implementation to support its viability, which could be learnt from other sports federation implementing HP interventions.
Key messages
• Sports federation have a key role to play to support sports clubs to promote health, by developing specific programs.
• Health Promotion development in sports clubs has similar scaling up implementation factor than other public health interventions.
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Affiliation(s)
- A Van Hoye
- Physical Education and Sport Sciences, University of Limerick , Limerick, Ireland
| | - C Regan
- Community and Health Department, Gaelic Athletic Association , Dublin, Ireland
| | - A Lane
- Technological University of the Shannon SHE Research Group, , Athlone, Ireland
| | - B Cullen
- Innovation and Research , Sport Ireland, Dublin, Ireland
| | - A Vuillemin
- Université Côte d'Azur LAHMESS, , France, France
| | - C Woods
- Physical Education and Sport Sciences, University of Limerick , Limerick, Ireland
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Ybarra ML, Rodriguez KM, Fehmie DA, Mojtabai R, Cullen B. Acceptability of Texting 4 Relapse Prevention, Text Messaging-Based Relapse Prevention Program for People With Schizophrenia and Schizoaffective Disorder. J Nerv Ment Dis 2022; 210:123-128. [PMID: 34570061 PMCID: PMC10069806 DOI: 10.1097/nmd.0000000000001421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT We report process outcomes of the pilot randomized controlled trial of Texting 4 Relapse Prevention (T4RP), a text messaging-based relapse prevention program for people with schizophrenia or schizoaffective disorder (SAD). Forty people were randomized to either the intervention or treatment as usual control group at a 2:1 ratio. Process indicators were collected at 6 months post enrollment.Over 90% of patients agreed or strongly agreed that the text messages were easy to understand, easy to answer, positive, and helped them feel supported. Patient acceptability was positively associated with recovery (β = 0.29, p = <0.001) and patient-provider communication scores (β = 1.04, p < 0.001), and negatively associated with symptoms of the disorder (β = -0.27, p = 0.07). Acceptability was similar by diagnosis (β, SAD diagnosis = 0.40, p = 0.90) and age (β = 0.05, p = 0.67). Findings suggest that a text messaging intervention aimed at preventing relapse is feasible and perceived as beneficial in individuals with schizophrenia and SAD. Future research might include a targeted study of T4RP within the context of hospital discharge when people with schizophrenia/SAD are at highest risk of relapse.
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Affiliation(s)
- Michele L. Ybarra
- Center for Innovative Public Health Research, 555 N El Camino Real A347, San Clemente, CA 92672 USA
| | - Katrina M. Rodriguez
- Department of Mental Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, 21287 USA
| | - Desiree A. Fehmie
- Center for Innovative Public Health Research, 555 N El Camino Real A347, San Clemente, CA 92672 USA
| | - Ramin Mojtabai
- Department of Mental Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, 21287 USA
| | - Bernadette Cullen
- Department of Mental Health, The Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, 21287 USA
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins Medical Institutions, Baltimore, Maryland, 21287 USA
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Green KM, Reboussin BA, Storr CL, Mojtabai R, Susukida R, Young AS, Cullen B, Luken A, Amin-Esmaeili M, Crum RM. Impact of Early, Weekly Drinking on Latent Classes of Alcohol Involvement Progression and Recovery: Evidence from the NESARC Waves 1 and 2. Addict Behav Rep 2022; 15:100410. [PMID: 35146117 PMCID: PMC8816649 DOI: 10.1016/j.abrep.2022.100410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2021] [Revised: 12/20/2021] [Accepted: 01/23/2022] [Indexed: 11/17/2022] Open
Abstract
Weekly drinking before age 18 seems to impact alcohol progression over time. For females, extreme transitions from no problems to severe problems were impacted. For males, transitions from moderate to severe alcohol problems were impacted. Early, weekly drinking also predicted increased recovery for males.
Introduction Early drinkers have been found to have higher risk of developing alcohol use disorder; however, the association of early drinking with progression to problematic alcohol involvement that does not meet disorder criteria (i.e., subclinical problems) or to severe stages of alcohol involvement, sex-specific associations, and relationship of early drinking with alcohol recovery have rarely been investigated. Methods Using data from Waves 1 and 2 of the National Epidemiologic Survey on Alcohol and Related Conditions (NESARC), we applied latent transition analyses to investigate the impact of weekly drinking before age 18 on alcohol progression and recovery operationalized as three classes of alcohol involvement using abuse and dependence indicators. We analyzed data separately for male (n = 12,276) and female (n = 14,750) drinkers and applied propensity score methods to address confounding. Results We observed significant associations between early, weekly drinking and alcohol involvement class membership at Wave 1 for both males and females. For males, early, weekly drinking was also associated with greater odds of transitioning from moderate to severe alcohol problems (aOR = 3.19, 95% CI = 1.72, 5.35). For females, early, weekly drinking predicted the transition from no to severe problems (aOR = 2.98, 95% CI = 1.11–8.00). Contrary to our hypothesis, early, weekly drinking was associated with greater likelihood of transition from severe to no problems for males (aOR = 3.23, 95% CI = 1.26, 8.26). Discussion Frequent, early drinking seems to be an important indicator of drinking progression with differential associations by sex. This information is useful to identify those at greater risk of progressing to severe drinking problems to intervene appropriately.
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Cascella N, Butala AA, Mills K, Kim MJ, Salimpour Y, Wojtasievicz T, Hwang B, Cullen B, Figee M, Moran L, Lenz F, Sawa A, Schretlen DJ, Anderson W. Deep Brain Stimulation of the Substantia Nigra Pars Reticulata for Treatment-Resistant Schizophrenia: A Case Report. Biol Psychiatry 2021; 90:e57-e59. [PMID: 33906736 DOI: 10.1016/j.biopsych.2021.03.007] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/24/2021] [Accepted: 03/02/2021] [Indexed: 12/26/2022]
Affiliation(s)
- Nicola Cascella
- Johns Hopkins Schizophrenia Center, Johns Hopkins Hospital, the Johns Hopkins University School of Medicine and Bloomberg School of Public Health, Baltimore, Maryland; Department of Psychiatry, Johns Hopkins Hospital, the Johns Hopkins University School of Medicine and Bloomberg School of Public Health, Baltimore, Maryland.
| | - Ankur A Butala
- Department of Psychiatry, Johns Hopkins Hospital, the Johns Hopkins University School of Medicine and Bloomberg School of Public Health, Baltimore, Maryland; Department of Neurology, Johns Hopkins Hospital, the Johns Hopkins University School of Medicine and Bloomberg School of Public Health, Baltimore, Maryland
| | - Kelly Mills
- Department of Neurology, Johns Hopkins Hospital, the Johns Hopkins University School of Medicine and Bloomberg School of Public Health, Baltimore, Maryland
| | - Min Jae Kim
- Department of Neurology, Johns Hopkins Hospital, the Johns Hopkins University School of Medicine and Bloomberg School of Public Health, Baltimore, Maryland
| | - Yousef Salimpour
- Department of Neurology, Johns Hopkins Hospital, the Johns Hopkins University School of Medicine and Bloomberg School of Public Health, Baltimore, Maryland
| | - Teresa Wojtasievicz
- Department of Neurosurgery, Johns Hopkins Hospital, the Johns Hopkins University School of Medicine and Bloomberg School of Public Health, Baltimore, Maryland
| | - Brian Hwang
- Department of Neurosurgery, Johns Hopkins Hospital, the Johns Hopkins University School of Medicine and Bloomberg School of Public Health, Baltimore, Maryland
| | - Bernadette Cullen
- Department of Psychiatry, Johns Hopkins Hospital, the Johns Hopkins University School of Medicine and Bloomberg School of Public Health, Baltimore, Maryland
| | - Martijn Figee
- Nash Family Center for Advanced Circuit Therapeutics, Icahn School of Medicine, New York, New York
| | - Lauren Moran
- Division of Psychotic Disorders, McLean Hospital, Belmont, Massachusetts
| | - Fred Lenz
- Department of Neurosurgery, Johns Hopkins Hospital, the Johns Hopkins University School of Medicine and Bloomberg School of Public Health, Baltimore, Maryland
| | - Akira Sawa
- Johns Hopkins Schizophrenia Center, Johns Hopkins Hospital, the Johns Hopkins University School of Medicine and Bloomberg School of Public Health, Baltimore, Maryland; Department of Psychiatry, Johns Hopkins Hospital, the Johns Hopkins University School of Medicine and Bloomberg School of Public Health, Baltimore, Maryland; Department of Neuroscience, Johns Hopkins Hospital, the Johns Hopkins University School of Medicine and Bloomberg School of Public Health, Baltimore, Maryland; Department of Biomedical Engineering, Johns Hopkins Hospital, the Johns Hopkins University School of Medicine and Bloomberg School of Public Health, Baltimore, Maryland; Department of Mental Health, Johns Hopkins Hospital, the Johns Hopkins University School of Medicine and Bloomberg School of Public Health, Baltimore, Maryland
| | - David J Schretlen
- Department of Psychiatry, Johns Hopkins Hospital, the Johns Hopkins University School of Medicine and Bloomberg School of Public Health, Baltimore, Maryland
| | - William Anderson
- Department of Neurosurgery, Johns Hopkins Hospital, the Johns Hopkins University School of Medicine and Bloomberg School of Public Health, Baltimore, Maryland
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Chan CP, Arnold AD, Howard JP, Shun-Shin MJ, Maclean E, Cullen B, Chow J, Lim PB, Ng FS, Linton NWF, Peters NS, Schilling RJ, Kanagaratnam P, Francis DP, Whinnett ZI. Explanation-visualised deep learning model for accessory pathway localisation using 12-lead electrocardiography. Europace 2021. [DOI: 10.1093/europace/euab116.510] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: Public Institution(s). Main funding source(s): British Heart Foundation Imperial Centre of Research Excellence
Background/Introduction
ECG algorithms for identifying accessory pathway (AP) locations are inaccurate and difficult to use. Human expert interpretation is poorly reproducible. Artificial intelligence (AI) techniques such as machine learning can improve accuracy in classification tasks by eschewing theory-driven predictions. More reproducible and accurate AP localisation could shorten procedure time and personalise ablation consent.
Purpose
We developed a neural network to perform AP localisation using 12-lead ECGs. Its decision-making process was analysed to enable explainability of the neural network.
Methods
A convolutional neural network was trained on raw, digital, intra-procedural 12-lead ECGs of patients with manifest APs who underwent successful ablation. ECGs were labelled with AP locations as left-sided, septal or right-sided using procedure reports, fluoroscopy and electro-anatomical maps. Accuracy of the neural network was assessed via 4-fold cross-validation and was compared to the Arruda algorithm. Five cardiologists were also assessed for their accuracy in determining locations in sub-groups of cases. The neural network was retrospectively analysed to identify areas of ECGs most influential to its predictions using importance mapping.
Results
In 156 cases, accuracy of the neural network (92.9%) was significantly higher than the Arruda algorithm (76.9%; p < 0.0001) and all five cardiologists (37.5% to 65.9%; p = 0.0001 to 0.0290). Importance mapping demonstrated that the QRS complexes of leads aVL and V1 were perceived as most influential, indicating interrogation of the lateral and anterior-posterior axes respectively.
The figure shows (A) architecture of the neural network, (B) accuracy of the neural network, Arruda algorithm and five cardiologists, (*, p = 0.05 – 0.01; **, p = 0.01 – 0.001; ***, p = 0.001 - 0.0001; ****, p < 0.0001; as compared to the neural network) and (C) example importance maps for 12-lead ECGs of left-sided, septal and right-sided APs (in order from left to right), with darker regions corresponding to greater relative importance.
Conclusion
AI ECG interpretation allows accurate, reproducible prediction of AP locations, superior to conventional algorithms and human interpretation. Although AI decision-making is thought of as a ‘black box’, explanation visualisation techniques such as importance mapping allow humans to understand aspects of how a neural network make decisions. A prospectively validated neural network could be integrated into clinical practice to improve pre-procedural AP localisation. Abstract Figure. Summary of results
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Affiliation(s)
- CP Chan
- National Heart and Lung Institute Imperial College, London, United Kingdom of Great Britain & Northern Ireland
| | - AD Arnold
- National Heart and Lung Institute Imperial College, London, United Kingdom of Great Britain & Northern Ireland
| | - JP Howard
- National Heart and Lung Institute Imperial College, London, United Kingdom of Great Britain & Northern Ireland
| | - MJ Shun-Shin
- National Heart and Lung Institute Imperial College, London, United Kingdom of Great Britain & Northern Ireland
| | - E Maclean
- Barts Heart Centre, London, United Kingdom of Great Britain & Northern Ireland
| | - B Cullen
- National Heart and Lung Institute Imperial College, London, United Kingdom of Great Britain & Northern Ireland
| | - J Chow
- National Heart and Lung Institute Imperial College, London, United Kingdom of Great Britain & Northern Ireland
| | - PB Lim
- National Heart and Lung Institute Imperial College, London, United Kingdom of Great Britain & Northern Ireland
| | - FS Ng
- National Heart and Lung Institute Imperial College, London, United Kingdom of Great Britain & Northern Ireland
| | - NWF Linton
- National Heart and Lung Institute Imperial College, London, United Kingdom of Great Britain & Northern Ireland
| | - NS Peters
- National Heart and Lung Institute Imperial College, London, United Kingdom of Great Britain & Northern Ireland
| | - RJ Schilling
- Barts Heart Centre, London, United Kingdom of Great Britain & Northern Ireland
| | - P Kanagaratnam
- National Heart and Lung Institute Imperial College, London, United Kingdom of Great Britain & Northern Ireland
| | - DP Francis
- National Heart and Lung Institute Imperial College, London, United Kingdom of Great Britain & Northern Ireland
| | - ZI Whinnett
- National Heart and Lung Institute Imperial College, London, United Kingdom of Great Britain & Northern Ireland
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Spivak S, Strain EC, Cullen B, Ruble AAE, Antoine DG, Mojtabai R. Electronic health record adoption among US substance use disorder and other mental health treatment facilities. Drug Alcohol Depend 2021; 220:108515. [PMID: 33461154 DOI: 10.1016/j.drugalcdep.2021.108515] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2020] [Revised: 12/08/2020] [Accepted: 12/13/2020] [Indexed: 11/25/2022]
Abstract
OBJECTIVE This study examined Electronic Health Record (EHR) utilization among US substance use disorder (SUD) versus mental health (MH) treatment facilities. METHODS Data from the National Survey of Substance Abuse Treatment Services and the National Mental Health Services Survey were used to examine differences in clinical and administrative utilization of EHR. RESULTS EHR use was significantly less common among SUD facilities compared to MH facilities for both non-exclusive (mixed computer and paper) and exclusive (paper-free) use. Fewer than 25 % of facilities of either type reported exclusive EHR use for core clinical activities (progress notes, laboratory monitoring, and prescriptions) with wide variability among states. Being an inpatient facility, having Joint Commission accreditation, being a private-for-profit, or a public facility were significantly positively associated with exclusive EHR use for core clinical activities; these associations were stronger among SUD facilities than MH facilities. Accepting Medicare was associated with exclusive EHR use for core clinical activities in both facility types, while accepting private insurance was associated with such use only among SUD treatment facilities. CONCLUSIONS EHR adoption among SUD facilities lags behind MH facilities. However, exclusive EHR use for clinical purposes remains elusive for both types of facilities with no more than a quarter of facilities in any state reporting such use. Some of the factors associated with exclusive EHR use for clinical purposes among SUD treatment facilities-such as Joint Commission accreditation-may be policy leverage points to expedite EHR adoption in these facilities.
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Affiliation(s)
- Stanislav Spivak
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Science, 405 North Caroline Street, Baltimore, MD, 21231, USA.
| | - Eric C Strain
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, 4940 Eastern Avenue Baltimore BBRC 3050, MD, 21224, USA
| | - Bernadette Cullen
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, 600 N. Wolfe Street Meyer 3-181, Baltimore, MD, 21287, USA
| | - An Anne E Ruble
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, 600 N. Wolfe Street Meyer 3-181, Baltimore, MD, 21287, USA
| | - Denis G Antoine
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, 600 N. Wolfe Street Meyer 3-181, Baltimore, MD, 21287, USA
| | - Ramin Mojtabai
- Johns Hopkins Bloomberg School of Public Health, Department of Mental Health, Hampton House 795B, 624 N. Broadway, Baltimore, MD, 21205, USA
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Moreton FC, Cullen B, Dickie DA, Lopez Gonzalez R, Santosh C, Delles C, Muir KW. Brain imaging factors associated with progression of subcortical hyperintensities in CADASIL over 2-year follow-up. Eur J Neurol 2020; 28:220-228. [PMID: 32931073 DOI: 10.1111/ene.14534] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Revised: 08/03/2020] [Accepted: 09/02/2020] [Indexed: 11/27/2022]
Abstract
BACKGROUND AND PURPOSE Mutations in the NOTCH3 gene cause cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), a cerebral small vessel disease manifesting with stroke, migraine and dementia in adults. The disease displays significant phenotypic variability that is incompletely explained. Early abnormalities in vascular function have been shown in animal models. We postulated that studying changes in vascular function may offer insights into disease progression. METHODS Twenty-two subjects with CADASIL [50% female, 50 (±11) years] from 19 pedigrees were included in a longitudinal multimodality study using brain magnetic resonance imaging (MRI), clinical measures, neuropsychology and measures of peripheral vascular function. MRI studies included measurement of structural brain changes, cerebral blood flow (CBF) and cerebrovascular reactivity by arterial spin labelling and a CO2 respiratory challenge. RESULTS Over 2 years, new stroke or transient ischaemic attack (TIA) occurred in five (23%) subjects and new significant disability in one (5%). There were significant increases in number of lacunes, subcortical hyperintensity volume and microbleeds, and a decrease in brain volume. CBF declined by 3.2 (±4.5) ml/100 g/min over 2 years. CBF and carotid-femoral pulse wave velocity at baseline predicted change in subcortical hyperintensity volume at follow-up. Carotid intima-media thickness and age predicted brain atrophy. Baseline CBF was lower in subjects who showed a decline in attention and working memory. CONCLUSIONS Cerebral blood flow predicts radiological progression of hyperintensities and thus is a potential biomarker of disease progression in CADASIL. Over 2 years, there were changes in several relevant imaging biomarkers (CBF, brain volume, lacunes, microbleeds and hyperintensity volume). Future studies in CADASIL should consider assessment of CBF as prognostic factor.
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Affiliation(s)
- F C Moreton
- Institute of Neuroscience and Psychology, Queen Elizabeth University Hospital Glasgow, University of Glasgow, Glasgow, UK
| | - B Cullen
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - D A Dickie
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - R Lopez Gonzalez
- Institute of Neuroscience and Psychology, Queen Elizabeth University Hospital Glasgow, University of Glasgow, Glasgow, UK.,Department of Clinical Physics and Bioengineering, Glasgow Royal Infirmary, Glasgow, UK
| | - C Santosh
- Institute of Neurological Sciences, Queen Elizabeth University Hospital Glasgow, Glasgow, UK
| | - C Delles
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Glasgow, UK
| | - K W Muir
- Institute of Neuroscience and Psychology, Queen Elizabeth University Hospital Glasgow, University of Glasgow, Glasgow, UK
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10
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Spivak S, Strain EC, Spivak A, Cullen B, Ruble AE, Parekh V, Green C, Mojtabai R. Integrated dual diagnosis treatment among United States mental health treatment facilities: 2010 to 2018. Drug Alcohol Depend 2020; 213:108074. [PMID: 32512404 DOI: 10.1016/j.drugalcdep.2020.108074] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2020] [Revised: 05/12/2020] [Accepted: 05/14/2020] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Little is known about the correlates of and recent trends in implementation of Integrated Dual Diagnosis model, an evidence-based approach for dual diagnosis services, in US mental health facilities between 2010 and 2018. METHODS Changes over time in Integrated Dual Diagnosis Treatment use were examined using multiple waves of a national survey of mental health treatment facilities that reported offering any substance use services. State and facility correlates of offering integrated dual diagnosis services among these facilities in 2018 were examined. RESULTS The proportion of mental health treatment facilities that reported offering any substance use services increased significantly from 50.1% in 2010 to 57.1% in 2018. Among these facilities, significantly fewer reported offering Integrated Dual Diagnosis Treatment in 2018 (74.8%) than in 2010 (79.6%). The prevalence of Integrated Dual Diagnosis Treatment use increased in more recent years in tandem with increase in substance use services, though the increases in Integrated Dual Diagnosis Treatment have not matched the expansion of substance use services. Mental health facilities with substance use services more commonly offered other mental health services and had more funding sources available. Facilities with any substance use disorder services that offered Integrated Dual Diagnosis Treatment were more commonly licensed by State Substance Agencies and more commonly offered psychotropics and group therapies. Facilities located in states that implemented the Integrated Dual Diagnosis Treatment model had a higher odds of offering this model. CONCLUSIONS The growth in the co-location of substance use treatment services within mental health treatment facilities has not been matched by true integration of these treatments, highlighting the need for further efforts to comprehensively address the complex needs of dually diagnosed patients.
