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Charney AW, Stahl EA, Green EK, Chen CY, Moran JL, Chambert K, Belliveau RA, Forty L, Gordon-Smith K, Lee PH, Bromet EJ, Buckley PF, Escamilla MA, Fanous AH, Fochtmann LJ, Lehrer DS, Malaspina D, Marder SR, Morley CP, Nicolini H, Perkins DO, Rakofsky JJ, Rapaport MH, Medeiros H, Sobell JL, Backlund L, Bergen SE, Juréus A, Schalling M, Lichtenstein P, Knowles JA, Burdick KE, Jones I, Jones LA, Hultman CM, Perlis R, Purcell SM, McCarroll SA, Pato CN, Pato MT, Florio AD, Craddock N, Landén M, Smoller JW, Ruderfer DM, Sklar P. Contribution of Rare Copy Number Variants to Bipolar Disorder Risk Is Limited to Schizoaffective Cases. Biol Psychiatry 2019; 86:110-119. [PMID: 30686506 PMCID: PMC6586545 DOI: 10.1016/j.biopsych.2018.12.009] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [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: 09/04/2018] [Revised: 11/13/2018] [Accepted: 12/12/2018] [Indexed: 12/27/2022]
Abstract
BACKGROUND Genetic risk for bipolar disorder (BD) is conferred through many common alleles, while a role for rare copy number variants (CNVs) is less clear. Subtypes of BD including schizoaffective disorder bipolar type (SAB), bipolar I disorder (BD I), and bipolar II disorder (BD II) differ according to the prominence and timing of psychosis, mania, and depression. The genetic factors contributing to the combination of symptoms among these subtypes are poorly understood. METHODS Rare large CNVs were analyzed in 6353 BD cases (3833 BD I [2676 with psychosis, 850 without psychosis, and 307 with unknown psychosis history], 1436 BD II, 579 SAB, and 505 BD not otherwise specified) and 8656 controls. CNV burden and a polygenic risk score (PRS) for schizophrenia were used to evaluate the relative contributions of rare and common variants to risk of BD, BD subtypes, and psychosis. RESULTS CNV burden did not differ between BD and controls when treated as a single diagnostic entity. However, burden in SAB was increased relative to controls (p = .001), BD I (p = .0003), and BD II (p = .0007). Burden and schizophrenia PRSs were increased in SAB compared with BD I with psychosis (CNV p = .0007, PRS p = .004), and BD I without psychosis (CNV p = .0004, PRS p = 3.9 × 10-5). Within BD I, psychosis was associated with increased schizophrenia PRSs (p = .005) but not CNV burden. CONCLUSIONS CNV burden in BD is limited to SAB. Rare and common genetic variants may contribute differently to risk for psychosis and perhaps other classes of psychiatric symptoms.
