1
|
Corbeil O, Brodeur S, Courteau J, Béchard L, Huot-Lavoie M, Angelopoulos E, Di Stefano S, Marrone E, Vanasse A, Fleury MJ, Stip E, Lesage A, Joober R, Demers MF, Roy MA. Treatment with psychostimulants and atomoxetine in people with psychotic disorders: reassessing the risk of clinical deterioration in a real-world setting. Br J Psychiatry 2024; 224:98-105. [PMID: 38044665 PMCID: PMC10884826 DOI: 10.1192/bjp.2023.149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 09/18/2023] [Accepted: 10/17/2023] [Indexed: 12/05/2023]
Abstract
BACKGROUND Although attention-deficit hyperactivity disorder (ADHD) is often comorbid with schizophrenia spectrum and other psychotic disorders (SZSPD), concerns about an increased risk of psychotic events have limited its treatment with either psychostimulants or atomoxetine. AIMS To examine whether the risk of hospital admission for psychosis in people with SZSPD was increased during the year following the introduction of such medications compared with the year before. METHOD This was a retrospective cohort study using Quebec (Canada) administrative health registries, including all Quebec residents with a public prescription drug insurance plan and a diagnosis of psychotic disorder, defined by relevant ICD-9 or ICD-10 codes, who initiated either methylphenidate, amphetamines or atomoxetine, between January 2010 and December 2016, in combination with antipsychotic medication. The primary outcome was time to hospital admission for psychosis within 1 year of initiation. State sequence analysis was also used to visualise admission trajectories for psychosis in the year following initiation of these medications, compared with the previous year. RESULTS Out of 2219 individuals, 1589 (71.6%) initiated methylphenidate, 339 (15.3%) amphetamines and 291 (13.1%) atomoxetine during the study period. After adjustment, the risk of hospital admission for psychosis was decreased during the 12 months following the introduction of these medications when used in combination with antipsychotics (adjusted HR = 0.36, 95% CI 0.24-0.54; P < 0.0001). CONCLUSIONS These findings suggest that, in a real-world setting, when used concurrently with antipsychotic medication, methylphenidate, amphetamines and atomoxetine may be safer than generally believed in individuals with psychotic disorders.
Collapse
Affiliation(s)
| | - Sébastien Brodeur
- Department of Psychiatry and Neurosciences, Laval University, Quebec, Canada; and Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - Josiane Courteau
- PRIMUS Research Group, Research Centre of Sherbrooke University Hospital Center (CRCHUS), Sherbrooke, Canada
| | | | | | | | | | - Erica Marrone
- Faculty of Pharmacy, Laval University, Quebec, Canada
| | - Alain Vanasse
- PRIMUS Research Group, Research Centre of Sherbrooke University Hospital Center (CRCHUS), Sherbrooke, Canada; and Department of Family Medicine and Urgent Medicine, University of Sherbrooke, Sherbrooke, Canada
| | - Marie-Josée Fleury
- Douglas Research Centre, Douglas Mental Health University Institute, Montreal, Canada; and Department of Psychiatry, McGill University, Montreal, Canada
| | - Emmanuel Stip
- Department de Psychiatry and Addictology, University of Montreal, Montreal, Canada; and Department of Psychiatry and Behavioral Science, College of Medicine and Health Science, United Arab Emirates University, Al Ain, UAE
| | - Alain Lesage
- Department of Psychiatry and Addictology, University of Montreal, Montreal, Canada; and Research Centre, Montreal University Institute of Mental Health, Montreal, Canada
| | - Ridha Joober
- Douglas Research Centre, Douglas Mental Health University Institute, Montreal, Canada; and Department of Psychiatry, McGill University, Montreal, Canada
| | - Marie-France Demers
- Faculty of Pharmacy, Laval University, Quebec, Canada; and CERVO Research Centre, Quebec, Canada
| | - Marc-André Roy
- Department of Psychiatry and Neurosciences, Laval University, Quebec, Canada; and CERVO Research Centre, Quebec, Canada
| |
Collapse
|
2
|
Walker EF, Aberizk K, Yuan E, Bilgrami Z, Ku BS, Guest RM. Developmental perspectives on the origins of psychotic disorders: The need for a transdiagnostic approach. Dev Psychopathol 2024:1-11. [PMID: 38406831 DOI: 10.1017/s0954579424000397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/27/2024]
Abstract
Research on serious mental disorders, particularly psychosis, has revealed highly variable symptom profiles and developmental trajectories prior to illness-onset. As Dante Cicchetti pointed out decades before the term "transdiagnostic" was widely used, the pathways to psychopathology emerge in a system involving equifinality and multifinality. Like most other psychological disorders, psychosis is associated with multiple domains of risk factors, both genetic and environmental, and there are many transdiagnostic developmental pathways that can lead to psychotic syndromes. In this article, we discuss our current understanding of heterogeneity in the etiology of psychosis and its implications for approaches to conceptualizing etiology and research. We highlight the need for examining risk factors at multiple levels and to increase the emphasis on transdiagnostic developmental trajectories as a key variable associated with etiologic subtypes. This will be increasingly feasible now that large, longitudinal datasets are becoming available and researchers have access to more sophisticated analytic tools, such as machine learning, which can identify more homogenous subtypes with the ultimate goal of enhancing options for treatment and preventive intervention.