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Affiliation(s)
- Stanislav Spivak
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, 405 North Caroline Street, Baltimore, MD, 21231, USA.
| | - Eric C Strain
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, 4940 Eastern Avenue Baltimore BBRC 3050, MD, 21224, USA
| | - Amethyst Spivak
- National Trafficking Shelter Alliance, 672 Old Mill R, #123, Millersville, MD, 21108, USA
| | - Bernadette Cullen
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, 600 N. Wolfe Street Meyer 188, Baltimore, MD, 21287, USA
| | - Anne E Ruble
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, 600 N. Wolfe Street Meyer 3-181, Baltimore, MD, 21287, USA
| | - Vinay Parekh
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, 600 N. Wolfe Street Meyer 3-181, Baltimore, MD 21287, USA
| | - Charee Green
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, 405 North Caroline Street, Baltimore, MD 21231, USA
| | - Ramin Mojtabai
- Johns Hopkins Bloomberg School of Public Health, Department of Mental Health, Hampton House 795B, 624 N. Broadway, Baltimore, MD 21205, USA
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Samuels J, Bienvenu OJ, Krasnow J, Wang Y, Grados MA, Cullen B, Goes FS, Maher B, Greenberg BD, McLaughlin NC, Rasmussen SA, Fyer AJ, Knowles JA, McCracken JT, Piacentini J, Geller D, Stewart SE, Murphy DL, Shugart YY, Riddle MA, Nestadt G. General personality dimensions, impairment and treatment response in obsessive-compulsive disorder. Personal Ment Health 2020; 14:186-198. [PMID: 31859455 PMCID: PMC7202992 DOI: 10.1002/pmh.1472] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/21/2019] [Revised: 10/17/2019] [Accepted: 11/06/2019] [Indexed: 11/08/2022]
Abstract
General personality dimensions are associated with clinical severity and treatment response in individuals with depression and many anxiety disorders, but little is known about these relationships in individuals with obsessive-compulsive disorder (OCD). Individuals in the current study included 705 adults with OCD who had participated in family and genetic studies of the disorder. Participants self-completed the Neuroticism, Extraversion, Openness Personality Inventory or Neuroticism, Extraversion, Openness Five-Factor Inventory-3. Relationships between personality scores, and subjective impairment and OCD treatment response, were evaluated. The odds of subjective impairment increased with (unit increase in) the neuroticism score (odds ratio, OR = 1.03; 95% CI = 1.01-1.04; p < 0.01) and decreased with extraversion scores (OR = 0.98; 95% CI = 0.96-0.99; p < 0.01). The odds of reporting a good response to serotonin/selective serotonin reuptake inhibitors (OR = 1.02; 95% CI = 1.01-1.04; p < 0.01) or cognitive behavioural therapy (OR = 1.03; 95% CI = 1.01-1.05; p < 0.01) increased with the extraversion score. The magnitude of these relationships did not change appreciably after adjusting for other clinical features related to one or more of the personality dimensions. The findings suggest that neuroticism and extraversion are associated with subjective impairment, and that extraversion is associated with self-reported treatment response, in individuals with OCD. © 2019 John Wiley & Sons, Ltd.
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Affiliation(s)
- Jack Samuels
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - O. Joseph Bienvenu
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Janice Krasnow
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Ying Wang
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Marco A. Grados
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Bernadette Cullen
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Fernando S. Goes
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Brion Maher
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland, USA
| | - Benjamin D. Greenberg
- Department of Psychiatry and Human Behavior, Brown Medical School, Butler Hospital, Providence, Rhode Island, USA
| | - Nicole C. McLaughlin
- Department of Psychiatry and Human Behavior, Brown Medical School, Butler Hospital, Providence, Rhode Island, USA
| | - Steven A. Rasmussen
- Department of Psychiatry and Human Behavior, Brown Medical School, Butler Hospital, Providence, Rhode Island, USA
| | - Abby J. Fyer
- Department of Psychiatry, College of Physicians and Surgeons at Columbia University and the New York State Psychiatric Institute, New York City, New York, USA
| | - James A. Knowles
- Department of Cell Biology, SUNY Downstate Medical Center, Brooklyn, New York, USA
| | - James T. McCracken
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, School of Medicine, Los Angeles, California, USA
| | - John Piacentini
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, School of Medicine, Los Angeles, California, USA
| | - Dan Geller
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts, USA
| | - S. Evelyn Stewart
- Department of Psychiatry, Faculty of Medicine, University of British Columbia, Vancouver
| | - Dennis L. Murphy
- Laboratory of Clinical Science, National Institute of Mental Health, National Institute of Health, Bethesda, Maryland, USA (deceased)
| | - Yin-Yao Shugart
- Unit of Statistical Genomics, Division of Intramural Research, National Institute of Mental Health, Bethesda, MD, USA
| | - Mark A. Riddle
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Gerald Nestadt
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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Abstract
OBJECTIVE The study examined the use of telepsychiatry in U.S. mental health facilities between 2010 and 2017. METHODS Changes over time in the availability of telepsychiatry were examined by using multiple waves of a national survey of mental health facilities. State and facility correlates of offering telepsychiatry in 2017 were examined. RESULTS The proportion of state facilities that self-reported offering telepsychiatry increased significantly from 15.2% in 2010 to 29.2% in 2017, with wide variability among states.. In 2017, facilities with telepsychiatry were more commonly publicly owned than to have others forms of ownership (odds ratio [OR]=2.72, 95% confidence interval [CI]=2.47-2.99, p<0.001), although the percentage of privately owned facilities offering telepsychiatry has increased significantly since 2010 (OR=2.94, 95% CI=2.14-4.05, p<.001). Facilities offering telepsychiatry had lower odds of receiving funding from Medicaid (OR=0.86, 95% CI=0.75-0.98, p<0.001) but higher odds of receiving funding from all other sources. Facilities in states that did not fund telepsychiatry had lower odds of offering these services in 2017 (OR=0.57, 95% CI=0.51-0.62, p<0.001). Telepsychiatry was more commonly offered in states with higher proportions of rural population (OR=1.64, 95% CI=1.45-1.85, p<0.001) and designated medically underserved areas (OR=1.36, 95% CI=1.25-1.47, p<0.001), compared with other states. CONCLUSIONS Nearly twice as many U.S. mental health facilities offered telepsychiatry in 2017 than in 2010. Medicaid funding lagged behind other funding sources, suggesting state administrative barriers. Telepsychiatry was commonly used by facilities in medically underserved and rural areas.
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Affiliation(s)
- Stanislav Spivak
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore (S. Spivak, Cullen, Meuchel, Johnston, Mojtabai); National Trafficking Shelter Alliance, Baltimore (A. Spivak); Department of Mental Health, Johns Hopkins University School of Public Health, Baltimore (Cullen, Mojtabai); Johns Hopkins Health Systems, Baltimore (Chernow, Green)
| | - Amethyst Spivak
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore (S. Spivak, Cullen, Meuchel, Johnston, Mojtabai); National Trafficking Shelter Alliance, Baltimore (A. Spivak); Department of Mental Health, Johns Hopkins University School of Public Health, Baltimore (Cullen, Mojtabai); Johns Hopkins Health Systems, Baltimore (Chernow, Green)
| | - Bernadette Cullen
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore (S. Spivak, Cullen, Meuchel, Johnston, Mojtabai); National Trafficking Shelter Alliance, Baltimore (A. Spivak); Department of Mental Health, Johns Hopkins University School of Public Health, Baltimore (Cullen, Mojtabai); Johns Hopkins Health Systems, Baltimore (Chernow, Green)
| | - Jennifer Meuchel
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore (S. Spivak, Cullen, Meuchel, Johnston, Mojtabai); National Trafficking Shelter Alliance, Baltimore (A. Spivak); Department of Mental Health, Johns Hopkins University School of Public Health, Baltimore (Cullen, Mojtabai); Johns Hopkins Health Systems, Baltimore (Chernow, Green)
| | - Deirdre Johnston
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore (S. Spivak, Cullen, Meuchel, Johnston, Mojtabai); National Trafficking Shelter Alliance, Baltimore (A. Spivak); Department of Mental Health, Johns Hopkins University School of Public Health, Baltimore (Cullen, Mojtabai); Johns Hopkins Health Systems, Baltimore (Chernow, Green)
| | - Rachel Chernow
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore (S. Spivak, Cullen, Meuchel, Johnston, Mojtabai); National Trafficking Shelter Alliance, Baltimore (A. Spivak); Department of Mental Health, Johns Hopkins University School of Public Health, Baltimore (Cullen, Mojtabai); Johns Hopkins Health Systems, Baltimore (Chernow, Green)
| | - Charee Green
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore (S. Spivak, Cullen, Meuchel, Johnston, Mojtabai); National Trafficking Shelter Alliance, Baltimore (A. Spivak); Department of Mental Health, Johns Hopkins University School of Public Health, Baltimore (Cullen, Mojtabai); Johns Hopkins Health Systems, Baltimore (Chernow, Green)
| | - Ramin Mojtabai
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore (S. Spivak, Cullen, Meuchel, Johnston, Mojtabai); National Trafficking Shelter Alliance, Baltimore (A. Spivak); Department of Mental Health, Johns Hopkins University School of Public Health, Baltimore (Cullen, Mojtabai); Johns Hopkins Health Systems, Baltimore (Chernow, Green)
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13
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Westwell-Roper C, Williams KA, Samuels J, Bienvenu OJ, Cullen B, Goes FS, Grados MA, Geller D, Greenberg BD, Knowles JA, Krasnow J, McLaughlin NC, Nestadt P, Shugart YY, Nestadt G, Stewart SE. Immune-Related Comorbidities in Childhood-Onset Obsessive Compulsive Disorder: Lifetime Prevalence in the Obsessive Compulsive Disorder Collaborative Genetics Association Study. J Child Adolesc Psychopharmacol 2019; 29:615-624. [PMID: 31170001 PMCID: PMC6786333 DOI: 10.1089/cap.2018.0140] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Objective: To evaluate the lifetime prevalence of infectious, inflammatory, and autoimmune disorders in a multisite study of probands with childhood-onset obsessive compulsive disorder (OCD) and their first-degree relatives. Methods: Medical questionnaires were completed by 1401 probands and 1045 first-degree relatives in the OCD Collaborative Genetics Association Study. Lifetime prevalence of immune-related diseases was compared with the highest available population estimate and reported as a point estimate with 95% adjusted Wald interval. Worst-episode OCD severity and symptom dimensions were assessed with the Yale-Brown Obsessive Compulsive Scale (YBOCS) and Symptom Checklist (YBOCS-CL). Results: Probands reported higher-than-expected prevalence of scarlet fever (4.0 [3.1-5.2]% vs. 1.0%-2.0%, z = 1.491, p < 0.001, n = 1389), encephalitis or meningitis (1.4 [0.9-2.1]% vs. 0.1%-0.4%, z = 5.913, p < 0.001, n = 1393), rheumatoid arthritis (1.1 [0.6-2.0]% vs. 0.2%-0.4%, z = 3.416, p < 0.001, n = 949) and rheumatic fever (0.6 [0.3-1.2]% vs. 0.1%-0.2%, z = 3.338, p < 0.001, n = 1390), but not systemic lupus erythematosus, diabetes, asthma, multiple sclerosis, psoriasis, or inflammatory bowel disease. First-degree relatives reported similarly elevated rates of scarlet fever, rheumatic fever, and encephalitis or meningitis independent of OCD status. There was no association between worst-episode severity and immune-related comorbidities, although probands reporting frequent ear or throat infections had increased severity of cleaning-/contamination-related symptoms (mean factor score 2.5 ± 0.9 vs. 2.3 ± 1.0, t = 3.183, p = 0.002, n = 822). Conclusion: These data suggest high rates of streptococcal-related and other immune-mediated diseases in patients with childhood-onset OCD and are consistent with epidemiological studies in adults noting familial clustering. Limitations include potential reporting bias and absence of a control group, underscoring the need for further prospective studies characterizing medical and psychiatric disease clusters and their interactions in children. Such studies may ultimately improve our understanding of OCD pathogenesis and aid in the development of adjunctive immune-modulating therapeutic strategies.
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Affiliation(s)
- Clara Westwell-Roper
- Department of Psychiatry, Faculty of Medicine, British Columbia Children's Hospital, University of British Columbia, Vancouver, Canada
| | - Kyle A. Williams
- Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts
| | - Jack Samuels
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - O. Joseph Bienvenu
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Bernadette Cullen
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Fernando S. Goes
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Marco A. Grados
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Daniel Geller
- Department of Psychiatry, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts
| | - Benjamin D. Greenberg
- Department of Psychiatry and Human Behavior, Brown Medical School, Butler Hospital, Providence, Rhode Island
| | - James A. Knowles
- Department of Psychiatry, University of Southern California School of Medicine, Los Angeles, California
| | - Janice Krasnow
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Nicole C. McLaughlin
- Department of Psychiatry and Human Behavior, Brown Medical School, Butler Hospital, Providence, Rhode Island
| | - Paul Nestadt
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Yin-Yao Shugart
- Unit of Statistical Genomics, Division of Intramural Research, National Institute of Mental Health, Bethesda, Maryland
| | - Gerald Nestadt
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - S. Evelyn Stewart
- Department of Psychiatry, Faculty of Medicine, British Columbia Children's Hospital, University of British Columbia, Vancouver, Canada.,Address correspondence to: S. Evelyn Stewart, MD, Department of Psychiatry, Faculty of Medicine, British Columbia Children's Hospital, University of British Columbia, Room A3-121, 950 West 28th Avenue, Vancouver, BC V5Z 4H4, Canada
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14
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Pacek LR, Reboussin BA, Green KM, LaFlair LN, Storr CL, Alvanzo AAH, Mojtabai R, Cullen B, Young AS, Tormohen K, Riehm K, Crum RM. Current tobacco use, nicotine dependence, and transitions across stages of alcohol involvement: A latent transition analysis approach. Int J Methods Psychiatr Res 2019; 28:e1789. [PMID: 31141253 PMCID: PMC6791727 DOI: 10.1002/mpr.1789] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/21/2018] [Revised: 04/29/2019] [Accepted: 05/05/2019] [Indexed: 02/02/2023] Open
Abstract
OBJECTIVES This study aims to examine the (a) probability of transition between stages of alcohol involvement and (b) influence of tobacco use and nicotine dependence on transitions. METHODS Data came from Waves 1 and 2 of the National Epidemiologic Survey on Alcohol and Related Conditions. Latent transition analysis estimated the probability of transitioning between stages of alcohol involvement across waves and the impact of tobacco use and nicotine dependence at Wave 1 on transitions. RESULTS Males reporting current tobacco use but no dependence at Wave 1 were more likely to progress from No Problems to Moderate Problems (adjusted odds ratio [aOR] = 1.79; 95% confidence interval [CI] [1.44, 2.22]) and from No Problems to Severe Problems (aOR = 2.44; 95% CI [1.25, 4.77]) than nontobacco users. Females reporting current tobacco use but no dependence were more likely to progress from No Problems to Moderate Problems (aOR = 2.00; 95% CI [1.37, 2.94]) and from No Problems to Severe Problems (aOR = 2.87; 95% CI [1.34, 6.13]). Females reporting current tobacco use and dependence were more likely than females not using tobacco to transition from Moderate to No Problems (aOR = 2.10; 95% CI [1.04, 4.22]). CONCLUSIONS Results suggest that tobacco use is a preceding correlate of progression in alcohol involvement among males and females. Among females, tobacco use and nicotine dependence are also related to alcohol involvement recovery.
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Affiliation(s)
- Lauren R Pacek
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC, USA
| | - Beth A Reboussin
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC, USA
| | - Kerry M Green
- Department of Behavioral and Community Health, University of Maryland School of Public Health, College Park, MD, USA
| | | | - Carla L Storr
- Family and Community Health, University of Maryland School of Nursing, Baltimore, MD, USA.,Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Anika A H Alvanzo
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Ramin Mojtabai
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Bernadette Cullen
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Andrea S Young
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kayla Tormohen
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Kira Riehm
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Rosa M Crum
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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15
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Spivak S, Cullen B, Eaton W, Nugent K, Spivak A, Fenton A, Rodriguez K, Mojtabai R. Prescription opioid use among individuals with serious mental illness. Psychiatry Res 2018; 267:85-87. [PMID: 29886275 DOI: 10.1016/j.psychres.2018.05.075] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 05/24/2018] [Accepted: 05/27/2018] [Indexed: 01/19/2023]
Abstract
Prevalence and correlates of prescription opioid use were explored in individuals with serious mental illness (SMI) by examining a sample of adults from two inner city community psychiatry clinics. Of 271 participants, 12.9% (n = 35) were on a prescribed opioid. Being on an opioid was significantly associated with history of heroin use and active prescription sedative-hypnotic use, including benzodiazepine use. Concurrent use of opioids with sedative-hypnotics was significantly associated with suicidal ideation. The results highlight risks of prescription opioid use in those with SMI, particularly in combination with prescription sedative-hypnotics.
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Affiliation(s)
- Stanislav Spivak
- Johns Hopkins University School of Medicine, 405 N. Caroline St, Baltimore, MD 21231, USA.
| | - Bernadette Cullen
- Johns Hopkins University School of Medicine, 405 N. Caroline St, Baltimore, MD 21231, USA; Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - William Eaton
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Katie Nugent
- Walter Reed Army Institute of Research, Bethesda, MD, USA
| | | | - Ashley Fenton
- Johns Hopkins Hospital School of Nursing, Baltimore, MD, USA
| | - Katrina Rodriguez
- Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Ramin Mojtabai
- Johns Hopkins University School of Medicine, 405 N. Caroline St, Baltimore, MD 21231, USA; Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
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16
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Cullen B, Smith DJ, Deary IJ, Evans JJ, Pell JP. The 'cognitive footprint' of psychiatric and neurological conditions: cross-sectional study in the UK Biobank cohort. Acta Psychiatr Scand 2017; 135:593-605. [PMID: 28387438 PMCID: PMC5434825 DOI: 10.1111/acps.12733] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/14/2017] [Indexed: 12/01/2022]
Abstract
OBJECTIVE We aimed to quantify the prevalence of cognitive impairment in adults with a history of mood disorder, schizophrenia, multiple sclerosis or Parkinson's disease, within a large general population cohort. METHOD Cross-sectional study using UK Biobank data (n = 502 642). Psychiatric and neurological exposure status was ascertained via self-reported diagnoses, hospital records and questionnaires. Impairment on reasoning, reaction time and memory tests was defined with reference to a single unexposed comparison group. Results were standardised for age and gender. Sensitivity analyses examined the influence of comorbidity, education, information sources and missing data. RESULTS Relative to the unexposed group, cognitive impairment was least common in major depression (standardised prevalence ratios across tests = 1.00 [95% CI 0.98, 1.02] to 1.49 [95% CI 1.24, 1.79]) and most common in schizophrenia (1.89 [95% CI 1.47, 2.42] to 3.92 [95% CI 2.34, 6.57]). Prevalence in mania/bipolar was similar to that in multiple sclerosis and Parkinson's disease. Estimated population attributable prevalence of cognitive impairment was higher for major depression (256 per 100 000 [95% CI 130, 381]) than for all other disorders. CONCLUSION Although the relative prevalence of cognitive impairment was lowest in major depression, the population attributable prevalence was highest overall for this group.
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Affiliation(s)
- B. Cullen
- Institute of Health and WellbeingUniversity of GlasgowGlasgowUK
| | - D. J. Smith
- Institute of Health and WellbeingUniversity of GlasgowGlasgowUK
| | - I. J. Deary
- Centre for Cognitive Ageing and Cognitive EpidemiologyUniversity of EdinburghEdinburghUK
| | - J. J. Evans
- Institute of Health and WellbeingUniversity of GlasgowGlasgowUK
| | - J. P. Pell
- Institute of Health and WellbeingUniversity of GlasgowGlasgowUK
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17
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Ritter ML, Guo W, Samuels JF, Wang Y, Nestadt PS, Krasnow J, Greenberg BD, Fyer AJ, McCracken JT, Geller DA, Murphy DL, Knowles JA, Grados MA, Riddle MA, Rasmussen SA, McLaughlin NC, Nurmi EL, Askland KD, Cullen B, Piacentini J, Pauls DL, Bienvenu J, Stewart E, Goes FS, Maher B, Pulver AE, Mattheisen M, Qian J, Nestadt G, Shugart YY. Genome Wide Association Study (GWAS) between Attention Deficit Hyperactivity Disorder (ADHD) and Obsessive Compulsive Disorder (OCD). Front Mol Neurosci 2017; 10:83. [PMID: 28386217 PMCID: PMC5362635 DOI: 10.3389/fnmol.2017.00083] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2016] [Accepted: 03/09/2017] [Indexed: 11/13/2022] Open
Abstract
Objective: The aim of this study was to identify any potential genetic overlap between attention deficit hyperactivity disorder (ADHD) and obsessive compulsive disorder (OCD). We hypothesized that since these disorders share a sub-phenotype, they may share common risk alleles. In this manuscript, we report the overlap found between these two disorders. Methods: A meta-analysis was conducted between ADHD and OCD, and polygenic risk scores (PRS) were calculated for both disorders. In addition, a protein-protein analysis was completed in order to examine the interactions between proteins; p-values for the protein-protein interaction analysis was calculated using permutation. Conclusion: None of the single nucleotide polymorphisms (SNPs) reached genome wide significance and there was little evidence of genetic overlap between ADHD and OCD.
