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Ou AH, Rosenthal SB, Adli M, Akiyama K, Akula N, Alda M, Amare AT, Ardau R, Arias B, Aubry JM, Backlund L, Bauer M, Baune BT, Bellivier F, Benabarre A, Bengesser S, Bhattacharjee AK, Biernacka JM, Cervantes P, Chen GB, Chen HC, Chillotti C, Cichon S, Clark SR, Colom F, Cousins DA, Cruceanu C, Czerski PM, Dantas CR, Dayer A, Del Zompo M, Degenhardt F, DePaulo JR, Étain B, Falkai P, Fellendorf FT, Ferensztajn-Rochowiak E, Forstner AJ, Frisén L, Frye MA, Fullerton JM, Gard S, Garnham JS, Goes FS, Grigoroiu-Serbanescu M, Grof P, Gruber O, Hashimoto R, Hauser J, Heilbronner U, Herms S, Hoffmann P, Hofmann A, Hou L, Jamain S, Jiménez E, Kahn JP, Kassem L, Kato T, Kittel-Schneider S, König B, Kuo PH, Kusumi I, Lackner N, Laje G, Landén M, Lavebratt C, Leboyer M, Leckband SG, Jaramillo CAL, MacQueen G, Maj M, Manchia M, Marie-Claire C, Martinsson L, Mattheisen M, McCarthy MJ, McElroy SL, McMahon FJ, Mitchell PB, Mitjans M, Mondimore FM, Monteleone P, Nievergelt CM, Nöthen MM, Novák T, Ösby U, Ozaki N, Papiol S, Perlis RH, Pisanu C, Potash JB, Pfennig A, Reich-Erkelenz D, Reif A, Reininghaus EZ, Rietschel M, Rouleau GA, Rybakowski JK, Schalling M, Schofield PR, Schubert KO, Schulze TG, Schweizer BW, Seemüller F, Severino G, Shekhtman T, Shilling PD, Shimoda K, Simhandl C, Slaney CM, Squassina A, Stamm T, Stopkova P, Tighe SK, Tortorella A, Turecki G, Vieta E, Volkert J, Witt S, Wray NR, Wright A, Young LT, Zandi PP, Kelsoe JR. Lithium response in bipolar disorder is associated with focal adhesion and PI3K-Akt networks: a multi-omics replication study. Transl Psychiatry 2024; 14:109. [PMID: 38395906 PMCID: PMC10891068 DOI: 10.1038/s41398-024-02811-4] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2023] [Revised: 12/06/2023] [Accepted: 01/29/2024] [Indexed: 02/25/2024] Open
Abstract
Lithium is the gold standard treatment for bipolar disorder (BD). However, its mechanism of action is incompletely understood, and prediction of treatment outcomes is limited. In our previous multi-omics study of the Pharmacogenomics of Bipolar Disorder (PGBD) sample combining transcriptomic and genomic data, we found that focal adhesion, the extracellular matrix (ECM), and PI3K-Akt signaling networks were associated with response to lithium. In this study, we replicated the results of our previous study using network propagation methods in a genome-wide association study of an independent sample of 2039 patients from the International Consortium on Lithium Genetics (ConLiGen) study. We identified functional enrichment in focal adhesion and PI3K-Akt pathways, but we did not find an association with the ECM pathway. Our results suggest that deficits in the neuronal growth cone and PI3K-Akt signaling, but not in ECM proteins, may influence response to lithium in BD.
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Affiliation(s)
- Anna H Ou
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Sara B Rosenthal
- Center for Computational Biology and Bioinformatics, Department of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Mazda Adli
- Department of Psychiatry and Psychotherapy, Charité- Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Germany
- Fliedner Klinik Berlin, Center for Psychiatry, Psychotherapy and Psychosomatic Medicine, Berlin, Germany
| | - Kazufumi Akiyama
- Department of Biological Psychiatry and Neuroscience, Dokkyo Medical University School of Medicine, Mibu, Japan
| | - Nirmala Akula
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health, US Department of Health & Human Services, Bethesda, MD, USA
| | - Martin Alda
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- National Institute of Mental Health, Klecany, Czech Republic
| | - Azmeraw T Amare
- Discipline of Psychiatry, University of Adelaide, Adelaide, SA, Australia
| | - Raffaella Ardau
- Unit of Clinical Pharmacology, Hospital University Agency of Cagliari, Cagliari, Italy
| | - Bárbara Arias
- Department of Evolutive Biology, Ecology and Environmental Sciences, Facultat de Biologia and Institut de Biomedicina (IBUB), Universitat de Barcelona, Barcelona, Spain
- CIBER de Salud Mental, ISCIII, Madrid, Barcelona, Catalonia, Spain
| | - Jean-Michel Aubry
- Department of Mental Health and Psychiatry, Mood Disorders Unit-Geneva University Hospitals, Geneva, Switzerland
| | - Lena Backlund
- Department of Molecular Medicine and Surgery, Karolinska Institutet and Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Michael Bauer
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Medical Faculty, Technische Universität Dresden, Dresden, Germany
| | - Bernhard T Baune
- Discipline of Psychiatry, University of Adelaide, Adelaide, SA, Australia
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Frank Bellivier
- INSERM UMR-S 1144-Université Paris Cité Département de Psychiatrie et de Médecine Addictologique, AP-HP, Groupe Hospitalier Lariboisière-F Widal, Paris, France
| | - Antonio Benabarre
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, ISCIII, Barcelona, Catalonia, Spain
| | - Susanne Bengesser
- Neurobiological Background and Anthropometrics in Bipolar Affective Disorder, Division of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | | | - Joanna M Biernacka
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Pablo Cervantes
- The Neuromodulation Unit, McGill University Health Centre, Montreal, QC, Canada
| | - Guo-Bo Chen
- The Neuromodulation Unit, McGill University Health Centre, Montreal, QC, Canada
| | - Hsi-Chung Chen
- Department of Psychiatry & Center of Sleep Disorders, National Taiwan University Hospital, Taipei, Taiwan
| | - Caterina Chillotti
- Unit of Clinical Pharmacology, Hospital University Agency of Cagliari, Cagliari, Italy
| | - Sven Cichon
- Institute of Human Genetics, University of Bonn and Department of Genomics, Life & Brain Center, Bonn, Germany
- Human Genomics Research Group, Department of Biomedicine, University Hospital Basel, Basel, Switzerland
| | - Scott R Clark
- Discipline of Psychiatry, University of Adelaide, Adelaide, SA, Australia
| | - Francesc Colom
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, ISCIII, Barcelona, Catalonia, Spain
| | - David A Cousins
- Campus for Ageing and Vitality, Newcastle University, Newcastle upon Tyne, UK
| | - Cristiana Cruceanu
- Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | - Piotr M Czerski
- Psychiatric Genetic Unit, Poznan University of Medical Sciences, Poznan, Poland
| | - Clarissa R Dantas
- Department of Psychiatry, University of Campinas (Unicamp), Campinas, Brazil
| | - Alexandre Dayer
- Department of Mental Health and Psychiatry, Mood Disorders Unit-Geneva University Hospitals, Geneva, Switzerland
| | - Maria Del Zompo
- Unit of Clinical Pharmacology, Hospital University Agency of Cagliari, Cagliari, Italy
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Franziska Degenhardt
- Institute of Human Genetics, University of Bonn and Department of Genomics, Life & Brain Center, Bonn, Germany
| | - J Raymond DePaulo
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Bruno Étain
- INSERM UMR-S 1144-Université Paris Cité Département de Psychiatrie et de Médecine Addictologique, AP-HP, Groupe Hospitalier Lariboisière-F Widal, Paris, France
| | - Peter Falkai
- Institute of Psychiatric Phenomics and Genomics (IPPG) and Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Frederike Tabea Fellendorf
- Neurobiological Background and Anthropometrics in Bipolar Affective Disorder, Division of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | | | - Andreas J Forstner
- Institute of Human Genetics, University of Bonn and Department of Genomics, Life & Brain Center, Bonn, Germany
| | - Louise Frisén
- Department of Molecular Medicine and Surgery, Karolinska Institutet and Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
- Department of Clinical Neuroscience, Karolinska Institutet and Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
- Child and Adolescent Psychiatry Research Center, Stockholm, Sweden
| | - Mark A Frye
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Janice M Fullerton
- Mental Illness Research Theme, Neuroscience Research Australia, Sydney, NSW, Australia
- School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Sébastien Gard
- Pôle de Psychiatrie Générale Universitaire, Centre Hospitalier Charles Perrens, Bordeaux, France
| | - Julie S Garnham
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Fernando S Goes
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Maria Grigoroiu-Serbanescu
- Biometric Psychiatric Genetics Research Unit, Alexandru Obregia Psychiatric Hospital, Bucharest, Romania
| | - Paul Grof
- Mood Disorders Center of Ottawa, Ottawa, ON, Canada
| | - Oliver Gruber
- Department of Psychiatry and Psychotherapy, University Medical Center (UMG), Georg-August University Göttingen, Göttingen, Germany
| | - Ryota Hashimoto
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Joanna Hauser
- Psychiatric Genetic Unit, Poznan University of Medical Sciences, Poznan, Poland
| | - Urs Heilbronner
- Institute of Psychiatric Phenomics and Genomics (IPPG) and Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Stefan Herms
- Institute of Human Genetics, University of Bonn and Department of Genomics, Life & Brain Center, Bonn, Germany
- Human Genomics Research Group, Department of Biomedicine, University Hospital Basel, Basel, Switzerland
| | - Per Hoffmann
- Institute of Human Genetics, University of Bonn and Department of Genomics, Life & Brain Center, Bonn, Germany
- Human Genomics Research Group, Department of Biomedicine, University Hospital Basel, Basel, Switzerland
| | - Andrea Hofmann
- Institute of Human Genetics, University of Bonn and Department of Genomics, Life & Brain Center, Bonn, Germany
| | - Liping Hou
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health, US Department of Health & Human Services, Bethesda, MD, USA
| | | | - Esther Jiménez
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, ISCIII, Barcelona, Catalonia, Spain
| | - Jean-Pierre Kahn
- Service de Psychiatrie et Psychologie Clinique, Centre Psychothérapique de Nancy-Laxou-Université de Lorraine, Nancy, France
| | - Layla Kassem
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health, US Department of Health & Human Services, Bethesda, MD, USA
| | - Tadafumi Kato
- Laboratory for Molecular Dynamics of Mental Disorders, RIKEN Brain Science Institute, Saitama, Japan
| | - Sarah Kittel-Schneider
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt-Goethe University, Frankfurt am Main, Germany
| | - Barbara König
- Department of Psychiatry and Psychotherapeutic Medicine, Landesklinikum Neunkirchen, Neunkirchen, Austria
| | - Po-Hsiu Kuo
- Institute of Epidemiology and Preventive Medicine, National Taiwan University, Taipei, Taiwan
| | - Ichiro Kusumi
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Nina Lackner
- Neurobiological Background and Anthropometrics in Bipolar Affective Disorder, Division of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Gonzalo Laje
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health, US Department of Health & Human Services, Bethesda, MD, USA
| | - Mikael Landén
- Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the Gothenburg University, Gothenburg, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Catharina Lavebratt
- Department of Molecular Medicine and Surgery, Karolinska Institutet and Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Marion Leboyer
- Assistance Publique-Hôpitaux de Paris, Hôpital Albert Chenevier-Henri Mondor, Pôle de Psychiatrie, Créteil, France
| | - Susan G Leckband
- Department of Pharmacy, VA San Diego Healthcare System, La Jolla, CA, USA
| | | | - Glenda MacQueen
- Department of Psychiatry, University of Calgary, Calgary, AB, Canada
| | - Mario Maj
- Department of Psychiatry, University of Naples SUN, Naples, Italy
| | - Mirko Manchia
- Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Department of Pharmacology, Dalhousie University, Halifax, NS, Canada
| | - Cynthia Marie-Claire
- INSERM UMR-S 1144-Université Paris Cité Département de Psychiatrie et de Médecine Addictologique, AP-HP, Groupe Hospitalier Lariboisière-F Widal, Paris, France
| | - Lina Martinsson
- Department of Clinical Neurosciences, Karolinska Institutet, Stockholm, Sweden
| | | | - Michael J McCarthy
- Department of Psychiatry, VA San Diego Healthcare System, La Jolla, CA, USA
| | - Susan L McElroy
- Department of Psychiatry, Lindner Center of Hope, University of Cincinnati, Mason, OH, USA
| | - Francis J McMahon
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health, US Department of Health & Human Services, Bethesda, MD, USA
| | - Philip B Mitchell
- School of Psychiatry, University of New South Wales, and Black Dog Institute, Sydney, NSW, Australia
| | - Marina Mitjans
- Department of Genetics, Microbiology, and Statistics, Faculty of Biology and Institut de Biomedicina (IBUB), Universitat de Barcelona, Barcelona, CIBER de Salud Mental, ISCIII, Madrid, Spain
| | - Francis M Mondimore
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Palmiero Monteleone
- Neurosciences Section, Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | | | - Markus M Nöthen
- Institute of Human Genetics, University of Bonn and Department of Genomics, Life & Brain Center, Bonn, Germany
| | - Tomas Novák
- National Institute of Mental Health, Klecany, Czech Republic
| | - Urban Ösby
- Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet and Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Norio Ozaki
- Department of Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Sergi Papiol
- Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Roy H Perlis
- Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Claudia Pisanu
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - James B Potash
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
| | - Andrea Pfennig
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Medical Faculty, Technische Universität Dresden, Dresden, Germany
| | - Daniela Reich-Erkelenz
- Institute of Psychiatric Phenomics and Genomics (IPPG) and Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt-Goethe University, Frankfurt am Main, Germany
| | - Eva Z Reininghaus
- Neurobiological Background and Anthropometrics in Bipolar Affective Disorder, Division of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Guy A Rouleau
- Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Janusz K Rybakowski
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Martin Schalling
- Department of Molecular Medicine and Surgery, Karolinska Institutet and Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Peter R Schofield
- Mental Illness Research Theme, Neuroscience Research Australia, Sydney, NSW, Australia
- School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
| | - K Oliver Schubert
- Discipline of Psychiatry, University of Adelaide, Adelaide, SA, Australia
| | - Thomas G Schulze
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health, US Department of Health & Human Services, Bethesda, MD, USA
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
- Institute of Psychiatric Phenomics and Genomics (IPPG) and Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University of Munich, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center (UMG), Georg-August University Göttingen, Göttingen, Germany
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Barbara W Schweizer
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Florian Seemüller
- Institute of Psychiatric Phenomics and Genomics (IPPG) and Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University of Munich, Munich, Germany
| | - Giovanni Severino
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Tatyana Shekhtman
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Veterans Administration, San Diego Healthcare System, San Diego, CA, USA
| | - Paul D Shilling
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Kazutaka Shimoda
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Mibu, Japan
| | | | - Claire M Slaney
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Alessio Squassina
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Thomas Stamm
- Department of Psychiatry and Psychotherapy, Charité- Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Germany
| | - Pavla Stopkova
- National Institute of Mental Health, Klecany, Czech Republic
| | - Sarah K Tighe
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
- University of Iowa Carver College of Medicine and University of Iowa College of Public Health, VA Quality Scholars Program, Iowa City VA Hospital, Iowa City, IA, USA
| | | | - Gustavo Turecki
- Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, ISCIII, Barcelona, Catalonia, Spain
| | - Julia Volkert
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt-Goethe University, Frankfurt am Main, Germany
| | - Stephanie Witt
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Naomi R Wray
- The University of Queensland, Queensland Brain Institute, Brisbane, QLD, Australia
| | - Adam Wright
- School of Psychiatry, University of New South Wales, and Black Dog Institute, Sydney, NSW, Australia
| | - L Trevor Young
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Peter P Zandi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - John R Kelsoe
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA.