Collapse
Affiliation(s)
- Elaine F Walker
- Department of Psychology, Emory University, Atlanta, GA, USA
| | - Katrina Aberizk
- Department of Psychology, Emory University, Atlanta, GA, USA
| | - Emerald Yuan
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Zarina Bilgrami
- Department of Psychology, Emory University, Atlanta, GA, USA
| | - Benson S Ku
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - Ryan M Guest
- Department of Psychology, Emory University, Atlanta, GA, USA
| |
Collapse
|
3
|
Beyazit U, Şirin H, Uzun ME, Kuru A, Yurdakul Y, Bütün Ayhan A, Yilmaz S. Attitudes of parents of children with ADHD towards genetic testing: Data from a Turkish sample. J Genet Couns 2023. [PMID: 38126130 DOI: 10.1002/jgc4.1841] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Revised: 11/16/2023] [Accepted: 12/08/2023] [Indexed: 12/23/2023]
Abstract
This study aimed to examine the opinions of parents with children diagnosed with attention deficit/hyperactivity disorder about genetic tests. A total of 540 parents living in Turkey participated in the study face-to-face and online. A questionnaire form prepared by the researchers was used as the data collection instrument. Face-to-face data were collected in different institutions in the cities of İzmir, Bursa and Antalya, while online data were collected through Google Forms. The results revealed that parents' views on genetic testing differed according to the sex and age of the child, as well as the parents' level of education and income, and whether the parents had genetic testing during pregnancy (p < 0.05). In the analysis, it was determined that parents' knowledge and awareness levels about genetic tests were generally low, while parents who reported that they would consider having genetic tests had concerns about the storage of their DNA materials, family conflicts that could be caused by genetic tests, and the compatibility of genetic tests with their religious beliefs.
Collapse
Affiliation(s)
- Utku Beyazit
- Child Development Department, Kumluca Health Sciences Faculty, Akdeniz University, Antalya, Turkey
| | - Hande Şirin
- Child Psychiatry Department, Bursa Higher Specialization Hospital of Education and Research, University of Health Sciences, Bursa, Turkey
| | - Mehmet Erdem Uzun
- Child Psychiatry Department, Bursa Higher Specialization Hospital of Education and Research, University of Health Sciences, Bursa, Turkey
| | - Alev Kuru
- Molecular Neuroscience, Institute of Health Sciences, University of Üsküdar, İstanbul, Turkey
| | - Yeşim Yurdakul
- Child Development Department, Kumluca Health Sciences Faculty, Akdeniz University, Antalya, Turkey
| | - Aynur Bütün Ayhan
- Child Development Department, Faculty of Health Sciences, Ankara University, Ankara, Turkey
| | - Serkan Yilmaz
- Faculty of Nursery, Ankara University, Ankara, Turkey
| |
Collapse
|
4
|
Misztal MC, Tio ES, Mohan A, Felsky D. Interactions between genetic risk for 21 neurodevelopmental and psychiatric disorders and sport activity on youth mental health. Psychiatry Res 2023; 330:115550. [PMID: 37973444 DOI: 10.1016/j.psychres.2023.115550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/04/2023] [Revised: 10/06/2023] [Accepted: 10/16/2023] [Indexed: 11/19/2023]
Abstract
Childhood is a sensitive period where behavioral disturbances, determined by genetics and environmental factors including sport activity, may emerge and impact risk of mental illness in adulthood. We aimed to determine if participation in sports can mitigate genetic risk for neurodevelopmental and psychiatric disorders in youth. We analyzed 4975 unrelated European youth (ages 9-10) from the Adolescent Brain Cognitive Development Study. Our outcomes were eight Child Behavior Checklist (CBCL) scores, measured annually. Polygenic risk scores (PRSs) were calculated for 21 disorders, and sport frequency and type were summarized. PRSs and sport variables were tested for main effects and interactions against CBCL outcomes using linear models. Cross-sectionally, PRSs for attention-deficit/hyperactivity disorder and major depressive disorder were associated with increases in multiple CBCL outcomes. Participation in non-contact or team sports, as well as more frequent sport participation reduced all cross-sectional CBCL outcomes, whereas involvement in contact sports increased attention problems and rule-breaking behavior. Interactions revealed that more frequent exercise was significantly associated with less rule breaking behavior in individuals with high genetic risk for obsessive compulsive disorder. Associations with longitudinal CBCL outcomes demonstrated weaker effects. We highlight the importance of genetic context when considering sports as an intervention for early life behavioural problems.