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Affiliation(s)
- McKenzie L. Ritter
- Unit on Statistical Genomics, National Institute of Mental Health, National Institutes of Health (NIH)Bethesda, MD, USA
| | - Wei Guo
- Unit on Statistical Genomics, National Institute of Mental Health, National Institutes of Health (NIH)Bethesda, MD, USA
| | - Jack F. Samuels
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of MedicineBaltimore, MD, USA
| | - Ying Wang
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of MedicineBaltimore, MD, USA
| | - Paul S. Nestadt
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public HealthBaltimore, MD, USA
| | - Janice Krasnow
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of MedicineBaltimore, MD, USA
| | - Benjamin D. Greenberg
- Department of Psychiatry, Faculty of Medicine, University of TorontoToronto, ON, Canada
| | - Abby J. Fyer
- New York State Psychiatric Institute, College of Physicians and Surgeons at Columbia UniversityNew York, NY, USA
| | - James T. McCracken
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles School of MedicineLos Angeles, CA, USA
| | - Daniel A. Geller
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical SchoolBoston, MA, USA
| | - Dennis L. Murphy
- Laboratory of Clinical Science, National Institute of Mental HealthBethesda, MD, USA
| | - James A. Knowles
- Department of Psychiatry and Behavioral Sciences, Keck School of Medicine at the University of Southern CaliforniaLos Angeles, CA, USA
| | - Marco A. Grados
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of MedicineBaltimore, MD, USA
| | - Mark A. Riddle
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of MedicineBaltimore, MD, USA
| | - Steven A. Rasmussen
- Department of Psychiatry, Faculty of Medicine, University of TorontoToronto, ON, Canada
| | - Nicole C. McLaughlin
- Department of Psychiatry, Faculty of Medicine, University of TorontoToronto, ON, Canada
| | - Erika L. Nurmi
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles School of MedicineLos Angeles, CA, USA
| | - Kathleen D. Askland
- Department of Psychiatry, Faculty of Medicine, University of TorontoToronto, ON, Canada
| | - Bernadette Cullen
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of MedicineBaltimore, MD, USA
| | - John Piacentini
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles School of MedicineLos Angeles, CA, USA
| | - David L. Pauls
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical SchoolBoston, MA, USA
| | - Joseph Bienvenu
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of MedicineBaltimore, MD, USA
| | - Evelyn Stewart
- Department of Psychiatry, University of British ColumbiaVancouver, BC, Canada
| | - Fernando S. Goes
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of MedicineBaltimore, MD, USA
| | - Brion Maher
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public HealthBaltimore, MD, USA
| | - Ann E. Pulver
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of MedicineBaltimore, MD, USA
| | - Manuel Mattheisen
- Department of Biomedicine and Center for Integrated Sequencing (iSEQ), Aarhus UniversityAarhus, Denmark
- Department of Biostatistics, Harvard School of Public HealthBoston, MA, USA
- Department of Genomic Mathematics, University of BonnBonn, Germany
| | - Ji Qian
- State Key Laboratory of Genetic Engineering, Life Science Institutes, Fudan UniversityShanghai, China
| | - Gerald Nestadt
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of MedicineBaltimore, MD, USA
| | - Yin Yao Shugart
- Unit on Statistical Genomics, National Institute of Mental Health, National Institutes of Health (NIH)Bethesda, MD, USA
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18
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Affiliation(s)
- R. J. Miller
- Senior Clinical Psychologist, St. Helens and Knowsley A.H.A
| | - B. Cullen
- Senior Occupational Therapist, St. Helens and Knowsley A.H.A
| | - R. O'Brien
- Sister in Charge, Dudley Wallis Day Unit, St. Helens and Knowsley A.H.A
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19
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Hagenaars SP, Harris SE, Davies G, Hill WD, Liewald DCM, Ritchie SJ, Marioni RE, Fawns-Ritchie C, Cullen B, Malik R, Worrall BB, Sudlow CLM, Wardlaw JM, Gallacher J, Pell J, McIntosh AM, Smith DJ, Gale CR, Deary IJ. Shared genetic aetiology between cognitive functions and physical and mental health in UK Biobank (N=112 151) and 24 GWAS consortia. Mol Psychiatry 2016; 21:1624-1632. [PMID: 26809841 PMCID: PMC5078856 DOI: 10.1038/mp.2015.225] [Citation(s) in RCA: 235] [Impact Index Per Article: 29.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 11/19/2015] [Accepted: 12/07/2015] [Indexed: 12/23/2022]
Abstract
Causes of the well-documented association between low levels of cognitive functioning and many adverse neuropsychiatric outcomes, poorer physical health and earlier death remain unknown. We used linkage disequilibrium regression and polygenic profile scoring to test for shared genetic aetiology between cognitive functions and neuropsychiatric disorders and physical health. Using information provided by many published genome-wide association study consortia, we created polygenic profile scores for 24 vascular-metabolic, neuropsychiatric, physiological-anthropometric and cognitive traits in the participants of UK Biobank, a very large population-based sample (N=112 151). Pleiotropy between cognitive and health traits was quantified by deriving genetic correlations using summary genome-wide association study statistics and to the method of linkage disequilibrium score regression. Substantial and significant genetic correlations were observed between cognitive test scores in the UK Biobank sample and many of the mental and physical health-related traits and disorders assessed here. In addition, highly significant associations were observed between the cognitive test scores in the UK Biobank sample and many polygenic profile scores, including coronary artery disease, stroke, Alzheimer's disease, schizophrenia, autism, major depressive disorder, body mass index, intracranial volume, infant head circumference and childhood cognitive ability. Where disease diagnosis was available for UK Biobank participants, we were able to show that these results were not confounded by those who had the relevant disease. These findings indicate that a substantial level of pleiotropy exists between cognitive abilities and many human mental and physical health disorders and traits and that it can be used to predict phenotypic variance across samples.
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Affiliation(s)
- S P Hagenaars
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
- Department of Psychology, University of Edinburgh, Edinburgh, UK
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - S E Harris
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
- Medical Genetics Section, Centre for Genomic and Experimental Medicine, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Edinburgh, UK
| | - G Davies
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
- Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - W D Hill
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
- Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - D C M Liewald
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
- Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - S J Ritchie
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
- Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - R E Marioni
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
- Medical Genetics Section, Centre for Genomic and Experimental Medicine, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Edinburgh, UK
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
| | - C Fawns-Ritchie
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
- Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - B Cullen
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - R Malik
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität, Munich, Germany
| | - METASTROKE Consortium, International Consortium for Blood Pressure GWAS
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
- Department of Psychology, University of Edinburgh, Edinburgh, UK
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
- Medical Genetics Section, Centre for Genomic and Experimental Medicine, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Edinburgh, UK
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität, Munich, Germany
- Department of Neurology, University of Virginia, Charlottesville, VA, USA
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
- Department of Psychiatry, University of Oxford, Oxford, UK
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - SpiroMeta Consortium
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
- Department of Psychology, University of Edinburgh, Edinburgh, UK
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
- Medical Genetics Section, Centre for Genomic and Experimental Medicine, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Edinburgh, UK
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität, Munich, Germany
- Department of Neurology, University of Virginia, Charlottesville, VA, USA
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
- Department of Psychiatry, University of Oxford, Oxford, UK
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - CHARGE Consortium Pulmonary Group, CHARGE Consortium Aging and Longevity Group
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
- Department of Psychology, University of Edinburgh, Edinburgh, UK
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
- Medical Genetics Section, Centre for Genomic and Experimental Medicine, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Edinburgh, UK
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
- Institute for Stroke and Dementia Research, Klinikum der Universität München, Ludwig-Maximilians-Universität, Munich, Germany
- Department of Neurology, University of Virginia, Charlottesville, VA, USA
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
- Department of Psychiatry, University of Oxford, Oxford, UK
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - B B Worrall
- Department of Neurology, University of Virginia, Charlottesville, VA, USA
- Department of Public Health Sciences, University of Virginia, Charlottesville, VA, USA
| | - C L M Sudlow
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
- Medical Genetics Section, Centre for Genomic and Experimental Medicine, MRC Institute of Genetics and Molecular Medicine, University of Edinburgh, Western General Hospital, Edinburgh, UK
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - J M Wardlaw
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
- Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - J Gallacher
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - J Pell
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - A M McIntosh
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - D J Smith
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - C R Gale
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
- Department of Psychology, University of Edinburgh, Edinburgh, UK
- MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton, UK
| | - I J Deary
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
- Department of Psychology, University of Edinburgh, Edinburgh, UK
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20
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Park JM, Samuels JF, Grados MA, Riddle MA, Bienvenu OJ, Goes FS, Cullen B, Wang Y, Krasnow J, Murphy DL, Rasmussen SA, McLaughlin NC, Piacentini J, Pauls DL, Stewart SE, Shugart YY, Maher B, Pulver AE, Knowles JA, Greenberg BD, Fyer AJ, McCracken JT, Nestadt G, Geller DA. ADHD and executive functioning deficits in OCD youths who hoard. J Psychiatr Res 2016; 82:141-8. [PMID: 27501140 DOI: 10.1016/j.jpsychires.2016.07.024] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/07/2016] [Revised: 06/29/2016] [Accepted: 07/28/2016] [Indexed: 10/21/2022]
Abstract
Hoarding is common among youth with obsessive compulsive disorder (OCD), with up to 26% of OCD youth exhibiting hoarding symptoms. Recent evidence from adult hoarding and OCD cohorts suggests that hoarding symptoms are associated with executive functioning deficits similar to those observed in subjects with attention deficit hyperactivity disorder (ADHD). However, while hoarding behavior often onsets during childhood, there is little information about executive function deficits and ADHD in affected children and adolescents. The study sample included 431 youths (ages 6-17 years) diagnosed with OCD who participated in the OCD Collaborative Genetics Study and the OCD Collaborative Genetics Association Study and completed a series of clinician-administered and parent report assessments, including diagnostic interviews and measures of executive functioning (Behavior Rating Inventory of Executive Functioning; BRIEF) and hoarding severity (Hoarding Rating Scale-Interview; HRS-I). 113 youths (26%) had clinically significant levels of hoarding compulsions. Youths with and without hoarding differed significantly on most executive functioning subdomains and composite indices as measured by the parent-rated BRIEF. Groups did not differ in the frequency of full DSM-IV ADHD diagnoses; however, the hoarding group had significantly greater number of inattention and hyperactivity symptoms compared to the non-hoarding group. In multivariate models, we found that overall BRIEF scores were related to hoarding severity, adjusting for age, gender and ADHD symptoms. These findings suggest an association between hoarding and executive functioning deficits in youths with OCD, and assessing executive functioning may be important for investigating the etiology and treatment of children and adolescents with hoarding and OCD.
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Affiliation(s)
- Jennifer M Park
- Stanford University School of Medicine, Department of Child and Adolescent Psychiatry, 1195 W Fremont Ave, Sunnyvale, CA, 94087, USA.
| | - Jack F Samuels
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, 1800 Orleans St, Baltimore, MD, 21287, USA
| | - Marco A Grados
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, 1800 Orleans St, Baltimore, MD, 21287, USA
| | - Mark A Riddle
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, 1800 Orleans St, Baltimore, MD, 21287, USA
| | - O Joseph Bienvenu
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, 1800 Orleans St, Baltimore, MD, 21287, USA
| | - Fernando S Goes
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, 1800 Orleans St, Baltimore, MD, 21287, USA
| | - Bernadette Cullen
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, 1800 Orleans St, Baltimore, MD, 21287, USA
| | - Ying Wang
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, 1800 Orleans St, Baltimore, MD, 21287, USA
| | - Janice Krasnow
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, 1800 Orleans St, Baltimore, MD, 21287, USA
| | - Dennis L Murphy
- Laboratory of Clinical Science, National Institute of Mental Health, National Institute of Health, 6001 Executive Boulevard, Rm 6200, MSC 9663, Bethesda, MD, 20892-9663, USA
| | - Steven A Rasmussen
- Brown Medical School, Department of Psychiatry and Human Behavior, Box G-A1, Providence, RI, 02912, USA
| | - Nicole C McLaughlin
- Brown Medical School, Department of Psychiatry and Human Behavior, Box G-A1, Providence, RI, 02912, USA
| | - John Piacentini
- University of California, Los Angeles School of Medicine, Department of Psychiatry and Biobehavioral Sciences, 757 Westwood Plaza, Los Angeles, CA, 90095, USA
| | - David L Pauls
- Massachusetts General Hospital and Harvard Medical School, Department of Psychiatry, 55 Fruit Street, Boston, MA, 02114, USA
| | - S Evelyn Stewart
- Faculty of Medicine, University of British Columbia, Department of Psychiatry, Detwiller Pavilion, 2255 Wesbrook Mall, Vancouver, BC, V6T 2A1, Canada
| | - Yin-Yao Shugart
- Unit of Statistical Genomics, Division of Intramural Research, National Institute of Mental Health, 6001 Executive Boulevard, Rm 6200, MSC 9663, Bethesda, MD, 20892-9663, USA
| | - Brion Maher
- Johns Hopkins University, Bloomberg School of Public Health, Department of Mental Health, 615 N Wolfe Street, Baltimore, MD, 21205, USA
| | - Ann E Pulver
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, 1800 Orleans St, Baltimore, MD, 21287, USA
| | - James A Knowles
- Keck School of Medicine, University of Southern California, 1975 Zonal Avenue, Los Angeles, CA, 90033, USA
| | - Benjamin D Greenberg
- Brown Medical School, Department of Psychiatry and Human Behavior, Box G-A1, Providence, RI, 02912, USA
| | - Abby J Fyer
- College of Physicians and Surgeons at Columbia University and the New York State Psychiatric Institute, Department of Psychiatry, 630 W 168th, Street, New York, NY, 10032, USA
| | - James T McCracken
- University of California, Los Angeles School of Medicine, Department of Psychiatry and Biobehavioral Sciences, 757 Westwood Plaza, Los Angeles, CA, 90095, USA
| | - Gerald Nestadt
- Johns Hopkins University School of Medicine, Department of Psychiatry and Behavioral Sciences, 1800 Orleans St, Baltimore, MD, 21287, USA
| | - Daniel A Geller
- Massachusetts General Hospital and Harvard Medical School, Department of Psychiatry, 55 Fruit Street, Boston, MA, 02114, USA
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21
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Gale CR, Hagenaars SP, Davies G, Hill WD, Liewald DCM, Cullen B, Penninx BW, Boomsma DI, Pell J, McIntosh AM, Smith DJ, Deary IJ, Harris SE. Pleiotropy between neuroticism and physical and mental health: findings from 108 038 men and women in UK Biobank. Transl Psychiatry 2016; 6:e791. [PMID: 27115122 PMCID: PMC4872414 DOI: 10.1038/tp.2016.56] [Citation(s) in RCA: 73] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Revised: 01/15/2016] [Accepted: 03/05/2016] [Indexed: 12/14/2022] Open
Abstract
People with higher levels of neuroticism have an increased risk of several types of mental disorder. Higher neuroticism has also been associated, less consistently, with increased risk of various physical health outcomes. We hypothesised that these associations may, in part, be due to shared genetic influences. We tested for pleiotropy between neuroticism and 17 mental and physical diseases or health traits using linkage disequilibrium regression and polygenic profile scoring. Genetic correlations were derived between neuroticism scores in 108 038 people in the UK Biobank and health-related measures from 14 large genome-wide association studies (GWASs). Summary information for the 17 GWASs was used to create polygenic risk scores for the health-related measures in the UK Biobank participants. Associations between the health-related polygenic scores and neuroticism were examined using regression, adjusting for age, sex, genotyping batch, genotyping array, assessment centre and population stratification. Genetic correlations were identified between neuroticism and anorexia nervosa (rg=0.17), major depressive disorder (rg=0.66) and schizophrenia (rg=0.21). Polygenic risk for several health-related measures were associated with neuroticism, in a positive direction in the case of bipolar disorder, borderline personality, major depressive disorder, negative affect, neuroticism (Genetics of Personality Consortium), schizophrenia, coronary artery disease, and smoking (β between 0.009-0.043), and in a negative direction in the case of body mass index (β=-0.0095). A high level of pleiotropy exists between neuroticism and some measures of mental and physical health, particularly major depressive disorder and schizophrenia.
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Affiliation(s)
- C R Gale
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK,Department of Psychology, University of Edinburgh, Edinburgh, UK,MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton, UK,MRC Lifecourse Epidemiology Unit, University of Southampton, Southampton General Hospital, Southampton SO16 6YD, UK. E-mail:
| | - S P Hagenaars
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK,Department of Psychology, University of Edinburgh, Edinburgh, UK,Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - G Davies
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK,Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - W D Hill
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK,Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - D C M Liewald
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK,Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - B Cullen
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - B W Penninx
- Department of Psychiatry, EMGO Institute for Health and Care Research and Neuroscience Campus Amsterdam, VU University Medical Center/GGZ inGeest, Amsterdam, The Netherlands
| | | | - D I Boomsma
- Department of Biological Psychology, VU University Amsterdam, Amsterdam, The Netherlands
| | - J Pell
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - A M McIntosh
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - D J Smith
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - I J Deary
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK,Department of Psychology, University of Edinburgh, Edinburgh, UK
| | - S E Harris
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK,Medical Genetics Section, University of Edinburgh Centre for Genomic and Experimental Medicine and MRC Institute of Genetics and Molecular Medicine, Western General Hospital, Edinburgh, UK
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22
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Riddle MA, Maher BS, Wang Y, Grados M, Bienvenu OJ, Goes FS, Cullen B, Murphy DL, Rauch SL, Greenberg BD, Knowles JA, McCracken JT, Pinto A, Piacentini J, Pauls DL, Rasmussen SA, Shugart YY, Nestadt G, Samuels J. OBSESSIVE-COMPULSIVE PERSONALITY DISORDER: EVIDENCE FOR TWO DIMENSIONS. Depress Anxiety 2016; 33:128-35. [PMID: 26594839 DOI: 10.1002/da.22452] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2015] [Revised: 09/23/2015] [Accepted: 10/18/2015] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND To determine possible dimensions that underlie obsessive-compulsive personality disorder (OCPD) and to investigate their clinical correlates, familiality, and genetic linkage. METHODS Participants were selected from 844 adults assessed with the Structured Instrument for the Diagnosis of DSM-IV Personality Disorders (SIDP) in the OCD Collaborative Genetics Study (OCGS) that targeted families with obsessive-compulsive disorder (OCD) affected sibling pairs. We conducted an exploratory factor analysis, which included the eight SIDP-derived DSM-IV OCPD traits and the indecision trait from the DSM-III, assessed clinical correlates, and estimated sib-sib correlations to evaluate familiality of the factors. Using MERLIN and MINX, we performed genome-wide quantitative trait locus (QTL) linkage analysis to test for allele sharing among individuals. RESULTS Two factors were identified: Factor 1: order/control (perfectionism, excessive devotion to work, overconscientiousness, reluctance to delegate, and rigidity); and Factor 2: hoarding/indecision (inability to discard and indecisiveness). Factor 1 score was associated with poor insight, whereas Factor 2 score was associated with task incompletion. A significant sib-sib correlation was found for Factor 2 (rICC = .354, P < .0001) but not Factor 1 (rICC = .129, P = .084). The linkage findings were different for the two factors. When Factor 2 was analyzed as a quantitative trait, a strong signal was detected on chromosome 10 at marker d10s1221: KAC LOD = 2.83, P = .0002; and marker d10s1225: KAC LOD = 1.35, P = .006. CONCLUSIONS The results indicate two factors of OCPD, order/control and hoarding/indecision. The hoarding/indecision factor is familial and shows modest linkage to a region on chromosome 10.
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Affiliation(s)
- Mark A Riddle
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Brion S Maher
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Ying Wang
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Marco Grados
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - O Joseph Bienvenu
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Fernando S Goes
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Bernadette Cullen
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Dennis L Murphy
- Laboratory of Clinical Science, National Institute of Mental Health, National Institute of Health, Bethesda, Maryland
| | - Scott L Rauch
- Department of Psychiatry, McLean Hospital, Harvard Medical School, Boston, Massachusetts
| | - Benjamin D Greenberg
- Department of Psychiatry and Human Behavior, Brown Medical School, Butler Hospital, Providence, Rhode Island
| | - James A Knowles
- Department of Psychiatry, University of Southern California School of Medicine, Los Angeles, California
| | - James T McCracken
- Department of Psychiatry and Biobehavioral Sciences, School of Medicine, University of California Los Angeles, Los Angeles, California
| | - Anthony Pinto
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York State Psychiatric Institute, New York City, New York
| | - John Piacentini
- Department of Psychiatry and Biobehavioral Sciences, School of Medicine, University of California Los Angeles, Los Angeles, California
| | - David L Pauls
- Department of Psychiatry, Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Steven A Rasmussen
- Department of Psychiatry and Human Behavior, Brown Medical School, Butler Hospital, Providence, Rhode Island
| | - Yin Yao Shugart
- Unit of Statistical Genomics, Division of Intramural Research, National Institute of Mental Health, National Institute of Health, Bethesda, Maryland
| | - Gerald Nestadt
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jack Samuels
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
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23
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Mroczkowski MM, Goes FS, Riddle MA, Grados MA, Bienvenu OJ, Greenberg BD, Fyer AJ, McCracken JT, Rauch SL, Murphy DL, Knowles JA, Piacentini J, Cullen B, Rasmussen SA, Pauls DL, Nestadt G, Samuels J. Dependent personality, separation anxiety disorder and other anxiety disorders in OCD. Personal Ment Health 2016; 10:22-8. [PMID: 26542617 DOI: 10.1002/pmh.1321] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Revised: 09/26/2015] [Accepted: 09/30/2015] [Indexed: 01/04/2023]
Abstract
BACKGROUND The purpose of this study was to investigate whether dependent personality and/or general personality dimensions might explain the strong relationships between separation anxiety disorder (Sep-AD) and three other anxiety disorders (agoraphobia, panic disorder and social anxiety disorder) in individuals with obsessive compulsive disorder (OCD). METHODS Using data from 509 adult participants collected during the OCD Collaborative Genetic Study, we used logistic regression models to evaluate the relationships between Sep-AD, dependent personality score, general personality dimensions and three additional anxiety disorders. RESULTS The dependent personality score was strongly associated with Sep-AD and the other anxiety disorders in models adjusted for age at interview, age at onset of OC symptoms and worst ever OCD severity score. Several general personality dimensions, especially neuroticism, extraversion and conscientiousness, were also related to Sep-AD and the other anxiety disorders. Sep-AD was not independently related to these anxiety disorders, in multivariate models including general personality and dependent personality disorder scores. CONCLUSIONS The results suggest that Sep-AD in childhood and these other anxiety disorders in adulthood are consequences of dependent personality disorder (for agoraphobia and panic disorder) or introversion (for social phobia). It is unknown whether these results would be similar in a non-OCD sample.