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Affiliation(s)
- Alexander W. Charney
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA.,Icahn Institute of Genomics and Multiscale Biology, Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA.,Friedman Brain Institute, Department of Neuroscience, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA,Department of Neurosurgery, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA
| | - Eli A. Stahl
- Icahn Institute of Genomics and Multiscale Biology, Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA
| | - Elaine K. Green
- School of Biomedical and Health Sciences, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth University, Portland Square, Plymouth, PL4 8AA, UK
| | - Chia-Yen Chen
- Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, 75 Ames Street, Cambridge, MA, 02142, USA.,Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, 185 Cambridge St., Boston, MA, 02114, USA
| | - Jennifer L. Moran
- Department of Psychiatry, Massachusetts General Hospital, 185 Cambridge St, Boston, MA, 02114, USA
| | - Kimberly Chambert
- Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, 75 Ames Street, Cambridge, MA, 02142, USA
| | - Richard A. Belliveau
- Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, 75 Ames Street, Cambridge, MA, 02142, USA
| | - Liz Forty
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff Unviersity, Hadyn Ellis Building, Maindy Road, Cardiff, CF14 4HQ, UK
| | - Katherine Gordon-Smith
- Department of Psychiatry, University of Birmingham, 25 Vincent Drive, Birmingham, B15 2FG, UK
| | - Phil H. Lee
- Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, 75 Ames Street, Cambridge, MA, 02142, USA.,Department of Psychiatry, Harvard Medical School, 77 Avenue Louis Pasteur, Boston MA 02115,Center for Human Genetic Research, Massachusetts General Hospital, 185 Cambridge St, Boston, MA, 02114, USA
| | - Evelyn J Bromet
- Department of Psychiatry, Stony Brook University, HSC, Level T-10, Room 020, Stony Brook, NY, 11794, USA
| | - Peter F Buckley
- School of Medicine, Virginia Commonwealth University, 1201 E Marshall St., Richmond, VA, 23298, USA.,Department of Psychiatry, Georgia Regents University Medical Center, 1120 15th Street, Augusta, GA, 30912, USA
| | - Michael A Escamilla
- Center of Excellence in Neuroscience, Department of Psychiatry, Texas Tech University Health Sciences Center at El Paso, 800 N. Mesa, Suite 200, El Paso, TX, 79902, USA
| | - Ayman H. Fanous
- Department of Psychiatry and the Behavioral Sciences, State University of New York, Downstate Medical Center, 450 Clarkson Ave., Brooklyn, NY, 11203, USA.,Department of Psychiatry, VA New York Harbor Healthcare System, 800 Poly Pl., Brooklyn, NY, 11209, USA
| | - Laura J Fochtmann
- Department of Psychiatry, Stony Brook University, HSC, Level T-10, Room 020, Stony Brook, NY, 11794, USA
| | - Douglas S. Lehrer
- Department of Psychiatry, Wright State University, 3640 Colonel Gleen Hwy, Dayton, OH, 45435, USA
| | - Dolores Malaspina
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA.,Icahn Institute of Genomics and Multiscale Biology, Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA.,Friedman Brain Institute, Department of Neuroscience, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA,Department of Psychiatry, New York University, 550 First Ave., New York, NY, 10016, USA
| | - Stephen R. Marder
- Semel Institute for Neuroscience, University of California, Los Angeles, 11301 Wilshire Blvd, Los Angeles, CA, 90073, USA
| | - Christopher P. Morley
- Department of Psychiatry and Behavioral Science, State University of New York, Upstate Medical University, 750 East Adams St, MIMC 200, Syracuse, NY, 13210, USA.,Department of Family Medicine, State University of New York, Upstate Medical University, 750 East Adams St, MIMC 200, Syracuse, NY, 13210, USA.,Department of Public Health and Preventive Medicine, State University of New York, Upstate Medical University, 750 East Adams St, MIMC 200, Syracuse, NY, 13210, USA
| | - Humberto Nicolini
- Center for Genomic Sciences, Universidad Autónoma de la Ciudad de México, Dr. García Diego # 168, Col. Doctores, Del., Mexico City, Mexico,Department of Psychiatry, Carracci Medical Group, 107 Carracci Street, Mexico City, Mexico
| | - Diana O. Perkins
- Department of Psychiatry, University of North Carolina at Chapel Hill, 321 S. Columbia Street, Chapel Hill, NC, 27516, USA