- Veterans Administration, San Diego Healthcare System, San Diego, CA, USA.
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CAGI, the Critical Assessment of Genome Interpretation, establishes progress and prospects for computational genetic variant interpretation methods. Genome Biol 2024; 25:53. [PMID: 38389099 PMCID: PMC10882881 DOI: 10.1186/s13059-023-03113-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2023] [Accepted: 11/17/2023] [Indexed: 02/24/2024] Open
Abstract
BACKGROUND The Critical Assessment of Genome Interpretation (CAGI) aims to advance the state-of-the-art for computational prediction of genetic variant impact, particularly where relevant to disease. The five complete editions of the CAGI community experiment comprised 50 challenges, in which participants made blind predictions of phenotypes from genetic data, and these were evaluated by independent assessors. RESULTS Performance was particularly strong for clinical pathogenic variants, including some difficult-to-diagnose cases, and extends to interpretation of cancer-related variants. Missense variant interpretation methods were able to estimate biochemical effects with increasing accuracy. Assessment of methods for regulatory variants and complex trait disease risk was less definitive and indicates performance potentially suitable for auxiliary use in the clinic. CONCLUSIONS Results show that while current methods are imperfect, they have major utility for research and clinical applications. Emerging methods and increasingly large, robust datasets for training and assessment promise further progress ahead.
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Ettman CK, Brantner CL, Albert M, Goes FS, Mojtabai R, Spivak S, Stuart EA, Zandi PP. Trends in Telepsychiatry and In-Person Psychiatric Care for Depression in an Academic Health System, 2017-2022. Psychiatr Serv 2024; 75:178-181. [PMID: 37554006 PMCID: PMC10862532 DOI: 10.1176/appi.ps.20230064] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 08/10/2023]
Abstract
OBJECTIVE The authors aimed to assess differences in appointment completion rates between telepsychiatry and in-person outpatient psychiatric care for patients with depression in an academic health system. METHODS Electronic health records of encounters for patients (ages ≥10) with a depression diagnosis and at least one scheduled outpatient psychiatric appointment (N=586,266 appointments; November 2017-October 2022) were assessed for appointment volume and completion of telepsychiatry versus in-person sessions. RESULTS Telepsychiatry became the dominant care modality after the onset of the COVID-19 pandemic, although the number of telepsychiatry and in-person appointments nearly converged by October 2022. Logistic regression showed that telepsychiatry appointments (July 2020-October 2022) were more likely (OR=1.30, 95% CI=1.27-1.34) to be completed than in-person appointments. CONCLUSIONS Telepsychiatry appointments were less likely to be canceled or missed than in-person appointments, suggesting that telepsychiatry improved efficiency and continuity of care. As in-person operations resume following the pandemic, maintaining telepsychiatry services may optimize hospital-level and patient outcomes.
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Affiliation(s)
- Catherine K Ettman
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Ettman, Brantner, Goes, Mojtabai, Stuart); Department of Medicine (Albert) and Department of Psychiatry and Behavioral Sciences (Goes, Spivak, Zandi), Johns Hopkins University School of Medicine, Baltimore
| | - Carly L Brantner
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Ettman, Brantner, Goes, Mojtabai, Stuart); Department of Medicine (Albert) and Department of Psychiatry and Behavioral Sciences (Goes, Spivak, Zandi), Johns Hopkins University School of Medicine, Baltimore
| | - Michael Albert
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Ettman, Brantner, Goes, Mojtabai, Stuart); Department of Medicine (Albert) and Department of Psychiatry and Behavioral Sciences (Goes, Spivak, Zandi), Johns Hopkins University School of Medicine, Baltimore
| | - Fernando S Goes
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Ettman, Brantner, Goes, Mojtabai, Stuart); Department of Medicine (Albert) and Department of Psychiatry and Behavioral Sciences (Goes, Spivak, Zandi), Johns Hopkins University School of Medicine, Baltimore
| | - Ramin Mojtabai
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Ettman, Brantner, Goes, Mojtabai, Stuart); Department of Medicine (Albert) and Department of Psychiatry and Behavioral Sciences (Goes, Spivak, Zandi), Johns Hopkins University School of Medicine, Baltimore
| | - Stanislav Spivak
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Ettman, Brantner, Goes, Mojtabai, Stuart); Department of Medicine (Albert) and Department of Psychiatry and Behavioral Sciences (Goes, Spivak, Zandi), Johns Hopkins University School of Medicine, Baltimore
| | - Elizabeth A Stuart
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Ettman, Brantner, Goes, Mojtabai, Stuart); Department of Medicine (Albert) and Department of Psychiatry and Behavioral Sciences (Goes, Spivak, Zandi), Johns Hopkins University School of Medicine, Baltimore
| | - Peter P Zandi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Ettman, Brantner, Goes, Mojtabai, Stuart); Department of Medicine (Albert) and Department of Psychiatry and Behavioral Sciences (Goes, Spivak, Zandi), Johns Hopkins University School of Medicine, Baltimore
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4
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Singh B, Yocum AK, Strawbridge R, Burdick KE, Millett CE, Peters AT, Sperry SH, Fico G, Vieta E, Verdolini N, Godin O, Leboyer M, Etain B, Tso IF, Coombes BJ, McInnis MG, Nierenberg AA, Young AH, Ashton MM, Berk M, Williams LJ, Keramatian K, Yatham LN, Overs BJ, Fullerton JM, Roberts G, Mitchell PB, Andreassen OA, Andreazza AC, Zandi PP, Pham D, Biernacka JM, Frye MA. Patterns of pharmacotherapy for bipolar disorder: A GBC survey. Bipolar Disord 2024; 26:22-32. [PMID: 37463846 PMCID: PMC10794603 DOI: 10.1111/bdi.13366] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 07/20/2023]
Abstract
OBJECTIVES To understand treatment practices for bipolar disorders (BD), this study leveraged the Global Bipolar Cohort collaborative network to investigate pharmacotherapeutic treatment patterns in multiple cohorts of well-characterized individuals with BD in North America, Europe, and Australia. METHODS Data on pharmacotherapy, demographics, diagnostic subtypes, and comorbidities were provided from each participating cohort. Individual site and regional pooled proportional meta-analyses with generalized linear mixed methods were conducted to identify prescription patterns. RESULTS This study included 10,351 individuals from North America (n = 3985), Europe (n = 3822), and Australia (n = 2544). Overall, participants were predominantly female (60%) with BD-I (60%; vs. BD-II = 33%). Cross-sectionally, mood-stabilizing anticonvulsants (44%), second-generation antipsychotics (42%), and antidepressants (38%) were the most prescribed medications. Lithium was prescribed in 29% of patients, primarily in the Australian (31%) and European (36%) cohorts. First-generation antipsychotics were prescribed in 24% of the European versus 1% in the North American cohort. Antidepressant prescription rates were higher in BD-II (47%) compared to BD-I (35%). Major limitations were significant differences among cohorts based on inclusion/exclusion criteria, data source, and time/year of enrollment into cohort. CONCLUSIONS Mood-stabilizing anticonvulsants, second-generation antipsychotics, and antidepressants were the most prescribed medications suggesting prescription patterns that are not necessarily guideline concordant. Significant differences exist in the prescription practices across different geographic regions, especially the underutilization of lithium in the North American cohorts and the higher utilization of first-generation antipsychotics in the European cohorts. There is a need to conduct future longitudinal studies to further explore these differences and their impact on outcomes, and to inform and implement evidence-based guidelines to help improve treatment practices in BD.