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Affiliation(s)
- M M Mroczkowski
- Department of Psychiatry, Columbia University College of Physicians and Surgeons, New York, NY, USA
| | - F S Goes
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - M A Riddle
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - M A Grados
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - O J Bienvenu
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - B D Greenberg
- Department of Psychiatry and Human Behavior, Brown University Alpert Medical School, Providence, RI, USA
| | - A J Fyer
- Department of Psychiatry, Columbia University College of Physicians and Surgeons and the New York State Psychiatric Institute, New York, NY, USA
| | - J T McCracken
- Department of Psychiatry and Biobehavioral Sciences, School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - S L Rauch
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - D L Murphy
- Laboratory of Clinical Science, NIMH, NIH, Bethesda, MD, USA
| | - J A Knowles
- Department of Psychiatry and the Behavioral Sciences, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - J Piacentini
- Department of Psychiatry and Biobehavioral Sciences, School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - B Cullen
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - S A Rasmussen
- Department of Psychiatry and Human Behavior, Brown University Alpert Medical School, Providence, RI, USA
| | - D L Pauls
- Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - G Nestadt
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - J Samuels
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Cullen B, Nicholl BI, Mackay DF, Martin D, Ul-Haq Z, McIntosh A, Gallacher J, Deary IJ, Pell JP, Evans JJ, Smith DJ. Cognitive function and lifetime features of depression and bipolar disorder in a large population sample: Cross-sectional study of 143,828 UK Biobank participants. Eur Psychiatry 2015; 30:950-8. [PMID: 26647871 DOI: 10.1016/j.eurpsy.2015.08.006] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/18/2015] [Accepted: 08/18/2015] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND This study investigated differences in cognitive performance between middle-aged adults with and without a lifetime history of mood disorder features, adjusting for a range of potential confounders. METHODS Cross-sectional analysis of baseline data from the UK Biobank cohort. Adults aged 40-69 (n=143,828) were assessed using measures of reasoning, reaction time and memory. Self-reported data on lifetime features of major depression and bipolar disorder were used to construct groups for comparison against controls. Regression models examined the association between mood disorder classification and cognitive performance, adjusting for sociodemographic, lifestyle and clinical confounders. RESULTS Inverse associations between lifetime history of bipolar or severe recurrent depression features and cognitive performance were attenuated or reversed after adjusting for confounders, including psychotropic medication use and current depressive symptoms. Participants with a lifetime history of single episode or moderate recurrent depression features outperformed controls to a small (but statistically significant) degree, independent of adjustment for confounders. There was a significant interaction between use of psychotropic medication and lifetime mood disorder features, with reduced cognitive performance observed in participants taking psychotropic medication. CONCLUSIONS In this general population sample of adults in middle age, lifetime features of recurrent depression or bipolar disorder were only associated with cognitive impairment within unadjusted analyses. These findings underscore the importance of adjusting for potential confounders when investigating mood disorder-related cognitive function.
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Affiliation(s)
- B Cullen
- Mental Health and Wellbeing, Institute of Health and Wellbeing, University of Glasgow, Ground Floor, Office Block, Queen Elizabeth University Hospital, Glasgow, G51 4TF UK.
| | - B I Nicholl
- General Practice and Primary Care, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - D F Mackay
- Public Health, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - D Martin
- Mental Health and Wellbeing, Institute of Health and Wellbeing, University of Glasgow, Ground Floor, Office Block, Queen Elizabeth University Hospital, Glasgow, G51 4TF UK
| | - Z Ul-Haq
- Public Health, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK; Institute of Public Health and Social Sciences, Khyber Medical University, Peshawar, Pakistan
| | - A McIntosh
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - J Gallacher
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - I J Deary
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
| | - J P Pell
- Public Health, Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - J J Evans
- Mental Health and Wellbeing, Institute of Health and Wellbeing, University of Glasgow, Ground Floor, Office Block, Queen Elizabeth University Hospital, Glasgow, G51 4TF UK
| | - D J Smith
- Mental Health and Wellbeing, Institute of Health and Wellbeing, University of Glasgow, Ground Floor, Office Block, Queen Elizabeth University Hospital, Glasgow, G51 4TF UK
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Yu D, Mathews CA, Scharf JM, Neale BM, Davis LK, Gamazon ER, Derks EM, Evans P, Edlund CK, Crane J, Fagerness JA, Osiecki L, Gallagher P, Gerber G, Haddad S, Illmann C, McGrath LM, Mayerfeld C, Arepalli S, Barlassina C, Barr CL, Bellodi L, Benarroch F, Berrió GB, Bienvenu OJ, Black D, Bloch MH, Brentani H, Bruun RD, Budman CL, Camarena B, Campbell DD, Cappi C, Cardona Silgado JC, Cavallini MC, Chavira DA, Chouinard S, Cook EH, Cookson MR, Coric V, Cullen B, Cusi D, Delorme R, Denys D, Dion Y, Eapen V, Egberts K, Falkai P, Fernandez T, Fournier E, Garrido H, Geller D, Gilbert D, Girard SL, Grabe HJ, Grados MA, Greenberg BD, Gross-Tsur V, Grünblatt E, Hardy J, Heiman GA, Hemmings SM, Herrera LD, Hezel DM, Hoekstra PJ, Jankovic J, Kennedy JL, King RA, Konkashbaev AI, Kremeyer B, Kurlan R, Lanzagorta N, Leboyer M, Leckman JF, Lennertz L, Liu C, Lochner C, Lowe TL, Lupoli S, Macciardi F, Maier W, Manunta P, Marconi M, McCracken JT, Mesa Restrepo SC, Moessner R, Moorjani P, Morgan J, Muller H, Murphy DL, Naarden AL, Ochoa WC, Ophoff RA, Pakstis AJ, Pato MT, Pato CN, Piacentini J, Pittenger C, Pollak Y, Rauch SL, Renner T, Reus VI, Richter MA, Riddle MA, Robertson MM, Romero R, Rosário MC, Rosenberg D, Ruhrmann S, Sabatti C, Salvi E, Sampaio AS, Samuels J, Sandor P, Service SK, Sheppard B, Singer HS, Smit JH, Stein DJ, Strengman E, Tischfield JA, Turiel M, Valencia Duarte AV, Vallada H, Veenstra-VanderWeele J, Walitza S, Walkup J, Wang Y, Weale M, Weiss R, Wendland JR, Westenberg HG, Yao Y, Hounie AG, Miguel EC, Nicolini H, Wagner M, Ruiz-Linares A, Cath DC, McMahon W, Posthuma D, Oostra BA, Nestadt G, Rouleau GA, Purcell S, Jenike MA, Heutink P, Hanna GL, Conti DV, Arnold PD, Freimer N, Stewart SE, Knowles JA, Cox NJ, Pauls DL. Cross-disorder genome-wide analyses suggest a complex genetic relationship between Tourette's syndrome and OCD. Am J Psychiatry 2015; 172:82-93. [PMID: 25158072 PMCID: PMC4282594 DOI: 10.1176/appi.ajp.2014.13101306] [Citation(s) in RCA: 89] [Impact Index Per Article: 9.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE Obsessive-compulsive disorder (OCD) and Tourette's syndrome are highly heritable neurodevelopmental disorders that are thought to share genetic risk factors. However, the identification of definitive susceptibility genes for these etiologically complex disorders remains elusive. The authors report a combined genome-wide association study (GWAS) of Tourette's syndrome and OCD. METHOD The authors conducted a GWAS in 2,723 cases (1,310 with OCD, 834 with Tourette's syndrome, 579 with OCD plus Tourette's syndrome/chronic tics), 5,667 ancestry-matched controls, and 290 OCD parent-child trios. GWAS summary statistics were examined for enrichment of functional variants associated with gene expression levels in brain regions. Polygenic score analyses were conducted to investigate the genetic architecture within and across the two disorders. RESULTS Although no individual single-nucleotide polymorphisms (SNPs) achieved genome-wide significance, the GWAS signals were enriched for SNPs strongly associated with variations in brain gene expression levels (expression quantitative loci, or eQTLs), suggesting the presence of true functional variants that contribute to risk of these disorders. Polygenic score analyses identified a significant polygenic component for OCD (p=2×10(-4)), predicting 3.2% of the phenotypic variance in an independent data set. In contrast, Tourette's syndrome had a smaller, nonsignificant polygenic component, predicting only 0.6% of the phenotypic variance (p=0.06). No significant polygenic signal was detected across the two disorders, although the sample is likely underpowered to detect a modest shared signal. Furthermore, the OCD polygenic signal was significantly attenuated when cases with both OCD and co-occurring Tourette's syndrome/chronic tics were included in the analysis (p=0.01). CONCLUSIONS Previous work has shown that Tourette's syndrome and OCD have some degree of shared genetic variation. However, the data from this study suggest that there are also distinct components to the genetic architectures of these two disorders. Furthermore, OCD with co-occurring Tourette's syndrome/chronic tics may have different underlying genetic susceptibility compared with OCD alone.
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Affiliation(s)
- Dongmei Yu
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics Research, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA,Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, Cambridge, Massachusetts, USA,Co-corresponding authors: Dongmei Yu, MS & David L. Pauls, Ph.D., Psychiatric & Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Simches Research Building, 6th Floor, 185 Cambridge Street, Boston, MA 02114
| | - Carol A. Mathews
- Department of Psychiatry, University of California at San Francisco, San Francisco, CA, USA
| | - Jeremiah M. Scharf
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics Research, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA,Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, Cambridge, Massachusetts, USA,Department of Neurology, Massachusetts General Hospital, Boston, MA, USA,Division of Cognitive and Behavioral Neurology, Brigham and Womens Hospital, Boston, MA, USA
| | - Benjamin M. Neale
- Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, Cambridge, Massachusetts, USA,Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Lea K. Davis
- Section of Genetic Medicine, Department of Medicine, University of Chicago, Chicago, Illinois, USA
| | - Eric R. Gamazon
- Section of Genetic Medicine, Department of Medicine, University of Chicago, Chicago, Illinois, USA
| | - Eske M. Derks
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands
| | - Patrick Evans
- Section of Genetic Medicine, Department of Medicine, University of Chicago, Chicago, Illinois, USA
| | - Christopher K. Edlund
- Department of Preventative Medicine, Division of Biostatistics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Jacquelyn Crane
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics Research, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Jesen A. Fagerness
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics Research, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Lisa Osiecki
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics Research, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Patience Gallagher
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics Research, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Gloria Gerber
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics Research, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Stephen Haddad
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics Research, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Cornelia Illmann
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics Research, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Lauren M. McGrath
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics Research, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA,Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, Cambridge, Massachusetts, USA
| | - Catherine Mayerfeld
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics Research, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Sampath Arepalli
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Cristina Barlassina
- Genomic and Bioinformatic Unit, Filarete Foundation, Milano, Italy,Department of Health Sciences, Graduate School of Nephrology, University of Milano
| | - Cathy L. Barr
- The Toronto Western Research Institute, University Health Network, Toronto, ON, Canada,The Hospital for Sick Children, Toronto, ON, Canada
| | | | - Fortu Benarroch
- Herman Dana Division of Child and Adolescent Psychiatry, Hadassah-Hebrew University Medical Center, Jerusalem, Israel
| | | | - O. Joseph Bienvenu
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Donald Black
- Department of Psychiatry, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Michael H. Bloch
- Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Helena Brentani
- Department of Psychiatry, University of São Paulo Medical School, Brazil
| | - Ruth D. Bruun
- North Shore-Long Island Jewish Medical Center, Manhasset, NY, USA,New York University Medical Center, New York, NY, USA
| | - Cathy L. Budman
- North Shore-Long Island Jewish Health System, Manhasset, NY, USA,Hofstra University School of Medicine, Hempstead, NY, USA
| | - Beatriz Camarena
- Instituto Nacional de Psiquiatría Ramon de la Fuente Muñiz, Mexico City, Mexico
| | - Desmond D. Campbell
- University College London, London, UK,Department of Psychiatry, University of Hong Kong, Hong Kong
| | - Carolina Cappi
- Department of Psychiatry, University of São Paulo Medical School, Brazil
| | | | | | - Denise A. Chavira
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA,Department of Psychology, University of California Los Angeles, Los Angeles, CA, USA
| | - Sylvain Chouinard
- Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Edwin H. Cook
- Institute for Juvenile Research, Department of Psychiatry, University of Illinois at Chicago, USA
| | - M. R. Cookson
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Vladimir Coric
- Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Bernadette Cullen
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Daniele Cusi
- Genomic and Bioinformatic Unit, Filarete Foundation, Milano, Italy,Department of Health Sciences, Graduate School of Nephrology, University of Milano
| | - Richard Delorme
- Human Genetics and Cognitive Functions, Institut Pasteur, Paris, France,Foundation Fondamental, French National Science Foundation, France,AP-HP, Robert Debré Hospital, Department of Child and Adolescent Psychiatry, Paris, France
| | - Damiaan Denys
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands,Netherlands Institute for Neuroscience, an Institute of the Royal Netherlands Academy of Arts and Sciences (NIN-KNAW), Amsterdam, The Netherlands
| | - Yves Dion
- Department of Psychiatry, University of Montreal, Montreal, Quebec, Canada
| | - Valsama Eapen
- Infant Child and Adolescent Psychiatry, University of New South Wales, Australia,Academic Unit of Child Psychiatry, South West Sydney LHD (AUCS), Australia
| | - Karin Egberts
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Germany
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University of Munich, Munich, Germany
| | - Thomas Fernandez
- Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | | | - Helena Garrido
- Clinica Herrera Amighetti, Avenida Escazú, San José, Costa Rica
| | - Daniel Geller
- OCD Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Donald Gilbert
- Cincinnati Children’s Hospital Medical Center and the University of Cincinnati, Cincinnati, OH, USA
| | - Simon L. Girard
- Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Hans J. Grabe
- Department of Psychiatry and Psychotherapy, Helios-Hospital Stralsund, University Medicine Greifswald, Greifswald, Germany
| | - Marco A. Grados
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Benjamin D. Greenberg
- Department of Psychiatry and Human Behavior, Brown Medical School, Butler Hospital, Providence, Rhode Island, USA
| | - Varda Gross-Tsur
- Neuropediatric Unit, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Edna Grünblatt
- Department of Child and Adolescent Psychiatry, University of Zurich, Zurich, Switzerland
| | | | - Gary A. Heiman
- Department of Genetics, Human Genetics Institute of New Jersey, Rutgers University, Piscataway, NJ, US
| | - Sian M.J. Hemmings
- Department of Psychiatry, University of Stellenbosch, Stellenbosch, South Africa
| | | | - Dianne M. Hezel
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics Research, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
| | - Pieter J. Hoekstra
- Department of Psychiatry, University Medical Center, University of Groningen, Groningen, The Netherlands
| | - Joseph Jankovic
- Parkinson’s Disease Center and Movement Disorders Clinic, Department of Neurology, Baylor College of Medicine, Houston, TX, USA
| | - James L. Kennedy
- Neurogenetics Section, Centre for Addiction and Mental Health, Toronto, Canada,Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
| | - Robert A. King
- Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Anuar I. Konkashbaev
- Section of Genetic Medicine, Department of Medicine, University of Chicago, Chicago, Illinois, USA
| | | | - Roger Kurlan
- Atlantic Neuroscience Institute, Overlook Hospital, Summit, NJ, USA
| | | | - Marion Leboyer
- Foundation Fondamental, French National Science Foundation, France,AP-HP, Robert Debré Hospital, Department of Child and Adolescent Psychiatry, Paris, France,Institut Mondor de Recherche Biomédicale, Psychiatric Genetics, Créteil, F 94000, France
| | - James F. Leckman
- Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Leonhard Lennertz
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Chunyu Liu
- Department of Psychiatry, Institute of Human Genetics, University of Illinois at Chicago, Chicago, Illinois, USA
| | - Christine Lochner
- MRC Unit on Anxiety & Stress Disorders, Department of Psychiatry, University of Stellenbosch, Stellenbosch, South Africa
| | - Thomas L. Lowe
- Department of Psychiatry, University of California at San Francisco, San Francisco, CA, USA
| | - Sara Lupoli
- Genomic and Bioinformatic Unit, Filarete Foundation, Milano, Italy,Department of Health Sciences, Graduate School of Nephrology, University of Milano
| | - Fabio Macciardi
- Department of Psychiatry and Human Behavior, School of Medicine, University of California Irvine (UCI), California, USA
| | - Wolfgang Maier
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Paolo Manunta
- Division of Nephrology and Dialysis, San Raffaele Scientific Institute - Chair of Nephrology, Università Vita Salute San Raffaele, Milan, Italy
| | - Maurizio Marconi
- Center of Transfusion Medicine and Immunohematology, Foundation IRCCS Ca’ Granda Ospedale Maggiore Policlinico, Milano, Italy
| | - James T. McCracken
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, David Geffen School of Medicine, California, USA
| | | | - Rainald Moessner
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Priya Moorjani
- Department of Genetics, Harvard University, Cambridge, MA, USA
| | | | | | - Dennis L. Murphy
- Laboratory of Clinical Science, NIMH Intramural Research Program, Bethesda, MD, USA
| | - Allan L. Naarden
- Department of Clinical Research, Medical City Dallas Hospital, Dallas, Texas, USA
| | | | - Roel A. Ophoff
- Department of Psychiatry, Rudolf Magnus Institute of Neuroscience, University Medical Center, Utrecht, The Netherlands,Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA
| | - Andrew J. Pakstis
- Department of Genetics, Yale University School of Medicine, New Haven, CT, USA
| | - Michele T. Pato
- Department of Psychiatry and the Behavioral Sciences, Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Carlos N. Pato
- Department of Psychiatry and the Behavioral Sciences, Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - John Piacentini
- Department of Psychiatry and Biobehavioral Sciences, University of California, Los Angeles, David Geffen School of Medicine, California, USA
| | - Christopher Pittenger
- Child Study Center, Yale University School of Medicine, New Haven, Connecticut, USA,Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA
| | - Yehuda Pollak
- Neuropediatric Unit, Shaare Zedek Medical Center, Jerusalem, Israel
| | - Scott L. Rauch
- Partners Psychiatry and McLean Hospital, Boston, MA, USA
| | - Tobias Renner
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University of Würzburg, Germany
| | - Victor I. Reus
- Department of Psychiatry, University of California at San Francisco, San Francisco, CA, USA
| | - Margaret A. Richter
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada,Frederick W. Thompson Anxiety Disorders Centre, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada
| | - Mark A. Riddle
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | | | | | - Maria C. Rosário
- Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, Federal University of São Paulo, Brazil
| | - David Rosenberg
- Department of Psychiatry & Behavioral Neurosciences, Wayne State University and the Detroit Medical Center
| | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne, Germany
| | - Chiara Sabatti
- Department of Health Research and Policy, Stanford University, Stanford, CA, USA
| | - Erika Salvi
- Genomic and Bioinformatic Unit, Filarete Foundation, Milano, Italy,Department of Health Sciences, Graduate School of Nephrology, University of Milano
| | - Aline S. Sampaio
- University Health Care Services - SMURB, Universidade Federal da Bahia, Salvador, Bahia, Brazil,Department of Psychiatry, Faculdade de Medicina da Universidade de Sao Paulo, Brazil
| | - Jack Samuels
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Paul Sandor
- Department of Psychiatry, University of Toronto and University Health Network, Toronto Western Research Institute and Youthdale Treatment Centers, Toronto, Ontario, Canada
| | - Susan K. Service
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA
| | - Brooke Sheppard
- Department of Psychiatry, University of California at San Francisco, San Francisco, CA, USA
| | | | - Jan H. Smit
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| | - Dan J. Stein
- University of Cape Town, Cape Town, South Africa
| | - Eric Strengman
- Department of Medical Genetics, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Jay A. Tischfield
- Department of Genetics, Human Genetics Institute of New Jersey, Rutgers University, Piscataway, NJ, US
| | - Maurizio Turiel
- Department of Health Technologies, University of Milano, Milano, Italy
| | | | - Homero Vallada
- Department of Psychiatry, University of São Paulo Medical School, Brazil
| | - Jeremy Veenstra-VanderWeele
- Departments of Psychiatry, Pediatrics, and Pharmacology, Kennedy Center for Research on Human Development, and Brain Institute, Vanderbilt University, Nashville, TN, USA
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry, University of Zurich, Zurich, Switzerland,Department of Child and Adolescent Psychiatry, University of Würzburg, Germany
| | - John Walkup
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Weill Cornell Medical Center, New York, NY, USA
| | - Ying Wang
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Mike Weale
- Department of Medical & Molecular Genetics, King’s College London, UK
| | | | - Jens R. Wendland
- Laboratory of Clinical Science, NIMH Intramural Research Program, Bethesda, MD, USA
| | - Herman G.M. Westenberg
- Department of Psychiatry, Academic Medical Center and Netherlands Institute for Neuroscience, an Institute of the Royal Netherlands Academy of Arts and Sciences (NIN-KNAW), Amsterdam, The Netherlands
| | - Yin Yao
- Unit on Statistical Genomics, NIMH Intramural Research Program, Bethesda, MD, USA
| | - Ana G. Hounie
- Department of Psychiatry, Faculdade de Medicina da Universidade de Sao Paulo, Brazil
| | | | | | - Michael Wagner
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | | | - Danielle C. Cath
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands,Department of Clinical & Health Psychology, Utrecht University, Utrecht, The Netherlands
| | - William McMahon
- Department of Psychiatry, University of Utah, Salt Lake City, Utah, USA
| | - Danielle Posthuma
- Section of Medical Genomics, Department of Clinical Genetics, VU University Medical Center Amsterdam, The Netherlands,Department of Functional Genomics, Center for Neurogenomics and Cognitive Research, Neuroscience Campus Amsterdam, VU University Amsterdam, De Boelelaan Amsterdam, The Netherlands,Department of Child and Adolescent Psychiatry, Erasmus University Medical Centre, Wytemaweg 8, Rotterdam, The Netherlands
| | - Ben A. Oostra
- Department of Clinical Genetics, Erasmus Medical Center, Rotterdam, The Netherlands
| | - Gerald Nestadt
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
| | - Guy A. Rouleau
- Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Shaun Purcell
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics Research, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA,Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, Cambridge, Massachusetts, USA,Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA,Mt. Sinai Medical Center, New York, NY, USA
| | - Michael A. Jenike
- OCD Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA
| | - Peter Heutink
- Section of Medical Genomics, Department of Clinical Genetics, VU University Medical Center Amsterdam, The Netherlands,German Center for Neurodegenerative Diseases, Tübingen, Germany
| | - Gregory L. Hanna
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - David V. Conti
- Department of Preventative Medicine, Division of Biostatistics, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Paul D. Arnold
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada,Program in Genetics and Genome Biology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Nelson Freimer
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, Los Angeles, CA, USA
| | - S. Evelyn Stewart
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics Research, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA,British Columbia Mental Health and Addictions Research Institute, University of British Columbia, Vancouver, BC, Canada
| | - James A. Knowles
- Department of Psychiatry and the Behavioral Sciences, Zilkha Neurogenetic Institute, Keck School of Medicine, University of Southern California, Los Angeles, CA, USA
| | - Nancy J. Cox
- Section of Genetic Medicine, Department of Medicine, University of Chicago, Chicago, Illinois, USA
| | - David L. Pauls
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics Research, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA,Co-corresponding authors: Dongmei Yu, MS & David L. Pauls, Ph.D., Psychiatric & Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Simches Research Building, 6th Floor, 185 Cambridge Street, Boston, MA 02114
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Tomkins SE, Rice BD, Roy K, Cullen B, Ncube FM. Universal treatment success among healthcare workers diagnosed with occupationally acquired acute hepatitis C. J Hosp Infect 2014; 89:69-71. [PMID: 25458741 DOI: 10.1016/j.jhin.2014.09.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2014] [Accepted: 09/29/2014] [Indexed: 10/24/2022]
Abstract
Healthcare workers (HCWs) are at risk of occupationally acquired hepatitis C. In the UK, 17 HCWs were diagnosed with occupationally acquired acute hepatitis C between 2002 and 2011. All 17 cases involved percutaneous injuries from hollowbore needles, 16 known to be contaminated with blood. Of these 17 HCWs, 15 received antiviral therapy and 14 are known to have achieved viral clearance. Treatment success was irrespective of genotype. The successful treatment of HCWs emphasizes the need for UK guidelines on the management of occupationally acquired acute hepatitis C.