Collapse
Affiliation(s)
- Melissa C Misztal
- The Krembil Centre for Neuroinformatics, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Earvin S Tio
- The Krembil Centre for Neuroinformatics, Centre for Addiction and Mental Health, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada
| | - Akshay Mohan
- The Krembil Centre for Neuroinformatics, Centre for Addiction and Mental Health, Toronto, ON, Canada; Centre for Industrial Relations and Human Resources, University of Toronto, Toronto, ON, Canada
| | - Daniel Felsky
- The Krembil Centre for Neuroinformatics, Centre for Addiction and Mental Health, Toronto, ON, Canada; Institute of Medical Science, University of Toronto, Toronto, ON, Canada; Department of Psychiatry, University of Toronto, Toronto, ON, Canada; Division of Biostatistics, Dalla Lana School of Public Health, University of Toronto, Toronto, ON, Canada.
| |
Collapse
|
5
|
Hernandez LM, Kim M, Zhang P, Bethlehem RAI, Hoftman G, Loughnan R, Smith D, Bookheimer SY, Fan CC, Bearden CE, Thompson WK, Gandal MJ. Multi-ancestry phenome-wide association of complement component 4 variation with psychiatric and brain phenotypes in youth. Genome Biol 2023; 24:42. [PMID: 36882872 PMCID: PMC9990244 DOI: 10.1186/s13059-023-02878-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 02/15/2023] [Indexed: 03/09/2023] Open
Abstract
BACKGROUND Increased expression of the complement component 4A (C4A) gene is associated with a greater lifetime risk of schizophrenia. In the brain, C4A is involved in synaptic pruning; yet, it remains unclear the extent to which upregulation of C4A alters brain development or is associated with the risk for psychotic symptoms in childhood. Here, we perform a multi-ancestry phenome-wide association study in 7789 children aged 9-12 years to examine the relationship between genetically regulated expression (GREx) of C4A, childhood brain structure, cognition, and psychiatric symptoms. RESULTS While C4A GREx is not related to childhood psychotic experiences, cognition, or global measures of brain structure, it is associated with a localized reduction in regional surface area (SA) of the entorhinal cortex. Furthermore, we show that reduced entorhinal cortex SA at 9-10 years predicts a greater number and severity of psychosis-like events at 1-year and 2-year follow-up time points. We also demonstrate that the effects of C4A on the entorhinal cortex are independent of genome-wide polygenic risk for schizophrenia. CONCLUSIONS Our results suggest neurodevelopmental effects of C4A on childhood medial temporal lobe structure, which may serve as a biomarker for schizophrenia risk prior to symptom onset.