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Affiliation(s)
- Balwinder Singh
- Mayo Clinic, Department of Psychiatry & Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | - Anastasia K Yocum
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| | - Rebecca Strawbridge
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Katherine E Burdick
- Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Caitlin E Millett
- Harvard Medical School, Brigham and Women's Hospital, Boston, Massachusetts, USA
| | - Amy T Peters
- Dauten Family Center for Bipolar Treatment Innovation, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Sarah H Sperry
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| | - Giovanna Fico
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Eduard Vieta
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Norma Verdolini
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
- Local Health Unit Umbria 1, Department of Mental Health, Mental Health Center of Perugia, Perugia, Italy
| | - Ophelia Godin
- INSERM U955, IMRB, Translational Neuro-Psychiatry, Fondation FondaMental, Univ Paris Est Créteil, Créteil, France
- Département Médico-Universitaire de Psychiatrie et d'Addictologie (DMU IMPACT), APHP, Hôpitaux Universitaires Henri Mondor, Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), Créteil, France
| | - Marion Leboyer
- INSERM U955, IMRB, Translational Neuro-Psychiatry, Fondation FondaMental, Univ Paris Est Créteil, Créteil, France
- Département Médico-Universitaire de Psychiatrie et d'Addictologie (DMU IMPACT), APHP, Hôpitaux Universitaires Henri Mondor, Fédération Hospitalo-Universitaire de Médecine de Précision en Psychiatrie (FHU ADAPT), Créteil, France
| | - Bruno Etain
- Groupe Hospitalo-universitaire AP-HP Nord, DMU Neurosciences, Hôpital Fernand Widal, Département de Psychiatrie et de Médecine Addictologique, INSERM UMRS 1144, Université de Paris, AP-HP, Paris, France
| | - Ivy F Tso
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
- Department of Psychiatry & Behavioral Health, The Ohio State University, Columbus, Ohio, USA
| | - Brandon J Coombes
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
| | - Melvin G McInnis
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| | - Andrew A Nierenberg
- Dauten Family Center for Bipolar Treatment Innovation, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Allan H Young
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Melanie M Ashton
- IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia
| | - Michael Berk
- IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia
- Orygen, The National Centre of Excellence in Youth Mental Health, Centre for Youth Mental Health, Florey Institute for Neuroscience and Mental Health and the Department of Psychiatry, The University of Melbourne, Melbourne, Victoria, Australia
| | - Lana J Williams
- IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Deakin University, Geelong, Victoria, Australia
| | - Kamyar Keramatian
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - Lakshmi N Yatham
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
| | - Bronwyn J Overs
- Neuroscience Research Australia, Randwick, Sydney, New South Wales, Australia
| | - Janice M Fullerton
- Neuroscience Research Australia, Randwick, Sydney, New South Wales, Australia
- School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Gloria Roberts
- School of Psychiatry, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Philip B Mitchell
- School of Medical Sciences, Faculty of Medicine, University of New South Wales, Sydney, New South Wales, Australia
| | - Ole A Andreassen
- NORMENT Centre, Division of Mental Health and Addiction, University of Oslo and Oslo University Hospital, Oslo, Norway
| | - Ana C Andreazza
- Department of Pharmacology & Toxicology, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada
| | - Peter P Zandi
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Daniel Pham
- The Milken Institute, Washington, District of Columbia, USA
| | - Joanna M Biernacka
- Mayo Clinic, Department of Psychiatry & Psychology, Mayo Clinic, Rochester, Minnesota, USA
- Groupe Hospitalo-universitaire AP-HP Nord, DMU Neurosciences, Hôpital Fernand Widal, Département de Psychiatrie et de Médecine Addictologique, INSERM UMRS 1144, Université de Paris, AP-HP, Paris, France
| | - Mark A Frye
- Mayo Clinic, Department of Psychiatry & Psychology, Mayo Clinic, Rochester, Minnesota, USA
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5
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Gargano MA, Matentzoglu N, Coleman B, Addo-Lartey EB, Anagnostopoulos A, Anderton J, Avillach P, Bagley AM, Bakštein E, Balhoff JP, Baynam G, Bello SM, Berk M, Bertram H, Bishop S, Blau H, Bodenstein DF, Botas P, Boztug K, Čady J, Callahan TJ, Cameron R, Carbon S, Castellanos F, Caufield JH, Chan LE, Chute C, Cruz-Rojo J, Dahan-Oliel N, Davids JR, de Dieuleveult M, de Souza V, de Vries BBA, de Vries E, DePaulo JR, Derfalvi B, Dhombres F, Diaz-Byrd C, Dingemans AJM, Donadille B, Duyzend M, Elfeky R, Essaid S, Fabrizzi C, Fico G, Firth HV, Freudenberg-Hua Y, Fullerton JM, Gabriel DL, Gilmour K, Giordano J, Goes FS, Moses RG, Green I, Griese M, Groza T, Gu W, Guthrie J, Gyori B, Hamosh A, Hanauer M, Hanušová K, He Y(O, Hegde H, Helbig I, Holasová K, Hoyt CT, Huang S, Hurwitz E, Jacobsen JOB, Jiang X, Joseph L, Keramatian K, King B, Knoflach K, Koolen DA, Kraus M, Kroll C, Kusters M, Ladewig MS, Lagorce D, Lai MC, Lapunzina P, Laraway B, Lewis-Smith D, Li X, Lucano C, Majd M, Marazita ML, Martinez-Glez V, McHenry TH, McInnis MG, McMurry JA, Mihulová M, Millett CE, Mitchell PB, Moslerová V, Narutomi K, Nematollahi S, Nevado J, Nierenberg AA, Čajbiková NN, Nurnberger JI, Ogishima S, Olson D, Ortiz A, Pachajoa H, Perez de Nanclares G, Peters A, Putman T, Rapp CK, Rath A, Reese J, Rekerle L, Roberts A, Roy S, Sanders SJ, Schuetz C, Schulte EC, Schulze TG, Schwarz M, Scott K, Seelow D, Seitz B, Shen Y, Similuk MN, Simon ES, Singh B, Smedley D, Smith CL, Smolinsky JT, Sperry S, Stafford E, Stefancsik R, Steinhaus R, Strawbridge R, Sundaramurthi JC, Talapova P, Tenorio Castano JA, Tesner P, Thomas RH, Thurm A, Turnovec M, van Gijn ME, Vasilevsky NA, Vlčková M, Walden A, Wang K, Wapner R, Ware JS, Wiafe AA, Wiafe SA, Wiggins LD, Williams AE, Wu C, Wyrwoll MJ, Xiong H, Yalin N, Yamamoto Y, Yatham LN, Yocum AK, Young AH, Yüksel Z, Zandi PP, Zankl A, Zarante I, Zvolský M, Toro S, Carmody LC, Harris NL, Munoz-Torres MC, Danis D, Mungall CJ, Köhler S, Haendel MA, Robinson PN. The Human Phenotype Ontology in 2024: phenotypes around the world. Nucleic Acids Res 2024; 52:D1333-D1346. [PMID: 37953324 PMCID: PMC10767975 DOI: 10.1093/nar/gkad1005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2023] [Revised: 10/12/2023] [Accepted: 10/19/2023] [Indexed: 11/14/2023] Open
Abstract
The Human Phenotype Ontology (HPO) is a widely used resource that comprehensively organizes and defines the phenotypic features of human disease, enabling computational inference and supporting genomic and phenotypic analyses through semantic similarity and machine learning algorithms. The HPO has widespread applications in clinical diagnostics and translational research, including genomic diagnostics, gene-disease discovery, and cohort analytics. In recent years, groups around the world have developed translations of the HPO from English to other languages, and the HPO browser has been internationalized, allowing users to view HPO term labels and in many cases synonyms and definitions in ten languages in addition to English. Since our last report, a total of 2239 new HPO terms and 49235 new HPO annotations were developed, many in collaboration with external groups in the fields of psychiatry, arthrogryposis, immunology and cardiology. The Medical Action Ontology (MAxO) is a new effort to model treatments and other measures taken for clinical management. Finally, the HPO consortium is contributing to efforts to integrate the HPO and the GA4GH Phenopacket Schema into electronic health records (EHRs) with the goal of more standardized and computable integration of rare disease data in EHRs.
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Affiliation(s)
| | | | - Ben Coleman
- The Jackson Laboratory for Genomic Medicine, Farmington, CT, USA
| | | | | | - Joel Anderton
- Center for Craniofacial and Dental Genetics, Department of Oral and Craniofacial Sciences, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | | | - Anita M Bagley
- Shriners Children's Northern California, Sacramento, CA, USA
| | - Eduard Bakštein
- National Institute of Mental Health, Klecany, Czech Republic
| | - James P Balhoff
- Renaissance Computing Institute, University of North Carolina, Chapel Hill, NC 27517, USA
| | - Gareth Baynam
- Rare Care Centre, Perth Children's Hospital, Perth, Australia
| | | | - Michael Berk
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Barwon Health, Geelong, Australia
| | - Holli Bertram
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Somer Bishop
- Department of Psychiatry and Behavioral Sciences, UCSF Weil Institute for Neuroscience, San Francisco, CA, USA
| | - Hannah Blau
- The Jackson Laboratory for Genomic Medicine, Farmington, CT, USA
| | - David F Bodenstein
- Department of Pharmacology and Toxicology, University of Toronto, Toronto, ON, Canada
| | | | - Kaan Boztug
- St. Anna Children's Cancer Research Institute (CCRI), Vienna, Austria
| | - Jolana Čady
- Institute of Health Information and Statistics of the Czech Republic, Prague, Czech Republic
| | - Tiffany J Callahan
- Department of Biomedical Informatics, Columbia University Irving Medical Center, NY, NY, USA
| | | | - Seth J Carbon
- Division of Environmental Genomics and Systems Biology, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
| | | | - J Harry Caufield
- Division of Environmental Genomics and Systems Biology, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
| | - Lauren E Chan
- College of Public Health and Human Sciences, Oregon State University, Corvallis, OR 97331, USA
| | - Christopher G Chute
- Schools of Medicine, Public Health, and Nursing, Johns Hopkins University, Baltimore, MD 21287, USA
| | - Jaime Cruz-Rojo
- UDISGEN (Dysmorphology and Genetics Unit), 12 de Octubre Hospital, Madrid, Spain
| | - Noémi Dahan-Oliel
- Department of Clinical Research, Shriners Hospitals for Children, Montreal, Quebec, Canada
| | - Jon R Davids
- Shriners Children's Northern California, Sacramento, CA, USA
| | - Maud de Dieuleveult
- Département I&D, AP-HP, Banque Nationale de Données Maladies Rares, Paris, France
| | - Vinicius de Souza
- European Bioinformatics Institute (EMBL-EBI), Wellcome Genome Campus, Hinxton CB10 1SD, UK
| | - Bert B A de Vries
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands
| | | | - J Raymond DePaulo
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Beata Derfalvi
- Department of Pediatrics, Dalhousie University, Halifax, NS, Canada
| | - Ferdinand Dhombres
- Fetal Medicine Department, Armand Trousseau Hospital, Sorbonne University, GRC26, INSERM, Limics, Paris, France
| | - Claudia Diaz-Byrd
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Alexander J M Dingemans
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands
| | - Bruno Donadille
- St Antoine Hospital, Reference Center for Rare Growth Endocrine Disorders, Sorbonne University, AP-HP, INSERM, US14 - Orphanet, Plateforme Maladies Rares, Paris, France
| | | | - Reem Elfeky
- Department of Immunology, GOS Hospital for Children NHS Foundation Trust, University College London, London, UK
| | - Shahim Essaid
- Department of Biomedical Informatics, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | | | - Giovanna Fico
- Bipolar and Depressive Disorders Unit, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Helen V Firth
- Addenbrooke's Hospital, Cambridge University Hospitals, Cambridge, UK
| | - Yun Freudenberg-Hua
- Department of Psychiatry, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
| | | | - Davera L Gabriel
- School of Medicine, Johns Hopkins University, Baltimore, MD 21287, USA
| | | | - Jessica Giordano
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, NY, USA
| | - Fernando S Goes
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Rachel Gore Moses
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Ian Green
- SNOMED International, London W2 6BD, UK
| | - Matthias Griese
- Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, German center for Lung research (DZL), Munich, Germany
| | - Tudor Groza
- Rare Care Centre, Perth Children's Hospital, Perth, Australia
| | | | - Julia Guthrie
- Department of Structural and Computational Biology, University of Vienna; Max Perutz Labs, Vienna, Austria
| | - Benjamin Gyori
- Khoury College of Computer Sciences, Northeastern University, Boston, MA, USA
| | - Ada Hamosh
- Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Marc Hanauer
- INSERM, US14 - Orphanet, Plateforme Maladies Rares, Paris, France
| | - Kateřina Hanušová
- Institute of Health Information and Statistics of the Czech Republic, Prague, Czech Republic
| | | | - Harshad Hegde
- Division of Environmental Genomics and Systems Biology, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
| | - Ingo Helbig
- Neurology, Children's Hospital of Philadelphia, Philadelphia, PA 19104, USA
| | - Kateřina Holasová
- Institute of Health Information and Statistics of the Czech Republic, Prague, Czech Republic
| | - Charles Tapley Hoyt
- Khoury College of Computer Sciences, Northeastern University, Boston, MA, USA
| | | | - Eric Hurwitz
- University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Julius O B Jacobsen
- William Harvey Research Institute, Queen Mary University of London, London, UK
| | | | - Lisa Joseph
- Neurodevelopmental and Behavioral Phenotyping Service, National Institute of Mental Health, Bethesda, MD, USA
| | - Kamyar Keramatian
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Bryan King
- Department of Psychiatry and Behavioral Sciences, UCSF Weil Institute for Neuroscience, San Francisco, CA, USA
| | - Katrin Knoflach
- Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, German center for Lung research (DZL), Munich, Germany
| | - David A Koolen
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, Netherlands
| | - Megan L Kraus
- University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Carlo Kroll
- William Harvey Research Institute, Queen Mary University of London, London, UK
| | - Maaike Kusters
- Immunology, NIHR Great Ormond Street Hospital BRC, London, UK
| | - Markus S Ladewig
- Department of Ophthalmology, University Clinic Marburg - Campus Fulda, Fulda, Germany
| | - David Lagorce
- INSERM, US14 - Orphanet, Plateforme Maladies Rares, Paris, France
| | - Meng-Chuan Lai
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - Pablo Lapunzina
- Institute of Medical and Molecular Genetics, Hospital Univ. La Paz, Madrid, Spain
| | - Bryan Laraway
- University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - David Lewis-Smith
- Translational and Clinical Research Institute, Henry Wellcome Building, Framlington Place, Newcastle University, Newcastle-Upon-Tyne NE14LP, UK
| | | | - Caterina Lucano
- INSERM, US14 - Orphanet, Plateforme Maladies Rares, Paris, France
| | - Marzieh Majd
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Mary L Marazita
- Center for Craniofacial and Dental Genetics, Department of Oral and Craniofacial Sciences, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Victor Martinez-Glez
- Center for Genomic Medicine, Parc Taulí Hospital Universitari, Institut d’Investigació i Innovació Parc Taulí (I3PT-CERCA), Sabadell, Spain