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Affiliation(s)
- S E Tomkins
- Centre for Infectious Disease Surveillance and Control, Public Health England, London, UK
| | - B D Rice
- Centre for Infectious Disease Surveillance and Control, Public Health England, London, UK.
| | - K Roy
- Health Protection Scotland, NHS National Services Scotland, Glasgow, UK
| | - B Cullen
- Health Protection Scotland, NHS National Services Scotland, Glasgow, UK
| | - F M Ncube
- Centre for Infectious Disease Surveillance and Control, Public Health England, London, UK
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Samuels J, Grados MA, Riddle MA, Bienvenu OJ, Goes FS, Cullen B, Wang Y, Greenberg BD, Fyer AJ, McCracken JT, Geller D, Murphy DL, Knowles JA, Rasmussen SA, McLaughlin NC, Piacentini J, Pauls DL, Stewart SE, Shugart YY, Maher B, Pulver AE, Nestadt G. Hoarding in Children and Adolescents with Obsessive-Compulsive Disorder. J Obsessive Compuls Relat Disord 2014; 3:325-331. [PMID: 25309849 PMCID: PMC4187108 DOI: 10.1016/j.jocrd.2014.08.001] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
Compared to studies in adults, there have been few studies of hoarding in children and adolescents with obsessive-compulsive disorder (OCD). In the current study, we evaluated OCD clinical features, Axis I disorders, and social reciprocity scores in 641 children and adolescents with OCD, of whom 163 (25%) had hoarding compulsions and 478 did not. We found that, as a group, youth with hoarding had an earlier age at onset and more severe lifetime OCD symptoms, poorer insight, more difficulty making decisions and completing tasks, and more overall impairment. The hoarding group also had a greater lifetime prevalence of panic disorder, specific phobia, Tourette disorder, and tics. As measured with the Social Reciprocity Scale, the hoarding group had more severe deficits in parent-rated domains of social communication, social motivation, and restricted interests and repetitive behavior. In a multivariable model, the overall social reciprocity score, age at onset of OCD symptoms, symmetry obsessions, and indecision were independently related to hoarding in these children and adolescents with OCD. These features should be considered as candidate risk factors for the development of hoarding behavior in pediatric OCD.
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Affiliation(s)
- Jack Samuels
- Department of Psychiatry and Behavioral Sciences, Johns
Hopkins University School of Medicine, Baltimore, Maryland
| | - Marco A. Grados
- Department of Psychiatry and Behavioral Sciences, Johns
Hopkins University School of Medicine, Baltimore, Maryland
| | - Mark A. Riddle
- Department of Psychiatry and Behavioral Sciences, Johns
Hopkins University School of Medicine, Baltimore, Maryland
| | - O. Joseph Bienvenu
- Department of Psychiatry and Behavioral Sciences, Johns
Hopkins University School of Medicine, Baltimore, Maryland
| | - Fernando S. Goes
- Department of Psychiatry and Behavioral Sciences, Johns
Hopkins University School of Medicine, Baltimore, Maryland
| | - Bernadette Cullen
- Department of Psychiatry and Behavioral Sciences, Johns
Hopkins University School of Medicine, Baltimore, Maryland
| | - Ying Wang
- Department of Psychiatry and Behavioral Sciences, Johns
Hopkins University School of Medicine, Baltimore, Maryland
| | - Benjamin D. Greenberg
- Department of Psychiatry and Human Behavior, Brown Medical
School, Butler Hospital, Providence, Rhode Island
| | - Abby J. Fyer
- Department of Psychiatry, College of Physicians and
Surgeons at Columbia University and the New York State Psychiatric Institute, New
York City, New York
| | - James T. McCracken
- Department of Psychiatry and Biobehavioral Sciences,
University of California, Los Angeles, School of Medicine, Los Angeles,
California
| | - Dan Geller
- Department of Psychiatry, Harvard Medical School, Boston,
Massachusetts
| | - Dennis L. Murphy
- Laboratory of Clinical Science, National Institute of
Mental Health, National Institute of Health, Bethesda, Maryland
| | - James A. Knowles
- Department of Psychiatry, University of Southern California
School of Medicine, Los Angeles, California
| | - Steven A. Rasmussen
- Department of Psychiatry and Human Behavior, Brown Medical
School, Butler Hospital, Providence, Rhode Island
| | - Nicole C. McLaughlin
- Department of Psychiatry and Human Behavior, Brown Medical
School, Butler Hospital, Providence, Rhode Island
| | - John Piacentini
- Department of Psychiatry and Biobehavioral Sciences,
University of California, Los Angeles, School of Medicine, Los Angeles,
California
| | - David L. Pauls
- Department of Psychiatry and Psychiatric and
Neurodevelopmental Genetics Unit, Massachusetts General Hospital and Harvard Medical
School, Boston, Massachusetts
| | - S. Evelyn Stewart
- Department of Psychiatry, Faculty of Medicine, University
of British Columbia, Vancouver
| | - Yin-Yao Shugart
- Unit of Statistical Genomics, Division of Intramural
Research, National Institute of Mental Health, Bethesda, MD, USA
| | - Brion Maher
- Department of Mental Health, Bloomberg School of Public
Health, Johns Hopkins University, Baltimore, Maryland
| | - Ann E. Pulver
- Department of Psychiatry and Behavioral Sciences, Johns
Hopkins University School of Medicine, Baltimore, Maryland
| | - Gerald Nestadt
- Department of Psychiatry and Behavioral Sciences, Johns
Hopkins University School of Medicine, Baltimore, Maryland
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28
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McGrath LM, Yu D, Marshall C, Davis LK, Thiruvahindrapuram B, Li B, Cappi C, Gerber G, Wolf A, Schroeder FA, Osiecki L, O'Dushlaine C, Kirby A, Illmann C, Haddad S, Gallagher P, Fagerness JA, Barr CL, Bellodi L, Benarroch F, Bienvenu OJ, Black DW, Bloch MH, Bruun RD, Budman CL, Camarena B, Cath DC, Cavallini MC, Chouinard S, Coric V, Cullen B, Delorme R, Denys D, Derks EM, Dion Y, Rosário MC, Eapen V, Evans P, Falkai P, Fernandez TV, Garrido H, Geller D, Grabe HJ, Grados MA, Greenberg BD, Gross-Tsur V, Grünblatt E, Heiman GA, Hemmings SMJ, Herrera LD, Hounie AG, Jankovic J, Kennedy JL, King RA, Kurlan R, Lanzagorta N, Leboyer M, Leckman JF, Lennertz L, Lochner C, Lowe TL, Lyon GJ, Macciardi F, Maier W, McCracken JT, McMahon W, Murphy DL, Naarden AL, Neale BM, Nurmi E, Pakstis AJ, Pato MT, Pato CN, Piacentini J, Pittenger C, Pollak Y, Reus VI, Richter MA, Riddle M, Robertson MM, Rosenberg D, Rouleau GA, Ruhrmann S, Sampaio AS, Samuels J, Sandor P, Sheppard B, Singer HS, Smit JH, Stein DJ, Tischfield JA, Vallada H, Veenstra-VanderWeele J, Walitza S, Wang Y, Wendland JR, Shugart YY, Miguel EC, Nicolini H, Oostra BA, Moessner R, Wagner M, Ruiz-Linares A, Heutink P, Nestadt G, Freimer N, Petryshen T, Posthuma D, Jenike MA, Cox NJ, Hanna GL, Brentani H, Scherer SW, Arnold PD, Stewart SE, Mathews CA, Knowles JA, Cook EH, Pauls DL, Wang K, Scharf JM. Copy number variation in obsessive-compulsive disorder and tourette syndrome: a cross-disorder study. J Am Acad Child Adolesc Psychiatry 2014; 53:910-9. [PMID: 25062598 PMCID: PMC4218748 DOI: 10.1016/j.jaac.2014.04.022] [Citation(s) in RCA: 97] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/11/2013] [Revised: 03/16/2014] [Accepted: 06/18/2014] [Indexed: 12/31/2022]
Abstract
OBJECTIVE Obsessive-compulsive disorder (OCD) and Tourette syndrome (TS) are heritable neurodevelopmental disorders with a partially shared genetic etiology. This study represents the first genome-wide investigation of large (>500 kb), rare (<1%) copy number variants (CNVs) in OCD and the largest genome-wide CNV analysis in TS to date. METHOD The primary analyses used a cross-disorder design for 2,699 case patients (1,613 ascertained for OCD, 1,086 ascertained for TS) and 1,789 controls. Parental data facilitated a de novo analysis in 348 OCD trios. RESULTS Although no global CNV burden was detected in the cross-disorder analysis or in secondary, disease-specific analyses, there was a 3.3-fold increased burden of large deletions previously associated with other neurodevelopmental disorders (p = .09). Half of these neurodevelopmental deletions were located in a single locus, 16p13.11 (5 case patient deletions: 0 control deletions, p = .08 in the current study, p = .025 compared to published controls). Three 16p13.11 deletions were confirmed de novo, providing further support for the etiological significance of this region. The overall OCD de novo rate was 1.4%, which is intermediate between published rates in controls (0.7%) and in individuals with autism or schizophrenia (2-4%). CONCLUSION Several converging lines of evidence implicate 16p13.11 deletions in OCD, with weaker evidence for a role in TS. The trend toward increased overall neurodevelopmental CNV burden in TS and OCD suggests that deletions previously associated with other neurodevelopmental disorders may also contribute to these phenotypes.
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Affiliation(s)
- Lauren M McGrath
- Massachusetts General Hospital, Boston; American University, Washington, DC; Harvard-MIT Broad Institute, Boston
| | - Dongmei Yu
- Massachusetts General Hospital, Boston; Harvard-MIT Broad Institute, Boston
| | | | | | | | - Bingbin Li
- University of Toronto and the Hospital for Sick Children, Toronto
| | | | | | | | | | | | | | | | | | | | | | | | - Cathy L Barr
- University of Toronto and the Hospital for Sick Children, Toronto; Toronto Western Research Institute, University Health Network, Toronto
| | | | | | | | | | | | - Ruth D Bruun
- North Shore-Long Island Jewish Medical Center, New Hyde Park, NY; New York University Medical Center, New York
| | - Cathy L Budman
- North Shore-Long Island Jewish Medical Center, New Hyde Park, NY; Hofstra University School of Medicine, Hempstead, NY
| | - Beatriz Camarena
- Instituto Nacional de Psiquiatría Ramon de la Fuente Muñiz, Mexico
| | | | | | | | | | | | - Richard Delorme
- Robert Debre University Hospital, Paris and the French National Science Foundation, Creteil, France; Institut Pasteur, Paris
| | - Damiaan Denys
- Netherlands Institute for Neuroscience, Amsterdam; Academic Medical Center, Amsterdam
| | | | | | | | | | | | | | | | - Helena Garrido
- Hospital Nacional de Niños, San Jose, Costa Rica; Clinica Herrera Amighetti, Avenida Escazú, San José, Costa Rica
| | | | - Hans J Grabe
- University Medicine Greifswald, Greifswald, Germany
| | | | | | | | | | | | | | | | | | | | | | | | | | | | - Marion Leboyer
- Robert Debre University Hospital, Paris and the French National Science Foundation, Creteil, France; Institut Mondor de Recherche Biomédicale, Créteil, France
| | | | | | | | - Thomas L Lowe
- University of California at San Francisco School of Medicine
| | | | | | | | | | | | - Dennis L Murphy
- National Institute of Mental Health (NIMH) Intramural Research Program, Bethesda, MD
| | | | - Benjamin M Neale
- Massachusetts General Hospital, Boston; Harvard-MIT Broad Institute, Boston
| | - Erika Nurmi
- University of California, Los Angeles (UCLA) School of Medicine
| | | | | | | | - John Piacentini
- University of California, Los Angeles (UCLA) School of Medicine
| | | | | | - Victor I Reus
- University of California at San Francisco School of Medicine
| | - Margaret A Richter
- University of Toronto and the Hospital for Sick Children, Toronto; Sunnybrook Health Sciences Centre, Toronto
| | - Mark Riddle
- Johns Hopkins University School of Medicine, Baltimore
| | | | | | | | | | - Aline S Sampaio
- Federal University of São Paulo; Universidade Federal da Bahia, Salvador, Bahia, Brazil
| | - Jack Samuels
- Johns Hopkins University School of Medicine, Baltimore
| | - Paul Sandor
- University of Toronto and the Hospital for Sick Children, Toronto; Toronto Western Research Institute, University Health Network, Toronto
| | - Brooke Sheppard
- University of California at San Francisco School of Medicine
| | | | - Jan H Smit
- VU Amsterdam and Erasmus University Medical Centre, Rotterdam; VU University Amsterdam; VU Medical Center, Amsterdam
| | | | | | | | | | | | - Ying Wang
- Johns Hopkins University School of Medicine, Baltimore
| | - Jens R Wendland
- National Institute of Mental Health (NIMH) Intramural Research Program, Bethesda, MD
| | - Yin Yao Shugart
- National Institute of Mental Health (NIMH) Intramural Research Program, Bethesda, MD
| | | | | | - Ben A Oostra
- Erasmus Medical Center Rotterdam, the Netherlands
| | | | | | | | - Peter Heutink
- German Center for Neurodegenerative Diseases, Bonn and VU Medical Center Amsterdam
| | | | - Nelson Freimer
- University of California, Los Angeles (UCLA) School of Medicine; Semel Institute for Neuroscience and Human Behavior, UCLA
| | - Tracey Petryshen
- Massachusetts General Hospital, Boston; Harvard-MIT Broad Institute, Boston
| | | | | | | | | | | | | | - Paul D Arnold
- University of Toronto and the Hospital for Sick Children, Toronto
| | - S Evelyn Stewart
- Massachusetts General Hospital, Boston; University of British Columbia, Vancouver
| | - Carol A Mathews
- University of California at San Francisco School of Medicine
| | | | | | | | - Kai Wang
- Zilkha Neurogenetic Institute, Los Angeles
| | - Jeremiah M Scharf
- Massachusetts General Hospital, Boston; Brigham and Womens Hospital, Boston; Harvard-MIT Broad Institute, Boston.
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29
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Mojtabai R, Cullen B, Everett A, Nugent KL, Sawa A, Sharifi V, Takayanagi Y, Toroney JS, Eaton WW. Reasons for not seeking general medical care among individuals with serious mental illness. Psychiatr Serv 2014; 65:818-21. [PMID: 24733659 DOI: 10.1176/appi.ps.201300348] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The study compared delays in seeking general medical care among adults with serious mental illness and a general population sample. Associations of delays with health status and use of emergency department services among individuals with serious mental illness were also assessed. METHODS Data for 271 persons with serious mental illness (clinic sample) and 40,016 participants in the National Health Interview Survey (NHIS sample) were compared. RESULTS Fifty-three percent of the clinic sample and 13% of the NHIS sample reported delays, most because of difficulties accessing services. In the clinic sample, delays were associated with receipt of routine care at a public clinic, rather than a physician's office; more severe depressive symptoms; and functional difficulties. Delays were also associated with poorer health status and use of emergency department services. CONCLUSIONS Integration of services as envisioned in the Affordable Care Act and targeted case management may reduce delays among individuals with serious mental illness.
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30
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Samuels J, Shugart YY, Wang Y, Grados MA, Bienvenu OJ, Pinto A, Rauch SL, Greenberg BD, Knowles JA, Fyer AJ, Piacentini J, Pauls DL, Cullen B, Rasmussen SA, Stewart SE, Geller DA, Maher BS, Goes FS, Murphy DL, McCracken JT, Riddle MA, Nestadt G. Clinical correlates and genetic linkage of social and communication difficulties in families with obsessive-compulsive disorder: Results from the OCD Collaborative Genetics Study. Am J Med Genet B Neuropsychiatr Genet 2014; 165B:326-36. [PMID: 24798771 DOI: 10.1002/ajmg.b.32235] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2013] [Accepted: 04/11/2014] [Indexed: 11/09/2022]
Abstract
Some individuals with obsessive-compulsive disorder (OCD) have autistic-like traits, including deficits in social and communication behaviors (pragmatics). The objective of this study was to determine if pragmatic impairment aggregates in OCD families and discriminates a clinically and genetically distinct subtype of OCD. We conducted clinical examinations on, and collected DNA samples from, 706 individuals with OCD in 221 multiply affected OCD families. Using the Pragmatic Rating Scale (PRS), we compared the prevalence of pragmatic impairment in OCD-affected relatives of probands with and without pragmatic impairment. We also compared clinical features of OCD-affected individuals in families having at least one, versus no, individual with pragmatic impairment, and assessed for linkage to OCD in the two groups of families. The odds of pragmatic impairment were substantially greater in OCD-affected relatives of probands with pragmatic impairment. Individuals in high-PRS families had greater odds of separation anxiety disorder and social phobia, and a greater number of schizotypal personality traits. In high-PRS families, there was suggestive linkage to OCD on chromosome 12 at marker D12S1064 and on chromosome X at marker DXS7132 whereas, in low-PRS families, there was suggestive linkage to chromosome 3 at marker D3S2398. Pragmatic impairment aggregates in OCD families. Separation anxiety disorder, social phobia, and schizotypal personality traits are part of a clinical spectrum associated with pragmatic impairment in these families. Specific regions of chromosomes 12 and X are linked to OCD in high-PRS families. Thus, pragmatic impairment may distinguish a clinically and genetically homogeneous subtype of OCD.