Collapse
Affiliation(s)
- Leanna M. Hernandez
- Department of Psychiatry, Semel Institute, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - Minsoo Kim
- Department of Psychiatry, Semel Institute, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Department of Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Program in Neurobehavioral Genetics, Semel Institute, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - Pan Zhang
- Department of Psychiatry, Semel Institute, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - Richard A. I. Bethlehem
- University of Cambridge, Department of Psychiatry, Cambridge Biomedical Campus, Cambridge, CB2 0SZ UK
| | - Gil Hoftman
- Department of Psychiatry, Semel Institute, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - Robert Loughnan
- Population Neuroscience and Genetics Lab, University of California, San Diego, San Diego, CA 92093 USA
| | - Diana Smith
- Population Neuroscience and Genetics Lab, University of California, San Diego, San Diego, CA 92093 USA
| | - Susan Y. Bookheimer
- Department of Psychiatry, Semel Institute, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - Chun Chieh Fan
- Population Neuroscience and Genetics Lab, University of California, San Diego, San Diego, CA 92093 USA
| | - Carrie E. Bearden
- Department of Psychiatry, Semel Institute, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095 USA
| | - Wesley K. Thompson
- Population Neuroscience and Genetics Lab, University of California, San Diego, San Diego, CA 92093 USA
| | - Michael J. Gandal
- Department of Psychiatry, Semel Institute, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Department of Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA 90095 USA
- Department of Psychiatry, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA USA
- Lifespan Brain Institute at Penn Med and the Children’s Hospital of Philadelphia, Philadelphia, PA USA
- Department of Genetics, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA USA
| |
Collapse
|
6
|
Green A, Baroud E, DiSalvo M, Faraone SV, Biederman J. Examining the impact of ADHD polygenic risk scores on ADHD and associated outcomes: A systematic review and meta-analysis. J Psychiatr Res 2022; 155:49-67. [PMID: 35988304 DOI: 10.1016/j.jpsychires.2022.07.032] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2022] [Revised: 07/12/2022] [Accepted: 07/18/2022] [Indexed: 11/29/2022]
Abstract
Early identification of attention-deficit/hyperactivity disorder (ADHD) is critical for mitigating the many negative functional outcomes associated with its diagnosis. Because of the strong genetic basis of ADHD, the use of polygenic risk scores (PRS) could potentially aid in the early identification of ADHD and associated outcomes. Therefore, a systematic search of the literature on the association between ADHD and PRS in pediatric populations was conducted. All articles were screened for a priori inclusion and exclusion criteria, and, after careful review, 33 studies were included in our systematic review and 16 studies with extractable data were included in our meta-analysis. The results of the review were categorized into three common themes: the associations between ADHD-PRS with 1) the diagnosis of ADHD and ADHD symptoms 2) comorbid psychopathology and 3) cognitive and educational outcomes. Higher ADHD-PRS were associated with increased odds of having a diagnosis (OR = 1.37; p<0.001) and more symptoms of ADHD (β = 0.06; p<0.001). While ADHD-PRS were associated with a persistent diagnostic trajectory over time in the systematic review, the meta-analysis did not confirm these findings (OR = 1.09; p = 0.62). Findings showed that ADHD-PRS were associated with increased odds for comorbid psychopathology such as anxiety/depression (OR = 1.16; p<0.001) and irritability/emotional dysregulation (OR = 1.14; p<0.001). Finally, while the systematic review showed that ADHD-PRS were associated with a variety of negative cognitive outcomes, the meta-analysis showed no significant association (β = 0.08; p = 0.07). Our review of the available literature suggests that ADHD-PRS, together with risk factors, may contribute to the early identification of children with suspected ADHD and associated disorders.
Collapse
Affiliation(s)
- Allison Green
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA; Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA
| | - Evelyne Baroud
- Division of Child and Adolescent Psychiatry, Department of Psychiatry, Massachusetts General Hospital and McLean Hospital, Harvard Medical School, Boston, MA, United States
| | - Maura DiSalvo
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA
| | | | - Joseph Biederman
- Clinical and Research Programs in Pediatric Psychopharmacology and Adult ADHD, Massachusetts General Hospital, Boston, MA, USA; Department of Psychiatry, Harvard Medical School, Boston, MA, USA.
| |
Collapse
|
7
|
Adamis D, Flynn C, Wrigley M, Gavin B, McNicholas F. ADHD in Adults: A Systematic Review and Meta-Analysis of Prevalence Studies in Outpatient Psychiatric Clinics. J Atten Disord 2022; 26:1523-1534. [PMID: 35373645 DOI: 10.1177/10870547221085503] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Systematic review and meta-analysis to estimate the pooled prevalence of ADHD in adult attendees of outpatient mental health clinics and to investigate factors influencing prevalence rates. METHODS The following were extracted: demographics, design of the study (screening only or two-phase), scales/criteria for diagnosis of ADHD, number of ADHD, and non-ADHD participants. RESULTS The pooled prevalence of ADHD from screening studies (n = 9) was 26.7%, (95% CI [17.2-37.4]), ADHD = 1727, No ADHD = 3,578. From studies employing a two-stage design (n = 5), prevalence was 14.61%, CI [10.39-19.41], ADHD = 561, No ADHD = 3,578. Age and gender did not have any significant effect on the estimated prevalence. By contrast exclusion of psychotic disorders lowers prevalence. The screening scale used also influence prevalence rates. CONCLUSION Meta-analysis shows high rates of adult ADHD among psychiatric outpatient clinics. Applying DSM-5 criteria increased prevalence rates. More methodologically robust studies, using two-stage design, need to be conducted to help assist in service planning.
