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Kendler KS, Ohlsson H, Sundquist J, Sundquist K. The predictive effect of family genetic risk scores as an indirect measure of causal effects of one disorder on another. Psychol Med 2024; 54:1867-1875. [PMID: 38314515 DOI: 10.1017/s0033291723003847] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2024]
Abstract
BACKGROUND One potential cause of comorbidity is the direct causal effect of one disorder - A - on risk for subsequent onset of disorder B. Could genetic risk scores be utilized to test for such an effect? If disorder A causally impacts on risk for disorder B, then genetic risk for disorder A should be lower in cases of disorder A with v. without a prior onset of B. METHODS In all individuals (n = 905 736) born in Sweden from 1980 to 1990, from six psychiatric and drug use disorders (major depression, anxiety disorders, alcohol use disorder, drug use disorder, bipolar disorder, and schizophrenia), we formed 14 pairs of disorders A and B. In these pairs, we compared, using Cox proportional hazards models, the predictive effect of the familial-genetic risk score (FGRS) for disorder B in those who had v. had not had a prior onset of disorder A. RESULTS In all pairs, the impact of the FGRS for disorder B was significantly stronger in cases without v. with a prior history of disorder A. These effects were similar across sex, stable across levels of FGRS and not likely due to clinician bias. In many of our disorder pairs, previous clinical studies suggest a mechanism for a causal effect of disorder A on B. CONCLUSIONS Our findings provide indirect evidence that the occurrence of one psychiatric or substance use disorder often has a causal effect on risk for subsequent disorders. This mechanism may substantially contribute to the widespread comorbidity among psychiatric conditions.
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Affiliation(s)
- Kenneth S Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Henrik Ohlsson
- Center for Primary Health Care Research, Department of Clinical Sciences, Malmö, Lund University, Malmö, Sweden
| | - Jan Sundquist
- Center for Primary Health Care Research, Department of Clinical Sciences, Malmö, Lund University, Malmö, Sweden
- University Clinic Primary Care Skåne, Region Skåne, Sweden
| | - Kristina Sundquist
- Center for Primary Health Care Research, Department of Clinical Sciences, Malmö, Lund University, Malmö, Sweden
- University Clinic Primary Care Skåne, Region Skåne, Sweden
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Zhu L, Ni T, Guan F. Methamphetamine-Induced Psychosis and Schizophrenia: A Call for Special Attention. Am J Psychiatry 2024; 181:168. [PMID: 38298079 DOI: 10.1176/appi.ajp.20230467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Affiliation(s)
- Li Zhu
- Department of Forensic Psychiatry, Key Laboratory of National Health Commission for Forensic Sciences, School of Medicine & Forensics, Xi'an Jiaotong University, Xi'an, China
| | - Tong Ni
- Department of Forensic Psychiatry, Key Laboratory of National Health Commission for Forensic Sciences, School of Medicine & Forensics, Xi'an Jiaotong University, Xi'an, China
| | - Fanglin Guan
- Department of Forensic Psychiatry, Key Laboratory of National Health Commission for Forensic Sciences, School of Medicine & Forensics, Xi'an Jiaotong University, Xi'an, China
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Rognli EB, Høye A, Bramness JG. Methamphetamine-Induced Psychosis and Schizophrenia: A Call for Special Attention: Response to Zhu et al. Am J Psychiatry 2024; 181:168-169. [PMID: 38298080 DOI: 10.1176/appi.ajp.20230522] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/02/2024]
Affiliation(s)
- Eline B Rognli
- Section for Clinical Addiction Research, Department on Substance Use Disorder Treatment, Oslo University Hospital, Oslo, Norway (Rognli); Center for Clinical Documentation and Evaluation (SKDE), Tromsø, Norway (Høye); Department of Clinical Medicine, University of Tromsø - The Arctic University of Norway, Tromsø, Norway (Høye); Division of Mental Health and Substance Abuse, University Hospital of North Norway, Tromsø, Norway (Høye, Bramness); Norwegian Institute of Public Health, Oslo, Norway (Bramness); Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Inland Hospital Trust, Hamar, Norway (Bramness)
| | - Anne Høye
- Section for Clinical Addiction Research, Department on Substance Use Disorder Treatment, Oslo University Hospital, Oslo, Norway (Rognli); Center for Clinical Documentation and Evaluation (SKDE), Tromsø, Norway (Høye); Department of Clinical Medicine, University of Tromsø - The Arctic University of Norway, Tromsø, Norway (Høye); Division of Mental Health and Substance Abuse, University Hospital of North Norway, Tromsø, Norway (Høye, Bramness); Norwegian Institute of Public Health, Oslo, Norway (Bramness); Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Inland Hospital Trust, Hamar, Norway (Bramness)
| | - Jørgen G Bramness
