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Haupt T, Elfving B, Eugen-Olsen J, Mors O, Köhler-Forsberg O. SuPAR in major depression: Association with 26 weeks antidepressant response and 10-year depression outcomes. Brain Behav Immun Health 2023; 33:100685. [PMID: 37731957 PMCID: PMC10507069 DOI: 10.1016/j.bbih.2023.100685] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 08/26/2023] [Accepted: 09/06/2023] [Indexed: 09/22/2023] Open
Abstract
Introduction Inflammation has been associated with depression and differential antidepressant (AD) treatment response. Soluble urokinase plasminogen activator receptor (suPAR) is a novel measure of chronic inflammation. We investigated whether suPAR is associated with depression severity and AD response. Methods We included 90 patients with major depressive disorder (MDD) who participated in a part-randomized clinical trial of 26 weeks of treatment with escitalopram or nortriptyline. suPAR levels were measured in serum samples collected at baseline and after 8, 12 and 26 weeks. Mixed effects models for the association between suPAR levels and AD response were performed. By merging with Danish nationwide registers, we included information on psychiatric hospital contacts during ten years after the GENDEP trial. Cox regression analyses calculated the hazard rate ratios between suPAR levels and subsequent hospitalizations. Results At baseline, higher suPAR levels were not associated with overall depression severity but with greater severity of neurovegetative depressive symptoms, specifically appetite and weight changes. 57 (63.3%) patients responded positively to treatment. Among 57 (63.3%) patients who achieved response, those who responded had significantly higher baseline suPAR levels levels, and response was associated with a significant decrease in suPAR during AD treatment. Remitters decreased from 3.1 ng/ml at baseline to 2.8 ng/ml after 26 weeks (p = 0.003) and responders from 3.0 to 2.8 ng/ml (p = 0.02), whereas non-remitters and non-responders showed unchanged suPAR levels. We found no correlation between a change in suPAR and a change in MADRS, but a lowering of suPAR correlated with a decrease in neurovegetative symptoms. We found no association between suPAR levels and 10-year risk for hospitalizations. Discussion The present study suggests that an elevated level of chronic inflammation, measured as the suPAR level, is associated with better response to AD treatment.
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Affiliation(s)
- T.H. Haupt
- Department of Clinical Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
- Psychiatric Center Ballerup, Ballerup, Denmark
| | - B. Elfving
- Translational Neuropsychiatry Unit (TNU), Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - J. Eugen-Olsen
- Department of Clinical Research, Copenhagen University Hospital Hvidovre, Hvidovre, Denmark
| | - O. Mors
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Psychosis Research Unit, Aarhus University Hospital - Psychiatry, Aarhus, Denmark
| | - O. Köhler-Forsberg
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Psychosis Research Unit, Aarhus University Hospital - Psychiatry, Aarhus, Denmark
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2
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Lorentzen E, Mors O, Kjaer J. The prevalence of self-harm behavior in schizophrenia spectrum disorders: a systematic review and meta-analysis. Eur Psychiatry 2022. [PMCID: PMC9567887 DOI: 10.1192/j.eurpsy.2022.1978] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Non-suicidal self-injury (NSSI) is intentional self-inflicted destruction of body tissue without suicidal intention, whereas deliberate self-harm (DSH) is self-inflicted destruction of body tissue regardless of intent. In clinical samples of patients with schizophrenia spectrum disorders (SSD) the estimates of prevalence and severity of self-harm behavior vary considerably. Objectives The aim of this study is to investigate the prevalence of NSSI and DSH, respectively, in individuals with SSD. Methods In adherence with PRISMA guidelines, a search of electronic databases (Pubmed, PsycInfo, and EMBASE) was conducted by two independent reviewers. Studies were included if the participants were diagnosed with SSD and DSH/NSSI were quantified by questionnaire or interview. Studies solely including patients with schizoaffective disorder, a severe intellectual disability, or autistic spectrum disorder were excluded. Meta-analysis of prevalence will be undertaken for NSSI and DSH, respectively. Further, the review will examine psychopathological correlates to DSH/NSSI, self-harming methods utilized in DSH/NSSI, and severity of DSH/NSSI. Results Following duplicate removal, 1891 abstracts were initially identified through the database searches. 148 abstracts were included in screening of full-text articles of which 33 met the eligibility criteria. Nine authors were contacted for the purpose of obtaining additional data. Preliminary results found that the observed lifetime prevalence of NSSI ranged from 14.1% to 57.1%, whereas the observed lifetime prevalence of DSH ranged from 12.9% to 68.0%. Conclusions Understanding how SSD and self-harming behavior are associated could identify subgroups of patients with SSD that are responsive to different pharmacological and psychosocial treatment approaches. Disclosure No significant relationships.
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Jefsen O, Dietz M, Friston K, Mors O, Shtyrov Y. Identifying prodromal biomarkers for schizophrenia and bipolar disorder using magnetoencephalography. Eur Psychiatry 2022. [PMCID: PMC9567799 DOI: 10.1192/j.eurpsy.2022.1641] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Introduction Schizophrenia (SZ) and bipolar disorder (BD) are severe mental illnesses with large overlapping heritability. Both disorders are associated with altered neurophysiological responses, as measured with magnetoencephalography (MEG) or electroencephalography (EEG), particularly reduced mismatch negativity (MMN) and 40 Hz auditory steady-state responses (ASSR). These deficits could potentially both serve as early markers of illness and provide insight into the underlying pathophysiology as endophenotypes. First-degree relatives to patients with SZ and BD also show some neurophysiological deficits, however whether these deficits can be detected in adolescent offspring of patients is undetermined. Objectives We aim to investigate whether adolescents at familial high risk of schizophrenia and bipolar disorder show aberrant MMN and ASSR compared to population-based controls. Methods We will investigate MMN and 40 Hz ASSR in 15 year old adolescents (n ≈ 175) born to parents diagnosed with either SZ (FHR-SZ), BD (FHR-BD), or neither SZ or BD (population-based controls, PBC) using MEG. We will first perform sensor-level analyses and subsequently apply dynamic causal modeling (DCM) to investigate effective connectivity and make inferences about the underlying neurobiological mechanisms. We will investigate whether current psychopathology, cognitive status, and genetic risk for SZ and BD predict neurophysiological responses in the adolescents. Investigations are part of The Danish High Risk and Resilience Study - VIA (VIA15), a population-based longitudinal cohort study integrating social, psychological and biological risk factors and outcomes for SZ and BD. Results Final results are expected in 2024 Conclusions The VIA15 study will allow for unprecedented insight into the neurobiological development of schizophrenia and bipolar disorder. Disclosure No significant relationships.
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Kjaer J, Holm T, Bliksted V, Ellegaard T, Dolmer S, Mors O. The Transdiagnostic Self-Injury Interview: A Feasibility Study. Eur Psychiatry 2022. [PMCID: PMC9566837 DOI: 10.1192/j.eurpsy.2022.1522] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction Non-suicidal self-injury (NSSI) is associated with emotional distress and mental disorders. In clinical samples NSSI is reported by 21% to 60% of all psychiatric patients. Developed NSSI instruments are not suitable for clinical settings because they are too time-consuming or lack validation across psychiatric diagnoses. The Transdiagnostic Self-Injury Interview (TSI) is semi-structured interview that accesses onset, frequency, methods, and severity of NSSI. It is transdiagnostic and developed for clinical settings. Objectives The purpose of the study is to evaluate the feasibility of a TSI validation study. The study will also provide preliminary validation of the instrument. Methods The feasibility study will recruit participants at in- and outpatient units from a university hospital. Participants can be included in the study if they are 18 years old and admitted to a psychiatric in- or outpatient unit. Instruments:
The Deliberate Self-Harm Inventory will be used to test concurrent validity. Convergent validity will be tested with the Columbia Suicidality Severity Rating Scale, the Personal and Social Performance scale, the Affective Lability Scale-short, and the Brief Trauma Questionnaire. Interrater reliability will be evaluated in groups of medical doctors, psychologist, and other clinical professionals. Feasibility are measured by inclusion of participants per week, the time each participant takes to complete the study instruments, and number of dropouts. Results Recruitment of participants will start in the fall of 2021. We aim to recruit 50 participants. Conclusions When TSI has been validated, it can be used to assess prevalence and severity of NSSI and clarify the need for treatment and supervision. Disclosure No significant relationships.
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Kølbæk P, Dines D, Hansen J, Opler M, Correll C, Mors O, Østergaard S. Standardized training in the rating of the six-item positive and negative syndrome scale (PANSS-6). Eur Psychiatry 2021. [PMCID: PMC9479920 DOI: 10.1192/j.eurpsy.2021.1580] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction The six-item Positive And Negative Syndrome Scale (PANSS-6) is short psychometric valid scale quantifying the severity of core schizophrenia symptoms. Using PANSS-6 to guide treatment decision-making requires that staff members’ ratings are valid and reliable. Objectives The objective of the study was to evaluate whether such valid and reliable PANSS-6 ratings can be obtained through a video-based training program. Methods One-hundred-and-four staff members from Aarhus University Hospital - Psychiatry, Denmark participated in the training. Participants conducted baseline PANSS-6 ratings based on a video of a patient being interviewed using the Simplified Positive And Negative Symptoms interview (SNAPSI). Subsequently, a theoretical introduction video was displayed followed by five SNAPSI patient interviews. After each SNAPSI video, individual ratings were performed before a video providing the gold standard scores was displayed. The validity of ratings was estimated by calculating the proportion of participants not deviating from the gold standard scores with >2 points on individual items or >6 points on the PANSS-6 total score. Reliability was evaluated after each step in the training by means of Gwet’s Agreement Coefficient (Gwet). Results By the end of the training, 72% of the participants rated within the acceptable deviations of the gold standard, ranging from 60% (nurses) to 91% (medical doctors/psychologists). The reliability improved (Gwet baseline vs. endpoint) for all PANSS-6 items, except for Blunted affect. Conclusions The majority of the staff members conducted valid PANSS-6 ratings after a brief standardized training program, supporting the implementation of PANSS-6 in clinical settings to facilitate measurement-based care. Conflict of interest Dr. Opler is a full-time employee of MedAvante-ProPhase Inc. Dr. Correll has been a consultant and/or advisor to or have received honoraria from: Acadia, Alkermes, Allergan, Angelini, Axsome, Gedeon Richter, Gerson Lehrman Group, Indivior, IntraCellular T
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6
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Nørgaard HCB, Schou Pedersen H, Fenger-Grøn M, Vestergaard M, Nordentoft M, Laursen TM, Mors O. Schizophrenia and attendance in primary healthcare: a population-based matched cohort study. Scand J Prim Health Care 2019; 37:358-365. [PMID: 31299863 PMCID: PMC6713101 DOI: 10.1080/02813432.2019.1639927] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Objective: Schizophrenia is associated with high mortality, somatic comorbidity and reduced life expectancy. The general practitioner (GP) plays a key role in the treatment of mental and physical multimorbidity. Nevertheless, it is unclear how much individuals with schizophrenia use primary healthcare. This study aims to investigate the yearly numbers of consultations in general practice for individuals with schizophrenia. Design and Setting: We performed a population-based matched cohort study of 21,757 individuals with schizophrenia and 435,140 age- and gender-matched references from Danish National Registers. Monthly general practice consultations were analysed using a generalized linear model with log link and assuming negative binomial distribution. Main outcome measures: Consultation rates in general practice up to17 years after index diagnosis. Results: Individuals with schizophrenia attended their GP more than references throughout the study period. The cases had 82% (95% CI: 78-87) and 76% (95% CI: 71-80) more consultations in primary care after 1 year and 5 years, respectively. Individuals with both schizophrenia and comorbid somatic illness attended even more. Conclusion: Individuals with schizophrenia are in regular contact with their GP, especially if they have comorbid illnesses. Whether an average of six consultations per year for individuals with schizophrenia is sufficient is up for debate. The study demonstrates a potential for an increased prevention and treatment of individuals with schizophrenia in general practice. KEY POINTS Schizophrenia is associated with high mortality, somatic comorbidity and reduced life expectancy. Little is known about the attendance pattern in primary care for individuals with schizophrenia. •We found high attendance rates in primary care for individuals diagnosed with schizophrenia from index diagnosis and at least 17 years after diagnosis, which suggests opportunities for earlier intervention to improve their somatic health. •We found an association between high illness comorbidity and increased risk of not attending the general practitioner. The most severely somatically and mentally ill individuals may thus be difficult to reach and support in the current healthcare system.
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Affiliation(s)
- H. C. B. Nørgaard
- Psychosis Research Unit, Aarhus University Hospital, Risskov, Denmark;
- Department of Clinical Medicine, Aarhus University, Aarhus N, Denmark;
- CONTACT H. C. B. Nørgaard Psychosis Research Unit, Aarhus University Hospital – Psychiatry, Palle Juul-Jensens Boulevard 175, 8200 Aarhus N, Denmark
| | - H. Schou Pedersen
- Research Unit for General Practice & Section for General Medical Practice, Department of Public Health, Aarhus University, Aarhus C, Denmark;
| | - M. Fenger-Grøn
- Research Unit for General Practice & Section for General Medical Practice, Department of Public Health, Aarhus University, Aarhus C, Denmark;
| | - M. Vestergaard
- Research Unit for General Practice & Section for General Medical Practice, Department of Public Health, Aarhus University, Aarhus C, Denmark;
| | - M. Nordentoft
- Psychiatric Center Copenhagen, University of Copenhagen, Hellerup, Denmark;
| | - T. M. Laursen
- National Centre for Register-based Research, Aarhus BSS, Aarhus University, Aarhus C, Denmark
| | - O. Mors
- Psychosis Research Unit, Aarhus University Hospital, Risskov, Denmark;
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7
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Gantriis DL, Thorup AAE, Harder S, Greve AN, Henriksen MT, Zahle KK, Stadsgaard H, Ellersgaard D, Burton BK, Christiani CJ, Spang K, Hemager N, Uddin MJ, Jepsen JRM, Plessen KJ, Nordentoft M, Mors O, Bliksted V. Home visits in the Danish High Risk and Resilience Study - VIA 7: assessment of the home environment of 508 7-year-old children born to parents diagnosed with schizophrenia or bipolar disorder. Acta Psychiatr Scand 2019; 140:126-134. [PMID: 31155701 DOI: 10.1111/acps.13057] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/28/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The home environment provided by the caregivers of a child is an influential single factor for development and well-being. We aimed to compare the quality of the home environment of children at familial high risk of schizophrenia or bipolar disorder with population-based controls. METHODS Danish nationwide registers were used to retrieve a cohort of 522 7-year-old children of parents diagnosed with schizophrenia (N = 202), bipolar disorder (N = 120) or none of these diagnoses (N = 200). The home environment was assessed using the Middle Childhood-Home Observation for Measurement of the Environment Inventory (MC-HOME Inventory). RESULTS The proportion of children living in home environments that were evaluated not to meet the needs of a 7-year-old child was significantly larger in the two familial high-risk groups. This was true for 21% of the children with familial predisposition for schizophrenia and 7% of children with familial disposition for bipolar disorder. CONCLUSION Children born to parents diagnosed with schizophrenia and to a lesser extent bipolar disorder are at an increased risk of growing up in a home environment with an insufficient level of stimulation and support. Identifying families with inadequate home environments is a necessary step towards specialized help and support to at-risk families.
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Affiliation(s)
- D L Gantriis
- Psychosis Research Unit, Aarhus University Hospital Psychiatry, Aarhus, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
| | - A A E Thorup
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark.,Child and Adolescent Mental Health Center, Mental Health Services, Copenhagen, Denmark
| | - S Harder
- Department of Psychology, University of Copenhagen, Copenhagen, Denmark
| | - A N Greve
- Psychosis Research Unit, Aarhus University Hospital Psychiatry, Aarhus, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
| | - M T Henriksen
- Psychosis Research Unit, Aarhus University Hospital Psychiatry, Aarhus, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
| | - K K Zahle
- Psychosis Research Unit, Aarhus University Hospital Psychiatry, Aarhus, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
| | - H Stadsgaard
- Psychosis Research Unit, Aarhus University Hospital Psychiatry, Aarhus, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
| | - D Ellersgaard
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark.,Mental Health Centre Copenhagen, Copenhagen University Hospital, Mental Health Services Capital Region, Copenhagen, Denmark
| | - B K Burton
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark.,Child and Adolescent Mental Health Center, Mental Health Services, Copenhagen, Denmark
| | - C J Christiani
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark.,Mental Health Centre Copenhagen, Copenhagen University Hospital, Mental Health Services Capital Region, Copenhagen, Denmark
| | - K Spang
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark.,Mental Health Centre Copenhagen, Copenhagen University Hospital, Mental Health Services Capital Region, Copenhagen, Denmark
| | - N Hemager
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark.,Child and Adolescent Mental Health Center, Mental Health Services, Copenhagen, Denmark.,Mental Health Centre Copenhagen, Copenhagen University Hospital, Mental Health Services Capital Region, Copenhagen, Denmark
| | - Md J Uddin
- Mental Health Centre Copenhagen, Copenhagen University Hospital, Mental Health Services Capital Region, Copenhagen, Denmark.,Section of Biostatistics, Department of Public Health, Copenhagen University, Copenhagen, Denmark
| | - J R M Jepsen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark.,Child and Adolescent Mental Health Center, Mental Health Services, Copenhagen, Denmark.,Mental Health Centre Copenhagen, Copenhagen University Hospital, Mental Health Services Capital Region, Copenhagen, Denmark.,Centre for Neuropsychiatric Schizophrenia Research & Centre for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Copenhagen University Hospital, Copenhagen, Denmark
| | - K J Plessen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark.,Child and Adolescent Mental Health Center, Mental Health Services, Copenhagen, Denmark.,Service of Child and Adolescent Psychiatry, Department of Psychiatry, University Medical Center, University of Lausanne, Lausanne, Switzerland
| | - M Nordentoft
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark.,Mental Health Centre Copenhagen, Copenhagen University Hospital, Mental Health Services Capital Region, Copenhagen, Denmark
| | - O Mors
- Psychosis Research Unit, Aarhus University Hospital Psychiatry, Aarhus, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
| | - V Bliksted
- Psychosis Research Unit, Aarhus University Hospital Psychiatry, Aarhus, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark.,Department of Clinical Medicine, Faculty of Health and Medical Sciences, Aarhus University, Aarhus, Denmark
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8
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Danielsen AA, Fenger MHJ, Østergaard SD, Nielbo KL, Mors O. Predicting mechanical restraint of psychiatric inpatients by applying machine learning on electronic health data. Acta Psychiatr Scand 2019; 140:147-157. [PMID: 31209866 DOI: 10.1111/acps.13061] [Citation(s) in RCA: 12] [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] [Accepted: 06/12/2019] [Indexed: 12/15/2022]
Abstract
OBJECTIVE Mechanical restraint (MR) is used to prevent patients from harming themselves or others during inpatient treatment. The objective of this study was to investigate whether incident MR occurring in the first 3 days following admission could be predicted based on analysis of electronic health data available after the first hour of admission. METHODS The dataset consisted of clinical notes from electronic health records from the Central Denmark Region and data from the Danish Health Registers from patients admitted to a psychiatric department in the period from 2011 to 2015. Supervised machine learning algorithms were trained on a randomly selected subset of the data and validated using an independent test dataset. RESULTS A total of 5050 patients with 8869 admissions were included in the study. One hundred patients were mechanically restrained in the period between one hour and 3 days after the admission. A Random Forest algorithm predicted MR with an area under the curve of 0.87 (95% CI 0.79-0.93). At 94% specificity, the sensitivity was 56%. Among the ten strongest predictors, nine were derived from the clinical notes. CONCLUSIONS These findings open for the development of an early warning system that may guide interventions to reduce the use of MR.