| | - Toby H McHenry
- Center for Craniofacial and Dental Genetics, Department of Oral and Craniofacial Sciences, School of Dental Medicine, University of Pittsburgh, Pittsburgh, PA, USA
| | - Melvin G McInnis
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Julie A McMurry
- University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Michaela Mihulová
- Department of Biology and Medical Genetics, 2nd Medical Faculty of Charles University and University Hospital Motol, Prague, Czech Republic
| | - Caitlin E Millett
- Feinstein Institutes for Medical Research, Northwell Health, Manhasset, NY, USA
| | - Philip B Mitchell
- Discipline of Psychiatry & Mental Health, School of Clinical Medicine, Faculty of Medicine & Health, University of New South Wales, Sydney, NSW, Australia
| | - Veronika Moslerová
- Department of Biology and Medical Genetics, 2nd Medical Faculty of Charles University and University Hospital Motol, Prague, Czech Republic
| | - Kenji Narutomi
- Okinawa Prefectural Nanbu Medical Center & Children's Medical Center
| | - Shahrzad Nematollahi
- School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada
| | - Julian Nevado
- Institute of Medical and Molecular Genetics, Hospital Univ. La Paz, Madrid, Spain
| | - Andrew A Nierenberg
- Dauten Family Center for Bipolar Treatment Innovation, Massachusetts General Hospital, Boston, MA, USA
| | - Nikola Novák Čajbiková
- Department of Biology and Medical Genetics, 2nd Medical Faculty of Charles University and University Hospital Motol, Prague, Czech Republic
| | - John I Nurnberger
- Stark Neurosciences Research Institute, Departments of Psychiatry and Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
| | | | - Daniel Olson
- Data Collaboration Center, Data Science, Critical Path Institute, Tucson, AZ, USA
| | - Abigail Ortiz
- Department of Psychiatry, University of Toronto, Toronto, ON, Canada
| | - Harry Pachajoa
- Centro de Investigaciones en Anomalías Congénitas y Enfermedades Raras (CIACER), Universidad Icesi, Cali, Colombia
| | - Guiomar Perez de Nanclares
- Molecular (epi) genetics lab, Bioaraba Health Research Institute, Araba University Hospital, Vitoria-Gasteiz, Spain
| | - Amy Peters
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Tim Putman
- University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Christina K Rapp
- Department of Pediatrics, Dr. von Hauner Children's Hospital, University Hospital, LMU Munich, German center for Lung research (DZL), Munich, Germany
| | - Ana Rath
- INSERM, US14 - Orphanet, Plateforme Maladies Rares, Paris, France
| | - Justin Reese
- Division of Environmental Genomics and Systems Biology, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
| | - Lauren Rekerle
- The Jackson Laboratory for Genomic Medicine, Farmington, CT, USA
| | - Angharad M Roberts
- National Heart & Lung Institute & MRC London Institute of Medical Sciences, Imperial College London, London W12 0HS, UK
| | - Suzy Roy
- SNOMED International, London W2 6BD, UK
| | - Stephan J Sanders
- Department of Paediatrics, Institute of Developmental and Regenerative Medicine, University of Oxford, Oxford, UK
| | - Catharina Schuetz
- Universitätsklinikum Carl Gustav Carus, Medizinische Fakultät, TU, Dresden, Germany
| | - Eva C Schulte
- Institute of Psychiatric Phenomics and Genomics (IPPG), LMU University Hospital, LMU Munich, Munich, Germany
| | - Thomas G Schulze
- Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Martin Schwarz
- Department of Biology and Medical Genetics, 2nd Medical Faculty of Charles University and University Hospital Motol, Prague, Czech Republic
| | - Katie Scott
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Dominik Seelow
- Exploratory Diagnostic Sciences, Berliner Institut für Gesundheitsforschung - Charité, Berlin, Germany
| | - Berthold Seitz
- Department of Ophthalmology, Saarland University Medical Center UKS, Homburg/Saar, Germany
| | | | - Morgan N Similuk
- National Institute of Allergy and Infectious Diseases, National Institutes of Health, Bethesda, MD 20892, USA
| | - Eric S Simon
- Eisenberg Family Depression Center, University of Michigan, Ann Arbor, MI, USA
| | - Balwinder Singh
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Damian Smedley
- William Harvey Research Institute, Queen Mary University of London, London, UK
| | | | - Jake T Smolinsky
- Human Genetics Institute of New Jersey, Rutgers University, Piscataway, NJ, USA
| | - Sarah Sperry
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | | | - Ray Stefancsik
- European Bioinformatics Institute (EMBL-EBI), Wellcome Genome Campus, Hinxton CB10 1SD, UK
| | - Robin Steinhaus
- Exploratory Diagnostic Sciences, Berliner Institut für Gesundheitsforschung - Charité, Berlin, Germany
| | - Rebecca Strawbridge
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | | | - Polina Talapova
- Institute for Research and Health Policy Studies, Tufts Medicine, Boston, MA 2111, USA
| | | | - Pavel Tesner
- Department of Biology and Medical Genetics, 2nd Medical Faculty of Charles University and University Hospital Motol, Prague, Czech Republic
| | - Rhys H Thomas
- Translational and Clinical Research Institute, Henry Wellcome Building, Framlington Place, Newcastle University, Newcastle-Upon-Tyne NE14LP, UK
| | - Audrey Thurm
- Neurodevelopmental and Behavioral Phenotyping Service, National Institute of Mental Health, Bethesda, MD, USA
| | - Marek Turnovec
- Department of Biology and Medical Genetics, 2nd Medical Faculty of Charles University and University Hospital Motol, Prague, Czech Republic
| | - Marielle E van Gijn
- Department of Genetics, University Medical Center Groningen, Groningen, Netherlands
| | | | - Markéta Vlčková
- Department of Biology and Medical Genetics, 2nd Medical Faculty of Charles University and University Hospital Motol, Prague, Czech Republic
| | - Anita Walden
- Department of Biomedical Informatics, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Kai Wang
- Chinese HPO Consortium, Beijing, China
| | - Ron Wapner
- Department of Obstetrics and Gynecology, Columbia University Irving Medical Center, New York, NY, USA
| | - James S Ware
- National Heart & Lung Institute & MRC London Institute of Medical Sciences, Imperial College London, London W12 0HS, UK
| | | | | | - Lisa D Wiggins
- National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Andrew E Williams
- Institute for Research and Health Policy Studies, Tufts Medicine, Boston, MA 2111, USA
| | - Chen Wu
- Chinese HPO Consortium, Beijing, China
| | - Margot J Wyrwoll
- Centre for Regenerative Medicine, Institute for Regeneration and Repair, Institute for Stem Cell Research, University of Edinburgh, Edinburgh, UK
| | - Hui Xiong
- Chinese HPO Consortium, Beijing, China
| | - Nefize Yalin
- Department of Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Yasunori Yamamoto
- Database Center for Life Science, Joint Support-Center for Data Science Research, Research Organization of Information and Systems, Japan
| | - Lakshmi N Yatham
- Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Anastasia K Yocum
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Allan H Young
- Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London & South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Monks Orchard Road, Beckenham, Kent, London SE5 8AF, UK
| | - Zafer Yüksel
- Department of Human Genetics, Bioscientia Healthcare GmbH, Ingelheim, Germany
| | - Peter P Zandi
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA
| | - Andreas Zankl
- Faculty of Medicine and Health, The University of Sydney, Camperdown, Australia
| | - Ignacio Zarante
- Institute of Human Genetics, Pontificia Universidad Javeriana, Bogotá, Colombia
| | - Miroslav Zvolský
- Institute of Health Information and Statistics of the Czech Republic, Prague, Czech Republic
| | - Sabrina Toro
- University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Leigh C Carmody
- The Jackson Laboratory for Genomic Medicine, Farmington, CT, USA
| | - Nomi L Harris
- Division of Environmental Genomics and Systems Biology, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
| | - Monica C Munoz-Torres
- Department of Biomedical Informatics, University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Daniel Danis
- The Jackson Laboratory for Genomic Medicine, Farmington, CT, USA
| | - Christopher J Mungall
- Division of Environmental Genomics and Systems Biology, Lawrence Berkeley National Laboratory, Berkeley, CA 94720, USA
| | | | - Melissa A Haendel
- University of Colorado Anschutz Medical Campus, Aurora, CO 80045, USA
| | - Peter N Robinson
- The Jackson Laboratory for Genomic Medicine, Farmington, CT, USA
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6
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Herrera-Rivero M, Adli M, Akiyama K, Akula N, Amare AT, Ardau R, Arias B, Aubry JM, Backlund L, Bellivier F, Benabarre A, Bengesser S, Bhattacharjee AK, Biernacka JM, Birner A, Cearns M, Cervantes P, Chen HC, Chillotti C, Cichon S, Clark SR, Colom F, Cruceanu C, Czerski PM, Dalkner N, Degenhardt F, Del Zompo M, DePaulo JR, Etain B, Falkai P, Ferensztajn-Rochowiak E, Forstner AJ, Frank J, Frisén L, Frye MA, Fullerton JM, Gallo C, Gard S, Garnham JS, Goes FS, Grigoroiu-Serbanescu M, Grof P, Hashimoto R, Hasler R, Hauser J, Heilbronner U, Herms S, Hoffmann P, Hou L, Hsu YH, Jamain S, Jiménez E, Kahn JP, Kassem L, Kato T, Kelsoe J, Kittel-Schneider S, Kuo PH, Kusumi I, König B, Laje G, Landén M, Lavebratt C, Leboyer M, Leckband SG, Maj M, Manchia M, Marie-Claire C, Martinsson L, McCarthy MJ, McElroy SL, Millischer V, Mitjans M, Mondimore FM, Monteleone P, Nievergelt CM, Novák T, Nöthen MM, O'Donovan C, Ozaki N, Papiol S, Pfennig A, Pisanu C, Potash JB, Reif A, Reininghaus E, Richard-Lepouriel H, Roberts G, Rouleau GA, Rybakowski JK, Schalling M, Schofield PR, Schubert KO, Schulte EC, Schweizer BW, Severino G, Shekhtman T, Shilling PD, Shimoda K, Simhandl C, Slaney CM, Squassina A, Stamm T, Stopkova P, Streit F, Tekola-Ayele F, Thalamuthu A, Tortorella A, Turecki G, Veeh J, Vieta E, Viswanath B, Witt SH, Zandi PP, Alda M, Bauer M, McMahon FJ, Mitchell PB, Rietschel M, Schulze TG, Baune BT. Exploring the genetics of lithium response in bipolar disorders. Res Sq 2023:rs.3.rs-3677630. [PMID: 38077040 PMCID: PMC10705597 DOI: 10.21203/rs.3.rs-3677630/v1] [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] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/22/2023]
Abstract
Background Lithium (Li) remains the treatment of choice for bipolar disorders (BP). Its mood-stabilizing effects help reduce the long-term burden of mania, depression and suicide risk in patients with BP. It also has been shown to have beneficial effects on disease-associated conditions, including sleep and cardiovascular disorders. However, the individual responses to Li treatment vary within and between diagnostic subtypes of BP (e.g. BP-I and BP-II) according to the clinical presentation. Moreover, long-term Li treatment has been linked to adverse side-effects that are a cause of concern and non-adherence, including the risk of developing chronic medical conditions such as thyroid and renal disease. In recent years, studies by the Consortium on Lithium Genetics (ConLiGen) have uncovered a number of genetic factors that contribute to the variability in Li treatment response in patients with BP. Here, we leveraged the ConLiGen cohort (N=2,064) to investigate the genetic basis of Li effects in BP. For this, we studied how Li response and linked genes associate with the psychiatric symptoms and polygenic load for medical comorbidities, placing particular emphasis on identifying differences between BP-I and BP-II. Results We found that clinical response to Li treatment, measured with the Alda scale, was associated with a diminished burden of mania, depression, substance and alcohol abuse, psychosis and suicidal ideation in patients with BP-I and, in patients with BP-II, of depression only. Our genetic analyses showed that a stronger clinical response to Li was modestly related to lower polygenic load for diabetes and hypertension in BP-I but not BP-II. Moreover, our results suggested that a number of genes that have been previously linked to Li response variability in BP differentially relate to the psychiatric symptomatology, particularly to the numbers of manic and depressive episodes, and to the polygenic load for comorbid conditions, including diabetes, hypertension and hypothyroidism. Conclusions Taken together, our findings suggest that the effects of Li on symptomatology and comorbidity in BP are partially modulated by common genetic factors, with differential effects between BP-I and BP-II.
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Affiliation(s)
| | | | | | - Nirmala Akula
- United States Department of Health and Human Services
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Josef Frank
- Central Institute of Mental Health, University of Heidelberg
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Liping Hou
- United States Department of Health and Human Services
| | | | | | | | | | - Layla Kassem
- United States Department of Health and Human Services
| | | | | | | | | | | | | | - Gonzalo Laje
- United States Department of Health and Human Services
| | | | | | | | | | - Mario Maj
- University of Campania 'Luigi Vanvitelli'
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Andrea Pfennig
- University Hospital Carl Gustav Carus, Technische Universität Dresden
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | - Fabian Streit
- Central Institute of Mental Health, University of Heidelberg
| | | | | | | | | | | | - Eduard Vieta
- Hospital Clinic, University of Barcelona, IDIBAPS
| | | | | | | | | | - Michael Bauer
- University Hospital Carl Gustav Carus, Technische Universität Dresden
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7
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Humphries EM, Ahn K, Kember RL, Lopes FL, Mocci E, Peralta JM, Blangero J, Glahn DC, Goes FS, Zandi PP, Kochunov P, Van Hout C, Shuldiner AR, Pollin TI, Mitchell BD, Bucan M, Hong LE, McMahon FJ, Ament SA. Genome-wide significant risk loci for mood disorders in the Old Order Amish founder population. Mol Psychiatry 2023; 28:5262-5271. [PMID: 36882501 PMCID: PMC10483025 DOI: 10.1038/s41380-023-02014-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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] [Received: 07/01/2022] [Revised: 02/19/2023] [Accepted: 02/23/2023] [Indexed: 03/09/2023]
Abstract
Genome-wide association studies (GWAS) of mood disorders in large case-control cohorts have identified numerous risk loci, yet pathophysiological mechanisms remain elusive, primarily due to the very small effects of common variants. We sought to discover risk variants with larger effects by conducting a genome-wide association study of mood disorders in a founder population, the Old Order Amish (OOA, n = 1,672). Our analysis revealed four genome-wide significant risk loci, all of which were associated with >2-fold relative risk. Quantitative behavioral and neurocognitive assessments (n = 314) revealed effects of risk variants on sub-clinical depressive symptoms and information processing speed. Network analysis suggested that OOA-specific risk loci harbor novel risk-associated genes that interact with known neuropsychiatry-associated genes via gene interaction networks. Annotation of the variants at these risk loci revealed population-enriched, non-synonymous variants in two genes encoding neurodevelopmental transcription factors, CUX1 and CNOT1. Our findings provide insight into the genetic architecture of mood disorders and a substrate for mechanistic and clinical studies.