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Affiliation(s)
- Jack Samuels
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Clarke DE, Wilcox HC, Miller L, Cullen B, Gerring J, Greiner LH, Newcomer A, McKitty MV, Regier DA, Narrow WE. Feasibility and acceptability of the DSM-5 Field Trial procedures in the Johns Hopkins Community Psychiatry Programs. Int J Methods Psychiatr Res 2014; 23:267-78. [PMID: 24615761 PMCID: PMC4047142 DOI: 10.1002/mpr.1419] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2013] [Revised: 05/31/2013] [Accepted: 06/03/2013] [Indexed: 11/11/2022] Open
Abstract
The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) contains criteria for psychiatric diagnoses that reflect advances in the science and conceptualization of mental disorders and address the needs of clinicians. DSM-5 also recommends research on dimensional measures of cross-cutting symptoms and diagnostic severity, which are expected to better capture patients' experiences with mental disorders. Prior to its May 2013 release, the American Psychiatric Association (APA) conducted field trials to examine the feasibility, clinical utility, reliability, and where possible, the validity of proposed DSM-5 diagnostic criteria and dimensional measures. The methods and measures proposed for the DSM-5 field trials were pilot tested in adult and child/adolescent clinical samples, with the goal to identify and correct design and procedural problems with the proposed methods before resources were expended for the larger DSM-5 Field Trials. Results allowed for the refinement of the protocols, procedures, and measures, which facilitated recruitment, implementation, and completion of the DSM-5 Field Trials. These results highlight the benefits of pilot studies in planning large multisite studies.
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Affiliation(s)
- Diana E Clarke
- American Psychiatric Association, Division of Research, Arlington, VA, USA; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
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Paksarian D, Mojtabai R, Kotov R, Cullen B, Nugent KL, Bromet EJ. Perceived trauma during hospitalization and treatment participation among individuals with psychotic disorders. Psychiatr Serv 2014; 65:266-9. [PMID: 24492906 PMCID: PMC4039016 DOI: 10.1176/appi.ps.201200556] [Citation(s) in RCA: 51] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
UNLABELLED OBJECTIVE; This study assessed the association of perceptions of traumatic experiences during psychiatric hospitalizations and treatment participation. METHODS Participants (N=395) in the Suffolk County Mental Health Project, who had been admitted for the first time for a psychotic disorder ten years earlier, were interviewed. The authors examined associations of perceived trauma and distressing or coercive experiences during hospitalizations in the past ten years with patient characteristics and treatment participation. RESULTS Sixty-nine percent of participants reported perceived trauma. Perceived trauma was more common among females versus males and homemakers versus full-time workers. It was not associated with treatment seeking or time in treatment. However, reporting forced medication was associated with reduced time in treatment, especially for persons with schizophrenia spectrum disorders. CONCLUSIONS Although perceptions of trauma during psychiatric hospitalization were common, they may be unrelated to treatment participation. However, there was modest evidence of a link between coercive experiences and reduced treatment time.
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33
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La Flair LN, Reboussin BA, Storr CL, Letourneau E, Green KM, Mojtabai R, Pacek LR, Alvanzo AA, Cullen B, Crum RM. Childhood abuse and neglect and transitions in stages of alcohol involvement among women: a latent transition analysis approach. Drug Alcohol Depend 2013; 132:491-8. [PMID: 23639389 PMCID: PMC3770786 DOI: 10.1016/j.drugalcdep.2013.03.012] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2012] [Revised: 03/13/2013] [Accepted: 03/14/2013] [Indexed: 10/26/2022]
Abstract
BACKGROUND Childhood abuse and neglect have been linked with alcohol disorders in adulthood yet less is known about the potential of early trauma to influence transitions in stages of alcohol involvement among women. Study aims were to (1) identify stages of women's alcohol involvement, (2) examine the probability of transitions between stages, and (3) investigate the influence of four domains of childhood abuse and neglect (sexual abuse, physical abuse, neglect, and witness to domestic violence), assessed individually and as poly-victimization, on transitions. METHODS The sample consisted of 11,750 adult female current drinkers identified in Wave 1 (2001-2002) and re-interviewed in Wave 2 (2004-2005) of the National Epidemiological Survey on Alcohol and Related Conditions. RESULTS Three stages of alcohol involvement emerged from latent class analysis of 11 DSM-IV abuse/dependence criteria: severe (1.5% at Wave 1, 1.9% at Wave 2), hazardous (13.6% at Wave 1, 16.0% at Wave 2), and non-problem drinking (82.1% at Wave 1, 84.5% at Wave 2). Adjusted latent transition analyses determined transition probabilities between stages across waves. Women reporting any childhood abuse and neglect were more likely to advance from the non-problem drinking class at Wave 1 to severe (AOR=3.90, 95% CI=1.78-8.53) and hazardous (AOR=1.56, 95% CI=1.22-2.01) drinking classes at Wave 2 relative to women without this history. Associations were also observed between individual domains and transition from no problems to severe alcohol stage. CONCLUSIONS Results suggest a long-term impact of childhood abuse and neglect as drivers of progression in women's alcohol involvement.
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Affiliation(s)
- Lareina N. La Flair
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, 624 N. Broadway, Hampton House 894, Baltimore, MD 21205, USA,Corresponding author. Tel.: +1 410 302 3899; fax: +1 410 614 7469. (LN. La Flair)
| | - Beth A. Reboussin
- Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, NC 27157, USA
| | - Carla L. Storr
- Department of Family and Community Health, University of Maryland School of Nursing, Baltimore, MD 21201, USA,Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Elizabeth Letourneau
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Kerry M. Green
- Department of Behavioral and Community Health, University of Maryland School of Public Health, College Park, MD 20742, USA
| | - Ramin Mojtabai
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Lauren R. Pacek
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
| | - Anika A.H. Alvanzo
- Division of General Internal Medicine, Johns Hopkins University School of Medicine, 1830 East Monument Street, Room 8047a, Baltimore, MD 21205, USA
| | - Bernadette Cullen
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Rosa M. Crum
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA,Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA
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34
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Stewart SE, Yu D, Scharf JM, Neale BM, Fagerness JA, Mathews CA, Arnold PD, Evans PD, Gamazon ER, Osiecki L, McGrath L, Haddad S, Crane J, Hezel D, Illman C, Mayerfeld C, Konkashbaev A, Liu C, Pluzhnikov A, Tikhomirov A, Edlund CK, Rauch SL, Moessner R, Falkai P, Maier W, Ruhrmann S, Grabe HJ, Lennertz L, Wagner M, Bellodi L, Cavallini MC, Richter MA, Cook EH, Kennedy JL, Rosenberg D, Stein DJ, Hemmings SMJ, Lochner C, Azzam A, Chavira DA, Fournier E, Garrido H, Sheppard B, Umaña P, Murphy DL, Wendland JR, Veenstra-VanderWeele J, Denys D, Blom R, Deforce D, Van Nieuwerburgh F, Westenberg HGM, Walitza S, Egberts K, Renner T, Miguel EC, Cappi C, Hounie AG, Conceição do Rosário M, Sampaio AS, Vallada H, Nicolini H, Lanzagorta N, Camarena B, Delorme R, Leboyer M, Pato CN, Pato MT, Voyiaziakis E, Heutink P, Cath DC, Posthuma D, Smit JH, Samuels J, Bienvenu OJ, Cullen B, Fyer AJ, Grados MA, Greenberg BD, McCracken JT, Riddle MA, Wang Y, Coric V, Leckman JF, Bloch M, Pittenger C, Eapen V, Black DW, Ophoff RA, Strengman E, Cusi D, Turiel M, Frau F, Macciardi F, Gibbs JR, Cookson MR, Singleton A, Hardy J, Crenshaw AT, Parkin MA, Mirel DB, Conti DV, Purcell S, Nestadt G, Hanna GL, Jenike MA, Knowles JA, Cox N, Pauls DL, Pauls DL. Genome-wide association study of obsessive-compulsive disorder. Mol Psychiatry 2013; 18:788-98. [PMID: 22889921 PMCID: PMC4218751 DOI: 10.1038/mp.2012.85] [Citation(s) in RCA: 214] [Impact Index Per Article: 19.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/04/2012] [Revised: 05/03/2012] [Accepted: 05/07/2012] [Indexed: 02/07/2023]
Abstract
Obsessive-compulsive disorder (OCD) is a common, debilitating neuropsychiatric illness with complex genetic etiology. The International OCD Foundation Genetics Collaborative (IOCDF-GC) is a multi-national collaboration established to discover the genetic variation predisposing to OCD. A set of individuals affected with DSM-IV OCD, a subset of their parents, and unselected controls, were genotyped with several different Illumina SNP microarrays. After extensive data cleaning, 1465 cases, 5557 ancestry-matched controls and 400 complete trios remained, with a common set of 469,410 autosomal and 9657 X-chromosome single nucleotide polymorphisms (SNPs). Ancestry-stratified case-control association analyses were conducted for three genetically-defined subpopulations and combined in two meta-analyses, with and without the trio-based analysis. In the case-control analysis, the lowest two P-values were located within DLGAP1 (P=2.49 × 10(-6) and P=3.44 × 10(-6)), a member of the neuronal postsynaptic density complex. In the trio analysis, rs6131295, near BTBD3, exceeded the genome-wide significance threshold with a P-value=3.84 × 10(-8). However, when trios were meta-analyzed with the case-control samples, the P-value for this variant was 3.62 × 10(-5), losing genome-wide significance. Although no SNPs were identified to be associated with OCD at a genome-wide significant level in the combined trio-case-control sample, a significant enrichment of methylation QTLs (P<0.001) and frontal lobe expression quantitative trait loci (eQTLs) (P=0.001) was observed within the top-ranked SNPs (P<0.01) from the trio-case-control analysis, suggesting these top signals may have a broad role in gene expression in the brain, and possibly in the etiology of OCD.
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Affiliation(s)
- S Evelyn Stewart
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics
Research, Harvard Medical School, Boston, Massachusetts, USA,Department of Psychiatry, Massachusetts General Hospital, Boston,
Massachusetts, USA,British Columbia Mental Health and Addictions Research Institute, University
of British Columbia, Vancouver, BC, Canada
| | - Dongmei Yu
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics
Research, Harvard Medical School, Boston, Massachusetts, USA,Department of Psychiatry, Massachusetts General Hospital, Boston,
Massachusetts, USA
| | - Jeremiah M Scharf
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics
Research, Harvard Medical School, Boston, Massachusetts, USA,Department of Psychiatry, Massachusetts General Hospital, Boston,
Massachusetts, USA,Department of Neurology, Massachusetts General Hospital, Boston,
Massachusetts, USA,Department of Neurology, Brigham and Women's Hospital, Boston,
Massachusetts,, USA,Program in Medical and Population Genetics, Broad Institute of Harvard and
MIT, Cambridge MA
| | - Benjamin M Neale
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics
Research, Harvard Medical School, Boston, Massachusetts, USA,Analytic and Translational Genetics Unit, Massachusetts General Hospital,
Boston Massachusetts, USA,Program in Medical and Population Genetics, Broad Institute of Harvard and
MIT, Cambridge MA
| | - Jesen A Fagerness
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics
Research, Harvard Medical School, Boston, Massachusetts, USA,Department of Psychiatry, Massachusetts General Hospital, Boston,
Massachusetts, USA
| | - Carol A Mathews
- Department of Psychiatry, University of California, San Francisco, USA
| | - Paul D Arnold
- Program in Genetics and Genome Biology, The Hospital for Sick Children,
Toronto, Ontario, Canada,Department of Psychiatry, University of Toronto, Toronto, Ontario,
Canada
| | - Patrick D Evans
- Section of Genetic Medicine, Department of Medicine, University of Chicago,
Chicago, Illinois, USA
| | - Eric R Gamazon
- Section of Genetic Medicine, Department of Medicine, University of Chicago,
Chicago, Illinois, USA
| | - Lisa Osiecki
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics
Research, Harvard Medical School, Boston, Massachusetts, USA,Department of Psychiatry, Massachusetts General Hospital, Boston,
Massachusetts, USA
| | - Lauren McGrath
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics
Research, Harvard Medical School, Boston, Massachusetts, USA,Department of Psychiatry, Massachusetts General Hospital, Boston,
Massachusetts, USA
| | - Stephen Haddad
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics
Research, Harvard Medical School, Boston, Massachusetts, USA,Department of Psychiatry, Massachusetts General Hospital, Boston,
Massachusetts, USA
| | - Jacquelyn Crane
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics
Research, Harvard Medical School, Boston, Massachusetts, USA,Department of Psychiatry, Massachusetts General Hospital, Boston,
Massachusetts, USA
| | - Dianne Hezel
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics
Research, Harvard Medical School, Boston, Massachusetts, USA,Department of Psychiatry, Massachusetts General Hospital, Boston,
Massachusetts, USA
| | - Cornelia Illman
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics
Research, Harvard Medical School, Boston, Massachusetts, USA,Department of Psychiatry, Massachusetts General Hospital, Boston,
Massachusetts, USA
| | - Catherine Mayerfeld
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics
Research, Harvard Medical School, Boston, Massachusetts, USA,Department of Psychiatry, Massachusetts General Hospital, Boston,
Massachusetts, USA
| | - Anuar Konkashbaev
- Section of Genetic Medicine, Department of Medicine, University of Chicago,
Chicago, Illinois, USA
| | - Chunyu Liu
- Department of Psychiatry, University of Chicago, Chicago, IL, USA
| | - Anna Pluzhnikov
- Section of Genetic Medicine, Department of Medicine, University of Chicago,
Chicago, Illinois, USA
| | - Anna Tikhomirov
- Section of Genetic Medicine, Department of Medicine, University of Chicago,
Chicago, Illinois, USA
| | - Christopher K Edlund
- Department of Preventative Medicine, Division of Biostatistics, Keck School
of Medicine, Zilkha Neurogenetic Institute, University of Southern California, Los Angeles,
California, USA,Epigenome Center, Keck School of Medicine, University of Southern
California, Los Angeles, California, USA
| | - Scott L Rauch
- Partners Psychiatry and McLean Hospital, Boston, Massachusetts, USA
| | - Rainald Moessner
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn,
Germany
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University of
Göttingen, Göttingen, Germany
| | - Wolfgang Maier
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn,
Germany
| | - Stephan Ruhrmann
- Department of Psychiatry and Psychotherapy, University of Cologne, Cologne,
Germany
| | - Hans-Jörgen Grabe
- Department of Psychiatry and Psychotherapy, Helios-Hospital Stralsund,
University Medicine Greifswald, Greifswald, Germany
| | - Leonard Lennertz
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn,
Germany
| | - Michael Wagner
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn,
Germany
| | - Laura Bellodi
- Psychiatry Universita Vita-Salute San Raffaele, Milano Italy
| | | | - Margaret A Richter
- Department of Psychiatry, University of Toronto, Toronto, Ontario,
Canada,Department of Psychiatry, Sunnybrook Health Sciences Centre, Toronto,
Ontario
| | - Edwin H Cook
- Institute for Juvenile Research, Department of Psychiatry, University of
Illinois at Chicago, USA
| | - James L Kennedy
- Department of Psychiatry, University of Toronto, Toronto, Ontario,
Canada,Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - David Rosenberg
- Child Psychiatry and Psychology, Wayne State University, Detroit, Michigan,
USA,Children's Hospital of Michigan, Detroit, Michigan, USA
| | - Dan J Stein
- University of Cape Town, Cape Town, South Africa
| | | | | | - Amin Azzam
- Department of Psychiatry, University of California, San Francisco, USA
| | - Denise A Chavira
- Department of Psychiatry, University of California, San Diego, La Jolla,
California, USA
| | | | | | - Brooke Sheppard
- Department of Psychiatry, University of California, San Francisco, USA
| | - Paul Umaña
- Hospital Nacional de Niños, San José, Costa Rica
| | - Dennis L Murphy
- Laboratory of Clinical Science, NIMH Intramural Research Program, Bethesda,
MD, USA
| | - Jens R Wendland
- Laboratory of Clinical Science, NIMH Intramural Research Program, Bethesda,
MD, USA,CNS Clinical Biomarker Group, Pharma Research and Early Development, F.