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Affiliation(s)
- A A Danielsen
- Psychosis Research Unit, Department for Psychosis, Aarhus University Hospital - Psychiatry, Aarhus, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - M H J Fenger
- Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark
| | - S D Østergaard
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Affective Disorders, Aarhus University Hospital - Psychiatry, Aarhus, Denmark.,Aarhus Institute of Advanced Studies, Aarhus University, Aarhus, Denmark
| | - K L Nielbo
- Department of History, University of Southern Denmark, Odense, Denmark
| | - O Mors
- Psychosis Research Unit, Department for Psychosis, Aarhus University Hospital - Psychiatry, Aarhus, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
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9
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Köhler-Forsberg O, N Lydholm C, Hjorthøj C, Nordentoft M, Mors O, Benros ME. Efficacy of anti-inflammatory treatment on major depressive disorder or depressive symptoms: meta-analysis of clinical trials. Acta Psychiatr Scand 2019; 139:404-419. [PMID: 30834514 DOI: 10.1111/acps.13016] [Citation(s) in RCA: 229] [Impact Index Per Article: 45.8] [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] [Accepted: 02/25/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND No study has gathered evidence from all randomized clinical trials (RCTs) with anti-inflammatory drugs measuring antidepressant effects including a detailed assessment of side-effects and bias. METHODS We performed a systematic review identifying RCTs published prior to January 1, 2018, studying antidepressant treatment effects and side-effects of pharmacological anti-inflammatory intervention in adults with major depressive disorder (MDD) or depressive symptoms. Outcomes were depression scores after treatment, remission, response, and side-effects. Pooled standard mean differences (SMD) and risk ratios (RR) including 95% confidence intervals (95%-CI) were calculated. RESULTS We identified 36 RCTs, whereof 13 investigated NSAIDs (N = 4214), 9 cytokine inhibitors (N = 3345), seven statins (N = 1576), 3 minocycline (N = 151), 2 pioglitazone (N = 77), and 2 glucocorticoids (N = 59). Anti-inflammatory agents improved depressive symptoms compared to placebo as add-on in patients with MDD (SMD = -0.64; 95%-CI = -0.88, -0.40; I2 = 51%; N = 597) and as monotherapy (SMD = -0.41; 95%-CI = -0.60, -0.22; I2 = 93%, N = 8825). Anti-inflammatory add-on improved response (RR = 1.76; 95%-CI = 1.44-2.16; I2 = 16%; N = 341) and remission (RR = 2.14; 95%-CI = 1.03-4.48; I2 = 57%; N = 270). We found a trend toward an increased risk for infections, and all studies showed high risk of bias. CONCLUSION Anti-inflammatory agents improved antidepressant treatment effects. Future RCTs need to include longer follow-up, identify optimal doses and subgroups of patients that can benefit from anti-inflammatory intervention.
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Affiliation(s)
- O Köhler-Forsberg
- Psychosis Research Unit, Aarhus University Hospital Psychiatry, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark.,Copenhagen Research Center for Mental Health -CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
| | - C N Lydholm
- Copenhagen Research Center for Mental Health -CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
| | - C Hjorthøj
- Copenhagen Research Center for Mental Health -CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark.,iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark.,Department of Public Health, Section of Epidemiology, University of Copenhagen, Copenhagen
| | - M Nordentoft
- Copenhagen Research Center for Mental Health -CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark.,iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
| | - O Mors
- Psychosis Research Unit, Aarhus University Hospital Psychiatry, Aarhus, Denmark.,Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark.,iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
| | - M E Benros
- Copenhagen Research Center for Mental Health -CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark.,iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
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10
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Østergaard SD, Foldager L, Mors O, Bech P, Correll CU. The validity and sensitivity of PANSS-6 in treatment-resistant schizophrenia. Acta Psychiatr Scand 2018; 138:420-431. [PMID: 30168131 DOI: 10.1111/acps.12952] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [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] [Accepted: 08/03/2018] [Indexed: 12/14/2022]
Abstract
OBJECTIVE To test the validity and sensitivity of the six-item version (PANSS-6) of the 30-item Positive and Negative Syndrome Scale (PANSS-30) in treatment-resistant schizophrenia (TRS). METHOD Using data from the clozapine phase (2E) of the Clinical Antipsychotic Trials of Intervention Effectiveness (CATIE) study, we investigated the following: (i) The scalability of PANSS-6 and PANSS-30; (ii) The correlation between PANSS-6 and PANSS-30 total scores; (iii) Whether PANSS-6 could identify cross-sectional symptom remission; and (iv) The efficacy of clozapine, olanzapine, risperidone and quetiapine in TRS using the 'speed of change' on PANSS-6 and PANSS-30 (change in total score per week) as outcome measures. RESULTS We found that (i) only PANSS-6 and not PANSS-30 was scalable; (ii) The correlation between PANSS-6 and PANSS-30 total scores was high (Spearman coefficient: 0.85), (iii) PANSS-6 accurately identified cross-sectional symptom remission as defined by the Andreasen et al. criteria; and (iv) The only antipsychotic that caused improvement (speed of change significantly lower than 0 during the first three months of treatment) was clozapine, both when using PANSS-6 (speed of change: -0.50 points/week; 95%CI: -0.84, -0.17) and PANSS-30 (speed of change: -1.41 points/week; 95%CI: -2.80, -0.02) as outcome measures. CONCLUSION PANSS-6 validly measures severity, remission and antipsychotic efficacy in TRS.
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Affiliation(s)
- S D Østergaard
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Affective Disorders, Aarhus University Hospital, Risskov, Denmark.,Aarhus Institute for Advanced Studies, Aarhus University, Aarhus, Denmark
| | - L Foldager
- Department of Animal Science, Aarhus University, Tjele, Denmark.,Bioinformatics Research Centre (BiRC), Aarhus University, Aarhus, Denmark
| | - O Mors
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Department of Affective Disorders, Aarhus University Hospital, Risskov, Denmark
| | - P Bech
- Psychiatric Research Unit, Psychiatric Centre North Zealand, Copenhagen University Hospital, Hillerød, Denmark
| | - C U Correll
- Division of Psychiatry Research, The Zucker Hillside Hospital, Glen Oaks, NY, USA.,Department of Psychiatry and Molecular Medicine, Hofstra Northwell School of Medicine, Hempstead, NY, USA.,Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin, Berlin, Germany
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11
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Østergaard SD, Nielsen RE, Mors O, Licht RW. Problematic definitions of bipolar I disorder and mixed episode in the upcoming ICD-11. Acta Psychiatr Scand 2018; 138:361-362. [PMID: 30144038 DOI: 10.1111/acps.12919] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- S D Østergaard
- Department of Affective Disorders, Aarhus University Hospital, Risskov, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Aarhus Institute of Advanced Studies, Aarhus University, Aarhus, Denmark
| | - R E Nielsen
- Department of Psychiatry, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
| | - O Mors
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Psychosis Research Unit, Aarhus University Hospital, Risskov, Denmark
| | - R W Licht
- Department of Psychiatry, Aalborg University Hospital, Aalborg, Denmark.,Department of Clinical Medicine, Aalborg University, Aalborg, Denmark
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12
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Pedersen CB, Bybjerg-Grauholm J, Pedersen MG, Grove J, Agerbo E, Bækvad-Hansen M, Poulsen JB, Hansen CS, McGrath JJ, Als TD, Goldstein JI, Neale BM, Daly MJ, Hougaard DM, Mors O, Nordentoft M, Børglum AD, Werge T, Mortensen PB. The iPSYCH2012 case-cohort sample: new directions for unravelling genetic and environmental architectures of severe mental disorders. Mol Psychiatry 2018; 23:6-14. [PMID: 28924187 PMCID: PMC5754466 DOI: 10.1038/mp.2017.196] [Citation(s) in RCA: 180] [Impact Index Per Article: 30.0] [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: 05/09/2017] [Revised: 07/06/2017] [Accepted: 07/13/2017] [Indexed: 12/16/2022]
Abstract
The Integrative Psychiatric Research (iPSYCH) consortium has established a large Danish population-based Case-Cohort sample (iPSYCH2012) aimed at unravelling the genetic and environmental architecture of severe mental disorders. The iPSYCH2012 sample is nested within the entire Danish population born between 1981 and 2005, including 1 472 762 persons. This paper introduces the iPSYCH2012 sample and outlines key future research directions. Cases were identified as persons with schizophrenia (N=3540), autism (N=16 146), attention-deficit/hyperactivity disorder (N=18 726) and affective disorder (N=26 380), of which 1928 had bipolar affective disorder. Controls were randomly sampled individuals (N=30 000). Within the sample of 86 189 individuals, a total of 57 377 individuals had at least one major mental disorder. DNA was extracted from the neonatal dried blood spot samples obtained from the Danish Neonatal Screening Biobank and genotyped using the Illumina PsychChip. Genotyping was successful for 90% of the sample. The assessments of exome sequencing, methylation profiling, metabolome profiling, vitamin-D, inflammatory and neurotrophic factors are in progress. For each individual, the iPSYCH2012 sample also includes longitudinal information on health, prescribed medicine, social and socioeconomic information, and analogous information among relatives. To the best of our knowledge, the iPSYCH2012 sample is the largest and most comprehensive data source for the combined study of genetic and environmental aetiologies of severe mental disorders.
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Affiliation(s)
- C B Pedersen
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark,National Centre for Register-Based Research, Business and Social Sciences, Aarhus University, Aarhus V, Denmark,Centre for Integrated Register-Based Research, CIRRAU, Aarhus University, Aarhus, Denmark,National Centre for Register-Based Research, Business and Social Sciences, Aarhus University, Fuglesangs Allé 4, Aarhus 8210, Denmark. E-mail:
| | - J Bybjerg-Grauholm
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark,Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | - M G Pedersen
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark,National Centre for Register-Based Research, Business and Social Sciences, Aarhus University, Aarhus V, Denmark,Centre for Integrated Register-Based Research, CIRRAU, Aarhus University, Aarhus, Denmark
| | - J Grove
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark,Centre for Integrative Sequencing, Department of Biomedicine and iSEQ, Aarhus University, Aarhus, Denmark,BiRC-Bioinformatics Research Centre, Aarhus University, Aarhus, Denmark
| | - E Agerbo
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark,National Centre for Register-Based Research, Business and Social Sciences, Aarhus University, Aarhus V, Denmark,Centre for Integrated Register-Based Research, CIRRAU, Aarhus University, Aarhus, Denmark
| | - M Bækvad-Hansen
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark,Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | - J B Poulsen
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark,Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | - C S Hansen
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark,Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | - J J McGrath
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark,National Centre for Register-Based Research, Business and Social Sciences, Aarhus University, Aarhus V, Denmark,Queensland Brain Institute, The University of Queensland, St Lucia, QLD, Australia,Queensland Centre for Mental Health Research, The Park Centre for Mental Health, Wacol, QLD, Australia
| | - T D Als
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark,Centre for Integrative Sequencing, Department of Biomedicine and iSEQ, Aarhus University, Aarhus, Denmark
| | - J I Goldstein
- Analytic and Translational Genetics Unit (ATGU), Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA,Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA,Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - B M Neale
- Analytic and Translational Genetics Unit (ATGU), Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA,Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA,Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - M J Daly
- Analytic and Translational Genetics Unit (ATGU), Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA,Program in Medical and Population Genetics, Broad Institute of Harvard and MIT, Cambridge, MA, USA,Stanley Center for Psychiatric Research, Broad Institute of Harvard and MIT, Cambridge, MA, USA
| | - D M Hougaard
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark,Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | - O Mors
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark,Psychosis Research Unit, Aarhus University Hospital, Risskov, Denmark
| | - M Nordentoft
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark,Mental Health Centre Copenhagen, Capital Region of Denmark, Copenhagen University Hospital, Copenhagen, Denmark
| | - A D Børglum
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark,Centre for Integrative Sequencing, Department of Biomedicine and iSEQ, Aarhus University, Aarhus, Denmark
| | - T Werge
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark,Mental Health Centre Sct. Hans, Capital Region of Denmark, Institute of Biological Psychiatry, Copenhagen University Hospital, Copenhagen, Denmark
| | - P B Mortensen
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark,National Centre for Register-Based Research, Business and Social Sciences, Aarhus University, Aarhus V, Denmark,Centre for Integrated Register-Based Research, CIRRAU, Aarhus University, Aarhus, Denmark,Centre for Integrative Sequencing, Department of Biomedicine and iSEQ, Aarhus University, Aarhus, Denmark
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13
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Gotfredsen DR, Wils RS, Hjorthøj C, Austin SF, Albert N, Secher RG, Thorup AAE, Mors O, Nordentoft M. Stability and development of psychotic symptoms and the use of antipsychotic medication - long-term follow-up. Psychol Med 2017; 47:2118-2129. [PMID: 28382874 DOI: 10.1017/s0033291717000563] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
BACKGROUND Few studies have evaluated the development in the use of antipsychotic medication and psychotic symptoms in patients with first-episode psychosis on a long-term basis. Our objective was to investigate how psychotic symptoms and the use of antipsychotic medication changed over a 10-year period in a cohort of patients with first-episode psychosis. METHOD The study is a longitudinal prospective cohort study over 10 years with follow-ups at years 1, 2, 5 and 10. A total of 496 patients with first-episode psychosis were included in a multi-centre study initiated between 1998 and 2000 in Copenhagen and Aarhus, Denmark. RESULTS At all follow-ups, a large proportion (20-30%) of patients had remission of psychotic symptoms without use of antipsychotic medication at the time of the follow-up. Patients who were in this group at the 5-year follow-up had an 87% [95% confidence interval (CI) 77-96%] chance of being in the same group at the 10-year follow-up. This stability was also the case for patients who had psychotic symptoms and were treated with antipsychotic medication at year 5, where there was a 67% (95% CI 56-78%) probability of being in this group at the consecutive follow-up. CONCLUSIONS A large group of patients with psychotic illness were in remission without the use of antipsychotic medication, peaking at year 10. Overall there was a large degree of stability in disease courses over the 10-year period. These results suggest that the long-term outcome of psychotic illness is heterogeneous and further investigation on a more individualized approach to long-term treatment is needed.
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Affiliation(s)
- D R Gotfredsen
- Mental Health Centre Copenhagen,Copenhagen University Hospital,Hellerup,Denmark
| | - R S Wils
- Mental Health Centre Copenhagen,Copenhagen University Hospital,Hellerup,Denmark
| | - C Hjorthøj
- Mental Health Centre Copenhagen,Copenhagen University Hospital,Hellerup,Denmark
| | - S F Austin
- Mental Health Centre Copenhagen,Copenhagen University Hospital,Hellerup,Denmark
| | - N Albert
- Mental Health Centre Copenhagen,Copenhagen University Hospital,Hellerup,Denmark
| | - R G Secher
- Mental Health Centre Copenhagen,Copenhagen University Hospital,Hellerup,Denmark
| | - A A E Thorup
- Mental Health Centre Copenhagen,Copenhagen University Hospital,Hellerup,Denmark
| | - O Mors
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research,iPSYCH,Aarhus,Denmark
| | - M Nordentoft
- Mental Health Centre Copenhagen,Copenhagen University Hospital,Hellerup,Denmark
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14
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Debost JC, Debost M, Grove J, Mors O, Hougaard DM, Børglum AD, Mortensen PB, Petersen L. COMT Val158Met and MTHFR C677T moderate risk of schizophrenia in response to childhood adversity. Acta Psychiatr Scand 2017; 136:85-95. [PMID: 28556887 DOI: 10.1111/acps.12761] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [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] [Accepted: 05/08/2017] [Indexed: 11/28/2022]
Abstract
OBJECTIVE Mesolimbic dopamine sensitization has been hypothesized to be a mediating factor of childhood adversity (CA) on schizophrenia risk. Activity of catechol-O-methyltransferase (COMT) Val158Met increases mesolimbic dopamine signaling and may be further regulated by methylenetetrahydrofolate reductase (MTHFR) C677T. This study investigates the three-way interaction between CA, COMT, and MTHFR. METHODS We conducted a nested case-control study on individuals born after 1981, linking population-based registers to study the three-way interaction. We included 1699 schizophrenia cases and 1681 controls, and used conditional logistic regression to report incidence rate ratios (IRRs). RESULTS Childhood adversity was robustly associated with schizophrenia. No main genetic effects were observed. MTHFR C677T increased schizophrenia risk in a dose-dependent manner per MTHFR T allele (P = 0.005) consequent upon CA exposure. After inclusion of the significant (P = 0.03) COMT × MTHFR × CA interaction, the risk was further increased per high-activity COMT Val allele. Hence, exposed COMT Val/Val and MTHFR T/T carriers had an IRR of 2.76 (95% CI, 1.66-4.61). Additional adjustments for ancestry and parental history of mental illness attenuated the results with the interaction being only marginally significant. CONCLUSION MTHFR C677T and COMT Val158Met interact with CA to increase risk of schizophrenia.
