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Aas M, Alameda L, Di Forti M, Quattrone D, Dazzan P, Trotta A, Ferraro L, Rodriguez V, Vassos E, Sham P, Tripoli G, Cascia CL, Barbera DL, Tarricone I, Muratori R, Berardi D, Lasalvia A, Tosato S, Szöke A, Llorca PM, Arango C, Tortelli A, de Haan L, Velthorst E, Bobes J, Bernardo M, Sanjuán J, Santos JL, Arrojo M, Del-Ben CM, Menezes PR, Selten JP, Jones PB, Jongsma HE, Kirkbride JB, Rutten BPF, van Os J, Gayer-Anderson C, Murray RM, Morgan C. Synergistic effects of childhood adversity and polygenic risk in first-episode psychosis: the EU-GEI study. Psychol Med 2023; 53:1970-1978. [PMID: 37310339 PMCID: PMC10106300 DOI: 10.1017/s0033291721003664] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [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: 04/26/2021] [Revised: 08/08/2021] [Accepted: 08/18/2021] [Indexed: 01/01/2023]
Abstract
BACKGROUND A history of childhood adversity is associated with psychotic disorder, with an increase in risk according to the number of exposures. However, it is not known why only some exposed individuals go on to develop psychosis. One possibility is pre-existing polygenic vulnerability. Here, we investigated, in the largest sample of first-episode psychosis (FEP) cases to date, whether childhood adversity and high polygenic risk scores for schizophrenia (SZ-PRS) combine synergistically to increase the risk of psychosis, over and above the effect of each alone. METHODS We assigned a schizophrenia-polygenic risk score (SZ-PRS), calculated from the Psychiatric Genomics Consortium (PGC2), to all participants in a sample of 384 FEP patients and 690 controls from the case-control component of the EU-GEI study. Only participants of European ancestry were included in the study. A history of childhood adversity was collected using the Childhood Trauma Questionnaire (CTQ). Synergistic effects were estimated using the interaction contrast ratio (ICR) [odds ratio (OR)exposure and PRS - ORexposure - ORPRS + 1] with adjustment for potential confounders. RESULTS There was some evidence that the combined effect of childhood adversities and polygenic risk was greater than the sum of each alone, as indicated by an ICR greater than zero [i.e. ICR 1.28, 95% confidence interval (CI) -1.29 to 3.85]. Examining subtypes of childhood adversities, the strongest synergetic effect was observed for physical abuse (ICR 6.25, 95% CI -6.25 to 20.88). CONCLUSIONS Our findings suggest possible synergistic effects of genetic liability and childhood adversity experiences in the onset of FEP, but larger samples are needed to increase precision of estimates.
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Affiliation(s)
- Monica Aas
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London SE5 8AF, UK
- Norment, Oslo University Hospital, Oslo, Norway
| | - Luis Alameda
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London SE5 8AF, UK
- Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program, Lausanne University Hospital (CHUV), Lausanne, Switzerland
- Instituto de Investigación Biomédica de Sevilla, Universidad de Sevilla, Seville, Spain
- Department of Psychiatry, Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Sevilla, Spain
| | - Marta Di Forti
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AE, UK
| | - Diego Quattrone
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AE, UK
| | - Paola Dazzan
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London SE5 8AF, UK
| | - Antonella Trotta
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London SE5 8AF, UK
| | - Laura Ferraro
- Biomedicine, Neuroscience and Advanced Diagnostic (BiND) Department, University of Palermo, Palermo, Italy
| | - Victoria Rodriguez
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London SE5 8AF, UK
| | - Evangelos Vassos
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London SE5 8AE, UK
| | - Pak Sham
- Department of Psychiatry, University of Hong Kong, Pok Fu Lam, Hong Kong
| | - Giada Tripoli
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London SE5 8AF, UK
- Biomedicine, Neuroscience and Advanced Diagnostic (BiND) Department, University of Palermo, Palermo, Italy
| | - Caterina La Cascia