Hoffmann-La Roche Ltd., Basel, Switzerland
| | - Jeremy Veenstra-VanderWeele
- Departments of Psychiatry, Pediatrics, and Pharmacology, Kennedy Center for
Research on Human Development, and Brain Institute, Vanderbilt University, Nashville,
Tennessee, USA
| | - Damiaan Denys
- Department of Psychiatry, Academic Medical Center and Netherlands Institute
for Neuroscience, an Institute of the Royal Netherlands Academy of Arts and Sciences
(NIN-KNAW), Amsterdam, The Netherlands
| | - Rianne Blom
- Department of Psychiatry, Academic Medical Center and Netherlands Institute
for Neuroscience, an Institute of the Royal Netherlands Academy of Arts and Sciences
(NIN-KNAW), Amsterdam, The Netherlands
| | - Dieter Deforce
- Laboratory of Pharmaceutical Biotechnology, Ghent University, Ghent,
Belgium
| | | | - Herman GM Westenberg
- Department of Psychiatry, Academic Medical Center and Netherlands Institute
for Neuroscience, an Institute of the Royal Netherlands Academy of Arts and Sciences
(NIN-KNAW), Amsterdam, The Netherlands
| | - Susanne Walitza
- Department of Child and Adolescent Psychiatry, University of Zurich,
Switzerland
| | - Karin Egberts
- Department of Child and Adolescent Psychiatry, Psychosomatics and
Psychotherapy, University of Würzburg, Germany
| | - Tobias Renner
- Department of Child and Adolescent Psychiatry, Psychosomatics and
Psychotherapy, University of Würzburg, Germany
| | | | - Carolina Cappi
- Department of Psychiatry, Faculdade de Medicina da Universidade de Sao
Paulo, Brazil
| | - Ana G Hounie
- Department of Psychiatry, Faculdade de Medicina da Universidade de Sao
Paulo, Brazil
| | | | - Aline S Sampaio
- Department of Psychiatry, Faculdade de Medicina da Universidade de Sao
Paulo, Brazil,University Health Care Services - SMURB, Federal University of Bahia,
Salvador, State of Bahia, Brazil
| | - Homero Vallada
- Department of Psychiatry, Faculdade de Medicina da Universidade de Sao
Paulo, Brazil
| | - Humberto Nicolini
- Centre for Genomic Sciences, University of Mexico City, Mexico,Carracci Medical Group, Mexico City, Mexico
| | | | - Beatriz Camarena
- Instituto Nacional de Psiquiatría Ramón de la Fuente
Muñiz, Depto. de Genética Psiquiátrica, México, D. F.,
México
| | - Richard Delorme
- AP-HP, Robert Debré Hospital, Department of Child and Adolescent
Psychiatry, Paris, France, INSERM U955,Institut Mondor de Recherche Biomédicale, Psychiatric Genetics,
Créteil, F 94000, France, Foundation Fondamental, French National Science
Foundation, France
| | - Marion Leboyer
- AP-HP, Robert Debré Hospital, Department of Child and Adolescent
Psychiatry, Paris, France, INSERM U955,Institut Mondor de Recherche Biomédicale, Psychiatric Genetics,
Créteil, F 94000, France, Foundation Fondamental, French National Science
Foundation, France
| | - Carlos N Pato
- Department of Psychiatry and The Behavioral Sciences, Zilkha Neurogenetic
Institute, Keck School of Medicine, University of Southern California, Los Angeles,
USA
| | - Michele T Pato
- Department of Psychiatry and The Behavioral Sciences, Zilkha Neurogenetic
Institute, Keck School of Medicine, University of Southern California, Los Angeles,
USA
| | - Emanuel Voyiaziakis
- Department of Psychiatry and The Behavioral Sciences, Zilkha Neurogenetic
Institute, Keck School of Medicine, University of Southern California, Los Angeles,
USA
| | - Peter Heutink
- Section of Medical Genomics, Department of Clinical Genetics, VU University
Medical Center Amsterdam, The Netherlands
| | - Danielle C Cath
- Department of Psychiatry, VU University Medical Center and Department of
Clinical and Health Psychology, Utrecht University, Utrecht, The Netherlands,Department of Psychiatry, EMGO Institute, VU University Medical Center,
Utrecht, The Netherlands
| | - Danielle Posthuma
- Section of Medical Genomics, Department of Clinical Genetics, VU University
Medical Center Amsterdam, The Netherlands
| | - Jan H Smit
- Department of Psychiatry, EMGO Institute, VU University Medical Center,
Utrecht, The Netherlands
| | - Jack Samuels
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University
School of Medicine, Baltimore, Maryland, USA
| | - O Joseph Bienvenu
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University
School of Medicine, Baltimore, Maryland, USA
| | - Bernadette Cullen
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University
School of Medicine, Baltimore, Maryland, USA
| | - Abby J Fyer
- Department of Psychiatry, College of Physicians and Surgeons at Columbia
University, New York City, New York, USA,New York State Psychiatric Institute, New York City, New York, USA
| | - Marco A Grados
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University
School of Medicine, Baltimore, Maryland, USA
| | - Benjamin D Greenberg
- Department of Psychiatry and Human Behavior, Brown Medical School, Butler
Hospital, Providence, Rhode Island, USA
| | - James T McCracken
- Department of Psychiatry and Biobehavioral Sciences, University of
California, Los Angeles, School of Medicine, California, USA
| | - Mark A Riddle
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University
School of Medicine, Baltimore, Maryland, USA
| | - Ying Wang
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University
School of Medicine, Baltimore, Maryland, USA
| | - Vladimir Coric
- Child Study Centre and Department of Psychiatry, Yale University, New
Haven, Connecticut, USA
| | - James F Leckman
- Child Study Centre, Pediatrics and Psychology, Yale University, New Haven,
Connecticut, USA
| | - Michael Bloch
- Child Study Centre and Department of Psychiatry, Yale University, New
Haven, Connecticut, USA
| | - Christopher Pittenger
- Child Study Centre and Department of Psychiatry, Yale University, New
Haven, Connecticut, USA
| | - Valsamma Eapen
- Infant, Child and Adolescent Psychiatry, University of New South Wales,
Academic Unit of Child Psychiatry, Sydney, Australia
| | - Donald W Black
- University of Iowa, Roy J. and Lucille A. Carver College of Medicine, Iowa
City, Iowa, USA
| | - Roel A Ophoff
- UCLA Center for Neurobehavioral Genetics, Los Angeles, California, USA and
University Medical Center Utrecht, Utrecht, The Netherlands
| | - Eric Strengman
- UCLA Center for Neurobehavioral Genetics, Los Angeles, California, USA and
University Medical Center Utrecht, Utrecht, The Netherlands
| | - Daniele Cusi
- Department of Medicine, Surgery and Dentistry, Graduate School of
Nephrology, University of Milano, Italy,Division of Nephrology, San Paolo Hospital, Milano, Italy
| | - Maurizio Turiel
- Department of Health Technologies, University of Milano, Italy
| | - Francesca Frau
- Department of Medicine, Surgery and Dentistry, Graduate School of
Nephrology, University of Milano, Italy,Filarete Foundation, Milano, Italy
| | - Fabio Macciardi
- Department of Psychiatry and Human Behavior, School of Medicine, University
of California Irvine (UCI), California, USA
| | - J Raphael Gibbs
- Laboratory of Neurogenetics, National Institute on Aging, National
Institutes of Health, Bethesda, Maryland, USA
| | - Mark R Cookson
- Laboratory of Neurogenetics, National Institute on Aging, National
Institutes of Health, Bethesda, Maryland, USA
| | - Andrew Singleton
- Laboratory of Neurogenetics, National Institute on Aging, National
Institutes of Health, Bethesda, Maryland, USA
| | | | - John Hardy
- Department of Molecular Neuroscience, University College of London,
Institute of Neurology, Queen Square, London, UK
| | | | | | | | | | - David V Conti
- Department of Preventative Medicine, Division of Biostatistics, Keck School
of Medicine, Zilkha Neurogenetic Institute, University of Southern California, Los Angeles,
California, USA,Epigenome Center, Keck School of Medicine, University of Southern
California, Los Angeles, California, USA
| | - Shaun Purcell
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics
Research, Harvard Medical School, Boston, Massachusetts, USA,Department of Psychiatry, Massachusetts General Hospital, Boston,
Massachusetts, USA,Department of Neurology, Brigham and Women's Hospital, Boston,
Massachusetts,, USA,The Broad Institute of Harvard-MIT, Cambridge, MA, USA
| | - Gerald Nestadt
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University
School of Medicine, Baltimore, Maryland, USA
| | - Gregory L Hanna
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Michael A Jenike
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics
Research, Harvard Medical School, Boston, Massachusetts, USA,Department of Psychiatry, Massachusetts General Hospital, Boston,
Massachusetts, USA
| | - James A Knowles
- Department of Psychiatry and The Behavioral Sciences, Zilkha Neurogenetic
Institute, Keck School of Medicine, University of Southern California, Los Angeles,
USA
| | - Nancy Cox
- Section of Genetic Medicine, Department of Medicine, University of Chicago,
Chicago, Illinois, USA
| | - David L Pauls
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics
Research, Harvard Medical School, Boston, Massachusetts, USA,Department of Psychiatry, Massachusetts General Hospital, Boston,
Massachusetts, USA,Corresponding Authors: Dr. S. Evelyn Stewart, Department of
Psychiatry, University of British Columbia, Vancouver, BC, Canada, V5Z 4H4, Tel: (604)
875-2000 ext. 4725; Fax: (604) 875-3871; ; Dr. David
L. Pauls, Psychiatric and Neurodevelopmental Genetics Unit, Center for Human Genetics
Research, Massachusetts General Hospital, Boston, MA 02114. Tel: (617) 726-0793; Fax:
(617) 726-0830;
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Stewart SE, Mayerfeld C, Arnold PD, Crane JR, O'Dushlaine C, Fagerness JA, Yu D, Scharf JM, Chan E, Kassam F, Moya PR, Wendland JR, Delorme R, Richter MA, Kennedy JL, Veenstra-VanderWeele J, Samuels J, Greenberg BD, McCracken JT, Knowles JA, Fyer AJ, Rauch SL, Riddle MA, Grados MA, Bienvenu OJ, Cullen B, Wang Y, Shugart YY, Piacentini J, Rasmussen S, Nestadt G, Murphy DL, Jenike MA, Cook EH, Pauls DL, Hanna GL, Mathews CA. Meta-analysis of association between obsessive-compulsive disorder and the 3' region of neuronal glutamate transporter gene SLC1A1. Am J Med Genet B Neuropsychiatr Genet 2013; 162B:367-79. [PMID: 23606572 DOI: 10.1002/ajmg.b.32137] [Citation(s) in RCA: 74] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2012] [Accepted: 01/15/2013] [Indexed: 12/12/2022]
Abstract
The neuronal glutamate transporter gene SLC1A1 is a candidate gene for obsessive-compulsive disorder (OCD) based on linkage studies and convergent evidence implicating glutamate in OCD etiology. The 3' end of SLC1A1 is the only genomic region with consistently demonstrated OCD association, especially when analyzing male-only probands. However, specific allele associations have not been consistently replicated, and recent OCD genome-wide association and meta-analysis studies have not incorporated all previously associated SLC1A1 SNPs. To clarify the nature of association between SLC1A1 and OCD, pooled analysis was performed on all available relevant raw study data, comprising a final sample of 815 trios, 306 cases and 634 controls. This revealed weak association between OCD and one of nine tested SLC1A1 polymorphisms (rs301443; uncorrected P = 0.046; non-significant corrected P). Secondary analyses of male-affecteds only (N = 358 trios and 133 cases) demonstrated modest association between OCD and a different SNP (rs12682807; uncorrected P = 0.012; non-significant corrected P). Findings of this meta-analysis are consistent with the trend of previous candidate gene studies in psychiatry and do not clarify the putative role of SLC1A1 in OCD pathophysiology. Nonetheless, it may be important to further examine the potential associations demonstrated in this amalgamated sample, especially since the SNPs with modest associations were not included in the more highly powered recent GWAS or in a past meta-analysis including five SLC1A1 polymorphisms. This study underscores the need for much larger sample sizes in future genetic association studies and suggests that next-generation sequencing may be beneficial in examining the potential role of rare variants in OCD.
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Affiliation(s)
- S E Stewart
- McLean Hospital, Belmont, Massachusetts, USA.
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Abstract
BACKGROUND In the course of their work, police staff are at risk of exposure to blood and body fluids (BBF) and potentially at risk of acquiring a blood-borne viral infection. AIMS To examine levels of anxiety among Scottish police staff following an occupational exposure to BBF. METHODS Police staff who reported an incident of exposure to their occupational health (OH) provider were invited to complete a postal questionnaire about their levels of self-reported anxiety after the incident and after contact with medical services (namely, OH and accident and emergency (A&E)). RESULTS Seventy exposed individuals (66% of those invited to take part) completed a questionnaire. Participants' self-reported anxiety after the incident varied widely. Levels of anxiety reduced over time and following contact with medical services. A&E staff were more likely to be the first point of medical contact for the most anxious individuals. Pre-incident training was not associated with post-incident anxiety. CONCLUSIONS The findings suggest that contact with medical services helps to alleviate post-exposure anxieties among police staff.
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Affiliation(s)
- K Dunleavy
- Institute for Applied Social and Health Research, School of Social Science, University of the West of Scotland, High Street, Paisley PA1 2BE, UK.
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Steinwachs DM, Roter DL, Skinner EA, Lehman AF, Fahey M, Cullen B, Everett AS, Gallucci G. A web-based program to empower patients who have schizophrenia to discuss quality of care with mental health providers. Psychiatr Serv 2012. [PMID: 22211208 DOI: 10.1176/appi.ps.62.11.1296] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Abstract
OBJECTIVE This study evaluated a Web-based tool to help patients with schizophrenia communicate with clinicians about evidence-based treatments. METHODS Fifty patients used an interactive Web-based intervention featuring actors simulating a patient discussing treatment concerns (intervention group; N=24) or were shown an educational video about schizophrenia treatment before an appointment for routine follow-up care (control group; N=26). The visits were recorded and analyzed by using the Roter Interaction Analysis System. RESULTS Visits by patients in the intervention group were longer (24 versus 19 minutes, p<.05) and had a proportionately greater patient contribution to the dialogue (288 versus 229 statements, p<.05) and a smaller ratio of clinician to patient talk (1.1 versus 1.4, p<.05) compared with visits by the control group. Patients in the intervention group asked more questions about treatment (2 versus .9, p<.05), disclosed more lifestyle information (76 versus 53 statements, p<.005), and more often checked that they understood information (3.6 versus 2.1 checks, p<.05). Clinicians asked more questions about treatment (7.5 versus 5.1, p<.05) and the medical condition (7.8 versus 4.7, p<.05) to control group patients but made more statements of empathy (1.3 versus .4, p<.03) and cues of interest (48 versus 22, p<.05) with the intervention group. The patient-centeredness ratio was greater for visits by patients in the intervention group than by the control group (8.5 versus 3.2, p<.05). Patients' tone was more dominant and respectful (p<.05) and clinicians' tone was more sympathetic (p<.05) during visits by patients in the intervention. CONCLUSIONS The Web-based tool empowered persons with schizophrenia to engage more fully in a patient-centered dialogue about their treatment.
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Affiliation(s)
- Donald M Steinwachs
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
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38
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Nestadt G, Wang Y, Grados MA, Riddle MA, Greenberg BD, Knowles JA, Fyer AJ, McCracken JT, Rauch SL, Murphy DL, Rasmussen SA, Cullen B, Piacentini J, Geller D, Pauls D, Bienvenu OJ, Chen Y, Liang KY, Goes FS, Maher B, Pulver AE, Shugart YY, Valle D, Samuels JF, Chang YC. Homeobox genes in obsessive-compulsive disorder. Am J Med Genet B Neuropsychiatr Genet 2012; 159B:53-60. [PMID: 22095678 PMCID: PMC3250212 DOI: 10.1002/ajmg.b.32001] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2011] [Accepted: 10/20/2011] [Indexed: 11/07/2022]
Abstract
BACKGROUND Despite evidence that obsessive-compulsive disorder (OCD) is a familial neuropsychiatric condition, progress aimed at identifying genetic determinants of the disorder has been slow. The OCD Collaborative Genetics Study (OCGS) has identified several OCD susceptibility loci through linkage analysis. METHODS In this study we investigate two regions on chromosomes 15q and 1q by first refining the linkage region using additional short tandem repeat polymorphic (STRP) markers. We then performed association analysis on single nucleotide polymorphisms (SNP) genotyped (markers placed every 2-4 kb) in the linkage regions in the OCGS sample of 376 rigorously phenotyped affected families. RESULTS Three SNPs are most strongly associated with OCD: rs11854486 (P = 0.00005 [0.046 after adjustment for multiple tests]; genetic relative risk (GRR) = 11.1 homozygous and 1.6 heterozygous) and rs4625687 [P = 0.00007 (after adjustment = 0.06); GRR = 2.4] on 15q; and rs4387163 (P = 0.0002 (after adjustment = 0.08); GRR = 1.97) on 1q. The first SNP is adjacent to NANOGP8, the second SNP is in MEIS2, and the third is 150 kb between PBX1 and LMX1A. CONCLUSIONS All the genes implicated by association signals are homeobox genes and are intimately involved in neurodevelopment. PBX1 and MEIS2 exert their effects by the formation of a heterodimeric complex, which is involved in development of the striatum, a brain region involved in the pathophysiology of OCD. NANOGP8 is a retrogene of NANOG, a homeobox transcription factor known to be involved in regulation of neuronal development. These findings need replication; but support the hypothesis that genes involved in striatal development are implicated in the pathogenesis of OCD.
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Affiliation(s)
- G Nestadt
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, Maryland 21287, USA.
| | - Y Wang
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University
| | - MA Grados
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University
| | - MA Riddle
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University
| | - BD Greenberg
- Department of Psychiatry and Human Behavior, Brown Medical School, Butler Hospital
| | - JA Knowles
- Department of Psychiatry, Keck Medical School, University of Southern California
| | - AJ Fyer
- College of Physicians and Surgeons at Columbia University
| | - JT McCracken
- Department of Psychiatry and Biobehavioral Sciences, School of Medicine, University of California, Los Angeles
| | - SL Rauch
- Departments of Psychiatry and Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital and Harvard Medical School
| | - DL Murphy
- Laboratory of Clinical Science, NIMH, NIH, Bethesda
| | - SA Rasmussen
- Department of Psychiatry and Human Behavior, Brown Medical School, Butler Hospital
| | - B Cullen
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University
| | - J Piacentini
- Department of Psychiatry and Biobehavioral Sciences, School of Medicine, University of California, Los Angeles
| | - D Geller
- Departments of Psychiatry and Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital and Harvard Medical School
| | - D Pauls
- Departments of Psychiatry and Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital and Harvard Medical School
| | - OJ Bienvenu
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University
| | - Y Chen
- Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University
| | - KY Liang
- Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University
| | - FS Goes
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University
| | - B Maher
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University
| | - AE Pulver
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University
| | - Y Y Shugart
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
,Genomic Research Branch, Division of Neuroscience and Basic Behavioral Science, National Institute of Mental Health, National Institutes of Health, Bethesda, MD
| | - D Valle
- Department of Pediatrics, School of Medicine, Johns Hopkins University
| | - JF Samuels
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University
| | - YC Chang
- Department of Medicine, University of Maryland School of Medicine
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Steinwachs DM, Roter DL, Skinner EA, Lehman AF, Fahey M, Cullen B, Everett AS, Gallucci G. A web-based program to empower patients who have schizophrenia to discuss quality of care with mental health providers. Psychiatr Serv 2011; 62:1296-302. [PMID: 22211208 PMCID: PMC3255477 DOI: 10.1176/ps.62.11.pss6211_1296] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This study evaluated a Web-based tool to help patients with schizophrenia communicate with clinicians about evidence-based treatments. METHODS Fifty patients used an interactive Web-based intervention featuring actors simulating a patient discussing treatment concerns (intervention group; N=24) or were shown an educational video about schizophrenia treatment before an appointment for routine follow-up care (control group; N=26). The visits were recorded and analyzed by using the Roter Interaction Analysis System. RESULTS Visits by patients in the intervention group were longer (24 versus 19 minutes, p<.05) and had a proportionately greater patient contribution to the dialogue (288 versus 229 statements, p<.05) and a smaller ratio of clinician to patient talk (1.1 versus 1.4, p<.05) compared with visits by the control group. Patients in the intervention group asked more questions about treatment (2 versus .9, p<.05), disclosed more lifestyle information (76 versus 53 statements, p<.005), and more often checked that they understood information (3.6 versus 2.1 checks, p<.05). Clinicians asked more questions about treatment (7.5 versus 5.1, p<.05) and the medical condition (7.8 versus 4.7, p<.05) to control group patients but made more statements of empathy (1.3 versus .4, p<.03) and cues of interest (48 versus 22, p<.05) with the intervention group. The patient-centeredness ratio was greater for visits by patients in the intervention group than by the control group (8.5 versus 3.2, p<.05). Patients' tone was more dominant and respectful (p<.05) and clinicians' tone was more sympathetic (p<.05) during visits by patients in the intervention. CONCLUSIONS The Web-based tool empowered persons with schizophrenia to engage more fully in a patient-centered dialogue about their treatment.
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Affiliation(s)
- Donald M Steinwachs
- Department of Health Policy and Management, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, USA.
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Samuels J, Wang Y, Riddle MA, Greenberg BD, Fyer AJ, McCracken JT, Rauch SL, Murphy DL, Grados MA, Knowles JA, Piacentini J, Cullen B, Bienvenu OJ, Rasmussen SA, Geller D, Pauls DL, Liang KY, Shugart YY, Nestadt G. Comprehensive family-based association study of the glutamate transporter gene SLC1A1 in obsessive-compulsive disorder. Am J Med Genet B Neuropsychiatr Genet 2011; 156B:472-7. [PMID: 21445956 PMCID: PMC3082623 DOI: 10.1002/ajmg.b.31184] [Citation(s) in RCA: 69] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2010] [Accepted: 03/02/2011] [Indexed: 12/25/2022]
Abstract
SLC1A1 encodes a neuronal glutamate transporter and is a promising candidate gene for obsessive-compulsive disorder (OCD). Several independent research groups have reported significant associations between OCD and single nucleotide polymorphisms (SNPs) in this gene. Previously, we evaluated 13 SNPs in, or near, SLC1A1 and reported a strong association signal with rs301443, a SNP 7.5 kb downstream of the gene [Shugart et al. (2009); Am J Med Genet Part B 150B:886–892]. The aims of the current study were first, to further investigate this finding by saturating the region around rs301443; and second, to explore the entire gene more thoroughly with a dense panel of SNP markers. We genotyped an additional 111 SNPs in or near SLC1A1, covering from 9 kb upstream to 84 kb downstream of the gene at average spacing of 1.7 kb per SNP, and conducted family-based association analyses in 1,576 participants in 377 families.We found that none of the surrounding markers were in linkage disequilibrium with rs301443, nor were any associated with OCD. We also found that SNP rs4740788, located about 8.8 kb upstream of the gene, was associated with OCD in all families (P = 0.003) and in families with male affecteds (P = 0.002). A three-SNP haplotype (rs4740788–rs10491734–rs10491733) was associated with OCD in the total sample (P = 0.00015) and in families with male affecteds (P = 0.0007). Although of nominal statistical significance considering the number of comparisons, these findings provide further support for the involvement of SLC1A1 in the pathogenesis of OCD.
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Affiliation(s)
- Jack Samuels
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA.
| | - Ying Wang
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Mark A. Riddle
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Benjamin D. Greenberg
- Department of Psychiatry and Human Behavior, Brown Medical School, Butler Hospital, Providence, Rhode Island
| | - Abby J. Fyer
- Department of Psychiatry, College of Physicians and Surgeons at Columbia University and the New York State Psychiatric Institute, New York City, New York
| | - James T. McCracken
- Department of Psychiatry and Biobehavioral Sciences University of California, Los Angeles, School of Medicine, Los Angeles, California
| | - Scott L. Rauch
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | | | - Marco A. Grados
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - James A. Knowles
- Department of Psychiatry, University of Southern California School of Medicine, Los Angeles, California
| | - John Piacentini
- Department of Psychiatry and Biobehavioral Sciences University of California, Los Angeles, School of Medicine, Los Angeles, California
| | - Bernadette Cullen
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - O. Joseph Bienvenu
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Steven A. Rasmussen
- Department of Psychiatry and Human Behavior, Brown Medical School, Butler Hospital, Providence, Rhode Island
| | - Daniel Geller
- Department of Psychiatry, Harvard Medical School, Boston, Massachusetts
| | - David L. Pauls
- Department of Psychiatry and Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - Kung-Yee Liang
- Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Yin Y. Shugart
- Genomic Research Branch, Division of Neuroscience and Basic Behavioral Science, National Institute of Mental Health, National Institutes of Health, Bethesda, Maryland
| | - Gerald Nestadt
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland
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Mroczkowski MM, Goes FS, Riddle MA, Grados MA, Bienvenu OJ, Greenberg BD, Fyer AJ, McCracken JT, Rauch SL, Murphy DL, Knowles JA, Piacentini J, Cullen B, Rasmussen SA, Geller DA, Pauls DL, Liang KY, Nestadt G, Samuels JF. Separation anxiety disorder in OCD. Depress Anxiety 2011; 28:256-62. [PMID: 21308883 DOI: 10.1002/da.20773] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2010] [Revised: 10/26/2010] [Accepted: 10/30/2010] [Indexed: 01/15/2023] Open
Abstract
BACKGROUND A history of separation anxiety disorder (SAD) is frequently reported by patients with obsessive-compulsive disorder (OCD). The purpose of this study was to determine if there are clinical differences between OCD-affected individuals with, versus without, a history of SAD. METHODS Using data collected during the OCD Collaborative Genetic Study, we studied 470 adult OCD participants; 80 had a history of SAD, whereas 390 did not. These two groups were compared as to onset and severity of OCD, lifetime prevalence of Axis I disorders, and number of personality disorder traits. RESULTS OCD participants with a history of SAD were significantly younger than the non-SAD group (mean, 34.2 versus 42.2 years; P<.001). They had an earlier age of onset of OCD symptoms (mean, 8.0 versus 10.5 years; P<.003) and more severe OCD, as measured by the Yale-Brown Obsessive Compulsive Scale (mean, 27.5 versus 25.0; P<.005). In addition, those with a history of SAD had a significantly greater lifetime prevalence of agoraphobia (odds ratio (OR) = 2.52, 95% confidence interval (CI) = 1.4-4.6, P<.003), panic disorder (OR = 1.84, CI = 1.03-3.3 P<.04), social phobia (OR = 1.69, CI 1.01-2.8, P<.048), after adjusting for age at interview, age at onset of OCD, and OCD severity in logistic regression models. There was a strong relationship between the number of dependent personality disorder traits and SAD (adjusted OR = 1.42, CI = 1.2-1.6, P<.001). CONCLUSIONS A history of SAD is associated with anxiety disorders and dependent personality disorder traits in individuals with OCD.