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Affiliation(s)
- J-C Debost
- Department of Economics and Business Economics, National Centre for Register-based Research, Aarhus University, Aarhus, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
| | - M Debost
- Department of Internal Medicine, Randers Regional Hospital, Randers NØ, Denmark
| | - J Grove
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark.,Department of Biomedicine, Aarhus University, Aarhus, Denmark.,Bioinformatics Research Centre, Aarhus University, Aarhus, Denmark.,iSEQ, Centre for Integrative Sequencing, Aarhus University, Aarhus, Denmark
| | - O Mors
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark.,iSEQ, Centre for Integrative Sequencing, Aarhus University, Aarhus, Denmark.,Centre for Psychiatric Research, Aarhus University Hospital Risskov, Aarhus, Denmark
| | - D M Hougaard
- Danish Centre for Neonatal Screening, Statens Serum Institut, Copenhagen, Denmark
| | - A D Børglum
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark.,Department of Biomedicine, Aarhus University, Aarhus, Denmark.,iSEQ, Centre for Integrative Sequencing, Aarhus University, Aarhus, Denmark
| | - P B Mortensen
- Department of Economics and Business Economics, National Centre for Register-based Research, Aarhus University, Aarhus, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark.,Centre for Integrated Register-based Research (CIRRAU), Aarhus University, Aarhus, Denmark
| | - L Petersen
- Department of Economics and Business Economics, National Centre for Register-based Research, Aarhus University, Aarhus, Denmark.,The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
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15
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Witt SH, Streit F, Jungkunz M, Frank J, Awasthi S, Reinbold CS, Treutlein J, Degenhardt F, Forstner AJ, Heilmann-Heimbach S, Dietl L, Schwarze CE, Schendel D, Strohmaier J, Abdellaoui A, Adolfsson R, Air TM, Akil H, Alda M, Alliey-Rodriguez N, Andreassen OA, Babadjanova G, Bass NJ, Bauer M, Baune BT, Bellivier F, Bergen S, Bethell A, Biernacka JM, Blackwood DHR, Boks MP, Boomsma DI, Børglum AD, Borrmann-Hassenbach M, Brennan P, Budde M, Buttenschøn HN, Byrne EM, Cervantes P, Clarke TK, Craddock N, Cruceanu C, Curtis D, Czerski PM, Dannlowski U, Davis T, de Geus EJC, Di Florio A, Djurovic S, Domenici E, Edenberg HJ, Etain B, Fischer SB, Forty L, Fraser C, Frye MA, Fullerton JM, Gade K, Gershon ES, Giegling I, Gordon SD, Gordon-Smith K, Grabe HJ, Green EK, Greenwood TA, Grigoroiu-Serbanescu M, Guzman-Parra J, Hall LS, Hamshere M, Hauser J, Hautzinger M, Heilbronner U, Herms S, Hitturlingappa S, Hoffmann P, Holmans P, Hottenga JJ, Jamain S, Jones I, Jones LA, Juréus A, Kahn RS, Kammerer-Ciernioch J, Kirov G, Kittel-Schneider S, Kloiber S, Knott SV, Kogevinas M, Landén M, Leber M, Leboyer M, Li QS, Lissowska J, Lucae S, Martin NG, Mayoral-Cleries F, McElroy SL, McIntosh AM, McKay JD, McQuillin A, Medland SE, Middeldorp CM, Milaneschi Y, Mitchell PB, Montgomery GW, Morken G, Mors O, Mühleisen TW, Müller-Myhsok B, Myers RM, Nievergelt CM, Nurnberger JI, O'Donovan MC, Loohuis LMO, Ophoff R, Oruc L, Owen MJ, Paciga SA, Penninx BWJH, Perry A, Pfennig A, Potash JB, Preisig M, Reif A, Rivas F, Rouleau GA, Schofield PR, Schulze TG, Schwarz M, Scott L, Sinnamon GCB, Stahl EA, Strauss J, Turecki G, Van der Auwera S, Vedder H, Vincent JB, Willemsen G, Witt CC, Wray NR, Xi HS, Tadic A, Dahmen N, Schott BH, Cichon S, Nöthen MM, Ripke S, Mobascher A, Rujescu D, Lieb K, Roepke S, Schmahl C, Bohus M, Rietschel M. Genome-wide association study of borderline personality disorder reveals genetic overlap with bipolar disorder, major depression and schizophrenia. Transl Psychiatry 2017; 7:e1155. [PMID: 28632202 PMCID: PMC5537640 DOI: 10.1038/tp.2017.115] [Citation(s) in RCA: 95] [Impact Index Per Article: 13.6] [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: 02/16/2017] [Accepted: 04/10/2017] [Indexed: 01/02/2023] Open
Abstract
Borderline personality disorder (BOR) is determined by environmental and genetic factors, and characterized by affective instability and impulsivity, diagnostic symptoms also observed in manic phases of bipolar disorder (BIP). Up to 20% of BIP patients show comorbidity with BOR. This report describes the first case-control genome-wide association study (GWAS) of BOR, performed in one of the largest BOR patient samples worldwide. The focus of our analysis was (i) to detect genes and gene sets involved in BOR and (ii) to investigate the genetic overlap with BIP. As there is considerable genetic overlap between BIP, major depression (MDD) and schizophrenia (SCZ) and a high comorbidity of BOR and MDD, we also analyzed the genetic overlap of BOR with SCZ and MDD. GWAS, gene-based tests and gene-set analyses were performed in 998 BOR patients and 1545 controls. Linkage disequilibrium score regression was used to detect the genetic overlap between BOR and these disorders. Single marker analysis revealed no significant association after correction for multiple testing. Gene-based analysis yielded two significant genes: DPYD (P=4.42 × 10-7) and PKP4 (P=8.67 × 10-7); and gene-set analysis yielded a significant finding for exocytosis (GO:0006887, PFDR=0.019; FDR, false discovery rate). Prior studies have implicated DPYD, PKP4 and exocytosis in BIP and SCZ. The most notable finding of the present study was the genetic overlap of BOR with BIP (rg=0.28 [P=2.99 × 10-3]), SCZ (rg=0.34 [P=4.37 × 10-5]) and MDD (rg=0.57 [P=1.04 × 10-3]). We believe our study is the first to demonstrate that BOR overlaps with BIP, MDD and SCZ on the genetic level. Whether this is confined to transdiagnostic clinical symptoms should be examined in future studies.
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Affiliation(s)
- S H Witt
- Central Institute of Mental Health, Department of Genetic Epidemiology in Psychiatry, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - F Streit
- Central Institute of Mental Health, Department of Genetic Epidemiology in Psychiatry, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - M Jungkunz
- Central Institute of Mental Health, Clinic of Psychosomatic and Psychotherapeutic Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Central Institute of Mental Health, Institute for Psychiatric and Psychosomatic Psychotherapy (IPPP)/Psychosomatic Medicine and Psychotherapy, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - J Frank
- Central Institute of Mental Health, Department of Genetic Epidemiology in Psychiatry, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - S Awasthi
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany
| | - C S Reinbold
- Human Genomics Research Group, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - J Treutlein
- Central Institute of Mental Health, Department of Genetic Epidemiology in Psychiatry, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - F Degenhardt
- Institute of Human Genetics, University of Bonn, Bonn, Germany
- Life and Brain Center, Department of Genomics, University of Bonn, Bonn, Germany
| | - A J Forstner
- Human Genomics Research Group, Department of Biomedicine, University of Basel, Basel, Switzerland
- Institute of Human Genetics, University of Bonn, Bonn, Germany
- Life and Brain Center, Department of Genomics, University of Bonn, Bonn, Germany
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
| | | | - L Dietl
- Department of Psychiatry, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - C E Schwarze
- Department of Clinical Psychology and Psychotherapy, University of Heidelberg, Heidelberg, Germany
| | - D Schendel
- Central Institute of Mental Health, Department of Genetic Epidemiology in Psychiatry, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - J Strohmaier
- Central Institute of Mental Health, Department of Genetic Epidemiology in Psychiatry, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - A Abdellaoui
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - R Adolfsson
- Department of Clinical Sciences, Psychiatry, Umeå University, Umeå, Sweden
| | - T M Air
- Discipline of Psychiatry, University of Adelaide, Adelaide, SA, Australia
| | - H Akil
- Molecular and Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI, USA
| | - M Alda
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - N Alliey-Rodriguez
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - O A Andreassen
- Division Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- NORMENT, University of Oslo, Oslo, Norway
| | - G Babadjanova
- Institute of Pulmonology, Russian State Medical University, Moscow, Russian Federation
| | - N J Bass
- Division of Psychiatry, University College London, London, UK
| | - M Bauer
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Dresden, Germany
| | - B T Baune
- Discipline of Psychiatry, University of Adelaide, Adelaide, SA, Australia
| | - F Bellivier
- Inserm, U1144, AP-HP, GH Saint-Louis, Département de Psychiatrie et de Médecine Addictologique, Paris, France
| | - S Bergen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - A Bethell
- National Center for Mental Health, Cardiff University, Cardiff, UK
| | - J M Biernacka
- Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - D H R Blackwood
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - M P Boks
- Urain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
| | - D I Boomsma
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - A D Børglum
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- iSEQ, Centre for Integrative Sequencing, Aarhus University, Aarhus, Denmark
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
| | | | - P Brennan
- Genetic Epidemiology Group, International Agency for Research on Cancer, Lyon, France
| | - M Budde
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Goettingen, Germany
- Medical Center of the University of Munich, Campus Innenstadt, Institute of Psychiatric Phenomics and Genomics (IPPG), Munich, Germany
| | - H N Buttenschøn
- Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - E M Byrne
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
| | - P Cervantes
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - T-K Clarke
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - N Craddock
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - C Cruceanu
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| | - D Curtis
- Centre for Psychiatry, Queen Mary University of London, London, UK
- UCL Genetics Institute, University College London, London, UK
| | - P M Czerski
- Laboratory of Psychiatric Genetics, Department of Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - U Dannlowski
- Department of Psychiatry, University of Marburg, Marburg, Germany
- Department of Psychiatry, University of Münste, Münster, Germany
| | - T Davis
- Discipline of Psychiatry, University of Adelaide, Adelaide, SA, Australia
| | - E J C de Geus
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - A Di Florio
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - S Djurovic
- Department of Medical Genetics, Oslo University Hospital Ullevål, Oslo, Norway
- NORMENT, KG Jebsen Centre for Psychosis Research, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - E Domenici
- Centre for Integrative Biology, Università degli Studi di Trento, Trento, Italy
| | - H J Edenberg
- Indiana University School of Medicine, Department of Biochemistry and Molecular Biology, Indianapolis, IN, USA
- Indiana University School of Medicine, Department of Medical and Molecular Genetics, Indianapolis, IN, USA
| | - B Etain
- Faculté de Médecine, Université Paris Est, Créteil, France
| | - S B Fischer
- Human Genomics Research Group, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - L Forty
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - C Fraser
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - M A Frye
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - J M Fullerton
- School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
- Neuroscience Research Australia, Sydney, NSW, Australia
| | - K Gade
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Goettingen, Germany
- Medical Center of the University of Munich, Campus Innenstadt, Institute of Psychiatric Phenomics and Genomics (IPPG), Munich, Germany
| | - E S Gershon
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - I Giegling
- Department of Psychiatry, University of Halle, Halle, Germany
| | - S D Gordon
- Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - K Gordon-Smith
- Department of Psychological Medicine, University of Worcester, Worcester, UK
| | - H J Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - E K Green
- School of Biomedical and Healthcare Sciences, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK
| | - T A Greenwood
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - M Grigoroiu-Serbanescu
- Biometric Psychiatric Genetics Research Unit, Alexandru Obregia Clinical Psychiatric Hospital, Bucharest, Romania
| | - J Guzman-Parra
- Mental Health Department, Biomedicine Institute, University Regional Hospital, Málaga, Spain
| | - L S Hall
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
- Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
| | - M Hamshere
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - J Hauser
- Laboratory of Psychiatric Genetics, Department of Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - M Hautzinger
- Department of Psychology, Eberhard Karls Universität Tübingen, Tubingen, Germany
| | - U Heilbronner
- Medical Center of the University of Munich, Campus Innenstadt, Institute of Psychiatric Phenomics and Genomics (IPPG), Munich, Germany
| | - S Herms
- Human Genomics Research Group, Department of Biomedicine, University of Basel, Basel, Switzerland
- Institute of Human Genetics, University of Bonn, Bonn, Germany
- Life and Brain Center, Department of Genomics, University of Bonn, Bonn, Germany
| | - S Hitturlingappa
- Discipline of Psychiatry, University of Adelaide, Adelaide, SA, Australia
| | - P Hoffmann
- Human Genomics Research Group, Department of Biomedicine, University of Basel, Basel, Switzerland
- Institute of Human Genetics, University of Bonn, Bonn, Germany
- Life and Brain Center, Department of Genomics, University of Bonn, Bonn, Germany
| | - P Holmans
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - J-J Hottenga
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - S Jamain
- Faculté de Médecine, Université Paris Est, Créteil, France
- Inserm U955, Psychiatrie Translationnelle, Créteil, France
| | - I Jones
- National Center for Mental Health, Cardiff University, Cardiff, UK
| | - L A Jones
- Department of Psychological Medicine, University of Worcester, Worcester, UK
| | - A Juréus
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - R S Kahn
- University Medical Center Utrecht, Division of Neuroscience, Department of Psychiatry, Utrecht, The Netherlands
| | | | - G Kirov
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - S Kittel-Schneider
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt am Main, Frankfurt am Main, Germany
| | - S Kloiber
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Max Planck Institute of Psychiatry, Munich, Germany
| | - S V Knott
- Department of Psychological Medicine, University of Worcester, Worcester, UK
| | - M Kogevinas
- Center for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
| | - M Landén
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - M Leber
- Clinic for Psychiatry and Psychotherapy, University Hospital Cologne, Cologne, Germany
| | - M Leboyer
- Inserm U955, Translational Psychiatry Laboratory, AP-HP, DHU PePSY, Department of Psychiatry, Université Paris Est, Créteil, France
| | - Q S Li
- Janssen Research and Development, LLC, Neuroscience Therapeutic Area, Titusville, NJ, USA
| | - J Lissowska
- M. Sklodowska-Curie Cancer Center and Institute of Oncology, Cancer Epidemiology and Prevention, Warsaw, Poland
| | - S Lucae
- Max Planck Institute of Psychiatry, Munich, Germany
| | - N G Martin
- Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia
| | - F Mayoral-Cleries
- Mental Health Department, Biomedicine Institute, University Regional Hospital, Málaga, Spain
| | - S L McElroy
- Lindner Center of HOPE, Research Institute, Mason, OH, USA
| | - A M McIntosh
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
| | - J D McKay
- Genetic Cancer Susceptibility Group, International Agency for Research on Cancer, Lyon, France
| | - A McQuillin
- Division of Psychiatry, University College London, London, UK
| | - S E Medland
- Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
| | - C M Middeldorp
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Y Milaneschi
- VU University Medical Center and GGZ inGeest, Department of Psychiatry, Amsterdam, The Netherlands
| | - P B Mitchell
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
- Black Dog Institute, Sydney, NSW, Australia
| | - G W Montgomery
- Institute for Molecular Biology, University of Queensland, Brisbane, QLD, Australia
| | - G Morken
- Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Psychiatry, St Olavs University Hospital, Trondheim, Norway
| | - O Mors
- Risskov, Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | - T W Mühleisen
- Research Center Juelich, Institute of Neuroscience and Medicine (INM-1), Juelich, Germany
- Division of Medical Genetics, University of Basel, Basel, Switzerland
| | - B Müller-Myhsok
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- University of Liverpool, Liverpool, UK
| | - R M Myers
- HudsonAlpha Institute for Biotechnology, Huntsville, AL, USA
| | - C M Nievergelt
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - J I Nurnberger
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - M C O'Donovan
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - L M O Loohuis
- Center for Neurobehavioral Genetics, University of California Los Angeles, Los Angeles, CA, USA
| | - R Ophoff
- University Medical Center Utrecht, Division of Brain Research, Utrecht, The Netherlands
| | - L Oruc
- Psychiatry Clinic, Clinical Center University of Sarajevo, Sarajevo, Bosnia-Herzegovina
| | - M J Owen
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - S A Paciga
- Pfizer Global Research and Development, Human Genetics and Computational Biomedicine, Groton, CT, USA
| | - B W J H Penninx
- VU University Medical Center and GGZ inGeest, Department of Psychiatry, Amsterdam, The Netherlands
| | - A Perry
- Department of Psychological Medicine, University of Worcester, Worcester, UK
| | - A Pfennig
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Dresden, Germany
| | - J B Potash
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
| | - M Preisig
- Department of Psychiatry, Psychiatric University Hospital of Lausanne, Lausanne, Switzerland
| | - A Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt am Main, Frankfurt am Main, Germany
| | - F Rivas
- Mental Health Department, Biomedicine Institute, University Regional Hospital, Málaga, Spain
| | - G A Rouleau
- Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, QC, Canada
- Montreal Neurological Institute and Hospital, Montreal, QC, Canada
| | - P R Schofield
- School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
- Neuroscience Research Australia, Sydney, NSW, Australia
| | - T G Schulze
- Central Institute of Mental Health, Department of Genetic Epidemiology in Psychiatry, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Goettingen, Germany
- Medical Center of the University of Munich, Campus Innenstadt, Institute of Psychiatric Phenomics and Genomics (IPPG), Munich, Germany
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
- NIMH Division of Intramural Research Programs, Human Genetics Branch, Bethesda, MD, USA
| | - M Schwarz
- Psychiatric Center Nordbaden, Wiesloch, Germany
| | - L Scott
- Center for Statistical Genetics, Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
| | - G C B Sinnamon
- School of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia
| | - E A Stahl
- Broad Institute of MIT and Harvard, Medical and Population Genetics, Cambridge, MA, USA
- Division of Psychiatric Genomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - J Strauss
- Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - G Turecki
- Department of Psychiatry, McGill University, Montreal, QC, Canada
| | - S Van der Auwera
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - H Vedder
- Psychiatric Center Nordbaden, Wiesloch, Germany
| | - J B Vincent
- Centre for Addiction and Mental Health, Molecular Neuropsychiatry and Development Laboratory, Toronto, ON, Canada
| | - G Willemsen
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - C C Witt
- Department of Anaesthesiology and Operative Intensive Care, University Hospital Mannheim, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
| | - N R Wray
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia
| | - H S Xi
- Pfizer Global Research and Development, Computational Sciences Center of Emphasis, Cambridge, MA, USA
| | - Bipolar Disorders Working Group of the Psychiatric Genomics Consortium
- Central Institute of Mental Health, Department of Genetic Epidemiology in Psychiatry, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Central Institute of Mental Health, Clinic of Psychosomatic and Psychotherapeutic Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Central Institute of Mental Health, Institute for Psychiatric and Psychosomatic Psychotherapy (IPPP)/Psychosomatic Medicine and Psychotherapy, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany
- Human Genomics Research Group, Department of Biomedicine, University of Basel, Basel, Switzerland
- Institute of Human Genetics, University of Bonn, Bonn, Germany
- Life and Brain Center, Department of Genomics, University of Bonn, Bonn, Germany
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
- Department of Psychiatry, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
- Department of Clinical Psychology and Psychotherapy, University of Heidelberg, Heidelberg, Germany
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Clinical Sciences, Psychiatry, Umeå University, Umeå, Sweden
- Discipline of Psychiatry, University of Adelaide, Adelaide, SA, Australia
- Molecular and Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI, USA
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
- Division Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- NORMENT, University of Oslo, Oslo, Norway
- Institute of Pulmonology, Russian State Medical University, Moscow, Russian Federation
- Division of Psychiatry, University College London, London, UK
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Dresden, Germany
- Inserm, U1144, AP-HP, GH Saint-Louis, Département de Psychiatrie et de Médecine Addictologique, Paris, France
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- National Center for Mental Health, Cardiff University, Cardiff, UK
- Health Sciences Research, Mayo Clinic, Rochester, MN, USA
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
- Urain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- iSEQ, Centre for Integrative Sequencing, Aarhus University, Aarhus, Denmark
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- Medical and Quality Assurance, Clinics of Upper Bavaria, Munich, Germany
- Genetic Epidemiology Group, International Agency for Research on Cancer, Lyon, France
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Goettingen, Germany
- Medical Center of the University of Munich, Campus Innenstadt, Institute of Psychiatric Phenomics and Genomics (IPPG), Munich, Germany
- Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
- Centre for Psychiatry, Queen Mary University of London, London, UK
- UCL Genetics Institute, University College London, London, UK
- Laboratory of Psychiatric Genetics, Department of Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
- Department of Psychiatry, University of Marburg, Marburg, Germany
- Department of Psychiatry, University of Münste, Münster, Germany
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
- Department of Medical Genetics, Oslo University Hospital Ullevål, Oslo, Norway
- NORMENT, KG Jebsen Centre for Psychosis Research, Department of Clinical Science, University of Bergen, Bergen, Norway
- Centre for Integrative Biology, Università degli Studi di Trento, Trento, Italy
- Indiana University School of Medicine, Department of Biochemistry and Molecular Biology, Indianapolis, IN, USA
- Indiana University School of Medicine, Department of Medical and Molecular Genetics, Indianapolis, IN, USA
- Faculté de Médecine, Université Paris Est, Créteil, France
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
- School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
- Neuroscience Research Australia, Sydney, NSW, Australia
- Department of Psychiatry, University of Halle, Halle, Germany
- Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- Department of Psychological Medicine, University of Worcester, Worcester, UK
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
- School of Biomedical and Healthcare Sciences, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Biometric Psychiatric Genetics Research Unit, Alexandru Obregia Clinical Psychiatric Hospital, Bucharest, Romania
- Mental Health Department, Biomedicine Institute, University Regional Hospital, Málaga, Spain
- Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
- Department of Psychology, Eberhard Karls Universität Tübingen, Tubingen, Germany
- Inserm U955, Psychiatrie Translationnelle, Créteil, France
- University Medical Center Utrecht, Division of Neuroscience, Department of Psychiatry, Utrecht, The Netherlands
- Center of Psychiatry Weinsberg, Weinsberg, Germany
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt am Main, Frankfurt am Main, Germany
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Max Planck Institute of Psychiatry, Munich, Germany
- Center for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
- Clinic for Psychiatry and Psychotherapy, University Hospital Cologne, Cologne, Germany