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Affiliation(s)
- Elizabeth M Humphries
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
- Program in Molecular Epidemiology, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Kwangmi Ahn
- Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
| | - Rachel L Kember
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Fabiana L Lopes
- Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
| | - Evelina Mocci
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Juan M Peralta
- University of Texas Rio Grande Valley, Harlingen, TX, USA
| | - John Blangero
- University of Texas Rio Grande Valley, Harlingen, TX, USA
| | | | - Fernando S Goes
- Departments of Epidemiology and Mental Health, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Peter P Zandi
- Departments of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Peter Kochunov
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Cristopher Van Hout
- Regeneron Genetics Center, Tarrytown, NY, USA
- Laboratorio Internacional de Investigatión sobre el Genoma Humano, Campus Juriquilla de la Universidad Nacional Autónoma de México, Querétaro, Querétaro, 76230, Mexico
| | - Alan R Shuldiner
- Regeneron Genetics Center, Tarrytown, NY, USA
- Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
- Program in Personalized and Genomic Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Toni I Pollin
- Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
- Program in Personalized and Genomic Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Braxton D Mitchell
- Department of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
- Program in Personalized and Genomic Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Maja Bucan
- Department of Genetics, University of Pennsylvania, Philadelphia, PA, USA
| | - L Elliot Hong
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD, USA
| | - Francis J McMahon
- Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
| | - Seth A Ament
- Institute for Genome Sciences, University of Maryland School of Medicine, Baltimore, MD, USA.
- Department of Psychiatry, Maryland Psychiatric Research Center, University of Maryland School of Medicine, Baltimore, MD, USA.
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8
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Amare AT, Thalamuthu A, Schubert KO, Fullerton JM, Ahmed M, Hartmann S, Papiol S, Heilbronner U, Degenhardt F, Tekola-Ayele F, Hou L, Hsu YH, Shekhtman T, Adli M, Akula N, Akiyama K, Ardau R, Arias B, Aubry JM, Hasler R, Richard-Lepouriel H, Perroud N, Backlund L, Bhattacharjee AK, Bellivier F, Benabarre A, Bengesser S, Biernacka JM, Birner A, Marie-Claire C, Cervantes P, Chen HC, Chillotti C, Cichon S, Cruceanu C, Czerski PM, Dalkner N, Del Zompo M, DePaulo JR, Étain B, Jamain S, Falkai P, Forstner AJ, Frisen L, Frye MA, Gard S, Garnham JS, Goes FS, Grigoroiu-Serbanescu M, Fallgatter AJ, Stegmaier S, Ethofer T, Biere S, Petrova K, Schuster C, Adorjan K, Budde M, Heilbronner M, Kalman JL, Kohshour MO, Reich-Erkelenz D, Schaupp SK, Schulte EC, Senner F, Vogl T, Anghelescu IG, Arolt V, Dannlowski U, Dietrich D, Figge C, Jäger M, Lang FU, Juckel G, Konrad C, Reimer J, Schmauß M, Schmitt A, Spitzer C, von Hagen M, Wiltfang J, Zimmermann J, Andlauer TFM, Fischer A, Bermpohl F, Ritter P, Matura S, Gryaznova A, Falkenberg I, Yildiz C, Kircher T, Schmidt J, Koch M, Gade K, Trost S, Haussleiter IS, Lambert M, Rohenkohl AC, Kraft V, Grof P, Hashimoto R, Hauser J, Herms S, Hoffmann P, Jiménez E, Kahn JP, Kassem L, Kuo PH, Kato T, Kelsoe J, Kittel-Schneider S, Ferensztajn-Rochowiak E, König B, Kusumi I, Laje G, Landén M, Lavebratt C, Leboyer M, Leckband SG, Tortorella A, Manchia M, Martinsson L, McCarthy MJ, McElroy S, Colom F, Millischer V, Mitjans M, Mondimore FM, Monteleone P, Nievergelt CM, Nöthen MM, Novák T, O'Donovan C, Ozaki N, Pfennig A, Pisanu C, Potash JB, Reif A, Reininghaus E, Rouleau GA, Rybakowski JK, Schalling M, Schofield PR, Schweizer BW, Severino G, Shilling PD, Shimoda K, Simhandl C, Slaney CM, Squassina A, Stamm T, Stopkova P, Maj M, Turecki G, Vieta E, Veeh J, Witt SH, Wright A, Zandi PP, Mitchell PB, Bauer M, Alda M, Rietschel M, McMahon FJ, Schulze TG, Clark SR, Baune BT. Association of polygenic score and the involvement of cholinergic and glutamatergic pathways with lithium treatment response in patients with bipolar disorder. Mol Psychiatry 2023; 28:5251-5261. [PMID: 37433967 DOI: 10.1038/s41380-023-02149-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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] [Received: 02/12/2023] [Revised: 05/31/2023] [Accepted: 06/16/2023] [Indexed: 07/13/2023]
Abstract
Lithium is regarded as the first-line treatment for bipolar disorder (BD), a severe and disabling mental health disorder that affects about 1% of the population worldwide. Nevertheless, lithium is not consistently effective, with only 30% of patients showing a favorable response to treatment. To provide personalized treatment options for bipolar patients, it is essential to identify prediction biomarkers such as polygenic scores. In this study, we developed a polygenic score for lithium treatment response (Li+PGS) in patients with BD. To gain further insights into lithium's possible molecular mechanism of action, we performed a genome-wide gene-based analysis. Using polygenic score modeling, via methods incorporating Bayesian regression and continuous shrinkage priors, Li+PGS was developed in the International Consortium of Lithium Genetics cohort (ConLi+Gen: N = 2367) and replicated in the combined PsyCourse (N = 89) and BipoLife (N = 102) studies. The associations of Li+PGS and lithium treatment response - defined in a continuous ALDA scale and a categorical outcome (good response vs. poor response) were tested using regression models, each adjusted for the covariates: age, sex, and the first four genetic principal components. Statistical significance was determined at P < 0.05. Li+PGS was positively associated with lithium treatment response in the ConLi+Gen cohort, in both the categorical (P = 9.8 × 10-12, R2 = 1.9%) and continuous (P = 6.4 × 10-9, R2 = 2.6%) outcomes. Compared to bipolar patients in the 1st decile of the risk distribution, individuals in the 10th decile had 3.47-fold (95%CI: 2.22-5.47) higher odds of responding favorably to lithium. The results were replicated in the independent cohorts for the categorical treatment outcome (P = 3.9 × 10-4, R2 = 0.9%), but not for the continuous outcome (P = 0.13). Gene-based analyses revealed 36 candidate genes that are enriched in biological pathways controlled by glutamate and acetylcholine. Li+PGS may be useful in the development of pharmacogenomic testing strategies by enabling a classification of bipolar patients according to their response to treatment.
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Affiliation(s)
- Azmeraw T Amare
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, SA, Australia.
| | - Anbupalam Thalamuthu
- Centre for Healthy Brain Ageing (CHeBA), Discipline of Psychiatry and Mental Health, UNSW Medicine & Health, University of New South Wales, Sydney, Australia
| | - Klaus Oliver Schubert
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, SA, Australia
- Northern Adelaide Local Health Network, Mental Health Services, Adelaide, SA, Australia
| | - Janice M Fullerton
- Neuroscience Research Australia, Sydney, NSW, Australia
- School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Muktar Ahmed
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, SA, Australia
| | - Simon Hartmann
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, SA, Australia
| | - Sergi Papiol
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilian-University Munich, Munich, Germany
| | - Urs Heilbronner
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
| | - Franziska Degenhardt
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, LVR Klinikum Essen, University of Duisburg-Essen, Rheinische Kliniken, Essen, Germany
| | - Fasil Tekola-Ayele
- Epidemiology Branch, Division of Population Health Research, Division of Intramural Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Liping Hou
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health, US Department of Health & Human Services, Bethesda, MD, USA
| | - Yi-Hsiang Hsu
- HSL Institute for Aging Research, Harvard Medical School, Boston, MA, USA
- Program for Quantitative Genomics, Harvard School of Public Health, Boston, MA, USA
| | - Tatyana Shekhtman
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Mazda Adli
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Germany
| | - Nirmala Akula
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health, US Department of Health & Human Services, Bethesda, MD, USA
| | - Kazufumi Akiyama
- Department of Biological Psychiatry and Neuroscience, Dokkyo Medical University School of Medicine, Mibu, Tochigi, Japan
| | - Raffaella Ardau
- Unit of Clinical Pharmacology, Hospital University Agency of Cagliari, Cagliari, Italy
| | - Bárbara Arias
- Unitat de Zoologia i Antropologia Biològica (Dpt. Biologia Evolutiva, Ecologia i Ciències Ambientals), Facultat de Biologia and Institut de Biomedicina (IBUB), University of Barcelona, CIBERSAM, Barcelona, Spain
| | - Jean-Michel Aubry
- Department of Psychiatry, Mood Disorders Unit, HUG - Geneva University Hospitals, Geneva, Switzerland
| | - Roland Hasler
- Department of Psychiatry, Mood Disorders Unit, HUG - Geneva University Hospitals, Geneva, Switzerland
| | - Hélène Richard-Lepouriel
- Department of Psychiatry, Mood Disorders Unit, HUG - Geneva University Hospitals, Geneva, Switzerland
| | - Nader Perroud
- Department of Psychiatry, Mood Disorders Unit, HUG - Geneva University Hospitals, Geneva, Switzerland
| | - Lena Backlund
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | | | - Frank Bellivier
- INSERM UMR-S 1144, Université Paris Cité, Département de Psychiatrie et de Médecine Addictologique, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-F.Widal, Paris, France
| | - Antonio Benabarre
- Bipolar and Depressive Disorders Program,, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Susanne Bengesser
- Department of Psychiatry and Psychotherapeutic Medicine, Research Unit for bipolar affective disorder, Medical University of Graz, Graz, Austria
| | - Joanna M Biernacka
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, MN, USA
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Armin Birner
- Department of Psychiatry and Psychotherapeutic Medicine, Research Unit for bipolar affective disorder, Medical University of Graz, Graz, Austria
| | - Cynthia Marie-Claire
- INSERM UMR-S 1144, Université Paris Cité, Département de Psychiatrie et de Médecine Addictologique, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-F.Widal, Paris, France
- Université Paris Cité, Inserm, Optimisation Thérapeutique en Neuropsychopharmacologie, F-75006, Paris, France
| | - Pablo Cervantes
- The Neuromodulation Unit, McGill University Health Centre, Montreal, Canada
| | - Hsi-Chung Chen
- Department of Psychiatry & Center of Sleep Disorders, National Taiwan University Hospital, Taipei, Taiwan
| | - Caterina Chillotti
- Unit of Clinical Pharmacology, Hospital University Agency of Cagliari, Cagliari, Italy
| | - Sven Cichon
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
- Department of Biomedicine, University Hospital Basel, Basel, Switzerland
- Institute of Neuroscience and Medicine (INM-1), Research Center Jülich, Jülich, Germany
| | - Cristiana Cruceanu
- Douglas Mental Health University Institute, McGill University, Montreal, Canada
| | - Piotr M Czerski
- Psychiatric Genetic Unit, Poznan University of Medical Sciences, Poznan, Poland
| | - Nina Dalkner
- Department of Psychiatry and Psychotherapeutic Medicine, Research Unit for bipolar affective disorder, Medical University of Graz, Graz, Austria
| | - Maria Del Zompo
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - J Raymond DePaulo
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Bruno Étain
- INSERM UMR-S 1144, Université Paris Cité, Département de Psychiatrie et de Médecine Addictologique, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-F.Widal, Paris, France
| | - Stephane Jamain
- Inserm U955, Translational Psychiatry laboratory, Fondation FondaMental, Créteil, France
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilian-University Munich, Munich, Germany
- Max Planck Institute of Psychiatry, Munich, Germany
| | - Andreas J Forstner
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
- Institute of Neuroscience and Medicine (INM-1), Research Center Jülich, Jülich, Germany
| | - Louise Frisen
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Mark A Frye
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Sébastien Gard
- Pôle de Psychiatrie Générale Universitaire, Hôpital Charles Perrens, Bordeaux, France
| | - Julie S Garnham
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Fernando S Goes
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Maria Grigoroiu-Serbanescu
- Biometric Psychiatric Genetics Research Unit, Alexandru Obregia Clinical Psychiatric Hospital, Bucharest, Romania
| | - Andreas J Fallgatter
- University Department of Psychiatry and Psychotherapy Tuebingen, University of Tübingen, Tuebingen, Germany
| | - Sophia Stegmaier
- Department of General Psychiatry, University of Tuebingen, Tuebingen, Germany
| | - Thomas Ethofer
- Department of General Psychiatry, University of Tuebingen, Tuebingen, Germany
- Department of Biomedical Resonance, University of Tuebingen, Tuebingen, Germany
| | - Silvia Biere
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Frankfurt, Goethe University, Frankfurt, Germany
| | - Kristiyana Petrova
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Frankfurt, Goethe University, Frankfurt, Germany
| | - Ceylan Schuster
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Frankfurt, Goethe University, Frankfurt, Germany