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Affiliation(s)
- Megan M Mroczkowski
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 1629 Thames Street, Baltimore, MD 21287, USA
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Dunleavy K, Taylor A, Gow J, Cullen B, Roy K. Management of blood and body fluid exposures in police service staff. Occup Med (Lond) 2010; 60:540-5. [DOI: 10.1093/occmed/kqq111] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Wang Y, Adamczyk A, Shugart YY, Samuels JF, Grados MA, Greenberg BD, Knowles JA, McCracken JT, Rauch SL, Murphy DL, Rasmussen SA, Cullen B, Pinto A, Fyer AJ, Piacentini J, Pauls DL, Bienvenu OJ, Riddle M, Liang KY, Valle D, Wang T, Nestadt G. A screen of SLC1A1 for OCD-related alleles. Am J Med Genet B Neuropsychiatr Genet 2010; 153B:675-679. [PMID: 19569082 DOI: 10.1002/ajmg.b.31001] [Citation(s) in RCA: 38] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
SLC1A1, which encodes the neuronal and epithelial glutamate transporter, is a promising candidate gene for obsessive-compulsive disorder (OCD). In this study, we conducted capillary electrophoresis single-strand conformation polymorphism (CE-SSCP) screen for all 12 identified exons, including all coding regions and approximately 50 bp of flanking introns of the human SLC1A1 in 378 OCD-affected individuals. Full sequencing was completed on samples that showed an aberrant SSCP tracing for identification of the underlying sequence variants. Our aim was to determine if there are differences in the frequencies of relatively common alleles, or rare functional alleles, in 378 OCD cases and 281 ethnically matched controls. We identified one nonsynonymous coding SNP (c.490A > G, T164A) and three synonymous coding SNP (c.81G > C, A27A; c.414A > G, T138T; c.1110T > C, T370T) in case samples. We found no statistical differences in genotype and allele frequencies of common cSNPs in SLC1A1 between the OCD cases and controls. The rare variant T164A was found only in one family. Further investigation of this variant is necessary to determine whether and how it is related to OCD. There was no other evidence of significant accumulation of deleterious coding mutations in SLC1A1 in the OCD cases.
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Affiliation(s)
- Y Wang
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - A Adamczyk
- Department of Pediatrics, School of Medicine, Mckusick-Nathan Institute of Genetic Medicine, Johns Hopkins University, Baltimore, Maryland
| | - Y Y Shugart
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - J F Samuels
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - M A Grados
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - B D Greenberg
- Department of Psychiatry and Human Behavior, Brown Medical School, Butler Hospital, Providence, Rhode Island
| | - J A Knowles
- Department of Psychiatry, University of Southern California, Los Angeles, California
| | - J T McCracken
- Department of Psychiatry and Biobehavioral Sciences, School of Medicine, University of California, Los Angeles, California
| | - S L Rauch
- Department of Psychiatry and Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - D L Murphy
- Laboratory of Clinical Science, NIMH, NIH, Bethesda, Maryland
| | - S A Rasmussen
- Department of Psychiatry and Human Behavior, Brown Medical School, Butler Hospital, Providence, Rhode Island
| | - B Cullen
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - A Pinto
- Department of Psychiatry, College of Physicians and Surgeons at Columbia University, New York, New York
| | - A J Fyer
- Department of Psychiatry, College of Physicians and Surgeons at Columbia University, New York, New York
| | - J Piacentini
- Department of Psychiatry and Biobehavioral Sciences, School of Medicine, University of California, Los Angeles, California
| | - D L Pauls
- Department of Psychiatry and Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts
| | - O J Bienvenu
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - M Riddle
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, Maryland
| | - K Y Liang
- Department of Biostatistics, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - D Valle
- Department of Pediatrics, School of Medicine, Mckusick-Nathan Institute of Genetic Medicine, Johns Hopkins University, Baltimore, Maryland
| | - T Wang
- Department of Pediatrics, School of Medicine, Mckusick-Nathan Institute of Genetic Medicine, Johns Hopkins University, Baltimore, Maryland
| | - G Nestadt
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, Maryland
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Shugart YY, Wang Y, Samuels JF, Grados MA, Greenberg BD, Knowles JA, McCracken JT, Rauch SL, Murphy DL, Rasmussen SA, Cullen B, Hoehn-Saric R, Pinto A, Fyer AJ, Piacentini J, Pauls DL, Bienvenu OJ, Riddle MA, Liang KY, Nestadt G. A family-based association study of the glutamate transporter gene SLC1A1 in obsessive-compulsive disorder in 378 families. Am J Med Genet B Neuropsychiatr Genet 2009; 150B:886-92. [PMID: 19152386 DOI: 10.1002/ajmg.b.30914] [Citation(s) in RCA: 89] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
SLC1A encodes the neuronal and epithelial glutamate transporter and was previously tested as a candidate for obsessive-compulsive disorder (OCD) by several research groups. Recently, three independent research groups reported significant association findings between OCD and several genetic variants in SLC1A1. This study reports the results from a family-based association study, which examined the association between 13 single nucleotide polymorphisms (SNPs) within or in proximity to the SLC1A1 gene. Although we did not replicate association findings for those significant SNPs reported by previous studies, our study indicated a strong association signal with the SNP RS301443 (P-value = 0.000067; Bonferroni corrected P-value = 0.0167) under a dominant model, with an estimated odds ratio of 3.5 (confidence interval: 2.66-4.50). Further, we conducted single SNP analysis after stratifying the full data set by the gender status of affected in each family. The P-value for RS301443 in families with the male affected was 0.00027, and the P-value in families with female affected was 0.076. The fact that we identified a signal which was not previously reported by the other research groups may be due to differences in study designs and sample ascertainment. However, it is also possible that this significant SNP may be part of a regulator for SLC1A1, given that it is roughly 7.5 kb away from the boundary of the SLC1A1 gene. However, this potential finding needs to be validated biologically. Further functional studies in this region are planned by this research group.
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Affiliation(s)
- Y Y Shugart
- Department of Epidemiology, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland 21044, USA.
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Nestadt G, Di CZ, Riddle MA, Grados MA, Greenberg BD, Fyer AJ, McCracken JT, Rauch SL, Murphy DL, Rasmussen SA, Cullen B, Pinto A, Knowles JA, Piacentini J, Pauls DL, Bienvenu OJ, Wang Y, Liang KY, Samuels JF, Roche KB. Obsessive-compulsive disorder: subclassification based on co-morbidity. Psychol Med 2009; 39:1491-1501. [PMID: 19046474 PMCID: PMC3039126 DOI: 10.1017/s0033291708004753] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND Obsessive-compulsive disorder (OCD) is probably an etiologically heterogeneous condition. Many patients manifest other psychiatric syndromes. This study investigated the relationship between OCD and co-morbid conditions to identify subtypes. METHOD Seven hundred and six individuals with OCD were assessed in the OCD Collaborative Genetics Study (OCGS). Multi-level latent class analysis was conducted based on the presence of eight co-morbid psychiatric conditions [generalized anxiety disorder (GAD), major depression, panic disorder (PD), separation anxiety disorder (SAD), tics, mania, somatization disorders (Som) and grooming disorders (GrD)]. The relationship of the derived classes to specific clinical characteristics was investigated. RESULTS Two and three classes of OCD syndromes emerge from the analyses. The two-class solution describes lesser and greater co-morbidity classes and the more descriptive three-class solution is characterized by: (1) an OCD simplex class, in which major depressive disorder (MDD) is the most frequent additional disorder; (2) an OCD co-morbid tic-related class, in which tics are prominent and affective syndromes are considerably rarer; and (3) an OCD co-morbid affective-related class in which PD and affective syndromes are highly represented. The OCD co-morbid tic-related class is predominantly male and characterized by high conscientiousness. The OCD co-morbid affective-related class is predominantly female, has a young age at onset, obsessive-compulsive personality disorder (OCPD) features, high scores on the 'taboo' factor of OCD symptoms, and low conscientiousness. CONCLUSIONS OCD can be classified into three classes based on co-morbidity. Membership within a class is differentially associated with other clinical characteristics. These classes, if replicated, should have important implications for research and clinical endeavors.
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Affiliation(s)
- G Nestadt
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, MD 21287, USA.
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Bienvenu OJ, Wang Y, Shugart YY, Welch JM, Grados MA, Fyer AJ, Rauch SL, McCracken JT, Rasmussen SA, Murphy DL, Cullen B, Valle D, Hoehn-Saric R, Greenberg BD, Pinto A, Knowles JA, Piacentini J, Pauls DL, Liang KY, Willour VL, Riddle M, Samuels JF, Feng G, Nestadt G. Sapap3 and pathological grooming in humans: Results from the OCD collaborative genetics study. Am J Med Genet B Neuropsychiatr Genet 2009; 150B:710-20. [PMID: 19051237 PMCID: PMC10885776 DOI: 10.1002/ajmg.b.30897] [Citation(s) in RCA: 147] [Impact Index Per Article: 9.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
SAP90/PSD95-associated protein (SAPAP) family proteins are post-synaptic density (PSD) components that interact with other proteins to form a key scaffolding complex at excitatory (glutamatergic) synapses. A recent study found that mice with a deletion of the Sapap3 gene groomed themselves excessively, exhibited increased anxiety-like behaviors, and had cortico-striatal synaptic defects, all of which were preventable with lentiviral-mediated expression of Sapap3 in the striatum; the behavioral abnormalities were also reversible with fluoxetine. In the current study, we sought to determine whether variation within the human Sapap3 gene was associated with grooming disorders (GDs: pathologic nail biting, pathologic skin picking, and/or trichotillomania) and/or obsessive-compulsive disorder (OCD) in 383 families thoroughly phenotyped for OCD genetic studies. We conducted family-based association analyses using the FBAT and GenAssoc statistical packages. Thirty-two percent of the 1,618 participants met criteria for a GD, and 65% met criteria for OCD. Four of six SNPs were nominally associated (P < 0.05) with at least one GD (genotypic relative risks: 1.6-3.3), and all three haplotypes were nominally associated with at least one GD (permuted P < 0.05). None of the SNPs or haplotypes were significantly associated with OCD itself. We conclude that Sapap3 is a promising functional candidate gene for human GDs, though further work is necessary to confirm this preliminary evidence of association.
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Affiliation(s)
- O J Bienvenu
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland 21287, USA.
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Wang Y, Samuels JF, Chang YC, Grados MA, Greenberg BD, Knowles JA, McCracken JT, Rauch SL, Murphy DL, Rasmussen SA, Cullen B, Hoehn-Saric R, Pinto A, Fyer AJ, Piacentini J, Pauls DL, Bienvenu OJ, Riddle M, Shugart YY, Liang KY, Nestadt G. Gender differences in genetic linkage and association on 11p15 in obsessive-compulsive disorder families. Am J Med Genet B Neuropsychiatr Genet 2009; 150B:33-40. [PMID: 18425788 DOI: 10.1002/ajmg.b.30760] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
Several clinical and genetic studies have reported gender differences in obsessive-compulsive disorder (OCD). Previously, we conducted a linkage genome scan using multipoint allele-sharing methods to test for linkage in 219 families participating in the OCD Collaborative Genetics Study. When these families were stratified by proband's gender, suggestive linkage to chromosome 11p15 at marker D11S2362 (KAC(all) = 2.92, P = 0.00012) was detected in families with male probands, but not in the ones with female probands. We have since conducted fine mapping with a denser microsatellite marker panel in the region of 11p15, and detected a significant linkage signal at D11S4146 (KAC(all) = 5.08, P < 0.00001) in the families of male probands. Subsequently, 632 SNPs were genotyped spanning a 4.0 Mb region of the 1 LOD unit interval surrounding the linkage peak in the original families and an additional 165 families. Six SNPs were associated with OCD (P < 0.001): two SNPs were identified when all the families were included, and four SNPs only in male proband families. No SNP showed significant association with the OCD phenotype only in the families with a female proband. The results suggest a possible gender effect in the etiology of OCD.
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Affiliation(s)
- Y Wang
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, MD 21287, USA
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Wilcox HC, Grados M, Samuels J, Riddle MA, Bienvenu OJ, Pinto A, Cullen B, Wang Y, Shugart YY, Liang KY, Nestadt G. The association between parental bonding and obsessive compulsive disorder in offspring at high familial risk. J Affect Disord 2008; 111:31-9. [PMID: 18299151 DOI: 10.1016/j.jad.2008.01.025] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2007] [Revised: 01/16/2008] [Accepted: 01/30/2008] [Indexed: 12/20/2022]
Abstract
BACKGROUND The aim of the current study is to estimate the association between parenting factors derived from the Parental Bonding Instrument (PBI) and a lifetime DSM-IV diagnosis of OCD. METHOD Data were from approximately 1200 adults from 465 families assessed as part of a large family and genetic study of OCD. The association of three parenting factors, for fathers and mothers, with offspring OCD status were examined; analyses were stratified by parental OCD status and family loading for OCD (multiplex versus sporadic). RESULTS Three factors were derived by principal components factor analysis of the PBI (maternal and paternal care, overprotection and control). Maternal overprotection was associated with OCD in offspring with familial OCD (familial cases) but only if neither parent was affected with OCD, which suggests independent but additive environmental and genetic risk (OR = 5.9, 95% CI 1.2, 29.9, p = 0.031). Paternal care was a protective factor in those not at high genetic risk (sporadic cases) (OR = 0.2, 95% CI 0.0, 0.8, p = 0.027). Maternal overprotection was also associated with offspring OCD in sporadic families (OR = 2.9, 95% CI 1.3, 6.6, p = 0.012). The finding that parental overprotection and care were not associated with offspring OCD when at least one parent had OCD addressed directly the hypothesis of maternal or paternal OCD adversely impacting parenting. CONCLUSIONS This study provides evidence that aspects of parenting may contribute to the development of OCD among offspring. Prospective studies of children at risk for OCD are needed to explore the direction of causality.
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Affiliation(s)
- Holly C Wilcox
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287-7228, USA.
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Liang KY, Wang Y, Shugart YY, Grados M, Fyer AJ, Rauch S, Murphy D, McCracken J, Rasmussen S, Cullen B, Hoehn-Saric R, Greenberg B, Pinto A, Knowles J, Piacentini J, Pauls D, Bienvenu O, Riddle M, Samuels J, Nestadt G. Evidence for potential relationship between SLC1A1 and a putative genetic linkage region on chromosome 14q to obsessive-compulsive disorder with compulsive hoarding. Am J Med Genet B Neuropsychiatr Genet 2008; 147B:1000-2. [PMID: 18286588 DOI: 10.1002/ajmg.b.30713] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Obsessive-compulsive disorder (OCD) is likely a disorder involving complex genetic transmission. This suggests that multiple genetic and environmental factors are involved in its etiology. This is complicated further by the probability of genetic heterogeneity for this phenotype. In this report, we describe a preliminary approach to deal with both complexities. SLC1A1, a glutamate transporter gene on chromosome 9p, was originally proposed to be related to OCD based on two linkage studies, and subsequently association of OCD to the gene has been replicated. Additionally, genetic linkage to a subtype of OCD, compulsive hoarding, has been reported on chromosome 14q. We hypothesized that both genomic regions contribute to OCD in some instances. Using the analytic program GENEFINDER we found that conditioning linkage on chromosome 14q to a marker adjacent to SLC1A1, reduced the size of the linkage region on chromosome 14q and provided evidence for interaction between the regions on chromosomes 9p and 14q.
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Affiliation(s)
- Kung-Yee Liang
- Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
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50
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Pinto A, Greenberg BD, Grados MA, Bienvenu OJ, Samuels JF, Murphy DL, Hasler G, Stout RL, Rauch SL, Shugart YY, Pauls DL, Knowles JA, Fyer AJ, McCracken JT, Piacentini J, Wang Y, Willour VL, Cullen B, Liang KY, Hoehn-Saric R, Riddle MA, Rasmussen SA, Nestadt G. Further development of YBOCS dimensions in the OCD Collaborative Genetics study: symptoms vs. categories. Psychiatry Res 2008; 160:83-93. [PMID: 18514325 PMCID: PMC2819420 DOI: 10.1016/j.psychres.2007.07.010] [Citation(s) in RCA: 108] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/16/2006] [Revised: 05/15/2007] [Accepted: 07/11/2007] [Indexed: 11/28/2022]
Abstract
Despite progress in identifying homogeneous subphenotypes of obsessive-compulsive disorder (OCD) through factor analysis of the Yale Brown Obsessive-Compulsive Scale Symptom Checklist (YBOCS-SC), prior solutions have been limited by a reliance on presupposed symptom categories rather than discrete symptoms. Furthermore, there have been few attempts to evaluate the familiality of OCD symptom dimensions. The purpose of this study was to extend prior work by this collaborative group in category-based dimensions by conducting the first-ever exploratory dichotomous factor analysis using individual OCD symptoms, comparing these results to a refined category-level solution, and testing the familiality of derived factors. Participants were 485 adults in the six-site OCD Collaborative Genetics Study, diagnosed with lifetime OCD using semi-structured interviews. YBOCS-SC data were factor analyzed at both the individual item and symptom category levels. Factor score intraclass correlations were calculated using a subsample of 145 independent affected sib pairs. The item- and category-level factor analyses yielded nearly identical 5-factor solutions. While significant sib-sib associations were found for four of the five factors, Hoarding and Taboo Thoughts were the most robustly familial (r ICC>or=0.2). This report presents considerable converging evidence for a five-factor structural model of OCD symptoms, including separate factor analyses employing individual symptoms and symptom categories, as well as sibling concordance. The results support investigation of this multidimensional model in OCD genetic linkage studies.
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Affiliation(s)
- Anthony Pinto
- Department of Psychiatry and Human Behavior, Brown Medical School, Butler Hospital, Providence, RI 02906, USA.
| | - Benjamin D. Greenberg
- Department of Psychiatry and Human Behavior, Brown Medical School, Butler Hospital, 345 Blackstone Blvd, Providence, RI USA
| | - Marco A. Grados
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, MD USA
| | - O. Joseph Bienvenu
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, MD USA
| | - Jack F. Samuels
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, MD USA
| | - Dennis L. Murphy
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD USA
| | - Gregor Hasler
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD USA
| | | | - Scott L. Rauch
- Psychiatric Neuroimaging Research Program and The Obsessive Compulsive Disorders Program, Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Charlestown, MA USA
| | - Yin Y. Shugart
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, MD USA
| | - David L. Pauls
- Psychiatric and Neurodevelopmental Genetics Unit in the Massachusetts General Hospital and Harvard Medical School, Charlestown, MA USA
| | - James A. Knowles
- Department of Psychiatry, Keck School of Medicine, University of Southern California, Los Angeles, CA USA
| | - Abby J. Fyer
- Department of Psychiatry, College of Physicians and Surgeons at Columbia University and the New York State Psychiatric Institute, New York City, NY USA
| | - James T. McCracken
- Department of Psychiatry and Biobehavioral Sciences, University of California-Los Angeles, School of Medicine, Los Angeles, CA USA
| | - John Piacentini
- Division of Child and Adolescent Psychiatry, University of California-Los Angeles, School of Medicine, Los Angeles, CA USA
| | - Ying Wang
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, MD USA
| | - Virginia L. Willour
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, MD USA
| | - Bernadette Cullen
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, MD USA
| | - Kung-Yee Liang
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, MD USA
| | - Rudolf Hoehn-Saric
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, MD USA
| | - Mark A. Riddle
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, MD USA
| | - Steven A. Rasmussen
- Department of Psychiatry and Human Behavior, Brown Medical School, Butler Hospital, 345 Blackstone Blvd, Providence, RI USA
| | - Gerald Nestadt
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 600 N. Wolfe Street, Baltimore, MD USA
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