- Inserm U955, Translational Psychiatry Laboratory, AP-HP, DHU PePSY, Department of Psychiatry, Université Paris Est, Créteil, France
- Janssen Research and Development, LLC, Neuroscience Therapeutic Area, Titusville, NJ, USA
- M. Sklodowska-Curie Cancer Center and Institute of Oncology, Cancer Epidemiology and Prevention, Warsaw, Poland
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia
- Lindner Center of HOPE, Research Institute, Mason, OH, USA
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
- Genetic Cancer Susceptibility Group, International Agency for Research on Cancer, Lyon, France
- Division of Psychiatry, University College London, London, UK
- VU University Medical Center and GGZ inGeest, Department of Psychiatry, Amsterdam, The Netherlands
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
- Black Dog Institute, Sydney, NSW, Australia
- Institute for Molecular Biology, University of Queensland, Brisbane, QLD, Australia
- Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Psychiatry, St Olavs University Hospital, Trondheim, Norway
- Risskov, Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Research Center Juelich, Institute of Neuroscience and Medicine (INM-1), Juelich, Germany
- Division of Medical Genetics, University of Basel, Basel, Switzerland
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- University of Liverpool, Liverpool, UK
- HudsonAlpha Institute for Biotechnology, Huntsville, AL, USA
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
- Center for Neurobehavioral Genetics, University of California Los Angeles, Los Angeles, CA, USA
- University Medical Center Utrecht, Division of Brain Research, Utrecht, The Netherlands
- Psychiatry Clinic, Clinical Center University of Sarajevo, Sarajevo, Bosnia-Herzegovina
- Pfizer Global Research and Development, Human Genetics and Computational Biomedicine, Groton, CT, USA
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
- Department of Psychiatry, Psychiatric University Hospital of Lausanne, Lausanne, Switzerland
- Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, QC, Canada
- Montreal Neurological Institute and Hospital, Montreal, QC, Canada
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
- NIMH Division of Intramural Research Programs, Human Genetics Branch, Bethesda, MD, USA
- Psychiatric Center Nordbaden, Wiesloch, Germany
- Center for Statistical Genetics, Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
- School of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia
- Broad Institute of MIT and Harvard, Medical and Population Genetics, Cambridge, MA, USA
- Division of Psychiatric Genomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Centre for Addiction and Mental Health, Molecular Neuropsychiatry and Development Laboratory, Toronto, ON, Canada
- Department of Anaesthesiology and Operative Intensive Care, University Hospital Mannheim, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia
- Pfizer Global Research and Development, Computational Sciences Center of Emphasis, Cambridge, MA, USA
- AGAPLESION Elisabethenstift gGmbh, Department of Psychiatry, Psychosomatics and Psychotherapy, Darmstadt, Germany
- University Medical Center, Department of Psychiatry and Psychotherapy, Mainz, Germany
- Leibniz Institute for Neurobiology, Magdeburg, Germany
- Department of Biomedicine, University of Basel, Basel, Switzerland
- Stanley Center for Psychiatric Research and Medical and Population Genetics Program, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Analytic and Translational Genetics Unit, Department of Medicine, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
| | - Major Depressive Disorder Working Group of the Psychiatric Genomics Consortium
- Central Institute of Mental Health, Department of Genetic Epidemiology in Psychiatry, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Central Institute of Mental Health, Clinic of Psychosomatic and Psychotherapeutic Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Central Institute of Mental Health, Institute for Psychiatric and Psychosomatic Psychotherapy (IPPP)/Psychosomatic Medicine and Psychotherapy, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany
- Human Genomics Research Group, Department of Biomedicine, University of Basel, Basel, Switzerland
- Institute of Human Genetics, University of Bonn, Bonn, Germany
- Life and Brain Center, Department of Genomics, University of Bonn, Bonn, Germany
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
- Department of Psychiatry, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
- Department of Clinical Psychology and Psychotherapy, University of Heidelberg, Heidelberg, Germany
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Clinical Sciences, Psychiatry, Umeå University, Umeå, Sweden
- Discipline of Psychiatry, University of Adelaide, Adelaide, SA, Australia
- Molecular and Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI, USA
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
- Division Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- NORMENT, University of Oslo, Oslo, Norway
- Institute of Pulmonology, Russian State Medical University, Moscow, Russian Federation
- Division of Psychiatry, University College London, London, UK
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Dresden, Germany
- Inserm, U1144, AP-HP, GH Saint-Louis, Département de Psychiatrie et de Médecine Addictologique, Paris, France
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- National Center for Mental Health, Cardiff University, Cardiff, UK
- Health Sciences Research, Mayo Clinic, Rochester, MN, USA
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
- Urain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- iSEQ, Centre for Integrative Sequencing, Aarhus University, Aarhus, Denmark
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- Medical and Quality Assurance, Clinics of Upper Bavaria, Munich, Germany
- Genetic Epidemiology Group, International Agency for Research on Cancer, Lyon, France
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Goettingen, Germany
- Medical Center of the University of Munich, Campus Innenstadt, Institute of Psychiatric Phenomics and Genomics (IPPG), Munich, Germany
- Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
- Centre for Psychiatry, Queen Mary University of London, London, UK
- UCL Genetics Institute, University College London, London, UK
- Laboratory of Psychiatric Genetics, Department of Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
- Department of Psychiatry, University of Marburg, Marburg, Germany
- Department of Psychiatry, University of Münste, Münster, Germany
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
- Department of Medical Genetics, Oslo University Hospital Ullevål, Oslo, Norway
- NORMENT, KG Jebsen Centre for Psychosis Research, Department of Clinical Science, University of Bergen, Bergen, Norway
- Centre for Integrative Biology, Università degli Studi di Trento, Trento, Italy
- Indiana University School of Medicine, Department of Biochemistry and Molecular Biology, Indianapolis, IN, USA
- Indiana University School of Medicine, Department of Medical and Molecular Genetics, Indianapolis, IN, USA
- Faculté de Médecine, Université Paris Est, Créteil, France
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
- School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
- Neuroscience Research Australia, Sydney, NSW, Australia
- Department of Psychiatry, University of Halle, Halle, Germany
- Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- Department of Psychological Medicine, University of Worcester, Worcester, UK
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
- School of Biomedical and Healthcare Sciences, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Biometric Psychiatric Genetics Research Unit, Alexandru Obregia Clinical Psychiatric Hospital, Bucharest, Romania
- Mental Health Department, Biomedicine Institute, University Regional Hospital, Málaga, Spain
- Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
- Department of Psychology, Eberhard Karls Universität Tübingen, Tubingen, Germany
- Inserm U955, Psychiatrie Translationnelle, Créteil, France
- University Medical Center Utrecht, Division of Neuroscience, Department of Psychiatry, Utrecht, The Netherlands
- Center of Psychiatry Weinsberg, Weinsberg, Germany
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt am Main, Frankfurt am Main, Germany
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Max Planck Institute of Psychiatry, Munich, Germany
- Center for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
- Clinic for Psychiatry and Psychotherapy, University Hospital Cologne, Cologne, Germany
- Inserm U955, Translational Psychiatry Laboratory, AP-HP, DHU PePSY, Department of Psychiatry, Université Paris Est, Créteil, France
- Janssen Research and Development, LLC, Neuroscience Therapeutic Area, Titusville, NJ, USA
- M. Sklodowska-Curie Cancer Center and Institute of Oncology, Cancer Epidemiology and Prevention, Warsaw, Poland
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia
- Lindner Center of HOPE, Research Institute, Mason, OH, USA
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
- Genetic Cancer Susceptibility Group, International Agency for Research on Cancer, Lyon, France
- Division of Psychiatry, University College London, London, UK
- VU University Medical Center and GGZ inGeest, Department of Psychiatry, Amsterdam, The Netherlands
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
- Black Dog Institute, Sydney, NSW, Australia
- Institute for Molecular Biology, University of Queensland, Brisbane, QLD, Australia
- Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Psychiatry, St Olavs University Hospital, Trondheim, Norway
- Risskov, Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Research Center Juelich, Institute of Neuroscience and Medicine (INM-1), Juelich, Germany
- Division of Medical Genetics, University of Basel, Basel, Switzerland
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- University of Liverpool, Liverpool, UK
- HudsonAlpha Institute for Biotechnology, Huntsville, AL, USA
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
- Center for Neurobehavioral Genetics, University of California Los Angeles, Los Angeles, CA, USA
- University Medical Center Utrecht, Division of Brain Research, Utrecht, The Netherlands
- Psychiatry Clinic, Clinical Center University of Sarajevo, Sarajevo, Bosnia-Herzegovina
- Pfizer Global Research and Development, Human Genetics and Computational Biomedicine, Groton, CT, USA
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
- Department of Psychiatry, Psychiatric University Hospital of Lausanne, Lausanne, Switzerland
- Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, QC, Canada
- Montreal Neurological Institute and Hospital, Montreal, QC, Canada
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
- NIMH Division of Intramural Research Programs, Human Genetics Branch, Bethesda, MD, USA
- Psychiatric Center Nordbaden, Wiesloch, Germany
- Center for Statistical Genetics, Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
- School of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia
- Broad Institute of MIT and Harvard, Medical and Population Genetics, Cambridge, MA, USA
- Division of Psychiatric Genomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Centre for Addiction and Mental Health, Molecular Neuropsychiatry and Development Laboratory, Toronto, ON, Canada
- Department of Anaesthesiology and Operative Intensive Care, University Hospital Mannheim, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia
- Pfizer Global Research and Development, Computational Sciences Center of Emphasis, Cambridge, MA, USA
- AGAPLESION Elisabethenstift gGmbh, Department of Psychiatry, Psychosomatics and Psychotherapy, Darmstadt, Germany
- University Medical Center, Department of Psychiatry and Psychotherapy, Mainz, Germany
- Leibniz Institute for Neurobiology, Magdeburg, Germany
- Department of Biomedicine, University of Basel, Basel, Switzerland
- Stanley Center for Psychiatric Research and Medical and Population Genetics Program, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Analytic and Translational Genetics Unit, Department of Medicine, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
| | - Schizophrenia Working Group of the Psychiatric Genomics Consortium
- Central Institute of Mental Health, Department of Genetic Epidemiology in Psychiatry, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Central Institute of Mental Health, Clinic of Psychosomatic and Psychotherapeutic Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Central Institute of Mental Health, Institute for Psychiatric and Psychosomatic Psychotherapy (IPPP)/Psychosomatic Medicine and Psychotherapy, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany
- Human Genomics Research Group, Department of Biomedicine, University of Basel, Basel, Switzerland
- Institute of Human Genetics, University of Bonn, Bonn, Germany
- Life and Brain Center, Department of Genomics, University of Bonn, Bonn, Germany
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
- Department of Psychiatry, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
- Department of Clinical Psychology and Psychotherapy, University of Heidelberg, Heidelberg, Germany
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Department of Clinical Sciences, Psychiatry, Umeå University, Umeå, Sweden
- Discipline of Psychiatry, University of Adelaide, Adelaide, SA, Australia
- Molecular and Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI, USA
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
- Division Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- NORMENT, University of Oslo, Oslo, Norway
- Institute of Pulmonology, Russian State Medical University, Moscow, Russian Federation
- Division of Psychiatry, University College London, London, UK
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Dresden, Germany
- Inserm, U1144, AP-HP, GH Saint-Louis, Département de Psychiatrie et de Médecine Addictologique, Paris, France
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- National Center for Mental Health, Cardiff University, Cardiff, UK
- Health Sciences Research, Mayo Clinic, Rochester, MN, USA
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
- Urain Center Rudolf Magnus, Department of Psychiatry, University Medical Center Utrecht, Utrecht, The Netherlands
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- iSEQ, Centre for Integrative Sequencing, Aarhus University, Aarhus, Denmark
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- Medical and Quality Assurance, Clinics of Upper Bavaria, Munich, Germany
- Genetic Epidemiology Group, International Agency for Research on Cancer, Lyon, France
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Goettingen, Germany
- Medical Center of the University of Munich, Campus Innenstadt, Institute of Psychiatric Phenomics and Genomics (IPPG), Munich, Germany
- Translational Neuropsychiatry Unit, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Queensland Brain Institute, The University of Queensland, Brisbane, QLD, Australia
- Department of Psychiatry, McGill University, Montreal, QC, Canada
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
- Centre for Psychiatry, Queen Mary University of London, London, UK
- UCL Genetics Institute, University College London, London, UK
- Laboratory of Psychiatric Genetics, Department of Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
- Department of Psychiatry, University of Marburg, Marburg, Germany
- Department of Psychiatry, University of Münste, Münster, Germany
- Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
- Department of Medical Genetics, Oslo University Hospital Ullevål, Oslo, Norway
- NORMENT, KG Jebsen Centre for Psychosis Research, Department of Clinical Science, University of Bergen, Bergen, Norway
- Centre for Integrative Biology, Università degli Studi di Trento, Trento, Italy
- Indiana University School of Medicine, Department of Biochemistry and Molecular Biology, Indianapolis, IN, USA
- Indiana University School of Medicine, Department of Medical and Molecular Genetics, Indianapolis, IN, USA
- Faculté de Médecine, Université Paris Est, Créteil, France
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
- School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
- Neuroscience Research Australia, Sydney, NSW, Australia
- Department of Psychiatry, University of Halle, Halle, Germany
- Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, QLD, Australia
- Department of Psychological Medicine, University of Worcester, Worcester, UK
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
- School of Biomedical and Healthcare Sciences, Plymouth University Peninsula Schools of Medicine and Dentistry, Plymouth, UK
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Biometric Psychiatric Genetics Research Unit, Alexandru Obregia Clinical Psychiatric Hospital, Bucharest, Romania
- Mental Health Department, Biomedicine Institute, University Regional Hospital, Málaga, Spain
- Institute of Genetic Medicine, Newcastle University, Newcastle upon Tyne, UK
- Department of Psychology, Eberhard Karls Universität Tübingen, Tubingen, Germany
- Inserm U955, Psychiatrie Translationnelle, Créteil, France
- University Medical Center Utrecht, Division of Neuroscience, Department of Psychiatry, Utrecht, The Netherlands
- Center of Psychiatry Weinsberg, Weinsberg, Germany
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt am Main, Frankfurt am Main, Germany
- Centre for Addiction and Mental Health, Toronto, ON, Canada
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
- Max Planck Institute of Psychiatry, Munich, Germany
- Center for Research in Environmental Epidemiology (CREAL), Barcelona, Spain
- Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
- Clinic for Psychiatry and Psychotherapy, University Hospital Cologne, Cologne, Germany
- Inserm U955, Translational Psychiatry Laboratory, AP-HP, DHU PePSY, Department of Psychiatry, Université Paris Est, Créteil, France
- Janssen Research and Development, LLC, Neuroscience Therapeutic Area, Titusville, NJ, USA
- M. Sklodowska-Curie Cancer Center and Institute of Oncology, Cancer Epidemiology and Prevention, Warsaw, Poland
- School of Psychology, The University of Queensland, Brisbane, QLD, Australia
- Lindner Center of HOPE, Research Institute, Mason, OH, USA
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
- Genetic Cancer Susceptibility Group, International Agency for Research on Cancer, Lyon, France
- Division of Psychiatry, University College London, London, UK
- VU University Medical Center and GGZ inGeest, Department of Psychiatry, Amsterdam, The Netherlands
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
- Black Dog Institute, Sydney, NSW, Australia
- Institute for Molecular Biology, University of Queensland, Brisbane, QLD, Australia
- Department of Neuroscience, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Psychiatry, St Olavs University Hospital, Trondheim, Norway
- Risskov, Psychosis Research Unit, Aarhus University Hospital, Aarhus, Denmark
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Research Center Juelich, Institute of Neuroscience and Medicine (INM-1), Juelich, Germany
- Division of Medical Genetics, University of Basel, Basel, Switzerland
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- University of Liverpool, Liverpool, UK
- HudsonAlpha Institute for Biotechnology, Huntsville, AL, USA
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
- Center for Neurobehavioral Genetics, University of California Los Angeles, Los Angeles, CA, USA
- University Medical Center Utrecht, Division of Brain Research, Utrecht, The Netherlands
- Psychiatry Clinic, Clinical Center University of Sarajevo, Sarajevo, Bosnia-Herzegovina
- Pfizer Global Research and Development, Human Genetics and Computational Biomedicine, Groton, CT, USA
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
- Department of Psychiatry, Psychiatric University Hospital of Lausanne, Lausanne, Switzerland
- Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, QC, Canada
- Montreal Neurological Institute and Hospital, Montreal, QC, Canada
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
- NIMH Division of Intramural Research Programs, Human Genetics Branch, Bethesda, MD, USA
- Psychiatric Center Nordbaden, Wiesloch, Germany
- Center for Statistical Genetics, Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
- School of Medicine and Dentistry, James Cook University, Townsville, QLD, Australia
- Broad Institute of MIT and Harvard, Medical and Population Genetics, Cambridge, MA, USA
- Division of Psychiatric Genomics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Centre for Addiction and Mental Health, Molecular Neuropsychiatry and Development Laboratory, Toronto, ON, Canada
- Department of Anaesthesiology and Operative Intensive Care, University Hospital Mannheim, Medical Faculty Mannheim/Heidelberg University, Mannheim, Germany
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, QLD, Australia
- Pfizer Global Research and Development, Computational Sciences Center of Emphasis, Cambridge, MA, USA
- AGAPLESION Elisabethenstift gGmbh, Department of Psychiatry, Psychosomatics and Psychotherapy, Darmstadt, Germany
- University Medical Center, Department of Psychiatry and Psychotherapy, Mainz, Germany
- Leibniz Institute for Neurobiology, Magdeburg, Germany
- Department of Biomedicine, University of Basel, Basel, Switzerland
- Stanley Center for Psychiatric Research and Medical and Population Genetics Program, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Analytic and Translational Genetics Unit, Department of Medicine, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
| | - A Tadic
- AGAPLESION Elisabethenstift gGmbh, Department of Psychiatry, Psychosomatics and Psychotherapy, Darmstadt, Germany
- University Medical Center, Department of Psychiatry and Psychotherapy, Mainz, Germany
| | - N Dahmen
- University Medical Center, Department of Psychiatry and Psychotherapy, Mainz, Germany
| | - B H Schott
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany
- Leibniz Institute for Neurobiology, Magdeburg, Germany
| | - S Cichon
- Institute of Human Genetics, University of Bonn, Bonn, Germany
- Research Center Juelich, Institute of Neuroscience and Medicine (INM-1), Juelich, Germany
- Division of Medical Genetics, University of Basel, Basel, Switzerland
- Department of Biomedicine, University of Basel, Basel, Switzerland
| | - M M Nöthen
- Institute of Human Genetics, University of Bonn, Bonn, Germany
- Life and Brain Center, Department of Genomics, University of Bonn, Bonn, Germany
| | - S Ripke
- Department of Psychiatry and Psychotherapy, Charité Universitätsmedizin Berlin, Campus Mitte, Berlin, Germany
- Stanley Center for Psychiatric Research and Medical and Population Genetics Program, Broad Institute of MIT and Harvard, Cambridge, MA, USA
- Analytic and Translational Genetics Unit, Department of Medicine, Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
| | - A Mobascher
- University Medical Center, Department of Psychiatry and Psychotherapy, Mainz, Germany
| | - D Rujescu
- Department of Psychiatry, University of Halle, Halle, Germany
| | - K Lieb
- University Medical Center, Department of Psychiatry and Psychotherapy, Mainz, Germany
| | - S Roepke
- Department of Psychiatry, Charité-Universitätsmedizin Berlin, Campus Benjamin Franklin, Berlin, Germany
| | - C Schmahl
- Central Institute of Mental Health, Clinic of Psychosomatic and Psychotherapeutic Medicine, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - M Bohus
- Central Institute of Mental Health, Institute for Psychiatric and Psychosomatic Psychotherapy (IPPP)/Psychosomatic Medicine and Psychotherapy, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - M Rietschel
- Central Institute of Mental Health, Department of Genetic Epidemiology in Psychiatry, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
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Meier SM, Plessen KJ, Verhulst F, Mors O, Mortensen PB, Pedersen CB, Agerbo E. Familial confounding of the association between maternal smoking during pregnancy and internalizing disorders in offspring. Psychol Med 2017; 47:1417-1426. [PMID: 28100290 DOI: 10.1017/s0033291716003627] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND Maternal smoking has consistently been associated with multiple adverse childhood outcomes including externalizing disorders. In contrast the association between maternal smoking during pregnancy (MSDP) and internalizing (anxiety and depressive) disorders in offspring has received less investigation. METHOD We conducted a nationwide cohort study including 957635 individuals born in Denmark between 1991 and 2007. Data on MSDP and diagnoses of depression or anxiety disorders were derived from national registers and patients were followed up from the age of 5 years to the end of 2012. Hazard rate ratios (HRRs) were estimated using stratified Cox regression models. Sibling data were used to disentangle individual- and familial-level effects of MSDP and to control for unmeasured familial confounding. RESULTS At the population level, offspring exposed to MSDP were at increased risk for both severe depression [HRR 1.29, 95% confidence interval (CI) 1.22-1.36] and severe anxiety disorders (HRR 1.26, 95% CI 1.20-1.32) even when controlling for maternal and paternal traits. However, there was no association between MSDP and internalizing disorders when controlling for the mother's propensity for MSDP (depression: HRR 1.11, 95% CI 0.94-1.30; anxiety disorders: HRR 0.94, 95% CI 0.80-1.11) or comparing differentially exposed siblings (depression: HRR 1.18, 95% CI 0.75-1.89; anxiety disorders: HRR 0.87, 95% CI 0.55-1.36). CONCLUSIONS The results suggest that familial background factors account for the association between MSDP and severe internalizing disorders not the specific exposure to MSDP.