- Biomedicine, Neuroscience and Advanced Diagnostic (BiND) Department, University of Palermo, Palermo, Italy
| | - Daniele La Barbera
- Biomedicine, Neuroscience and Advanced Diagnostic (BiND) Department, University of Palermo, Palermo, Italy
| | - Ilaria Tarricone
- Department of Medical and Surgical Science, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, 40126 Bologna, Italy
| | - Roberto Muratori
- Department of Mental Health and Pathological Addiction, Bologna Local Health Authority, Bologna, Italy
| | - Domenico Berardi
- Department of Biomedical and Neuro-motor Sciences, Psychiatry Unit, Alma Mater Studiorum Università di Bologna, 40126 Bologna, Italy
| | - Antonio Lasalvia
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
| | - Sarah Tosato
- Section of Psychiatry, Department of Neuroscience, Biomedicine and Movement Sciences, University of Verona, Piazzale L.A. Scuro 10, 37134 Verona, Italy
| | - Andrei Szöke
- INSERM U955, Equipe 15, Institut National de la Santé et de la Recherche Médicale, 94010 Créteil, France
| | - Pierre-Michel Llorca
- CMPB CHU Clermont-Ferrand, EA 7280, University Clermont Auvergne, Clermont-Ferrand, France
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM (CIBERSAM), 28007 Madrid, Spain
| | - Andrea Tortelli
- Etablissement Public de Santé Maison Blanche, 75020 Paris, France
| | - Lieuwe de Haan
- Department of Psychiatry, Early Psychosis Section, Amsterdam UMC, Location: Academic Medical Centre, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
| | - Eva Velthorst
- Department of Psychiatry, Early Psychosis Section, Amsterdam UMC, Location: Academic Medical Centre, University of Amsterdam, 1105 AZ Amsterdam, The Netherlands
- Department of Psychiatry, Icahn School of Medicine, Mount Sinai, NY, USA
| | - Julio Bobes
- Faculty of Medicine and Health Sciences – Psychiatry, Universidad de Oviedo, ISPA, INEUROPA, CIBERSAM, 33006 Oviedo, Spain
| | - Miguel Bernardo
- Barcelona Clinic Schizophrenia Unit, Hospital Clinic of Barcelona, University of Barcelona; IDIBAPS, CIBERSAM, 08036 Barcelona, Spain
| | - Julio Sanjuán
- Department of Psychiatry, School of Medicine, Universidad de Valencia, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), 46010 Valencia, Spain
| | - Jose Luis Santos
- Department of Psychiatry, Servicio de Psiquiatría Hospital ‘Virgen de la Luz’, 16002 Cuenca, Spain
| | - Manuel Arrojo
- Department of Psychiatry, Psychiatry Genetic Group, Instituto de Investigación Sanitaria de Santiago de Compostela, Complejo Hospitalario Universitario de Santiago de Compostela, 15706 Santiago de Compostela, Spain
| | - Cristina Marta Del-Ben
- Division of Psychiatry, Department of Neuroscience and Behaviour, Ribeirão Preto Medical School, University of São Paulo, São Paulo 14049-900, Brazil
| | - Paulo Rossi Menezes
- Department of Preventative Medicine, Faculdade de Medicina FMUSP, University of São Paulo, São Paulo 01246-903, Brazil
| | - Jean-Paul Selten
- Rivierduinen Institute for Mental Health Care, 2333 ZZ Leiden, The Netherlands
| | - Peter B. Jones
- Department of Psychiatry, University of Cambridge, Cambridge CB2 0SZ, UK
| | - Hannah E. Jongsma
- Psylife Group, Division of Psychiatry, University College London, London W1T 7NF, UK
| | - James B. Kirkbride
- Psylife Group, Division of Psychiatry, University College London, London W1T 7NF, UK
| | - Bart P. F. Rutten
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, 6200 MD Maastricht, The Netherlands
| | - Jim van Os
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London SE5 8AF, UK
- Department of Psychiatry and Neuropsychology, School of Mental Health and Neuroscience, South Limburg Mental Health Research and Teaching Network, Maastricht University Medical Centre, 6200 MD Maastricht, The Netherlands
| | - Charlotte Gayer-Anderson
- Health Service and Population Research, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London SE5 8AF, UK
| | - Robin M. Murray
- Department of Psychosis Studies, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London SE5 8AF, UK
| | - Craig Morgan
- Health Service and Population Research, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London SE5 8AF, UK
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