- Section for Clinical Addiction Research, Department on Substance Use Disorder Treatment, Oslo University Hospital, Oslo, Norway (Rognli); Center for Clinical Documentation and Evaluation (SKDE), Tromsø, Norway (Høye); Department of Clinical Medicine, University of Tromsø - The Arctic University of Norway, Tromsø, Norway (Høye); Division of Mental Health and Substance Abuse, University Hospital of North Norway, Tromsø, Norway (Høye, Bramness); Norwegian Institute of Public Health, Oslo, Norway (Bramness); Norwegian National Advisory Unit on Concurrent Substance Abuse and Mental Health Disorders, Inland Hospital Trust, Hamar, Norway (Bramness)
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Anderson KK, Rodrigues R, Le B, Mamun M, Archie S, Edwards J, Elton-Marshall T, Gilliland J, Myran DT, Palaniyappan L, Perlman CM, Seabrook JA, Murray RM, Shariff SZ. Impact of non-medical cannabis legalization with market restrictions on health service use and incident cases of psychotic disorder in Ontario, Canada. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2024; 123:104285. [PMID: 38071933 DOI: 10.1016/j.drugpo.2023.104285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 09/01/2023] [Accepted: 12/01/2023] [Indexed: 01/17/2024]
Abstract
BACKGROUND Cannabis is a risk factor in the onset and persistence of psychotic disorders. There is concern that non-medical cannabis legalization in Canada may have population-level impacts on psychotic disorders. We sought to examine changes in health service use and incident cases of psychotic disorder following cannabis legalization, during a period of tight restrictions on retail stores and product types. METHODS We conducted a cross-sectional interrupted time-series analysis using linked population-based health administrative data from Ontario (Canada) from January 2014 to March 2020. We identified psychosis-related outpatient visits, emergency department visits, hospitalizations, and inpatient length of stay, as well as incident cases of psychotic disorders, among people aged 14 to 60 years. RESULTS We did not find evidence of increases in health service use or incident cases of psychotic disorders over the short-term (17 month) period following cannabis legalization. However, we found clear increasing trends in health service use and incident cases of substance-induced psychotic disorders over the entire observation window (2014-2020). CONCLUSION Our findings suggest that the initial period of tight market restriction following legalization of non-medical cannabis was not associated with an increase in health service use or frequency of psychotic disorders. A longer post-legalization observation period, which includes expansion of the commercial cannabis market, is needed to fully understand the population-level impacts of non-medical cannabis legalization; thus, it would be premature to conclude that the legalization of non-medical cannabis did not lead to increases in health service use and incident cases of psychotic disorder.
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Affiliation(s)
- Kelly K Anderson
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London ON Canada; Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London ON Canada; ICES Western, London ON Canada; Lawson Health Research Institute, London Health Sciences Centre, London ON Canada.
| | - Rebecca Rodrigues
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London ON Canada
| | | | - Maliha Mamun
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London ON Canada
| | - Suzanne Archie
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton ON Canada
| | - Jordan Edwards
- Department of Psychiatry and Behavioural Neurosciences, McMaster University, Hamilton ON Canada
| | - Tara Elton-Marshall
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London ON Canada; School of Epidemiology and Public Health, University of Ottawa, Ottawa ON Canada; Institute of Mental Health Policy Research, Centre for Addiction and Mental Health, Toronto ON Canada; Dalla Lana School of Public Health, University of Toronto, Toronto ON Canada
| | - Jason Gilliland
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London ON Canada; Department of Pediatrics, Schulich School of Medicine and Dentistry, Western University, London ON Canada; Department of Geography and Environment, Western University, London ON Canada
| | - Daniel Thomas Myran
- Department of Family Medicine, University of Ottawa, Ottawa ON Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa ON Canada; ICES uOttawa, Ottawa Hospital Research Institute, Ottawa ON Canada
| | - Lena Palaniyappan
- Department of Psychiatry, Schulich School of Medicine and Dentistry, Western University, London ON Canada; Douglas Mental Health University Institute, Department of Psychiatry, McGill University, Montreal ON Canada
| | | | - Jamie A Seabrook
- Department of Epidemiology and Biostatistics, Schulich School of Medicine and Dentistry, Western University, London ON Canada; Department of Pediatrics, Schulich School of Medicine and Dentistry, Western University, London ON Canada; School of Food and Nutritional Sciences, Brescia University College, London ON Canada
| | - Robin M Murray
- Institute of Psychiatry, Psychology, and Neuroscience, King's College London, United Kingdom
| | - Salimah Z Shariff
- Arthur Labatt Family School of Nursing, Western University, London ON Canada; ICES Western, London ON Canada; Lawson Health Research Institute, London Health Sciences Centre, London ON Canada
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