Collapse
Affiliation(s)
- Dimitrios Adamis
- Sligo Mental Health Services, Ireland.,University College Dublin, Ireland.,Research and Academic Institute of Athens, Greece
| | | | - Margo Wrigley
- National Clinical Programme for Adult ADHD, Dublin, Ireland
| | | | | |
Collapse
|
8
|
Fusar-Poli P, Manchia M, Koutsouleris N, Leslie D, Woopen C, Calkins ME, Dunn M, Tourneau CL, Mannikko M, Mollema T, Oliver D, Rietschel M, Reininghaus EZ, Squassina A, Valmaggia L, Kessing LV, Vieta E, Correll CU, Arango C, Andreassen OA. Ethical considerations for precision psychiatry: A roadmap for research and clinical practice. Eur Neuropsychopharmacol 2022; 63:17-34. [PMID: 36041245 DOI: 10.1016/j.euroneuro.2022.08.001] [Citation(s) in RCA: 28] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2022] [Revised: 07/04/2022] [Accepted: 08/05/2022] [Indexed: 12/14/2022]
Abstract
Precision psychiatry is an emerging field with transformative opportunities for mental health. However, the use of clinical prediction models carries unprecedented ethical challenges, which must be addressed before accessing the potential benefits of precision psychiatry. This critical review covers multidisciplinary areas, including psychiatry, ethics, statistics and machine-learning, healthcare and academia, as well as input from people with lived experience of mental disorders, their family, and carers. We aimed to identify core ethical considerations for precision psychiatry and mitigate concerns by designing a roadmap for research and clinical practice. We identified priorities: learning from somatic medicine; identifying precision psychiatry use cases; enhancing transparency and generalizability; fostering implementation; promoting mental health literacy; communicating risk estimates; data protection and privacy; and fostering the equitable distribution of mental health care. We hope this blueprint will advance research and practice and enable people with mental health problems to benefit from precision psychiatry.
Collapse
Affiliation(s)
- Paolo Fusar-Poli
- Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; South London and Maudsley NHS Foundation Trust, London, UK; Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
| | - Mirko Manchia
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy; Unit of Clinical Psychiatry, University Hospital Agency of Cagliari, Cagliari, Italy; Department of Pharmacology, Dalhousie University, Halifax, Nova Scotia, Canada
| | | | | | | | - Monica E Calkins
- Neurodevelopment and Psychosis Section and Lifespan Brain Institute of Penn/CHOP, Department of Psychiatry, Perelman School of Medicine, University of Pennsylvania, USA
| | - Michael Dunn
- Centre for Biomedical Ethics, Yong Loo Lin School of Medicine, National University of Singapore
| | - Christophe Le Tourneau
- Institut Curie, Department of Drug Development and Innovation (D3i), INSERM U900 Research unit, Paris-Saclay University, France
| | - Miia Mannikko
- European Federation of Associations of Families of People with Mental Illness (EUFAMI), Leuven, Belgium
| | - Tineke Mollema
- Global Alliance of Mental Illness Advocacy Networks-Europe (GAMIAN), Brussels, Belgium
| | - Dominic Oliver
- Early Psychosis: Interventions and Clinical-Detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Eva Z Reininghaus
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Alessio Squassina
- Section of Neuroscience and Clinical Pharmacology, Department of Biomedical Sciences, University of Cagliari, Italy
| | - Lucia Valmaggia
- South London and Maudsley NHS Foundation Trust, London, UK; Department of Psychology, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK; Department of Psychiatry, KU Leuven, Belgium
| | - Lars Vedel Kessing
- Copenhagen Affective disorder Research Center (CADIC), Psychiatric Center Copenhagen, Denmark; Department of clinical Medicine, University of Copenhagen, Denmark
| | - Eduard Vieta
- Hospital Clinic, Institute of Neuroscience, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Christoph U Correll