| | - Kristina Adorjan
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilian-University Munich, Munich, Germany
| | - Monika Budde
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
| | - Maria Heilbronner
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
| | - Janos L Kalman
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilian-University Munich, Munich, Germany
| | - Mojtaba Oraki Kohshour
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Department of Immunology, Faculty of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Daniela Reich-Erkelenz
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
| | - Sabrina K Schaupp
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
| | - Eva C Schulte
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilian-University Munich, Munich, Germany
| | - Fanny Senner
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilian-University Munich, Munich, Germany
| | - Thomas Vogl
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
| | - Ion-George Anghelescu
- Department of Psychiatry and Psychotherapy, Mental Health Institute Berlin, Berlin, Germany
| | - Volker Arolt
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Münster, Münster, Germany
| | - Detlef Dietrich
- AMEOS Clinical Center Hildesheim, Hildesheim, Germany
- Center for Systems Neuroscience (ZSN), Hannover, Germany
| | - Christian Figge
- Karl-Jaspers Clinic, European Medical School Oldenburg-Groningen, Oldenburg, 26160, Germany
| | - Markus Jäger
- Department of Psychiatry II, Ulm University, Bezirkskrankenhaus Günzburg, Günzburg, Germany
| | - Fabian U Lang
- Department of Psychiatry II, Ulm University, Bezirkskrankenhaus Günzburg, Günzburg, Germany
| | - Georg Juckel
- Department of Psychiatry, Ruhr University Bochum, LWL University Hospital, Bochum, Germany
| | - Carsten Konrad
- Department of Psychiatry and Psychotherapy, Agaplesion Diakonieklinikum, Rotenburg, Germany
| | - Jens Reimer
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
- Department of Psychiatry, Health North Hospital Group, Bremen, Germany
| | - Max Schmauß
- Department of Psychiatry and Psychotherapy, Bezirkskrankenhaus Augsburg, Augsburg, Germany
| | - Andrea Schmitt
- Department of Psychiatry and Psychotherapy, University Hospital, Ludwig-Maximilian-University Munich, Munich, Germany
- Laboratory of Neuroscience (LIM27), Institute of Psychiatry, University of Sao Paulo, São Paulo, Brazil
| | - Carsten Spitzer
- Department of Psychosomatic Medicine and Psychotherapy, University Medical Center Rostock, Rostock, Germany
| | - Martin von Hagen
- Clinic for Psychiatry and Psychotherapy, Clinical Center Werra-Meißner, Eschwege, Germany
| | - Jens Wiltfang
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
| | - Jörg Zimmermann
- Psychiatrieverbund Oldenburger Land gGmbH, Karl-Jaspers-Klinik, Bad Zwischenahn, Germany
| | - Till F M Andlauer
- Department of Neurology, University Hospital rechts der Isar, School of Medicine, Technical University of Munich, Munich, Germany
| | - Andre Fischer
- German Center for Neurodegenerative Diseases (DZNE), Göttingen, Germany
| | - Felix Bermpohl
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Germany
| | - Philipp Ritter
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Medical Faculty, Technische Universität Dresden, Dresden, Germany
| | - Silke Matura
- Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital of Frankfurt, Goethe University, Frankfurt, Germany
| | - Anna Gryaznova
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
| | - Irina Falkenberg
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Cüneyt Yildiz
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Marburg, Germany
| | - Julia Schmidt
- Institute for Medical Informatics, University Medical Center Göttingen, Göttingen, Germany
| | - Marius Koch
- Institute for Medical Informatics, University Medical Center Göttingen, Göttingen, Germany
| | - Kathrin Gade
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Sarah Trost
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Ida S Haussleiter
- Department of Psychiatry, Ruhr University Bochum, LWL University Hospital, Bochum, Germany
| | - Martin Lambert
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Anja C Rohenkohl
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Vivien Kraft
- Department of Psychiatry and Psychotherapy, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Paul Grof
- Mood Disorders Center of Ottawa, Ontario, Canada
| | - Ryota Hashimoto
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, 4-1-1 Ogawahigashi, Kodaira, Tokyo, 187-8553, Japan
| | - Joanna Hauser
- Psychiatric Genetic Unit, Poznan University of Medical Sciences, Poznan, Poland
| | - Stefan Herms
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
- Department of Biomedicine, University Hospital Basel, Basel, Switzerland
| | - Per Hoffmann
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
- Department of Biomedicine, University Hospital Basel, Basel, Switzerland
| | - Esther Jiménez
- Bipolar and Depressive Disorders Program,, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Jean-Pierre Kahn
- Service de Psychiatrie et Psychologie Clinique, Centre Psychothérapique de Nancy - Université de Lorraine, Nancy, France
| | - Layla Kassem
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health, US Department of Health & Human Services, Bethesda, MD, USA
| | - Po-Hsiu Kuo
- Department of Public Health & Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Tadafumi Kato
- Laboratory for Molecular Dynamics of Mental Disorders, RIKEN Brain Science Institute, Saitama, Japan
| | - John Kelsoe
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Sarah Kittel-Schneider
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
- Department of Psychiatry, Psychotherapy and Psychosomatic Medicine, University Hospital of Würzburg, Wurzburg, Germany
| | | | - Barbara König
- Department of Psychiatry and Psychotherapeutic Medicine, Landesklinikum Neunkirchen, Neunkirchen, Austria
| | - Ichiro Kusumi
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Gonzalo Laje
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health, US Department of Health & Human Services, Bethesda, MD, USA
| | - Mikael Landén
- Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the Gothenburg University, Gothenburg, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Catharina Lavebratt
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Marion Leboyer
- Inserm U955, Translational Psychiatry laboratory, Université Paris-Est-Créteil, Department of Psychiatry and Addictology of Mondor University Hospital, AP-HP, Fondation FondaMental, Créteil, France
| | - Susan G Leckband
- Office of Mental Health, VA San Diego Healthcare System, San Diego, CA, USA
| | | | - Mirko Manchia
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Department of Pharmacology, Dalhousie University, Halifax, NS, Canada
| | - Lina Martinsson
- Department of Clinical Neurosciences, Karolinska Institutet, Stockholm, Sweden
| | - Michael J McCarthy
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
- Department of Psychiatry, VA San Diego Healthcare System, San Diego, CA, USA
| | - Susan McElroy
- Department of Psychiatry, Lindner Center of Hope / University of Cincinnati, Mason, OH, USA
| | - Francesc Colom
- Mental Health Research Group, IMIM-Hospital del Mar, Barcelona, Catalonia, Spain
- Department of Genetics, Microbiology and Statistics, Faculty of Biology, University of Barcelona, Barcelona, Spain
| | - Vincent Millischer
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
| | - Marina Mitjans
- Department of Genetics, Microbiology and Statistics, Faculty of Biology, University of Barcelona, Barcelona, Spain
- Institut de Biomedicina de la Universitat de Barcelona (IBUB), Barcelona, Spain
- Centro de Investigación Biomédica en Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Francis M Mondimore
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Palmiero Monteleone
- Neurosciences Section, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | | | - Markus M Nöthen
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Tomas Novák
- National Institute of Mental Health, Klecany, Czech Republic
| | - Claire O'Donovan
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Norio Ozaki
- Department of Psychiatry & Department of Child and Adolescent Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Andrea Pfennig
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Medical Faculty, Technische Universität Dresden, Dresden, Germany
| | - Claudia Pisanu
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - James B Potash
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - Eva Reininghaus
- Department of Psychiatry and Psychotherapeutic Medicine, Research Unit for bipolar affective disorder, Medical University of Graz, Graz, Austria
| | - Guy A Rouleau
- Montreal Neurological Institute and Hospital, McGill University, Montreal, Canada
| | - Janusz K Rybakowski
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Martin Schalling
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Peter R Schofield
- Neuroscience Research Australia, Sydney, NSW, Australia
- School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Barbara W Schweizer
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Giovanni Severino
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Paul D Shilling
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Katzutaka Shimoda
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Mibu, Tochigi, Japan
| | - Christian Simhandl
- Bipolar Center Wiener Neustadt, Sigmund Freud University, Medical Faculty, Vienna, Austria
| | - Claire M Slaney
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Alessio Squassina
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Thomas Stamm
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Germany
- Department of Clinical Psychiatry and Psychotherapy, Brandenburg Medical School, Brandenburg, Germany
| | - Pavla Stopkova
- National Institute of Mental Health, Klecany, Czech Republic
| | - Mario Maj
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Gustavo Turecki
- Douglas Mental Health University Institute, McGill University, Montreal, Canada
| | - Eduard Vieta
- Bipolar and Depressive Disorders Program,, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Julia Veeh
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - Stephanie H Witt
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Adam Wright
- School of Psychiatry, University of New South Wales, and Black Dog Institute, Sydney, Australia
| | - Peter P Zandi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Philip B Mitchell
- School of Psychiatry, University of New South Wales, and Black Dog Institute, Sydney, Australia
| | - Michael Bauer
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Medical Faculty, Technische Universität Dresden, Dresden, Germany
| | - Martin Alda
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
- National Institute of Mental Health, Klecany, Czech Republic
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Francis J McMahon
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health, US Department of Health & Human Services, Bethesda, MD, USA
| | - Thomas G Schulze
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, Norton College of Medicine, Syracuse, NY, USA
| | - Scott R Clark
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, SA, Australia
| | - Bernhard T Baune
- Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany
- Department of Psychiatry, Melbourne Medical School, University of Melbourne, Parkville, VIC, Australia
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia
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9
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Mishra HK, Wei H, Rohr KE, Ko I, Nievergelt CM, Maihofer AX, Shilling PD, Alda M, Berrettini WH, Brennand KJ, Calabrese JR, Coryell WH, Frye M, Gage F, Gershon E, McInnis MG, Nurnberger J, Oedegaard KJ, Zandi PP, Kelsoe JR, McCarthy MJ. Contributions of circadian clock genes to cell survival in fibroblast models of lithium-responsive bipolar disorder. Eur Neuropsychopharmacol 2023; 74:1-14. [PMID: 37126998 DOI: 10.1016/j.euroneuro.2023.04.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [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] [Received: 02/10/2023] [Revised: 04/07/2023] [Accepted: 04/11/2023] [Indexed: 05/03/2023]
Abstract
Bipolar disorder (BD) is characterized by mood episodes, disrupted circadian rhythms and gray matter reduction in the brain. Lithium is an effective pharmacotherapy for BD, but not all patients respond to treatment. Lithium has neuroprotective properties and beneficial effects on circadian rhythms that may distinguish lithium responders (Li-R) from non-responders (Li-NR). The circadian clock regulates molecular pathways involved in apoptosis and cell survival, but how this overlap impacts BD and/or lithium responsiveness is unknown. In primary fibroblasts from Li-R/Li-NR BD patients and controls, we found patterns of co-expression among circadian clock and cell survival genes that distinguished BD vs. control, and Li-R vs. Li-NR cells. In cellular models of apoptosis using staurosporine (STS), lithium preferentially protected fibroblasts against apoptosis in BD vs. control samples, regardless of Li-R/Li-NR status. When examining the effects of lithium treatment of cells in vitro, caspase activation by lithium correlated with period alteration, but the relationship differed in control, Li-R and Li-NR samples. Knockdown of Per1 and Per3 in mouse fibroblasts altered caspase activity, cell death and circadian rhythms in an opposite manner. In BD cells, genetic variation in PER1 and PER3 predicted sensitivity to apoptosis in a manner consistent with knockdown studies. We conclude that distinct patterns of coordination between circadian clock and cell survival genes in BD may help predict lithium response.