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Affiliation(s)
- S M Meier
- National Centre for Register-Based Research NCRR, Aarhus University, Aarhus V,Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research iPSYCH, Denmark
- Child and Adolescent Mental Health Centre - Mental Health Services Capital Region, Copenhagen Region,Denmark
| | - K J Plessen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research iPSYCH, Denmark
- Child and Adolescent Mental Health Centre - Mental Health Services Capital Region, Copenhagen Region,Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - F Verhulst
- Child and Adolescent Psychiatry, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Denmark
| | - O Mors
- Psychosis Research Unit, Aarhus University Hospital, Risskov,Denmark
| | - P B Mortensen
- National Centre for Register-Based Research NCRR, Aarhus University, Aarhus V,Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research iPSYCH, Denmark
- CIRRAU - Centre for Integrated Register-based Research, Aarhus University, Aarhus V, Denmark
| | - C B Pedersen
- National Centre for Register-Based Research NCRR, Aarhus University, Aarhus V,Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research iPSYCH, Denmark
- CIRRAU - Centre for Integrated Register-based Research, Aarhus University, Aarhus V, Denmark
| | - E Agerbo
- National Centre for Register-Based Research NCRR, Aarhus University, Aarhus V,Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research iPSYCH, Denmark
- CIRRAU - Centre for Integrated Register-based Research, Aarhus University, Aarhus V, Denmark
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Nordentoft M, Speyer H, Norgaard H, Birk M, Mors O. The Impact of the Change Trial on Physical Health in People With Schizophrenia. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.081] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Life expectancy in patients with schizophrenia is reduced by 20 years for men and 15 years for women compared to the general population. About 60% of the excess mortality is due to physical illnesses, with cardiovascular disease being dominant. The aim of this trial was to improve the cardiovascular risk profile.MethodsThe CHANGE trial was an investigator-initiated, randomised, parallel-group, superiority, multi-centre trial with blinded outcome assessment. Patients diagnosed with schizophrenia spectrum disorders and increased waist circumference according (>88 cm for women, >102 cm for men), were recruited and centrally randomised 1:1:1 to 12-months of lifestyle coaching plus care coordination versus care coordination alone versus treatment as usual. The primary outcome was 10-year risk of cardiovascular disease assessed post-treatment and standardised to age 60, secondary outcomes included cardiorespiratory fitness and physical activity. Clinical.Trials.gov NCT01585493.FindingsA total of 428 participants were randomly assigned to the CHANGE intervention (n = 138); care coordination (n = 142); or treatment as usual (n = 148). At 12 months, the mean 10 years risk of cardiovascular disease was 8.4% (SD 6.7) in the CHANGE group, 8.5% (SD 7.5) in the care coordination group and 8.0% (SD 6.5) in the treatment as usual group (P = 0.41). We found no intervention effects for any secondary or explorative outcomes, including weight, cardiorespiratory fitness, physical activity, diet or smoking.InterpretationThe CHANGE trial did not support individual lifestyle coaching or care coordination as superior compared with treatment as usual in reducing the cardiovascular risk in patients with schizophrenia and increased waist circumference.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Greve A, Jepsen J, Bliksted V, Rasmussen E, Gantriis D, Burton B, Ellersgaard D, Christiani C, Spang K, Hemager N, Thorup A, Nordentoft M, Plessen K, Mors O. Associations between cognition in parents with schizophrenia or bipolar disorder and their 7-year old high-risk offspring. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.1578] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
IntroductionNeurocognitive and social cognitive impairments are central characteristics of schizophrenia and, to a lesser extent, of bipolar disorder. Birth cohorts and familial high risk studies have described cognitive impairments in subjects before onset of diagnosis as well as in children with increased genetic risk for development of the disorders.ObjectivesTo our knowledge, this is the first study to investigate the correlations between neurocogntion and social cognition in parents and offspring simultaneously and with the same methodology. We will divide the parents into subgroups (cognitive impairment and good cognitive functioning) and use these subgroups to describe correlations with their offspring. Identifying associations between parents and offspring can add important clues to risk factors for schizophrenia and bipolar disorder and, on the long-term, help the development of more effective and potentially preventive treatments.MethodsThis study is part of the Danish high risk and resilience study–VIA7. The VIA7 cohort consists of 522 children age 7 with zero, 1 or 2 parents diagnosed with schizophrenia or bipolar disorder and both of their biological parents. We assessed neurocognition and social cognition with a comprehensive test battery including: intelligence (RIST), executive functions (WAIS-IV, D-KEFS, CANTAB), verbal memory (TOMAL2), attention, emotion recognition, decision making and response control (CANTAB), theory of mind (animated triangles) and social perception (TASIT). Parental subgroups were based on the 95% CI of the controls (cognitive impairment < 95%CI and good cognitive functioning > 95% CI).ResultsData analysis is ongoing and results will be presented at the conference.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Pedersen S, Petersen L, Mors O, Østergaard S. The Association Between School Achievement and Subsequent Development of Bipolar Disorder. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.2172] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
IntroductionPrior studies have indicated that both high and low school achievement are associated with development of bipolar disorder (BD). We believe that the latter association may be due to the confounding effect of family history of mental disorder.ObjectiveTo further investigate the association between school achievement and subsequent development of BD by adding adjustment for family history of mental disorder.MethodsWe are conducting a historical prospective cohort study based on data from nationwide Danish registers. The cohort consists of all individuals born in Denmark 1986–97 of Danish-born parents, who were alive and living in Denmark at age 16 years, and who have completed final examinations in 9th grade between 2002 and 2014 (n = 578,247). The cohort members will be followed until death, emigration, development of bipolar disorder, or end of study, whichever comes first. Hazard rate ratios for bipolar disorder will be calculated in a Cox model using the z-score for examination grades as unit of exposure. The regression analyses will be adjusted for a series of potential confounders including family history of mental disorder.ResultsWe expect to find a positive association between high school achievement and development of BD. In contrast, we expect to demonstrate that the association between low school achievement and BD detected in prior studies is due to confounding by family history of mental disorder. The results will be shown at the conference.ConclusionsBy further testing the potential link between eminence and BD, we hope to contribute to a more balanced perception of BD.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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20
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Lescai F, Als TD, Li Q, Nyegaard M, Andorsdottir G, Biskopstø M, Hedemand A, Fiorentino A, O'Brien N, Jarram A, Liang J, Grove J, Pallesen J, Eickhardt E, Mattheisen M, Bolund L, Demontis D, Wang AG, McQuillin A, Mors O, Wang J, Børglum AD. Whole-exome sequencing of individuals from an isolated population implicates rare risk variants in bipolar disorder. Transl Psychiatry 2017; 7:e1034. [PMID: 28195573 PMCID: PMC5438033 DOI: 10.1038/tp.2017.3] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [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: 11/29/2016] [Accepted: 11/30/2016] [Indexed: 12/20/2022] Open
Abstract
Bipolar disorder affects about 1% of the world's population, and its estimated heritability is about 75%. Only few whole genome or whole-exome sequencing studies in bipolar disorder have been reported, and no rare coding variants have yet been robustly identified. The use of isolated populations might help finding variants with a recent origin, more likely to have drifted to higher frequency by chance. Following this approach, we investigated 28 bipolar cases and 214 controls from the Faroe Islands by whole exome sequencing, and the results were followed-up in a British sample of 2025 cases and 1358 controls. Seventeen variants in 16 genes in the single-variant analysis, and 3 genes in the gene-based statistics surpassed exome-wide significance in the discovery phase. The discovery findings were supported by enrichment analysis of common variants from genome-wide association studies (GWAS) data and interrogation of protein-protein interaction networks. The replication in the British sample confirmed the association with NOS1 (missense variant rs79487279) and NCL (gene-based test). A number of variants from the discovery set were not present in the replication sample, including a novel PITPNM2 missense variant, which is located in a highly significant schizophrenia GWAS locus. Likewise, PIK3C2A identified in the gene-based analysis is located in a combined bipolar and schizophrenia GWAS locus. Our results show support both for existing findings in the literature, as well as for new risk genes, and identify rare variants that might provide additional information on the underlying biology of bipolar disorder.
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Affiliation(s)
- F Lescai
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- iPSYCH—The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- iSEQ—Centre for Integrative Sequencing, Aarhus University, Aarhus, Denmark
| | - T D Als
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- iPSYCH—The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- iSEQ—Centre for Integrative Sequencing, Aarhus University, Aarhus, Denmark
| | - Q Li
- BGI-Shenzhen, Shenzhen, China
| | - M Nyegaard
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- iPSYCH—The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- iSEQ—Centre for Integrative Sequencing, Aarhus University, Aarhus, Denmark
| | - G Andorsdottir
- Genetic Biobank of the Faroe Islands, Tórshavn, Faroe Islands
| | - M Biskopstø
- Genetic Biobank of the Faroe Islands, Tórshavn, Faroe Islands
| | - A Hedemand
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- iPSYCH—The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- iSEQ—Centre for Integrative Sequencing, Aarhus University, Aarhus, Denmark
| | - A Fiorentino
- Division of Psychiatry, University College London, London, UK
| | - N O'Brien
- Division of Psychiatry, University College London, London, UK
| | - A Jarram
- Division of Psychiatry, University College London, London, UK
| | - J Liang
- BGI-Shenzhen, Shenzhen, China
| | - J Grove
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- iPSYCH—The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- iSEQ—Centre for Integrative Sequencing, Aarhus University, Aarhus, Denmark
- BiRC—Bioinformatics Research Centre, Aarhus University, Aarhus, Denmark
| | - J Pallesen
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- iPSYCH—The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- iSEQ—Centre for Integrative Sequencing, Aarhus University, Aarhus, Denmark
| | - E Eickhardt
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- iPSYCH—The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- iSEQ—Centre for Integrative Sequencing, Aarhus University, Aarhus, Denmark
| | - M Mattheisen
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- iPSYCH—The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- iSEQ—Centre for Integrative Sequencing, Aarhus University, Aarhus, Denmark
| | - L Bolund
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- iSEQ—Centre for Integrative Sequencing, Aarhus University, Aarhus, Denmark
- Aarhus University Hospital, Risskov, Aarhus, Denmark
| | - D Demontis
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- iPSYCH—The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- iSEQ—Centre for Integrative Sequencing, Aarhus University, Aarhus, Denmark
| | - A G Wang
- Mental Health Centre Amager, Copenhagen, Denmark
| | | | - O Mors
- iPSYCH—The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- iSEQ—Centre for Integrative Sequencing, Aarhus University, Aarhus, Denmark
- Aarhus University Hospital, Risskov, Aarhus, Denmark
| | - J Wang
- iSEQ—Centre for Integrative Sequencing, Aarhus University, Aarhus, Denmark
- BGI-Shenzhen, Shenzhen, China
| | - A D Børglum
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- iPSYCH—The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- iSEQ—Centre for Integrative Sequencing, Aarhus University, Aarhus, Denmark
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21
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Köhler O, Petersen L, Mors O, Mortensen PB, Yolken RH, Gasse C, Benros ME. Infections and exposure to anti-infective agents and the risk of severe mental disorders: a nationwide study. Acta Psychiatr Scand 2017; 135:97-105. [PMID: 27870529 DOI: 10.1111/acps.12671] [Citation(s) in RCA: 78] [Impact Index Per Article: 11.1] [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] [Accepted: 10/30/2016] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Severe infections are associated with increased risks of mental disorders; however, this is the first large-scale study investigating whether infections treated with anti-infective agents in the primary care setting increase the risks of schizophrenia and affective disorders. METHOD We identified all individuals born in Denmark 1985-2002 (N = 1 015 447) and studied the association between infections treated with anti-infective agents and the subsequent risk of schizophrenia and affective disorders during 1995-2013. Cox regression analyses were adjusted for important confounders. RESULTS Infections treated with anti-infective agents were associated with increased risks of schizophrenia by a hazard rate ratio (HRR) of 1.37 (95%-CI = 1.20-1.57) and affective disorders by a HRR of 1.64 (95%-CI = 1.48-1.82), fitting a dose-response and temporal relationship (P < 0.001). The excess risk was primarily driven by infections treated with antibiotics, whereas infections treated with antivirals, antimycotics, and antiparasitic agents were not significant after mutual adjustment. Individuals with infections requiring hospitalization had the highest risks for schizophrenia (HRR = 2.05; 95%-CI = 1.77-2.38) and affective disorders (HRR = 2.59; 95%-CI = 2.31-2.89). CONCLUSION Infections treated with anti-infective agents and particularly infections requiring hospitalizations were associated with increased risks of schizophrenia and affective disorders, which may be mediated by effects of infections/inflammation on the brain, alterations of the microbiome, genetics, or other environmental factors.
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Affiliation(s)
- O Köhler
- Psychosis Research Unit, Aarhus University Hospital, Risskov, Denmark.,iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
| | - L Petersen
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark.,National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
| | - O Mors
- Psychosis Research Unit, Aarhus University Hospital, Risskov, Denmark.,iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark.,Centre for Integrated Register-based Research at Aarhus University (CIRRAU), Aarhus, Denmark
| | - P B Mortensen
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark.,National Centre for Register-based Research, Aarhus University, Aarhus, Denmark.,Centre for Integrated Register-based Research at Aarhus University (CIRRAU), Aarhus, Denmark
| | - R H Yolken
- Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - C Gasse
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
| | - M E Benros
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark.,Mental Health Centre Copenhagen, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
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22
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Østergaard SD, Mors O, Correll CU, Bech P. Association of Positive and Negative Syndrome Scale (PANSS) short forms with global functioning and quality of life. Acta Psychiatr Scand 2016; 134:565-566. [PMID: 27869989 DOI: 10.1111/acps.12668] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- S D Østergaard
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Psychosis Research Unit, Aarhus University Hospital, Risskov, Denmark
| | - O Mors
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.,Psychosis Research Unit, Aarhus University Hospital, Risskov, Denmark
| | - C U Correll
- Division of Psychiatry Research, The Zucker Hillside Hospital, Glen Oaks, NY, USA.,Department of Psychiatry and Molecular Medicine, Hofstra North Shore - LIJ School of Medicine, Hempstead, NY, USA.,Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, NY, USA
| | - P Bech
- Psychiatric Research Unit, Psychiatric Centre North Zealand, Copenhagen University Hospital, Hillerød, Denmark
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23
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Starnawska A, Tan Q, Lenart A, McGue M, Mors O, Børglum AD, Christensen K, Nyegaard M, Christiansen L. Blood DNA methylation age is not associated with cognitive functioning in middle-aged monozygotic twins. Neurobiol Aging 2016; 50:60-63. [PMID: 27889677 DOI: 10.1016/j.neurobiolaging.2016.10.025] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [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: 02/08/2016] [Revised: 09/23/2016] [Accepted: 10/25/2016] [Indexed: 10/20/2022]
Abstract
The epigenetic clock, also known as DNA methylation age (DNAmAge), represents age-related changes of DNA methylation at multiple sites of the genome and is suggested to be a biomarker for biological age. Elevated blood DNAmAge is associated with all-cause mortality, with the strongest effects reported in a recent intrapair twin study where epigenetically older twins had increased mortality risk in comparison to their co-twins. In the study presented here, we hypothesize that DNAmAge in blood is associated with cross-sectional and longitudinal cognitive abilities in middle-aged individuals. In 486 monozygotic twins, we investigated the association of DNAmAge, difference between DNAmAge and chronological age and age acceleration with cognition. Despite using a powerful paired twin design, we found no evidence for association of blood DNAmAge with cognitive abilities. This observation was confirmed in unpaired analyses, where DNAmAge initially correlated with cognitive abilities, until adjusting for chronological age. Overall, our study shows that for middle-aged individuals DNAmAge calculated in blood does not correlate with cognitive abilities.
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Affiliation(s)
- A Starnawska
- Department of Biomedicine, Aarhus University, Aarhus, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark; Center for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark.
| | - Q Tan
- The Danish Aging Research Center, and The Danish Twin Registry, Institute of Public Health, University of Southern Denmark, Odense, Denmark; Department of Clinical Genetics, Odense University Hospital, Odense, Denmark
| | - A Lenart
- Max Planck Odense Center on the Biodemography of Aging, Institute of Public Health, University of Southern Denmark, Odense, Denmark
| | - M McGue
- The Danish Aging Research Center, and The Danish Twin Registry, Institute of Public Health, University of Southern Denmark, Odense, Denmark; Department of Psychology, University of Minnesota, Minneapolis, MN, USA
| | - O Mors
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark; Psychosis Research Unit, Aarhus University Hospital, Risskov, Denmark
| | - A D Børglum
- Department of Biomedicine, Aarhus University, Aarhus, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark; Center for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark
| | - K Christensen
- The Danish Aging Research Center, and The Danish Twin Registry, Institute of Public Health, University of Southern Denmark, Odense, Denmark; Department of Clinical Genetics, Odense University Hospital, Odense, Denmark; Department of Clinical Biochemistry and Pharmacology, Odense University Hospital, Odense, Denmark
| | - M Nyegaard
- Department of Biomedicine, Aarhus University, Aarhus, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark; Center for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark
| | - L Christiansen
- The Danish Aging Research Center, and The Danish Twin Registry, Institute of Public Health, University of Southern Denmark, Odense, Denmark
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24
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Nørgaard H, Søndergaard Pedersen H, Fenger-Grøn M, Mors O, Nordentoft M, Vestergaard M, Munk Laursen T. Increased use of primary care during 6 years of prodromal schizophrenia. Acta Psychiatr Scand 2016; 134:225-33. [PMID: 27295520 DOI: 10.1111/acps.12600] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [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] [Accepted: 05/17/2016] [Indexed: 02/03/2023]
Abstract
BACKGROUND Early diagnosis is important for the course of schizophrenia. AIM To investigate whether prodromal symptoms of schizophrenia lead to increased use of primary care. METHOD A register-based cohort study of 21 894 cases with incident schizophrenia and 437 880 matched controls. RESULTS Cases used daytime primary care 43% more than controls during the 6 years before diagnosis (IRR = 1.43; 95% CI: 1.39; 1.48) and 132% more during the last 2 months (IRR = 2.32; 95% CI: 2.27; 2.37), and 34% (IRR = 1.34; 95% CI: 1.23; 1.48) vs. 374% more for out-of-hours services (IRR = 3.74; 95% CI: 3.52; 3.98). Six years before index diagnosis, 30% of cases had at least one psychiatric contact without being diagnosed with schizophrenia, increasing to 75% 1 month before diagnosis. CONCLUSION Increased help-seeking behaviour was seen at least 6 years before index diagnosis, suggesting a 'window' for earlier diagnosis of prodromal schizophrenia.