- The Zucker Hillside Hospital, Department of Psychiatry, Northwell Health, Glen Oaks, NY, USA; Department of Psychiatry and Molecular Medicine, Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Hempstead, NY, USA; Center for Psychiatric Neuroscience; The Feinstein Institutes for Medical Research, Manhasset, NY, USA; Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
| | - Celso Arango
- Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, Gregorio Marañón; Health Research Institute (IiGSM), School of Medicine, Universidad Complutense de Madrid; Biomedical Research Center for Mental Health (CIBERSAM), Madrid, Spain
| | - Ole A Andreassen
- NORMENT, Institute of Clinical Medicine, University of Oslo and Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | | |
Collapse
|
9
|
Alexander-Bloch A, Huguet G, Schultz LM, Huffnagle N, Jacquemont S, Seidlitz J, Saci Z, Moore TM, Bethlehem RAI, Mollon J, Knowles EK, Raznahan A, Merikangas A, Chaiyachati BH, Raman H, Schmitt JE, Barzilay R, Calkins ME, Shinohara RT, Satterthwaite TD, Gur RC, Glahn DC, Almasy L, Gur RE, Hakonarson H, Glessner J. Copy Number Variant Risk Scores Associated With Cognition, Psychopathology, and Brain Structure in Youths in the Philadelphia Neurodevelopmental Cohort. JAMA Psychiatry 2022; 79:699-709. [PMID: 35544191 PMCID: PMC9096695 DOI: 10.1001/jamapsychiatry.2022.1017] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 03/16/2022] [Indexed: 12/23/2022]
Abstract
Importance Psychiatric and cognitive phenotypes have been associated with a range of specific, rare copy number variants (CNVs). Moreover, IQ is strongly associated with CNV risk scores that model the predicted risk of CNVs across the genome. But the utility of CNV risk scores for psychiatric phenotypes has been sparsely examined. Objective To determine how CNV risk scores, common genetic variation indexed by polygenic scores (PGSs), and environmental factors combine to associate with cognition and psychopathology in a community sample. Design, Setting, and Participants The Philadelphia Neurodevelopmental Cohort is a community-based study examining genetics, psychopathology, neurocognition, and neuroimaging. Participants were recruited through the Children's Hospital of Philadelphia pediatric network. Participants with stable health and fluency in English underwent genotypic and phenotypic characterization from November 5, 2009, through December 30, 2011. Data were analyzed from January 1 through July 30, 2021. Exposures The study examined (1) CNV risk scores derived from models of burden, predicted intolerance, and gene dosage sensitivity; (2) PGSs from genomewide association studies related to developmental outcomes; and (3) environmental factors, including trauma exposure and neighborhood socioeconomic status. Main Outcomes and Measures The study examined (1) neurocognition, with the Penn Computerized Neurocognitive Battery; (2) psychopathology, with structured interviews based on the Schedule for Affective Disorders and Schizophrenia for School-Age Children; and (3) brain volume, with magnetic resonance imaging. Results Participants included 9498 youths aged 8 to 21 years; 4906 (51.7%) were female, and the mean (SD) age was 14.2 (3.7) years. After quality control, 18 185 total CNVs greater than 50 kilobases (10 517 deletions and 7668 duplications) were identified in 7101 unrelated participants genotyped on Illumina arrays. In these participants, elevated CNV risk scores were associated with lower overall accuracy on cognitive tests (standardized β = 0.12; 95% CI, 0.10-0.14; P = 7.41 × 10-26); lower accuracy across a range of cognitive subdomains; increased overall psychopathology; increased psychosis-spectrum symptoms; and higher deviation from a normative developmental model of brain volume. Statistical models of developmental outcomes were significantly improved when CNV risk scores were combined with PGSs and environmental factors. Conclusions and Relevance In this study, elevated CNV risk scores were associated with lower cognitive ability, higher psychopathology including psychosis-spectrum symptoms, and greater deviations from normative magnetic resonance imaging models of brain development. Together, these results represent a step toward synthesizing rare genetic, common genetic, and environmental factors to understand clinically relevant outcomes in youth.