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Affiliation(s)
- Himanshu K Mishra
- VA San Diego Healthcare System, San Diego, CA, USA; Department of Psychiatry and Center for Circadian Biology, University of California San Diego, La Jolla, CA, USA
| | - Heather Wei
- VA San Diego Healthcare System, San Diego, CA, USA; Department of Psychiatry and Center for Circadian Biology, University of California San Diego, La Jolla, CA, USA
| | - Kayla E Rohr
- VA San Diego Healthcare System, San Diego, CA, USA; Department of Psychiatry and Center for Circadian Biology, University of California San Diego, La Jolla, CA, USA
| | - Insu Ko
- Department of Psychiatry and Center for Circadian Biology, University of California San Diego, La Jolla, CA, USA
| | - Caroline M Nievergelt
- Department of Psychiatry and Center for Circadian Biology, University of California San Diego, La Jolla, CA, USA
| | - Adam X Maihofer
- Department of Psychiatry and Center for Circadian Biology, University of California San Diego, La Jolla, CA, USA
| | - Paul D Shilling
- Department of Psychiatry and Center for Circadian Biology, University of California San Diego, La Jolla, CA, USA
| | - Martin Alda
- Department of Psychiatry, Dalhousie University Halifax, Canada
| | - Wade H Berrettini
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Kristen J Brennand
- Departments of Neuroscience and Psychiatry, Icahn School of Medicine at Mt Sinai, USA
| | - Joseph R Calabrese
- Department of Psychiatry, Case Western Reserve University, Cleveland, OH, USA
| | | | - Mark Frye
- Department of Psychiatry, Mayo Clinic Rochester, MN, USA
| | - Fred Gage
- Laboratory of Genetics, Salk Institute for Biological Studies, La Jolla, CA, USA
| | - Elliot Gershon
- Department of Psychiatry, University of Chicago, Chicago, IL, USA
| | - Melvin G McInnis
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - John Nurnberger
- Department of Psychiatry, Indiana University, Indianapolis, IN, USA
| | - Ketil J Oedegaard
- Section for Psychiatry, University of Bergen and Norment and KG Jebsen Centre for Neuropsychiatry, Division of Psychiatry Haukeland University Hospital, Bergen, Norway
| | - Peter P Zandi
- Department of Psychiatry, Johns Hopkins University, Baltimore, MD, USA
| | - John R Kelsoe
- Department of Psychiatry and Center for Circadian Biology, University of California San Diego, La Jolla, CA, USA
| | - Michael J McCarthy
- VA San Diego Healthcare System, San Diego, CA, USA; Department of Psychiatry and Center for Circadian Biology, University of California San Diego, La Jolla, CA, USA.
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10
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Stapp EK, Fullerton JM, Musci RJ, Zandi PP, McInnis MG, Mitchell PB, Hulvershorn LA, Ghaziuddin N, Roberts G, Ferrera AG, Nurnberger JI, Wilcox HC. Family environment and polygenic risk in the bipolar high-risk context. JCPP Adv 2023; 3:e12143. [PMID: 37378048 PMCID: PMC10292829 DOI: 10.1002/jcv2.12143] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2022] [Accepted: 01/10/2023] [Indexed: 09/27/2023] Open
Abstract
Background The interaction of polygenic risk (PRS) and environmental effects on development of bipolar disorder (BD) is understudied, as are high-risk offspring perceptions of their family environment (FE). We tested the association of offspring-perceived FE in interaction with BD-PRS on liability for BD in offspring at high or low familial risk for BD. Methods Offspring of a parent with BD (oBD; n = 266) or no psychiatric disorders (n = 174), aged 12-21 at recruitment, participated in the US and Australia. Empirically-derived profiles of FE classified offspring by their perceived levels of familial cohesion, flexibility, and conflict. Offspring BD-PRS were derived from Psychiatric Genomics Consortium BD-GWAS. Lifetime DSM-IV bipolar disorders were derived from the Schedule for Affective Disorders and Schizophrenia for School-Aged Children. We used a novel stepwise approach for latent class modeling with predictors and distal outcomes. Results Fifty-two offspring were diagnosed with BD. For those with well-functioning FE (two-thirds of the sample), higher BD-PRS tracked positively with liability for BD. However, for those with high-conflict FEs, the relationship between BD-PRS and liability to BD was negative, with highest risk for BD observed with lower BD-PRS. In exploratory analyses, European-ancestry offspring with BD had elevated history of suicidal ideation in high-conflict FE compared to well-functioning-FE, and of suicide attempt with low-BD-PRS and high-conflict FE. Conclusions The data suggest that the relationship of BD-PRS and offspring liability for BD differed between well-functioning versus high-conflict FE, potentially in line with a multifactorial liability threshold model and supporting future study of and interventions improving family dynamics.
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Affiliation(s)
- Emma K. Stapp
- Department of Mental HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
- Genetic Epidemiology BranchNational Institute of Mental HealthBethesdaMarylandUSA
| | - Janice M. Fullerton
- Neuroscience Research AustraliaRandwickNew South WalesAustralia
- School of Medical SciencesUniversity of New South WalesSydneyNew South WalesAustralia
| | - Rashelle J. Musci
- Department of Mental HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | - Peter P. Zandi
- Department of Mental HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
| | | | - Philip B. Mitchell
- School of PsychiatryUniversity of New South WalesSydneyNew South WalesAustralia
| | | | - Neera Ghaziuddin
- Department of PsychiatryUniversity of MichiganAnn ArborMichiganUSA
| | - Gloria Roberts
- School of PsychiatryUniversity of New South WalesSydneyNew South WalesAustralia
| | | | - John I. Nurnberger
- Department of PsychiatryIndiana University School of MedicineIndianapolisIndianaUSA
- Department of Medical and Molecular GeneticsIndiana University School of MedicineIndianapolisIndianaUSA
- Stark Neurosciences Research InstituteIndiana University School of MedicineIndianapolisIndianaUSA
| | - Holly C. Wilcox
- Department of Mental HealthJohns Hopkins Bloomberg School of Public HealthBaltimoreMarylandUSA
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11
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Niemsiri V, Rosenthal SB, Nievergelt CM, Maihofer AX, Marchetto MC, Santos R, Shekhtman T, Alliey-Rodriguez N, Anand A, Balaraman Y, Berrettini WH, Bertram H, Burdick KE, Calabrese JR, Calkin CV, Conroy C, Coryell WH, DeModena A, Eyler LT, Feeder S, Fisher C, Frazier N, Frye MA, Gao K, Garnham J, Gershon ES, Goes FS, Goto T, Harrington GJ, Jakobsen P, Kamali M, Kelly M, Leckband SG, Lohoff FW, McCarthy MJ, McInnis MG, Craig D, Millett CE, Mondimore F, Morken G, Nurnberger JI, Donovan CO, Øedegaard KJ, Ryan K, Schinagle M, Shilling PD, Slaney C, Stapp EK, Stautland A, Tarwater B, Zandi PP, Alda M, Fisch KM, Gage FH, Kelsoe JR. Focal adhesion is associated with lithium response in bipolar disorder: evidence from a network-based multi-omics analysis. Mol Psychiatry 2023:10.1038/s41380-022-01909-9. [PMID: 36991131 DOI: 10.1038/s41380-022-01909-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2021] [Revised: 11/14/2022] [Accepted: 12/02/2022] [Indexed: 03/31/2023]
Abstract
Lithium (Li) is one of the most effective drugs for treating bipolar disorder (BD), however, there is presently no way to predict response to guide treatment. The aim of this study is to identify functional genes and pathways that distinguish BD Li responders (LR) from BD Li non-responders (NR). An initial Pharmacogenomics of Bipolar Disorder study (PGBD) GWAS of lithium response did not provide any significant results. As a result, we then employed network-based integrative analysis of transcriptomic and genomic data. In transcriptomic study of iPSC-derived neurons, 41 significantly differentially expressed (DE) genes were identified in LR vs NR regardless of lithium exposure. In the PGBD, post-GWAS gene prioritization using the GWA-boosting (GWAB) approach identified 1119 candidate genes. Following DE-derived network propagation, there was a highly significant overlap of genes between the top 500- and top 2000-proximal gene networks and the GWAB gene list (Phypergeometric = 1.28E-09 and 4.10E-18, respectively). Functional enrichment analyses of the top 500 proximal network genes identified focal adhesion and the extracellular matrix (ECM) as the most significant functions. Our findings suggest that the difference between LR and NR was a much greater effect than that of lithium. The direct impact of dysregulation of focal adhesion on axon guidance and neuronal circuits could underpin mechanisms of response to lithium, as well as underlying BD. It also highlights the power of integrative multi-omics analysis of transcriptomic and genomic profiling to gain molecular insights into lithium response in BD.
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Affiliation(s)
- Vipavee Niemsiri
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Sara Brin Rosenthal
- Center for Computational Biology and Bioinformatics, University of California, San Diego, La Jolla, CA, USA
| | | | - Adam X Maihofer
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Maria C Marchetto
- Department of Anthropology, University of California, San Diego, La Jolla, CA, USA
- Laboratory of Genetics, Salk Institute for Biological Studies, La Jolla, CA, USA
| | - Renata Santos
- Laboratory of Genetics, Salk Institute for Biological Studies, La Jolla, CA, USA
- University of Paris, Institute of Psychiatry and Neuroscience of Paris (IPNP), INSERM U1261266, Laboratory of Dynamics of Neuronal Structure in Health and Disease, Paris, France
| | - Tatyana Shekhtman
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Ney Alliey-Rodriguez
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
- Department of Psychiatry and Behavioral Neuroscience, Northwestern University, Chicago, IL, USA
| | - Amit Anand
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Yokesh Balaraman
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Wade H Berrettini
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Holli Bertram
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Katherine E Burdick
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Joseph R Calabrese
- Mood Disorders Program, Case Western Reserve University School of Medicine, Cleveland, OH, USA
- Mood Disorders Program, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Cynthia V Calkin
- Department of Psychiatry and Medical Neuroscience, Dalhousie University, Halifax, NS, Canada
| | - Carla Conroy
- Mood Disorders Program, Case Western Reserve University School of Medicine, Cleveland, OH, USA
- Mood Disorders Program, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | | | - Anna DeModena
- Psychiatry Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - Lisa T Eyler
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Scott Feeder
- Department of Psychiatry, The Mayo Clinic, Rochester, MN, USA
| | - Carrie Fisher
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Nicole Frazier
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Mark A Frye
- Department of Psychiatry, The Mayo Clinic, Rochester, MN, USA
| | - Keming Gao
- Mood Disorders Program, Case Western Reserve University School of Medicine, Cleveland, OH, USA
- Mood Disorders Program, University Hospitals Cleveland Medical Center, Cleveland, OH, USA
| | - Julie Garnham
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Elliot S Gershon
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - Fernando S Goes
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Toyomi Goto
- Mood Disorders Program, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | | | - Petter Jakobsen
- Norment, Division of Psychiatry, Haukeland University Hospital and Department of Clinical medicine, University of Bergen, Bergen, Norway
| | - Masoud Kamali
- Department of Psychiatry, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Marisa Kelly
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Susan G Leckband
- Psychiatry Service, VA San Diego Healthcare System, San Diego, CA, USA
| | - Falk W Lohoff
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - Michael J McCarthy
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Melvin G McInnis
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - David Craig
- Department of Translational Genomics, University of Southern California, Los Angeles, CA, USA
| | - Caitlin E Millett
- Department of Psychiatry, Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Francis Mondimore
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Gunnar Morken
- Division of Mental Health Care, St Olavs University Hospital, and Department of Mental Health, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
| | - John I Nurnberger
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
- Medical and Molecular Genetics, Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, IN, USA
| | | | - Ketil J Øedegaard
- Norment, Division of Psychiatry, Haukeland University Hospital and Department of Clinical medicine, University of Bergen, Bergen, Norway
| | - Kelly Ryan
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Martha Schinagle
- Mood Disorders Program, Case Western Reserve University School of Medicine, Cleveland, OH, USA
| | - Paul D Shilling
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Claire Slaney
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Emma K Stapp
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Johns Hopkins University, Baltimore, MD, USA
| | - Andrea Stautland
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
| | - Bruce Tarwater
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
| | - Peter P Zandi
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Martin Alda
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- National Institute of Mental Health, Klecany, Czech Republic
| | - Kathleen M Fisch
- Center for Computational Biology and Bioinformatics, University of California, San Diego, La Jolla, CA, USA
- Department of Obstetrics, Gynecology & Reproductive Sciences, University of California, San Diego, La Jolla, CA, USA
| | - Fred H Gage
- Laboratory of Genetics, Salk Institute for Biological Studies, La Jolla, CA, USA
| | - John R Kelsoe
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA.
- Institute for Genomic Medicine, University of California, San Diego, La Jolla, CA, USA.