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Affiliation(s)
- Hcb Nørgaard
- Psychosis Research Unit, Aarhus University Hospital, Risskov, Denmark.,Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
| | | | - M Fenger-Grøn
- Research Unit for General Practice, Aarhus University, Aarhus, Denmark
| | - O Mors
- Psychosis Research Unit, Aarhus University Hospital, Risskov, Denmark
| | - M Nordentoft
- Psychiatric Center Copenhagen, Copenhagen University, Copenhagen, Denmark
| | - M Vestergaard
- Research Unit for General Practice, Aarhus University, Aarhus, Denmark
| | - T Munk Laursen
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
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25
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Meier SM, Agerbo E, Maier R, Pedersen CB, Lang M, Grove J, Hollegaard MV, Demontis D, Trabjerg BB, Hjorthøj C, Ripke S, Degenhardt F, Nöthen MM, Rujescu D, Maier W, Werge T, Mors O, Hougaard DM, Børglum AD, Wray NR, Rietschel M, Nordentoft M, Mortensen PB, Mattheisen M. High loading of polygenic risk in cases with chronic schizophrenia. Mol Psychiatry 2016; 21:969-74. [PMID: 26324100 DOI: 10.1038/mp.2015.130] [Citation(s) in RCA: 51] [Impact Index Per Article: 6.4] [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: 04/08/2015] [Revised: 07/21/2015] [Accepted: 07/23/2015] [Indexed: 11/09/2022]
Abstract
Genomic risk profile scores (GRPSs) have been shown to predict case-control status of schizophrenia (SCZ), albeit with varying sensitivity and specificity. The extent to which this variability in prediction accuracy is related to differences in sampling strategies is unknown. Danish population-based registers and Neonatal Biobanks were used to identify two independent incident data sets (denoted target and replication) comprising together 1861 cases with SCZ and 1706 controls. A third data set was a German prevalent sample with diagnoses assigned to 1773 SCZ cases and 2161 controls based on clinical interviews. GRPSs were calculated based on the genome-wide association results from the largest SCZ meta-analysis yet conducted. As measures of genetic risk prediction, Nagelkerke pseudo-R(2) and variance explained on the liability scale were calculated. GRPS for SCZ showed positive correlations with the number of psychiatric admissions across all P-value thresholds in both the incident and prevalent samples. In permutation-based test, Nagelkerke pseudo-R(2) values derived from samples enriched for frequently admitted cases were found to be significantly higher than for the full data sets (Ptarget=0.017, Preplication=0.04). Oversampling of frequently admitted cases further resulted in a higher proportion of variance explained on the liability scale (improvementtarget= 50%; improvementreplication= 162%). GRPSs are significantly correlated with chronicity of SCZ. Oversampling of cases with a high number of admissions significantly increased the amount of variance in liability explained by GRPS. This suggests that at least part of the effect of common single-nucleotide polymorphisms is on the deteriorative course of illness.
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Affiliation(s)
- S M Meier
- National Centre for Register-Based Research, Aarhus University, Aarhus C, Denmark.,Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Denmark.,Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Mannheim, Germany
| | - E Agerbo
- National Centre for Register-Based Research, Aarhus University, Aarhus C, Denmark.,Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Denmark.,Centre for Integrated Register-based Research, Aarhus University, Aarhus C, Denmark
| | - R Maier
- Queensland Brain Institute, University of Queensland, Brisbane, Queensland, Australia
| | - C B Pedersen
- National Centre for Register-Based Research, Aarhus University, Aarhus C, Denmark.,Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Denmark.,Centre for Integrated Register-based Research, Aarhus University, Aarhus C, Denmark
| | - M Lang
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Mannheim, Germany
| | - J Grove
- Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Denmark.,Department of Biomedicine, Aarhus University, Aarhus C, Denmark.,Bioinformatics Research Centre, Aarhus University, Aarhus C, Denmark.,Centre for integrative Sequencing (iSEQ), Aarhus University, Aarhus C, Denmark
| | - M V Hollegaard
- Danish Centre for Neonatal Screening, Department of Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | - D Demontis
- Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Denmark.,Department of Biomedicine, Aarhus University, Aarhus C, Denmark.,Centre for integrative Sequencing (iSEQ), Aarhus University, Aarhus C, Denmark
| | - B B Trabjerg
- National Centre for Register-Based Research, Aarhus University, Aarhus C, Denmark.,Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Denmark
| | - C Hjorthøj
- Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Denmark.,Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, University of Copenhagen, Copenhagen, Denmark.,Institute of Clinical Medicine, Faculty of Health Sciences, University of Copenhagen, Copenhagen, Denmark
| | - S Ripke
- Analytical and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.,Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - F Degenhardt
- Institute of Human Genetics, University of Bonn, Bonn, Germany.,Department of Genomics, Life and Brain Center, University of Bonn, Bonn, Germany
| | - M M Nöthen
- Institute of Human Genetics, University of Bonn, Bonn, Germany.,Department of Genomics, Life and Brain Center, University of Bonn, Bonn, Germany
| | - D Rujescu
- Department of Psychiatry, Psychotherapy and Psychosomatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - W Maier
- Department of Psychiatry, University of Bonn, Bonn, Germany
| | | | - T Werge
- Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Denmark.,Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, University of Copenhagen, Copenhagen, Denmark
| | - O Mors
- Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Denmark.,Centre for Psychiatric Research, Aarhus University Hospital, Risskov, Denmark
| | - D M Hougaard
- Danish Centre for Neonatal Screening, Department of Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | - A D Børglum
- Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Denmark.,Department of Biomedicine, Aarhus University, Aarhus C, Denmark.,Centre for integrative Sequencing (iSEQ), Aarhus University, Aarhus C, Denmark.,Centre for Psychiatric Research, Aarhus University Hospital, Risskov, Denmark
| | - N R Wray
- Queensland Brain Institute, University of Queensland, Brisbane, Queensland, Australia
| | - M Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Mannheim, Germany
| | - M Nordentoft
- Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Denmark.,Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, University of Copenhagen, Copenhagen, Denmark.,Department of Psychiatry, Psychotherapy and Psychosomatics, Martin-Luther-University Halle-Wittenberg, Halle, Germany
| | - P B Mortensen
- National Centre for Register-Based Research, Aarhus University, Aarhus C, Denmark.,Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Denmark.,Centre for Integrated Register-based Research, Aarhus University, Aarhus C, Denmark.,Centre for integrative Sequencing (iSEQ), Aarhus University, Aarhus C, Denmark
| | - M Mattheisen
- Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Denmark.,Department of Biomedicine, Aarhus University, Aarhus C, Denmark.,Centre for integrative Sequencing (iSEQ), Aarhus University, Aarhus C, Denmark.,Institute of Human Genetics, University of Bonn, Bonn, Germany.,Department of Genomics, Life and Brain Center, University of Bonn, Bonn, Germany
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26
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Starnawska A, Demontis D, Pen A, Hedemand A, Nielsen AL, Staunstrup NH, Grove J, Als TD, Jarram A, O'Brien NL, Mors O, McQuillin A, Børglum AD, Nyegaard M. CACNA1C hypermethylation is associated with bipolar disorder. Transl Psychiatry 2016; 6:e831. [PMID: 27271857 PMCID: PMC4931616 DOI: 10.1038/tp.2016.99] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [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: 12/10/2015] [Revised: 03/05/2016] [Accepted: 04/15/2016] [Indexed: 12/19/2022] Open
Abstract
The CACNA1C gene, encoding a subunit of the L-type voltage-gated calcium channel is one of the best-supported susceptibility genes for bipolar disorder (BD). Genome-wide association studies have identified a cluster of non-coding single-nucleotide polymorphisms (SNPs) in intron 3 to be highly associated with BD and schizophrenia. The mechanism by which these SNPs confer risk of BD appears to be through an altered regulation of CACNA1C expression. The role of CACNA1C DNA methylation in BD has not yet been addressed. The aim of this study was to investigate if CACNA1C DNA methylation is altered in BD. First, the methylation status of five CpG islands (CGIs) across CACNA1C in blood from BD subjects (n=40) and healthy controls (n=38) was determined. Four islands were almost completely methylated or completely unmethylated, while one island (CGI 3) in intron 3 displayed intermediate methylation levels. In the main analysis, the methylation status of CGI 3 was analyzed in a larger sample of BD subjects (n=582) and control individuals (n=319). Out of six CpG sites that were investigated, five sites showed significant hypermethylation in cases (lowest P=1.16 × 10(-7) for CpG35). Nearby SNPs were found to influence the methylation level, and we identified rs2238056 in intron 3 as the strongest methylation quantitative trait locus (P=2.6 × 10(-7)) for CpG35. In addition, we found an increased methylation in females, and no difference between bipolar I and II. In conclusion, we find that CACNA1C methylation is associated with BD and suggest that the regulatory effect of the non-coding risk variants involves a shift in DNA methylation.
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Affiliation(s)
- A Starnawska
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Denmark
- Center for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark
| | - D Demontis
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Denmark
- Center for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark
| | - A Pen
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- Department of Molecular Biology and Genetics, Aarhus University, Aarhus, Denmark
| | - A Hedemand
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Denmark
- Center for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark
| | - A L Nielsen
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Denmark
- Center for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark
| | - N H Staunstrup
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Denmark
- Center for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark
| | - J Grove
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Denmark
- Center for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark
| | - T D Als
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Denmark
- Center for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark
| | - A Jarram
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK
| | - N L O'Brien
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK
| | - O Mors
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Denmark
- Research Department P, Aarhus University Hospital, Risskov, Denmark
| | - A McQuillin
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK
| | - A D Børglum
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Denmark
- Center for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark
| | - M Nyegaard
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Denmark
- Center for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark
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27
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Østergaard SD, Lemming OM, Mors O, Correll CU, Bech P. PANSS-6: a brief rating scale for the measurement of severity in schizophrenia. Acta Psychiatr Scand 2016; 133:436-44. [PMID: 26558537 DOI: 10.1111/acps.12526] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [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] [Accepted: 10/12/2015] [Indexed: 01/18/2023]
Abstract
OBJECTIVE The 30-item Positive and Negative Syndrome Scale (PANSS-30) is the most widely used rating scale in schizophrenia, but too long for clinical use. Shorter PANSS versions have been proposed, including the PANSS-14 and PANSS-8. However, none of these PANSS versions has been validated using the parametric Rasch rating scale model, which evaluates 'scalability'. Scalability means that each item in a rating scale provides unique information regarding syndrome severity and is a statistical prerequisite for using the total score as a measure of overall severity. METHOD Based on data from two randomized placebo-controlled trials in schizophrenia, we tested the scalability of PANSS-30, PANSS-14 and PANSS-8 by means of the parametric Rasch rating scale model. Furthermore, we tested whether a scalable PANSS version could separate efficacy of haloperidol and sertindole from placebo. RESULTS Neither PANSS-30, PANSS-14 nor PANSS-8 was scalable. However, PANSS-6, consisting of the items: P1-Delusions, P2-Conceptual disorganization, P3-Hallucinations, N1-Blunted Affect, N4-Social withdrawal, N6-Lack of spontaneity and flow of conversation, was scalable. Furthermore, PANSS-6 captured superior symptom reduction and higher remission rates during treatment with haloperidol and sertindole vs. placebo. CONCLUSION PANSS-6 is a short schizophrenia severity rating scale that adequately separates antipsychotic efficacy from that of placebo.
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Affiliation(s)
- S D Østergaard
- Department of Clinical Medicine, Aarhus University Hospital, Aarhus, Denmark.,Psychosis Research Unit, Aarhus University Hospital, Risskov, Denmark
| | | | - O Mors
- Psychosis Research Unit, Aarhus University Hospital, Risskov, Denmark
| | - C U Correll
- Division of Psychiatry Research, The Zucker Hillside Hospital, Glen Oaks, NY, USA.,Department of Psychiatry and Molecular Medicine, Hofstra North Shore - LIJ School of Medicine, Hempstead, NY, USA.,Department of Psychiatry and Behavioral Sciences, Albert Einstein College of Medicine, Bronx, NY, USA
| | - P Bech
- Psychiatric Research Unit, Psychiatric Centre North Zealand, Copenhagen University Hospital, Hillerød, Denmark
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28
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Ferentinos P, Koukounari A, Power R, Rivera M, Uher R, Craddock N, Owen MJ, Korszun A, Jones L, Jones I, Gill M, Rice JP, Ising M, Maier W, Mors O, Rietschel M, Preisig M, Binder EB, Aitchison KJ, Mendlewicz J, Souery D, Hauser J, Henigsberg N, Breen G, Craig IW, Farmer AE, Müller-Myhsok B, McGuffin P, Lewis CM. Familiality and SNP heritability of age at onset and episodicity in major depressive disorder. Psychol Med 2015; 45:2215-2225. [PMID: 25698070 PMCID: PMC4462162 DOI: 10.1017/s0033291715000215] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2014] [Revised: 01/11/2015] [Accepted: 01/22/2015] [Indexed: 11/24/2022]
Abstract
BACKGROUND Strategies to dissect phenotypic and genetic heterogeneity of major depressive disorder (MDD) have mainly relied on subphenotypes, such as age at onset (AAO) and recurrence/episodicity. Yet, evidence on whether these subphenotypes are familial or heritable is scarce. The aims of this study are to investigate the familiality of AAO and episode frequency in MDD and to assess the proportion of their variance explained by common single nucleotide polymorphisms (SNP heritability). METHOD For investigating familiality, we used 691 families with 2-5 full siblings with recurrent MDD from the DeNt study. We fitted (square root) AAO and episode count in a linear and a negative binomial mixed model, respectively, with family as random effect and adjusting for sex, age and center. The strength of familiality was assessed with intraclass correlation coefficients (ICC). For estimating SNP heritabilities, we used 3468 unrelated MDD cases from the RADIANT and GSK Munich studies. After similarly adjusting for covariates, derived residuals were used with the GREML method in GCTA (genome-wide complex trait analysis) software. RESULTS Significant familial clustering was found for both AAO (ICC = 0.28) and episodicity (ICC = 0.07). We calculated from respective ICC estimates the maximal additive heritability of AAO (0.56) and episodicity (0.15). SNP heritability of AAO was 0.17 (p = 0.04); analysis was underpowered for calculating SNP heritability of episodicity. CONCLUSIONS AAO and episodicity aggregate in families to a moderate and small degree, respectively. AAO is under stronger additive genetic control than episodicity. Larger samples are needed to calculate the SNP heritability of episodicity. The described statistical framework could be useful in future analyses.
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Affiliation(s)
- P. Ferentinos
- MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- 2nd Department of Psychiatry, Attikon General Hospital, University of Athens, Athens, Greece
| | - A. Koukounari
- Department of Biostatistics, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - R. Power
- MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - M. Rivera
- MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Centro de Investigación Biomédica en Red de Salud Mental CIBERSAM, University of Granada, Spain
| | - R. Uher
- MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Dalhousie University Department of Psychiatry, Halifax, Nova Scotia, Canada
| | - N. Craddock
- MRC Centre for Neuropsychiatric Genetics and Genomics, Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff, UK
| | - M. J. Owen
- MRC Centre for Neuropsychiatric Genetics and Genomics, Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff, UK
| | - A. Korszun
- Barts and The London Medical School, Queen Mary University of London, London, UK
| | - L. Jones
- Department of Psychiatry, University of Birmingham, Birmingham, UK
| | - I. Jones
- MRC Centre for Neuropsychiatric Genetics and Genomics, Neuroscience and Mental Health Research Institute, Cardiff University, Cardiff, UK
| | - M. Gill
- Department of Psychiatry, Trinity Centre for Health Science, Dublin, Ireland
| | - J. P. Rice
- Department of Psychiatry, Washington University, St. Louis, Missouri, USA
| | - M. Ising
- Max Planck Institute of Psychiatry, Munich, Germany
| | - W. Maier
- Department of Psychiatry, University of Bonn & German Center of Neurodegenerative Diseases (DZNE), Bonn, Germany
| | - O. Mors
- Centre for Psychiatric Research, Aarhus University Hospital, Risskov, Denmark
| | - M. Rietschel
- Division of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Mannheim, Germany
| | - M. Preisig
- University Hospital Center and University of Lausanne, Lausanne, Switzerland
| | - E. B. Binder
- Max Planck Institute of Psychiatry, Munich, Germany
| | - K. J. Aitchison
- Departments of Psychiatry and Medical Genetics, University of Alberta, Edmonton, Alberta, Canada
| | - J. Mendlewicz
- Department of Psychiatry, Free University of Brussels, Brussels, Belgium
| | - D. Souery
- Centre Européen de Psychologie Médicale PSY-PLURIEL, Bruxelles, Belgium
| | - J. Hauser
- Department of Genetics in Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - N. Henigsberg
- Department of Psychiatry, University of Zagreb, Zagreb, Croatia
| | - G. Breen
- MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- NIHR Biomedical Research Centre for Mental Health, South London and Maudsley NHS Foundation Trust and Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - I. W. Craig
- MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - A. E. Farmer
- MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | | | - P. McGuffin
- MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - C. M. Lewis
- MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Division of Genetics and Molecular Medicine, King's College London, London, UK
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Köhler O, Thisted H, Mors O, Gasse C. The Global Assessment of Functioning (GAF) as Potential Predictor for Relapse Among 5,674 Incident Schizophrenia Patients – a Nationwide Study. Eur Psychiatry 2015. [DOI: 10.1016/s0924-9338(15)30230-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Abstract
BACKGROUND The post-pubertal association of female gender with emotional disorder is a robust finding. However, studies exploring the association of gender and emotional disorders before puberty are few and present diverging results. The aim of this study was to present gender-specific incidence rates of emotional disorders throughout childhood. METHOD This is a population-based cohort study of 907,806 Danish 3- to 18-year-olds. The outcome was assignment of an emotional disorder diagnosis based on in-patient and out-patient data from The Danish Psychiatric Central Register. Outcome measures were incidence rates and cumulative incidences for unipolar depressive disorder (ICD-10: F32-F33), anxiety disorders (ICD-10: F40-F42), and emotional disorders with onset specific to childhood (ICD-10: F93). RESULTS Pre-pubertal incidence rates for depressive and anxiety disorders were higher for boys than girls. At age 12 years the pattern reversed. The cumulative incidence for any emotional disorder (F32-F33, F40-F42, F93) on the 11th birthday was 0.52% (95% CI 0.50-0.55) for boys and 0.31% (95% CI 0.29-0.33) for girls. On the 19th birthday cumulative incidence was 2.33% (95% CI 2.24-2.43) for boys and 3.77% (95% CI 3.64-3.90) for girls. The pre-pubertal male preponderance was also significant for depressive disorders (F32-F33, p = 0.00144) and anxiety disorders (F40-F42, F93, p < 0.00001) separately. CONCLUSIONS Emotional disorders seem to display a male preponderance before the age of 12 years and a female preponderance thereafter. Studies exploring this gender-age interaction are needed. Still, the results question the general assumption that females throughout the lifespan are more at risk for emotional disorders than males.