| | - Jeffrey J. Rakofsky
- Department of Psychiatry and Behavioral Sciences, Emory University, 101 Woodruff Circle Suite 4000, Atlanta, GA, 30322, USA
| | - Mark H. Rapaport
- Department of Psychiatry and Behavioral Sciences, Emory University, 101 Woodruff Circle Suite 4000, Atlanta, GA, 30322, USA
| | - Helena Medeiros
- Department of Psychiatry and the Behavioral Sciences, State University of New York, Downstate Medical Center, 450 Clarkson Ave., Brooklyn, NY, 11203, USA
| | - Janet L. Sobell
- Department of Psychiatry and the Behavioral Sciences, University of Southern California, Keck School of Medicine, 2250 Alcazar Street, Los Angeles, CA, 90033, USA
| | - Lena Backlund
- Department of Clinical Neuroscience, Karolinska Institutet, Vårdvägen 3, Stockholm, 11281, Sweden
| | - Sarah E. Bergen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels väg 12 A, Stockholm, 17177, Sweden
| | - Anders Juréus
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels väg 12 A, Stockholm, 17177, Sweden
| | - Martin Schalling
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Cmm (L8:00), Stockholm, 17176, Sweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels väg 12 A, Stockholm, 17177, Sweden
| | - James A. Knowles
- Department of Cell Biology, State University of New York, Downstate Medical Center, 450 Clarkson Ave., Brooklyn, NY, 11203, USA
| | - Katherine E. Burdick
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA.,Department of Psychiatry, Harvard Medical School, 77 Avenue Louis Pasteur, Boston MA 02115,Department of Psychiatry, Brigham and Women’s Hospital, 221 Longwood Ave Boston MA, 02115, USA
| | - Ian Jones
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff Unviersity, Hadyn Ellis Building, Maindy Road, Cardiff, CF14 4HQ, UK
| | - Lisa A Jones
- Department of Psychiatry, University of Birmingham, 25 Vincent Drive, Birmingham, B15 2FG, UK
| | - Christina M. Hultman
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels väg 12 A, Stockholm, 17177, Sweden
| | - Roy Perlis
- Center for Experimental Therapeutics, Massachusetts General Hospital, 185 Cambridge St, Boston, MA, 02114, USA
| | - Shaun M. Purcell
- Department of Psychiatry, Harvard Medical School, 77 Avenue Louis Pasteur, Boston MA 02115,Department of Psychiatry, Brigham and Women’s Hospital, 221 Longwood Ave Boston MA, 02115, USA
| | - Steven A. McCarroll
- Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, 75 Ames Street, Cambridge, MA, 02142, USA.,Department of Genetics, Harvard Medical School, 77 Avenue Louis Pasteur, Boston, MA, 02115, USA
| | - Carlos N. Pato
- Department of Psychiatry and the Behavioral Sciences, State University of New York, Downstate Medical Center, 450 Clarkson Ave., Brooklyn, NY, 11203, USA
| | - Michele T. Pato
- Department of Psychiatry and the Behavioral Sciences, State University of New York, Downstate Medical Center, 450 Clarkson Ave., Brooklyn, NY, 11203, USA
| | - Ariana Di Florio
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff Unviersity, Hadyn Ellis Building, Maindy Road, Cardiff, CF14 4HQ, UK.,Department of Psychiatry, University of North Carolina at Chapel Hill, 321 S. Columbia Street, Chapel Hill, NC, 27516, USA
| | - Nick Craddock
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff Unviersity, Hadyn Ellis Building, Maindy Road, Cardiff, CF14 4HQ, UK
| | - Mikael Landén
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Nobels väg 12 A, Stockholm, 17177, Sweden,Institute of neuroscience and physiology, Sahlgenska academy at the Gothenburg university, Blå Sträket 15, Gothenburg, 41345, Sweden
| | - Jordan W. Smoller
- Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, 75 Ames Street, Cambridge, MA, 02142, USA.,Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital, 185 Cambridge St., Boston, MA, 02114, USA
| | - Douglas M. Ruderfer
- Division of Genetic Medicine, Departments of Medicine, Biomedical Informatics and Psychiatry, Vanderbilt Genetics Institute, Vanderbilt University Medical Center, Nashville, TN USA
| | - Pamela Sklar
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA.,Icahn Institute of Genomics and Multiscale Biology, Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA.,Friedman Brain Institute, Department of Neuroscience, Icahn School of Medicine at Mount Sinai, One Gustave L. Levy Place, New York, NY, 10029, USA
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