Collapse
Affiliation(s)
- Aaron Alexander-Bloch
- Department of Child and Adolescent Psychiatry and Behavioral Science, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- The Lifespan Brain Institute, Children’s Hospital of Philadelphia and Penn Medicine, University of Pennsylvania, Philadelphia
- Neurodevelopment and Psychosis Section, Department of Psychiatry, University of Pennsylvania, Philadelphia
| | - Guillaume Huguet
- Department of Pediatrics, University of Montreal, Montreal, Quebec, Canada
- Research Center of the Sainte-Justine University Hospital, Montreal, Quebec, Canada
| | - Laura M. Schultz
- The Lifespan Brain Institute, Children’s Hospital of Philadelphia and Penn Medicine, University of Pennsylvania, Philadelphia
- Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Nicholas Huffnagle
- Department of Child and Adolescent Psychiatry and Behavioral Science, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- The Lifespan Brain Institute, Children’s Hospital of Philadelphia and Penn Medicine, University of Pennsylvania, Philadelphia
| | - Sebastien Jacquemont
- Department of Pediatrics, University of Montreal, Montreal, Quebec, Canada
- Research Center of the Sainte-Justine University Hospital, Montreal, Quebec, Canada
| | - Jakob Seidlitz
- Department of Child and Adolescent Psychiatry and Behavioral Science, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- The Lifespan Brain Institute, Children’s Hospital of Philadelphia and Penn Medicine, University of Pennsylvania, Philadelphia
- Neurodevelopment and Psychosis Section, Department of Psychiatry, University of Pennsylvania, Philadelphia
| | - Zohra Saci
- Research Center of the Sainte-Justine University Hospital, Montreal, Quebec, Canada
| | - Tyler M. Moore
- The Lifespan Brain Institute, Children’s Hospital of Philadelphia and Penn Medicine, University of Pennsylvania, Philadelphia
- Neurodevelopment and Psychosis Section, Department of Psychiatry, University of Pennsylvania, Philadelphia
| | | | - Josephine Mollon
- Department of Psychiatry, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Emma K. Knowles
- Department of Psychiatry, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Armin Raznahan
- Section on Developmental Neurogenomics, National Institute of Mental Health, Bethesda, Maryland
| | - Alison Merikangas
- The Lifespan Brain Institute, Children’s Hospital of Philadelphia and Penn Medicine, University of Pennsylvania, Philadelphia
- Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- Department of Genetics, University of Pennsylvania, Philadelphia
| | - Barbara H. Chaiyachati
- The Lifespan Brain Institute, Children’s Hospital of Philadelphia and Penn Medicine, University of Pennsylvania, Philadelphia
- Center for Applied Genomics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- Department of Pediatrics, University of Pennsylvania, Philadelphia
| | | | - J. Eric Schmitt
- Department of Radiology, University of Pennsylvania, Philadelphia, Pennsylvania
| | - Ran Barzilay
- Department of Child and Adolescent Psychiatry and Behavioral Science, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- The Lifespan Brain Institute, Children’s Hospital of Philadelphia and Penn Medicine, University of Pennsylvania, Philadelphia
- Neurodevelopment and Psychosis Section, Department of Psychiatry, University of Pennsylvania, Philadelphia
| | - Monica E. Calkins
- The Lifespan Brain Institute, Children’s Hospital of Philadelphia and Penn Medicine, University of Pennsylvania, Philadelphia
- Neurodevelopment and Psychosis Section, Department of Psychiatry, University of Pennsylvania, Philadelphia
| | - Russel T. Shinohara
- Penn Statistics in Imaging and Visualization Center, University of Pennsylvania, Philadelphia
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia
- Penn Center for Biomedical Image Computing and Analytics, University of Pennsylvania, Philadelphia
| | - Theodore D. Satterthwaite
- The Lifespan Brain Institute, Children’s Hospital of Philadelphia and Penn Medicine, University of Pennsylvania, Philadelphia
- Neurodevelopment and Psychosis Section, Department of Psychiatry, University of Pennsylvania, Philadelphia
- Penn Lifespan Informatics and Neuroimaging Center, University of Pennsylvania, Philadelphia
| | - Ruben C. Gur
- The Lifespan Brain Institute, Children’s Hospital of Philadelphia and Penn Medicine, University of Pennsylvania, Philadelphia
- Neurodevelopment and Psychosis Section, Department of Psychiatry, University of Pennsylvania, Philadelphia
| | - David C. Glahn
- Department of Psychiatry, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts
| | - Laura Almasy
- The Lifespan Brain Institute, Children’s Hospital of Philadelphia and Penn Medicine, University of Pennsylvania, Philadelphia
- Department of Biomedical and Health Informatics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- Department of Genetics, University of Pennsylvania, Philadelphia
| | - Raquel E. Gur
- Department of Child and Adolescent Psychiatry and Behavioral Science, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- The Lifespan Brain Institute, Children’s Hospital of Philadelphia and Penn Medicine, University of Pennsylvania, Philadelphia
- Neurodevelopment and Psychosis Section, Department of Psychiatry, University of Pennsylvania, Philadelphia
| | - Hakon Hakonarson
- Center for Applied Genomics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