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Affiliation(s)
- R Wesselhoeft
- Department of Child and Adolescent Mental Health Odense, Research Unit,University of Southern Denmark,Odense C,Denmark
| | - C B Pedersen
- National Centre for Register-Based Research, Business and Social Sciences,Aarhus University,Aarhus,Denmark
| | - P B Mortensen
- National Centre for Register-Based Research, Business and Social Sciences,Aarhus University,Aarhus,Denmark
| | - O Mors
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research,iPSYCH,Denmark
| | - N Bilenberg
- Department of Child and Adolescent Mental Health Odense, Research Unit,University of Southern Denmark,Odense C,Denmark
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Raunkjaer NM, Stokholm ZA, Willert MV, Mors O, Vestergaard JM, Frederiksen TW, Kolstad HA. 0180 Does long-term stress cause depression? Occupational noise exposure and the use of antidepressants. Occup Environ Med 2014. [DOI: 10.1136/oemed-2014-102362.260] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Børglum AD, Demontis D, Grove J, Pallesen J, Hollegaard MV, Pedersen CB, Hedemand A, Mattheisen M, Uitterlinden A, Nyegaard M, Ørntoft T, Wiuf C, Didriksen M, Nordentoft M, Nöthen MM, Rietschel M, Ophoff RA, Cichon S, Yolken RH, Hougaard DM, Mortensen PB, Mors O. Genome-wide study of association and interaction with maternal cytomegalovirus infection suggests new schizophrenia loci. Mol Psychiatry 2014; 19:325-33. [PMID: 23358160 PMCID: PMC3932405 DOI: 10.1038/mp.2013.2] [Citation(s) in RCA: 146] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2012] [Revised: 11/22/2012] [Accepted: 12/14/2012] [Indexed: 12/13/2022]
Abstract
Genetic and environmental components as well as their interaction contribute to the risk of schizophrenia, making it highly relevant to include environmental factors in genetic studies of schizophrenia. This study comprises genome-wide association (GWA) and follow-up analyses of all individuals born in Denmark since 1981 and diagnosed with schizophrenia as well as controls from the same birth cohort. Furthermore, we present the first genome-wide interaction survey of single nucleotide polymorphisms (SNPs) and maternal cytomegalovirus (CMV) infection. The GWA analysis included 888 cases and 882 controls, and the follow-up investigation of the top GWA results was performed in independent Danish (1396 cases and 1803 controls) and German-Dutch (1169 cases, 3714 controls) samples. The SNPs most strongly associated in the single-marker analysis of the combined Danish samples were rs4757144 in ARNTL (P=3.78 × 10(-6)) and rs8057927 in CDH13 (P=1.39 × 10(-5)). Both genes have previously been linked to schizophrenia or other psychiatric disorders. The strongest associated SNP in the combined analysis, including Danish and German-Dutch samples, was rs12922317 in RUNDC2A (P=9.04 × 10(-7)). A region-based analysis summarizing independent signals in segments of 100 kb identified a new region-based genome-wide significant locus overlapping the gene ZEB1 (P=7.0 × 10(-7)). This signal was replicated in the follow-up analysis (P=2.3 × 10(-2)). Significant interaction with maternal CMV infection was found for rs7902091 (P(SNP × CMV)=7.3 × 10(-7)) in CTNNA3, a gene not previously implicated in schizophrenia, stressing the importance of including environmental factors in genetic studies.
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Affiliation(s)
- A D Børglum
- Department of Biomedicine and Centre for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark
- Centre for Psychiatric Research, Aarhus University Hospital, Risskov, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus and Copenhagen, Denmark
| | - D Demontis
- Department of Biomedicine and Centre for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus and Copenhagen, Denmark
| | - J Grove
- Department of Biomedicine and Centre for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus and Copenhagen, Denmark
- Bioinformatics Research Centre, Aarhus University, Aarhus, Denmark
| | - J Pallesen
- Department of Biomedicine and Centre for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus and Copenhagen, Denmark
| | - M V Hollegaard
- Section of Neonatal Screening and Hormones, Statens Serum Institute, Copenhagen, Denmark
| | - C B Pedersen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus and Copenhagen, Denmark
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
| | - A Hedemand
- Department of Biomedicine and Centre for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus and Copenhagen, Denmark
| | - M Mattheisen
- Department of Genomics, Life and Brain Center, University of Bonn, Bonn, Germany
- Department of Biostatistics, Harvard School of Public Health, Boston, MA, USA
- Institute for Genomic Mathematics, University of Bonn, Bonn, Germany
| | - GROUP investigators
- Department of Biomedicine and Centre for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark
- Centre for Psychiatric Research, Aarhus University Hospital, Risskov, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus and Copenhagen, Denmark
- Bioinformatics Research Centre, Aarhus University, Aarhus, Denmark
- Section of Neonatal Screening and Hormones, Statens Serum Institute, Copenhagen, Denmark
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
- Department of Genomics, Life and Brain Center, University of Bonn, Bonn, Germany
- Department of Biostatistics, Harvard School of Public Health, Boston, MA, USA
- Institute for Genomic Mathematics, University of Bonn, Bonn, Germany
- For a full list of members, see Appendix
- Department of Internal Medicine, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
- Department of Molecular Medicine, Aarhus University Hospital, Skejby, Denmark
- Department of Mathematical Science, University of Copenhagen, Copenhagen, Denmark
- Synaptic transmission, H. Lundbeck A/S, Valby, Denmark
- Psychiatric Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
- Institute of Human Genetics, University of Bonn, Bonn, Germany
- German Center for Neurodegenerative Disorders (DZNE), Bonn, Germany
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, University of Heidelberg, Manheim, Germany
- Department of Medical Genetics and Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, The Netherlands
- Institute of Neuroscience and Medicine (INM-1), Research Center Juelich, Juelich, Germany
- Stanley Division of Developmental Neurovirology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - A Uitterlinden
- Department of Internal Medicine, Erasmus Medical Center Rotterdam, Rotterdam, The Netherlands
| | - M Nyegaard
- Department of Biomedicine and Centre for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus and Copenhagen, Denmark
| | - T Ørntoft
- Department of Molecular Medicine, Aarhus University Hospital, Skejby, Denmark
| | - C Wiuf
- Bioinformatics Research Centre, Aarhus University, Aarhus, Denmark
- Department of Mathematical Science, University of Copenhagen, Copenhagen, Denmark
| | - M Didriksen
- Synaptic transmission, H. Lundbeck A/S, Valby, Denmark
| | - M Nordentoft
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus and Copenhagen, Denmark
- Psychiatric Centre Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
| | - M M Nöthen
- Department of Genomics, Life and Brain Center, University of Bonn, Bonn, Germany
- Institute of Human Genetics, University of Bonn, Bonn, Germany
- German Center for Neurodegenerative Disorders (DZNE), Bonn, Germany
| | - M Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, University of Heidelberg, Manheim, Germany
| | - R A Ophoff
- Department of Medical Genetics and Rudolf Magnus Institute of Neuroscience, University Medical Center Utrecht, Utrecht, The Netherlands
| | - S Cichon
- Department of Genomics, Life and Brain Center, University of Bonn, Bonn, Germany
- Institute of Human Genetics, University of Bonn, Bonn, Germany
- Institute of Neuroscience and Medicine (INM-1), Research Center Juelich, Juelich, Germany
| | - R H Yolken
- Stanley Division of Developmental Neurovirology, Department of Pediatrics, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - D M Hougaard
- Section of Neonatal Screening and Hormones, Statens Serum Institute, Copenhagen, Denmark
| | - P B Mortensen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus and Copenhagen, Denmark
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
| | - O Mors
- Centre for Psychiatric Research, Aarhus University Hospital, Risskov, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus and Copenhagen, Denmark
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Power RA, Wingenbach T, Cohen-Woods S, Uher R, Ng MY, Butler AW, Ising M, Craddock N, Owen MJ, Korszun A, Jones L, Jones I, Gill M, Rice JP, Maier W, Zobel A, Mors O, Placentino A, Rietschel M, Lucae S, Holsboer F, Binder EB, Keers R, Tozzi F, Muglia P, Breen G, Craig IW, Müller-Myhsok B, Kennedy JL, Strauss J, Vincent JB, Lewis CM, Farmer AE, McGuffin P. Estimating the heritability of reporting stressful life events captured by common genetic variants. Psychol Med 2013; 43:1965-1971. [PMID: 23237013 DOI: 10.1017/s0033291712002589] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [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: 11/06/2022]
Abstract
BACKGROUND Although usually thought of as external environmental stressors, a significant heritable component has been reported for measures of stressful life events (SLEs) in twin studies. Method We examined the variance in SLEs captured by common genetic variants from a genome-wide association study (GWAS) of 2578 individuals. Genome-wide complex trait analysis (GCTA) was used to estimate the phenotypic variance tagged by single nucleotide polymorphisms (SNPs). We also performed a GWAS on the number of SLEs, and looked at correlations between siblings. RESULTS A significant proportion of variance in SLEs was captured by SNPs (30%, p = 0.04). When events were divided into those considered to be dependent or independent, an equal amount of variance was explained for both. This 'heritability' was in part confounded by personality measures of neuroticism and psychoticism. A GWAS for the total number of SLEs revealed one SNP that reached genome-wide significance (p = 4 × 10-8), although this association was not replicated in separate samples. Using available sibling data for 744 individuals, we also found a significant positive correlation of R 2 = 0.08 in SLEs (p = 0.03). CONCLUSIONS These results provide independent validation from molecular data for the heritability of reporting environmental measures, and show that this heritability is in part due to both common variants and the confounding effect of personality.
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Affiliation(s)
- R A Power
- MRC Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, UK.
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Affiliation(s)
- R Uher
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada.
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Uher R, Carver S, Power RA, Mors O, Maier W, Rietschel M, Hauser J, Dernovsek MZ, Henigsberg N, Souery D, Placentino A, Farmer A, McGuffin P. Non-steroidal anti-inflammatory drugs and efficacy of antidepressants in major depressive disorder. Psychol Med 2012; 42:2027-2035. [PMID: 22391106 DOI: 10.1017/s0033291712000190] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [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: 02/08/2023]
Abstract
BACKGROUND It has been proposed that non-steroidal anti-inflammatory drugs (NSAIDs) may interfere with the efficacy of antidepressants and contribute to treatment resistance in major depressive disorder (MDD). This effect requires replication and a test of whether it is specific to serotonin-reuptake inhibiting (SRI) antidepressants. METHOD We tested the effect of concomitant medication with NSAIDs on the efficacy of escitalopram, a SRI antidepressant, and nortriptyline, a tricyclic antidepressant, among 811 subjects with MDD treated for up to 12 weeks in the GENDEP study. Effects of NSAIDs on improvement of depressive symptoms were tested in mixed-effect linear models. Effects on remission were tested in logistic regression. Age, sex, baseline severity and centre of recruitment were considered as potential confounding factors. RESULTS Ten percent (n=78) of subjects were taking NSAIDs during the antidepressant treatment. Older subjects were significantly more likely to take NSAIDs. After controlling for age, sex, centre of recruitment and baseline severity, concomitant medication with NSAIDs did not significantly influence the efficacy of escitalopram [β=0.035, 95% confidence interval (CI) -0.145 to 0.215, p=0.704] or nortriptyline (β=0.075, 95% CI -0.131 to 0.281, p=0.476). Although slightly fewer subjects who took NSAIDs reached remission [odds ratio (OR) 0.80, 95% CI 0.49-1.31, p=0.383], this non-significant effect was reversed after controlling for age, sex, baseline severity and recruitment centre effects (OR 1.04, 95% CI 0.61-1.77, p=0.882). CONCLUSIONS NSAIDs are unlikely to affect the efficacy of SRI or other antidepressants. Concurrent use of NSAIDs and antidepressants does not need to be avoided.
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Affiliation(s)
- R Uher
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, UK.
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Rietschel M, Mattheisen M, Degenhardt F, Mühleisen TW, Kirsch P, Esslinger C, Herms S, Demontis D, Steffens M, Strohmaier J, Haenisch B, Breuer R, Czerski PM, Giegling I, Strengman E, Schmael C, Mors O, Mortensen PB, Hougaard DM, Ørntoft T, Kapelski P, Priebe L, Basmanav FF, Forstner AJ, Hoffman P, Meier S, Nikitopoulos J, Moebus S, Alexander M, Mössner R, Wichmann HE, Schreiber S, Rivandeneira F, Hofman A, Uitterlinden AG, Wienker TF, Schumacher J, Hauser J, Maier W, Cantor RM, Erk S, Schulze TG, Craddock N, Owen MJ, O'Donovan MC, Børglum AD, Rujescu D, Walter H, Meyer-Lindenberg A, Nöthen NM, Ophoff RA, Cichon S. Association between genetic variation in a region on chromosome 11 and schizophrenia in large samples from Europe. Mol Psychiatry 2012; 17:906-17. [PMID: 21747397 DOI: 10.1038/mp.2011.80] [Citation(s) in RCA: 93] [Impact Index Per Article: 7.8] [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] [Indexed: 01/12/2023]
Abstract
Recent molecular studies have implicated common alleles of small to moderate effect and rare alleles with larger effect sizes in the genetic architecture of schizophrenia (SCZ). It is expected that the reliable detection of risk variants with very small effect sizes can only be achieved through the recruitment of very large samples of patients and controls (that is tens of thousands), or large, potentially more homogeneous samples that have been recruited from confined geographical areas using identical diagnostic criteria. Applying the latter strategy, we performed a genome-wide association study (GWAS) of 1169 clinically well characterized and ethnically homogeneous SCZ patients from a confined area of Western Europe (464 from Germany, 705 from The Netherlands) and 3714 ethnically matched controls (1272 and 2442, respectively). In a subsequent follow-up study of our top GWAS results, we included an additional 2569 SCZ patients and 4088 controls (from Germany, The Netherlands and Denmark). Genetic variation in a region on chromosome 11 that contains the candidate genes AMBRA1, DGKZ, CHRM4 and MDK was significantly associated with SCZ in the combined sample (n=11 540; P=3.89 × 10(-9), odds ratio (OR)=1.25). This finding was replicated in 23 206 independent samples of European ancestry (P=0.0029, OR=1.11). In a subsequent imaging genetics study, healthy carriers of the risk allele exhibited altered activation in the cingulate cortex during a cognitive control task. The area of interest is a critical interface between emotion regulation and cognition that is structurally and functionally abnormal in SCZ and bipolar disorder.
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Affiliation(s)
- M Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, University of Heidelberg, Mannheim, Germany.
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Erhardt A, Akula N, Schumacher J, Czamara D, Karbalai N, Müller-Myhsok B, Mors O, Borglum A, Kristensen AS, Woldbye DPD, Koefoed P, Eriksson E, Maron E, Metspalu A, Nurnberger J, Philibert RA, Kennedy J, Domschke K, Reif A, Deckert J, Otowa T, Kawamura Y, Kaiya H, Okazaki Y, Tanii H, Tokunaga K, Sasaki T, Ioannidis JPA, McMahon FJ, Binder EB. Replication and meta-analysis of TMEM132D gene variants in panic disorder. Transl Psychiatry 2012; 2:e156. [PMID: 22948381 PMCID: PMC3565207 DOI: 10.1038/tp.2012.85] [Citation(s) in RCA: 65] [Impact Index Per Article: 5.4] [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] [Indexed: 02/06/2023] Open
Abstract
A recent genome-wide association study in patients with panic disorder (PD) identified a risk haplotype consisting of two single-nucleotide polymorphisms (SNPs) (rs7309727 and rs11060369) located in intron 3 of TMEM132D to be associated with PD in three independent samples. Now we report a subsequent confirmation study using five additional PD case-control samples (n = 1670 cases and n = 2266 controls) assembled as part of the Panic Disorder International Consortium (PanIC) study for a total of 2678 cases and 3262 controls in the analysis. In the new independent samples of European ancestry (EA), the association of rs7309727 and the risk haplotype rs7309727-rs11060369 was, indeed, replicated, with the strongest signal coming from patients with primary PD, that is, patients without major psychiatric comorbidities (n = 1038 cases and n = 2411 controls). This finding was paralleled by the results of the meta-analysis across all samples, in which the risk haplotype and rs7309727 reached P-levels of P = 1.4e-8 and P = 1.1e-8, respectively, when restricting the samples to individuals of EA with primary PD. In the Japanese sample no associations with PD could be found. The present results support the initial finding that TMEM132D gene contributes to genetic susceptibility for PD in individuals of EA. Our results also indicate that patient ascertainment and genetic background could be important sources of heterogeneity modifying this association signal in different populations.
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Affiliation(s)
- A Erhardt
- Max-Planck-Institute of Psychiatry, Munich, Germany.
| | - N Akula
- Human Genetics Branch, National Institute of Mental Health Intramural Research Program, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD, USA
| | - J Schumacher
- Institute for Human Genetics, University of Bonn, Bonn, Germany
| | - D Czamara
- Max-Planck-Institute of Psychiatry, Munich, Germany
| | - N Karbalai
- Max-Planck-Institute of Psychiatry, Munich, Germany
| | | | - O Mors
- Department of Psychiatry, Aarhus University, Aarhus, Denmark
| | - A Borglum
- Department of Biomedicine, Human Genetics, Aarhus University, Aarhus, Denmark
| | - A S Kristensen
- Department of Psychiatry, Aarhus University, Aarhus, Denmark
| | - D P D Woldbye
- Department of Neuroscience and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - P Koefoed
- Department of Neuroscience and Pharmacology, University of Copenhagen, Copenhagen, Denmark
| | - E Eriksson
- University of Gothenburg, Gothenburg, Sweden
| | - E Maron
- University of Tartu, Tartu, Estonia
| | - A Metspalu
- Estonian Biocentre, Tartu, Estonia,Estonian Genome Center, Institute of Molecular and Cell Biology, University of Tartu, Tartu, Estonia
| | - J Nurnberger
- Department of Psychiatry, Indiana University, Indianapolis, IN, USA
| | - R A Philibert
- Behavioural Genetics, University of Iowa, Iowa, IA, USA
| | - J Kennedy
- University of Toronto, Toronto, Canada
| | - K Domschke
- Department of Psychiatry, University of Würzburg, Würzburg, Germany
| | - A Reif
- Department of Psychiatry, University of Würzburg, Würzburg, Germany
| | - J Deckert
- Department of Psychiatry, University of Würzburg, Würzburg, Germany
| | - T Otowa
- Department of Neuropsychiatry, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - Y Kawamura
- Research Center for Panic Disorder, Nagoya Mental Clinic, Nagoya, Japan
| | - H Kaiya
- Akasaka Mental Clinic, Tokyo, Japan,Research Center for PanIC Disorder, Nagoya, Japan
| | - Y Okazaki
- Department of Neurology, Tokyo Metropolitan Matsuzawa Hospital, Tokyo, Japan
| | - H Tanii
- Department of Neuropsychiatry, Graduate School of Medicine, Mie University, Mie, Japan
| | - K Tokunaga
- Department of Human Genetics, Graduate School of Medicine, University of Tokyo, Tokyo, Japan
| | - T Sasaki
- Laboratory of Health Education, Graduate School of Education, University of Tokyo, Tokyo, Japan
| | - J P A Ioannidis
- Stanford Prevention Research Center, Departments of Medicine, Health Research and Policy, and Statistics, Stanford University, Stanford, CA, USA
| | - F J McMahon
- Human Genetics Branch, National Institute of Mental Health Intramural Research Program, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD, USA
| | - E B Binder
- Max-Planck-Institute of Psychiatry, Munich, Germany
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Pedersen CB, Demontis D, Pedersen MS, Agerbo E, Mortensen PB, Børglum AD, Hougaard DM, Hollegaard MV, Mors O, Cantor-Graae E. Risk of schizophrenia in relation to parental origin and genome-wide divergence. Psychol Med 2012; 42:1515-1521. [PMID: 22067478 DOI: 10.1017/s0033291711002376] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
BACKGROUND Second-generation immigrants have an increased risk of schizophrenia, a finding that still lacks a satisfactory explanation. Various operational definitions of second-generation immigrants have been used, including foreign parental country of birth. However, with increasing global migration, it is not clear that parental country of birth necessarily is informative with regard to ethnicity. We compare two independently collected measures of parental foreign ethnicity, parental foreign country of birth versus genetic divergence, based on genome-wide genotypic data, to access which measure most efficiently captures the increased risk of schizophrenia among second-generation immigrants residing in Denmark. METHOD A case-control study covering all children born in Denmark since 1981 included 892 cases of schizophrenia and 883 matched controls. Genetic divergence was assessed using principal component analyses of the genotypic data. Independently, parental foreign country of birth was assessed using information recorded prospectively in the Danish Civil Registration System. We compared incidence rate ratios of schizophrenia associated with these two independently collected measures of parental foreign ethnicity. RESULTS People with foreign-born parents had a significantly increased risk of schizophrenia [relative risk (RR) 1.94 (95% confidence intervals (CI) 1.41-2.65)]. Genetically divergent persons also had a significant increased risk [RR 2.43 (95% CI 1.55-3.82)]. Mutual adjustment of parental foreign country of birth and genetic divergence showed no difference between these measures with regard to their potential impact on the results. CONCLUSIONS In terms of RR of schizophrenia, genetic divergence and parental foreign country of birth are interchangeable entities, and both entities have validity with regard to identifying second-generation immigrants.