- Department of Pediatrics, University of Pennsylvania, Philadelphia
| | - Joseph Glessner
- Center for Applied Genomics, Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
| |
Collapse
|
10
|
Akingbuwa WA, Hammerschlag AR, Bartels M, Middeldorp CM. Systematic Review: Molecular Studies of Common Genetic Variation in Child and Adolescent Psychiatric Disorders. J Am Acad Child Adolesc Psychiatry 2022; 61:227-242. [PMID: 33932494 DOI: 10.1016/j.jaac.2021.03.020] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2020] [Revised: 03/08/2021] [Accepted: 03/19/2021] [Indexed: 12/13/2022]
Abstract
OBJECTIVE A systematic review of studies using molecular genetics and statistical approaches to investigate the role of common genetic variation in the development, persistence, and comorbidity of childhood psychiatric traits was conducted. METHOD A literature review was performed using the PubMed database, following PRISMA guidelines. There were 131 studies meeting inclusion criteria, having investigated at least one type of childhood-onset or childhood-measured psychiatric disorder or trait with the aim of identifying trait-associated common genetic variants, estimating the contribution of single nucleotide polymorphisms (SNPs) to the amount of variance explained (SNP-based heritability), investigating genetic overlap between psychiatric traits, or investigating whether the stability in traits or the association with adult traits is explained by genetic factors. RESULTS The first robustly associated genetic variants have started to be identified for childhood psychiatric traits. There were substantial contributions of common genetic variants to many traits, with variation in single nucleotide polymorphism heritability estimates depending on age and raters. Moreover, genetic variants also appeared to explain comorbidity as well as stability across a range of psychiatric traits in childhood and across the life span. CONCLUSION Common genetic variation plays a substantial role in childhood psychiatric traits. Increased sample sizes will lead to increased power to identify genetic variants and to understand genetic architecture, which will ultimately be beneficial to targeted and prevention strategies. This can be achieved by harmonizing phenotype measurements, as is already proposed by large international consortia and by including the collection of genetic material in every study.
Collapse
Affiliation(s)
- Wonuola A Akingbuwa
- Ms. Akingbuwa, Dr. Hammerschlag, and Profs. Bartels and Middeldorp are with Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Ms. Akingbuwa, Dr. Hammerschlag, and Prof. Bartels are also with Amsterdam Public Health Research Institute, Amsterdam University Medical Centres, Amsterdam, The Netherlands.
| | - Anke R Hammerschlag
- Ms. Akingbuwa, Dr. Hammerschlag, and Profs. Bartels and Middeldorp are with Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Ms. Akingbuwa, Dr. Hammerschlag, and Prof. Bartels are also with Amsterdam Public Health Research Institute, Amsterdam University Medical Centres, Amsterdam, The Netherlands; Dr. Hammerschlag and Prof. Middeldorp are also with the Child Health Research Centre, the University of Queensland, Brisbane, Queensland, Australia
| | - Meike Bartels
- Ms. Akingbuwa, Dr. Hammerschlag, and Profs. Bartels and Middeldorp are with Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Ms. Akingbuwa, Dr. Hammerschlag, and Prof. Bartels are also with Amsterdam Public Health Research Institute, Amsterdam University Medical Centres, Amsterdam, The Netherlands
| | - Christel M Middeldorp
- Ms. Akingbuwa, Dr. Hammerschlag, and Profs. Bartels and Middeldorp are with Vrije Universiteit Amsterdam, Amsterdam, The Netherlands; Dr. Hammerschlag and Prof. Middeldorp are also with the Child Health Research Centre, the University of Queensland, Brisbane, Queensland, Australia; Prof. Middeldorp is also with the Child and Youth Mental Health Service, Children's Health Queensland Hospital and Health Services, Brisbane, Queensland, Australia
| |
Collapse
|
11
|
Sakurai T. Social processes and social environment during development. Semin Cell Dev Biol 2021; 129:40-46. [PMID: 34649805 DOI: 10.1016/j.semcdb.2021.09.016] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 09/20/2021] [Accepted: 09/28/2021] [Indexed: 12/24/2022]
Abstract
Social behavior involves many processes including cognitive functions. Altered social behaviors associated with many psychiatric disorders might have alterations in the processes. Poor social environment affects development and maturation of cognitive functions that are important for social cognition, possibly introducing social stress as well as vulnerability to the stress into the developing brain. Adolescence and early adulthood have higher sensitivity to social stress, which may be linked to the onset of psychiatric disorders during this time period. Understanding social behavioral processes in detail will be crucial for elucidating mechanisms of emerging the social behavior phenotypes in psychiatric disorders and for devising therapeutic and preventive interventions to introduce the resilience for the onset of psychiatric disorders through modulation of social circuitries.
Collapse
Affiliation(s)
- Takeshi Sakurai
- Medical Innovation Center Kyoto University Graduate School of Medicine, 53 ShogoinKawahara-cho, Sakyo-ku, Kyoto 606-8507, Japan; Department of Pathology, Columbia University Vagelos College of Physicians and Surgeons, New York, USA.
| |
Collapse
|