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Affiliation(s)
- C B Pedersen
- National Centre for Register-based-Research, Aarhus University, Aarhus, Denmark.
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Rivera M, Cohen-Woods S, Kapur K, Breen G, Ng MY, Butler AW, Craddock N, Gill M, Korszun A, Maier W, Mors O, Owen MJ, Preisig M, Bergmann S, Tozzi F, Rice J, Rietschel M, Rucker J, Schosser A, Aitchison KJ, Uher R, Craig IW, Lewis CM, Farmer AE, McGuffin P. Depressive disorder moderates the effect of the FTO gene on body mass index. Mol Psychiatry 2012; 17:604-11. [PMID: 21502950 DOI: 10.1038/mp.2011.45] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.3] [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: 01/07/2023]
Abstract
There is evidence that obesity-related disorders are increased among people with depression. Variation in the FTO (fat mass and obesity associated) gene has been shown to contribute to common forms of human obesity. This study aimed to investigate the genetic influence of polymorphisms in FTO in relation to body mass index (BMI) in two independent samples of major depressive disorder (MDD) cases and controls. We analysed 88 polymorphisms in the FTO gene in a clinically ascertained sample of 2442 MDD cases and 809 controls (Radiant Study). In all, 8 of the top 10 single-nucleotide polymorphisms (SNPs) showing the strongest associations with BMI were followed-up in a population-based cohort (PsyCoLaus Study) consisting of 1292 depression cases and 1690 controls. Linear regression analyses of the FTO variants and BMI yielded 10 SNPs significantly associated with increased BMI in the depressive group but not the control group in the Radiant sample. The same pattern was found in the PsyCoLaus sample. We found a significant interaction between genotype and affected status in relation to BMI for seven SNPs in Radiant (P<0.0057), with PsyCoLaus giving supportive evidence for five SNPs (P-values between 0.03 and 0.06), which increased in significance when the data were combined in a meta-analysis. This is the first study investigating FTO and BMI within the context of MDD, and the results indicate that having a history of depression moderates the effect of FTO on BMI. This finding suggests that FTO is involved in the mechanism underlying the association between mood disorders and obesity.
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Affiliation(s)
- M Rivera
- MRC SGDP Centre, Institute of Psychiatry, King's College London, Denmark Hill, London, UK.
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40
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Uher R, Perlis RH, Henigsberg N, Zobel A, Rietschel M, Mors O, Hauser J, Dernovsek MZ, Souery D, Bajs M, Maier W, Aitchison KJ, Farmer A, McGuffin P. Depression symptom dimensions as predictors of antidepressant treatment outcome: replicable evidence for interest-activity symptoms. Psychol Med 2012; 42:967-980. [PMID: 21929846 PMCID: PMC3787526 DOI: 10.1017/s0033291711001905] [Citation(s) in RCA: 246] [Impact Index Per Article: 20.5] [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] [Indexed: 12/28/2022]
Abstract
BACKGROUND Symptom dimensions have not yet been comprehensively tested as predictors of the substantial heterogeneity in outcomes of antidepressant treatment in major depressive disorder. METHOD We tested nine symptom dimensions derived from a previously published factor analysis of depression rating scales as predictors of outcome in 811 adults with moderate to severe depression treated with flexibly dosed escitalopram or nortriptyline in Genome-based Therapeutic Drugs for Depression (GENDEP). The effects of symptom dimensions were tested in mixed-effect regression models that controlled for overall initial depression severity, age, sex and recruitment centre. Significant results were tested for replicability in 3637 adult out-patients with non-psychotic major depression treated with citalopram in level I of Sequenced Treatment Alternatives to Relieve Depression (STAR*D). RESULTS The interest-activity symptom dimension (reflecting low interest, reduced activity, indecisiveness and lack of enjoyment) at baseline strongly predicted poor treatment outcome in GENDEP, irrespective of overall depression severity, antidepressant type and outcome measure used. The prediction of poor treatment outcome by the interest-activity dimension was robustly replicated in STAR*D, independent of a comprehensive list of baseline covariates. CONCLUSIONS Loss of interest, diminished activity and inability to make decisions predict poor outcome of antidepressant treatment even after adjustment for overall depression severity and other clinical covariates. The prominence of such symptoms may require additional treatment strategies and should be accounted for in future investigations of antidepressant response.
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Affiliation(s)
- R Uher
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, UK.
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41
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42
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Buttenschøn HN, Kristensen AS, Buch HN, Andersen JH, Bonde JP, Grynderup M, Hansen AM, Kolstad H, Kaergaard A, Kaerlev L, Mikkelsen S, Thomsen JF, Koefoed P, Erhardt A, Woldbye DPD, Børglum AD, Mors O. The norepinephrine transporter gene is a candidate gene for panic disorder. J Neural Transm (Vienna) 2011; 118:969-76. [PMID: 21416264 DOI: 10.1007/s00702-011-0624-7] [Citation(s) in RCA: 22] [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] [Subscribe] [Scholar Register] [Received: 11/11/2010] [Accepted: 03/03/2011] [Indexed: 02/06/2023]
Abstract
Panic disorder (PD) is an anxiety disorder characterized by recurrent panic attacks with a lifetime prevalence of 4.7%. Genetic factors are known to contribute to the development of the disorder. Several lines of evidence point towards a major role of the norepinephrine system in the pathogenesis of PD. The SLC6A2 gene is located on chromosome 16q12.2 and encodes the norepinephrine transporter (NET), responsible for the reuptake of norepinephrine into presynaptic nerve terminals. The aim of the present study was to analyze genetic variants located within the NET gene for association with PD. The case-control sample consisted of 449 patients with PD and 279 ethnically matched controls. All cases fulfilled the ICD-10 diagnostic criteria for PD. Genotyping was performed using the Sequenom platform (Sequenom, Inc, San Diego, USA). To test for allelic and haplotypic association, the PLINK software was used, and COMBASSOC was applied to test for gene-wise association. After quality control 29 single nucleotide polymorphisms (SNPs) spanning the gene-region were successfully analyzed. Seven SNPs located within the 5' end of the gene were significantly associated with PD. Furthermore, the NET gene showed overall evidence for association with the disease (P = 0.000035). In conclusion, the present study indicates that NET could be a susceptibility gene for PD.
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Affiliation(s)
- H N Buttenschøn
- Centre for Psychiatric Research, Aarhus University Hospital, Risskov, Skovagervej 2, 8240 Risskov, Denmark.
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43
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Helverskov JL, Lyng B, Clausen L, Mors O, Frydenberg M, Thomsen PH, Rokkedal K. Empirical Support for a Reclassification of Eating Disorders NOS. Eur Eat Disorders Rev 2010; 19:303-15. [DOI: 10.1002/erv.1067] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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44
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Laegsgaard MM, Stamp AS, Hall EOC, Mors O. The perceived and predicted implications of psychiatric genetic knowledge among persons with multiple cases of depression in the family. Acta Psychiatr Scand 2010; 122:470-80. [PMID: 20346073 DOI: 10.1111/j.1600-0447.2010.01555.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [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: 01/05/2023]
Abstract
OBJECTIVE Psychiatric genetic research raises hope regarding better treatment and prevention, but also regarding a possible de-stigmatizing effect of attributing mental illness to genetics. This study explores i) the impact on family relations of participating in a genetic study; ii) the impact of biogenetic attributions on perceptions of depression and stigma and iii) the perceived benefits and concerns regarding psychiatric genetic testing. METHOD Focus groups were conducted with 17 participants suffering from depression, with multiple cases of depression in the family, and previously participating in a genetic study. RESULTS Participating in a genetic study caused more openness about depression in most families. A biogenetic explanation of depression was perceived as having the potential of diminishing self stigma. Testing of self and children was widely accepted, whereas prenatal testing raised concern. CONCLUSION Persons suffering from depression may benefit from endorsing a biogenetic explanation, especially in relation to self-understanding and self-stigma.
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Affiliation(s)
- M M Laegsgaard
- Centre for Psychiatric Research, Aarhus Psychiatric University Hospital, Risskov, Denmark.
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45
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Helverskov J, Clausen L, Mors O, Frydenberg M, Thomsen P, Rokkedal K. Trans-diagnostic outcome of eating disorders: A 30-month follow-up study of 629 patients. Eur Eat Disorders Rev 2010; 18:453-63. [DOI: 10.1002/erv.1025] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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46
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Perroud N, Uher R, Ng MYM, Guipponi M, Hauser J, Henigsberg N, Maier W, Mors O, Gennarelli M, Rietschel M, Souery D, Dernovsek MZ, Stamp AS, Lathrop M, Farmer A, Breen G, Aitchison KJ, Lewis CM, Craig IW, McGuffin P. Genome-wide association study of increasing suicidal ideation during antidepressant treatment in the GENDEP project. Pharmacogenomics J 2010; 12:68-77. [PMID: 20877300 DOI: 10.1038/tpj.2010.70] [Citation(s) in RCA: 77] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
Suicidal thoughts during antidepressant treatment have been the focus of several candidate gene association studies. The aim of the present genome-wide association study was to identify additional genetic variants involved in increasing suicidal ideation during escitalopram and nortriptyline treatment. A total of 706 adult participants of European ancestry, treated for major depression with escitalopram or nortriptyline over 12 weeks in the Genome-Based Therapeutic Drugs for Depression (GENDEP) study were genotyped with Illumina Human 610-Quad Beadchips (Illumina, San Diego, CA, USA). A total of 244 subjects experienced an increase in suicidal ideation during follow-up. The genetic marker most significantly associated with increasing suicidality (8.28 × 10(-7)) was a single-nucleotide polymorphism (SNP; rs11143230) located 30 kb downstream of a gene encoding guanine deaminase (GDA) on chromosome 9q21.13. Two suggestive drug-specific associations within KCNIP4 (Kv channel-interacting protein 4; chromosome 4p15.31) and near ELP3 (elongation protein 3 homolog; chromosome 8p21.1) were found in subjects treated with escitalopram. Suggestive drug by gene interactions for two SNPs near structural variants on chromosome 4q12, one SNP in the apolipoprotein O (APOO) gene on chromosome Xp22.11 and one on chromosome 11q24.3 were found. The most significant association within a set of 33 candidate genes was in the neurotrophic tyrosine kinase receptor type 2 (NTRK2) gene. Finally, we also found trend for an association within genes previously associated with psychiatric phenotypes indirectly linked to suicidal behavior, that is, GRIP1, NXPH1 and ANK3. The results suggest novel pathways involved in increasing suicidal ideation during antidepressant treatment and should help to target treatment to reduce the risk of this dramatic adverse event. Limited power precludes definitive conclusions and replication in larger sample is warranted.
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Affiliation(s)
- N Perroud
- MRC Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, UK.
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47
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Uher R, Muthén B, Souery D, Mors O, Jaracz J, Placentino A, Petrovic A, Zobel A, Henigsberg N, Rietschel M, Aitchison KJ, Farmer A, McGuffin P. Trajectories of change in depression severity during treatment with antidepressants. Psychol Med 2010; 40:1367-1377. [PMID: 19863842 DOI: 10.1017/s0033291709991528] [Citation(s) in RCA: 90] [Impact Index Per Article: 6.4] [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: 12/16/2022]
Abstract
BACKGROUND Response and remission defined by cut-off values on the last observed depression severity score are commonly used as outcome criteria in clinical trials, but ignore the time course of symptomatic change and may lead to inefficient analyses. We explore alternative categorization of outcome by naturally occurring trajectories of symptom change. METHOD Growth mixture models were applied to repeated measurements of depression severity in 807 participants with major depression treated for 12 weeks with escitalopram or nortriptyline in the part-randomized Genome-based Therapeutic Drugs for Depression study. Latent trajectory classes were validated as outcomes in drug efficacy comparison and pharmacogenetic analyses. RESULTS The final two-piece growth mixture model categorized participants into a majority (75%) following a gradual improvement trajectory and the remainder following a trajectory with rapid initial improvement. The rapid improvement trajectory was over-represented among nortriptyline-treated participants and showed an antidepressant-specific pattern of pharmacogenetic associations. In contrast, conventional response and remission favoured escitalopram and produced chance results in pharmacogenetic analyses. Controlling for drop-out reduced drug differences on response and remission but did not affect latent trajectory results. CONCLUSIONS Latent trajectory mixture models capture heterogeneity in the development of clinical response after the initiation of antidepressants and provide an outcome that is distinct from traditional endpoint measures. It differentiates between antidepressants with different modes of action and is robust against bias due to differential discontinuation.
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Affiliation(s)
- R Uher
- Medical Research Council Social, Genetic and Developmental Psychiatry Research Centre, Institute of Psychiatry, King's College London, UK.
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Koefoed P, Hansen TVO, Woldbye DPD, Werge T, Mors O, Hansen T, Jakobsen KD, Nordentoft M, Wang A, Bolwig TG, Rehfeld JF. An intron 1 polymorphism in the cholecystokinin-A receptor gene associated with schizophrenia in males. Acta Psychiatr Scand 2009; 120:281-7. [PMID: 19753663 DOI: 10.1111/j.1600-0447.2009.01400.x] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.1] [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: 11/28/2022]
Abstract
OBJECTIVE To identify whether a genetic variation (rs1800857; IVS1-5T>C) in the neuropeptide cholecystokinin-A receptor (CCKAR) gene is a risk factor in the pathogenesis of schizophrenia. METHOD The variation was analysed in a case-control design comprising 508 patients with schizophrenia and 1619 control subjects. A possible functional impact of this variant on CCKAR protein synthesis through alterations in splicing was analysed in an exon-trapping assay. RESULTS In males only, the risk variant, IVS1-5C, was associated with a significantly increased risk of schizophrenia. Carrying one risk allele was associated with an increased risk of 1.74 (Odds Ratio, OR) and homozygosity (CC) was associated with an OR of 3.19. The variation had no impact on protein synthesis of CCKAR. CONCLUSION This is the first report associating the CCKAR gene variant with schizophrenia specifically in men. Our study strengthens the conclusion that a CCKAR dysfunction could be involved in the aetiology of schizophrenia.
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Affiliation(s)
- P Koefoed
- Department of Neuroscience and Pharmacology, Laboratory for Neuropsychiatry, University of Copenhagen & Centre of Psychiatry, Rigshospitalet, Denmark.
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49
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Ball HA, Samaan Z, Brewster S, Craddock N, Gill M, Korszun A, Maier W, Middleton L, Mors O, Owen MJ, Perry J, Preisig M, Rice J, Rietschel M, Jones L, Jones I, Farmer AE, McGuffin P. Depression, migraine with aura and migraine without aura: their familiality and interrelatedness. Cephalalgia 2009; 29:848-54. [PMID: 19239674 DOI: 10.1111/j.1468-2982.2008.01808.x] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
Migraine is frequently comorbid with depression. There appear to be common aetiological factors for both disorders, but the aetiology of migraine within depressed patients, in particular the significance of aura, has been little studied. A large sample of concordantly depressed sibling pairs [the Depression-Network (DeNT) sample] was assessed as having migraine with aura (MA), migraine without aura (MoA), probable migraine or no migraine according to International Headache Society guidelines. Correlations between siblings' migraine status were used to assess the nature of familial liability to migraine. A multiple threshold isocorrelational model fit best, in which different syndromes are conceptualized as different severities of one underlying dimension rather than as having separate aetiologies. Thus, MA and MoA were found to be different forms of the same disorder, with MA occupying the more extreme end of the spectrum of liability. Implications for our understanding of the relationship between migraine and depression are discussed.
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Affiliation(s)
- H A Ball
- Medical Research Council Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, UK.
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50
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Uher R, Farmer A, Maier W, Rietschel M, Hauser J, Marusic A, Mors O, Elkin A, Williamson RJ, Schmael C, Henigsberg N, Perez J, Mendlewicz J, Janzing JGE, Zobel A, Skibinska M, Kozel D, Stamp AS, Bajs M, Placentino A, Barreto M, McGuffin P, Aitchison KJ. Measuring depression: comparison and integration of three scales in the GENDEP study. Psychol Med 2008; 38:289-300. [PMID: 17922940 DOI: 10.1017/s0033291707001730] [Citation(s) in RCA: 181] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND A number of scales are used to estimate the severity of depression. However, differences between self-report and clinician rating, multi-dimensionality and different weighting of individual symptoms in summed scores may affect the validity of measurement. In this study we examined and integrated the psychometric properties of three commonly used rating scales. METHOD The 17-item Hamilton Depression Rating Scale (HAMD-17), the Montgomery-Asberg Depression Rating Scale (MADRS) and the Beck Depression Inventory (BDI) were administered to 660 adult patients with unipolar depression in a multi-centre pharmacogenetic study. Item response theory (IRT) and factor analysis were used to evaluate their psychometric properties and estimate true depression severity, as well as to group items and derive factor scores. RESULTS The MADRS and the BDI provide internally consistent but mutually distinct estimates of depression severity. The HAMD-17 is not internally consistent and contains several items less suitable for out-patients. Factor analyses indicated a dominant depression factor. A model comprising three dimensions, namely 'observed mood and anxiety', 'cognitive' and 'neurovegetative', provided a more detailed description of depression severity. CONCLUSIONS The MADRS and the BDI can be recommended as complementary measures of depression severity. The three factor scores are proposed for external validation.
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Affiliation(s)
- R Uher
- Medical Research Council, Social, Genetic and Developmental Psychiatry Research Centre, Institute of Psychiatry, King's College London, UK.
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