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12
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Zandi PP, Morreale M, Reti IM, Maixner DF, McDonald WM, Patel PD, Achtyes E, Bhati MT, Carr BR, Conroy SK, Cristancho M, Dubin MJ, Francis A, Glazer K, Ingram W, Khurshid K, McClintock SM, Pinjari OF, Reeves K, Rodriguez NF, Sampson S, Seiner SJ, Selek S, Sheline Y, Smetana RW, Soda T, Trapp NT, Wright JH, Husain M, Weiner RD. National Network of Depression Centers' Recommendations on Harmonizing Clinical Documentation of Electroconvulsive Therapy. J ECT 2022; 38:159-164. [PMID: 35704844 PMCID: PMC9420739 DOI: 10.1097/yct.0000000000000840] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Accepted: 01/07/2022] [Indexed: 11/26/2022]
Abstract
ABSTRACT Electroconvulsive therapy (ECT) is a highly therapeutic and cost-effective treatment for severe and/or treatment-resistant major depression. However, because of the varied clinical practices, there is a great deal of heterogeneity in how ECT is delivered and documented. This represents both an opportunity to study how differences in implementation influence clinical outcomes and a challenge for carrying out coordinated quality improvement and research efforts across multiple ECT centers. The National Network of Depression Centers, a consortium of 26+ US academic medical centers of excellence providing care for patients with mood disorders, formed a task group with the goals of promoting best clinical practices for the delivery of ECT and to facilitate large-scale, multisite quality improvement and research to advance more effective and safe use of this treatment modality. The National Network of Depression Centers Task Group on ECT set out to define best practices for harmonizing the clinical documentation of ECT across treatment centers to promote clinical interoperability and facilitate a nationwide collaboration that would enable multisite quality improvement and longitudinal research in real-world settings. This article reports on the work of this effort. It focuses on the use of ECT for major depressive disorder, which accounts for the majority of ECT referrals in most countries. However, most of the recommendations on clinical documentation proposed herein will be applicable to the use of ECT for any of its indications.
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Affiliation(s)
- Peter P. Zandi
- From the Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD
| | - Michael Morreale
- From the Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD
| | - Irving M. Reti
- From the Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD
| | | | - William M. McDonald
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA
| | - Paresh D. Patel
- Department of Psychiatry, University of Michigan, Ann Arbor, MI
| | - Eric Achtyes
- Division of Psychiatry and Behavioral Medicine, Michigan State University, Grand Rapids, MI
| | - Mahendra T. Bhati
- Psychiatry and Behavioral Sciences, Stanford University, Stanford, CA
| | - Brent R. Carr
- Department of Psychiatry, University of Florida Health, Gainsville, FL
| | - Susan K. Conroy
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN
| | - Mario Cristancho
- Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA
| | - Marc J. Dubin
- Department of Psychiatry, Weill Cornell Medicine, New York, NY
| | - Andrew Francis
- Department of Psychiatry and Behavioral Health, Penn State University, Hershey, PA
| | - Kara Glazer
- From the Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD
| | - Wendy Ingram
- Department of Mental Health, Johns Hopkins University, Baltimore, MD
| | - Khurshid Khurshid
- Department of Psychiatry, UMass Memorial Health Care, Worchester, MA
| | | | - Omar F. Pinjari
- Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Care Center at Houston, Houston, TX
| | - Kevin Reeves
- Department of Psychiatry and Behavioral Health, Ohio State University College of Medicine
| | - Nelson F. Rodriguez
- Department of Psychiatry, University of Cincinnati College of Medicine, Cincinatti, OH
| | - Shirlene Sampson
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN
| | | | - Salih Selek
- Faillace Department of Psychiatry and Behavioral Sciences, McGovern Medical School, University of Texas Health Care Center at Houston, Houston, TX
| | - Yvette Sheline
- Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA
| | - Roy W. Smetana
- Department of Psychiatry, Weill Cornell Medicine, New York, NY
| | - Takahiro Soda
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC
| | - Nicholas T. Trapp
- Department of Psychiatry, Carver College of Medicine, University of Iowa Healthcare, Iowa City, IA
| | - Jesse H. Wright
- Department of Psychiatry and Behavioral Sciences, University of Louisville School of Medicine, Louisville, KY
| | - Mustafa Husain
- Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX
| | - Richard D. Weiner
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, NC
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13
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Cearns M, Amare AT, Schubert KO, Thalamuthu A, Frank J, Streit F, Adli M, Akula N, Akiyama K, Ardau R, Arias B, Aubry J, Backlund L, Bhattacharjee AK, Bellivier F, Benabarre A, Bengesser S, Biernacka JM, Birner A, Brichant-Petitjean C, Cervantes P, Chen H, Chillotti C, Cichon S, Cruceanu C, Czerski PM, Dalkner N, Dayer A, Degenhardt F, Zompo MD, DePaulo JR, Étain B, Falkai P, Forstner AJ, Frisen L, Frye MA, Fullerton JM, Gard S, Garnham JS, Goes FS, Grigoroiu-Serbanescu M, Grof P, Hashimoto R, Hauser J, Heilbronner U, Herms S, Hoffmann P, Hofmann A, Hou L, Hsu YH, Jamain S, Jiménez E, Kahn JP, Kassem L, Kuo PH, Kato T, Kelsoe J, Kittel-Schneider S, Kliwicki S, König B, Kusumi I, Laje G, Landén M, Lavebratt C, Leboyer M, Leckband SG, Maj M, Manchia M, Martinsson L, McCarthy MJ, McElroy S, Colom F, Mitjans M, Mondimore FM, Monteleone P, Nievergelt CM, Nöthen MM, Novák T, O'Donovan C, Ozaki N, Millischer V, Papiol S, Pfennig A, Pisanu C, Potash JB, Reif A, Reininghaus E, Rouleau GA, Rybakowski JK, Schalling M, Schofield PR, Schweizer BW, Severino G, Shekhtman T, Shilling PD, Shimoda K, Simhandl C, Slaney CM, Squassina A, Stamm T, Stopkova P, TekolaAyele F, Tortorella A, Turecki G, Veeh J, Vieta E, Witt SH, Roberts G, Zandi PP, Alda M, Bauer M, McMahon FJ, Mitchell PB, Schulze TG, Rietschel M, Clark SR, Baune BT. Using polygenic scores and clinical data for bipolar disorder patient stratification and lithium response prediction: machine learning approach - CORRIGENDUM. Br J Psychiatry 2022; 221:494. [PMID: 35505515 DOI: 10.1192/bjp.2022.55] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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14
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Federoff M, McCarthy MJ, Anand A, Berrettini WH, Bertram H, Bhattacharjee A, Calkin CV, Conroy C, Coryell WH, D'Arcangelo N, DeModena A, Fisher C, Feeder S, Frazier N, Frye MA, Gao K, Garnham J, Gershon ES, Alliey-Rodriguez N, Glazer K, Goes F, Karberg T, Harrington G, Jakobsen P, Kamali M, Kelly M, Leckband SG, Lohoff F, Maihofer AX, McInnis MG, Mondimore F, Morken G, Nurnberger JI, Oedegaard KJ, Ritchey M, Ryan K, Schinagle M, Schoeyen H, Schwebel C, Shaw M, Shilling PD, Slaney C, Stautland A, Tarwater B, Calabrese JR, Alda M, Nievergelt CM, Zandi PP, Kelsoe JR. Correction of depression-associated circadian rhythm abnormalities is associated with lithium response in bipolar disorder. Bipolar Disord 2022; 24:521-529. [PMID: 34825444 DOI: 10.1111/bdi.13162] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [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] [Indexed: 11/27/2022]
Abstract
BACKGROUND Bipolar disorder (BD) is characterized by episodes of depression and mania and disrupted circadian rhythms. Lithium is an effective therapy for BD, but only 30%-40% of patients are fully responsive. Preclinical models show that lithium alters circadian rhythms. However, it is unknown if the circadian rhythm effects of lithium are essential to its therapeutic properties. METHODS In secondary analyses of a multi-center, prospective, trial of lithium for BD, we examined the relationship between circadian rhythms and therapeutic response to lithium. Using standardized instruments, we measured morningness, diurnal changes in mood, sleep, and energy (circadian rhythm disturbances) in a cross-sectional study of 386 BD subjects with varying lithium exposure histories. Next, we tracked symptoms of depression and mania prospectively over 12 weeks in a subset of 88 BD patients initiating treatment with lithium. Total, circadian, and affective mood symptoms were scored separately and analyzed. RESULTS Subjects with no prior lithium exposure had the most circadian disruption, while patients stable on lithium monotherapy had the least. Patients who were stable on lithium with another drug or unstable on lithium showed intermediate levels of disruption. Treatment with lithium for 12 weeks yielded significant reductions in total and affective depression symptoms. Lithium responders (Li-Rs) showed improvement in circadian symptoms of depression, but non-responders did not. There was no difference between Li-Rs and nonresponders in affective, circadian, or total symptoms of mania. CONCLUSIONS Exposure to lithium is associated with reduced circadian disruption. Lithium response at 12 weeks was selectively associated with the reduction of circadian depressive symptoms. We conclude that stabilization of circadian rhythms may be an important feature of lithium's therapeutic effects. CLINICAL TRIALS REGISTRY NCT0127253.
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Affiliation(s)
- Monica Federoff
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Michael J McCarthy
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA.,Department of Psychiatry, VA San Diego Healthcare System, La Jolla, California, USA
| | - Amit Anand
- Department of Psychiatry, Case Western Reserve University, Cleveland, Ohio, USA
| | - Wade H Berrettini
- University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | | | - Abesh Bhattacharjee
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA.,Department of Psychiatry, VA San Diego Healthcare System, La Jolla, California, USA
| | | | - Carla Conroy
- Department of Psychiatry, Case Western Reserve University, Cleveland, Ohio, USA
| | | | - Nicole D'Arcangelo
- Department of Psychiatry, Case Western Reserve University, Cleveland, Ohio, USA
| | - Anna DeModena
- Department of Psychiatry, VA San Diego Healthcare System, La Jolla, California, USA
| | - Carrie Fisher
- Departments of Psychiatry and Medical and Molecular Genetics, Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | | | | | | | - Keming Gao
- Department of Psychiatry, Case Western Reserve University, Cleveland, Ohio, USA
| | | | | | | | - Kara Glazer
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Fernando Goes
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Toyomi Karberg
- Department of Psychiatry, Case Western Reserve University, Cleveland, Ohio, USA
| | | | - Petter Jakobsen
- NORMENT, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Medicine, University of Bergen, Norway
| | | | - Marisa Kelly
- University of Michigan, Ann Arbor, Michigan, USA
| | - Susan G Leckband
- Department of Psychiatry, VA San Diego Healthcare System, La Jolla, California, USA
| | - Falk Lohoff
- University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Adam X Maihofer
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | | | - Francis Mondimore
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Gunnar Morken
- Division of Psychiatry, St. Olav University Hospital of Trondheim and Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - John I Nurnberger
- Departments of Psychiatry and Medical and Molecular Genetics, Stark Neurosciences Research Institute, Indiana University School of Medicine, Indianapolis, Indiana, USA
| | - Ketil J Oedegaard
- NORMENT, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway.,Department of Clinical Medicine, University of Bergen, Norway
| | - Megan Ritchey
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - Kelly Ryan
- University of Michigan, Ann Arbor, Michigan, USA
| | - Martha Schinagle
- Department of Psychiatry, Case Western Reserve University, Cleveland, Ohio, USA
| | - Helle Schoeyen
- Department of Clinical Medicine, University of Bergen, Norway.,Clinic of Adult Psychiatry, Stavanger University Hospital, Stavanger, Norway
| | - Candice Schwebel
- University of Pennsylvania Perelman School of Medicine, Philadelphia, Pennsylvania, USA
| | - Martha Shaw
- University of Chicago, Chicago, Illinois, USA
| | - Paul D Shilling
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | | | | | | | - Joseph R Calabrese
- Department of Psychiatry, Case Western Reserve University, Cleveland, Ohio, USA
| | | | - Caroline M Nievergelt
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Peter P Zandi
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins School of Medicine, Baltimore, Maryland, USA
| | - John R Kelsoe
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
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15
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Zandi PP, Jaffe AE, Goes FS, Burke EE, Collado-Torres L, Huuki-Myers L, Seyedian A, Lin Y, Seifuddin F, Pirooznia M, Ross CA, Kleinman JE, Weinberger DR, Hyde TM. Amygdala and anterior cingulate transcriptomes from individuals with bipolar disorder reveal downregulated neuroimmune and synaptic pathways. Nat Neurosci 2022; 25:381-389. [PMID: 35260864 PMCID: PMC8915427 DOI: 10.1038/s41593-022-01024-6] [Citation(s) in RCA: 22] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2021] [Accepted: 01/26/2022] [Indexed: 12/12/2022]
Abstract
Recent genetic studies have identified variants associated with bipolar disorder (BD), but it remains unclear how brain gene expression is altered in BD and how genetic risk for BD may contribute to these alterations. Here, we obtained transcriptomes from subgenual anterior cingulate cortex and amygdala samples from post-mortem brains of individuals with BD and neurotypical controls, including 511 total samples from 295 unique donors. We examined differential gene expression between cases and controls and the transcriptional effects of BD-associated genetic variants. We found two coexpressed modules that were associated with transcriptional changes in BD: one enriched for immune and inflammatory genes and the other with genes related to the postsynaptic membrane. Over 50% of BD genome-wide significant loci contained significant expression quantitative trait loci (QTL) (eQTL), and these data converged on several individual genes, including SCN2A and GRIN2A. Thus, these data implicate specific genes and pathways that may contribute to the pathology of BP.
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Affiliation(s)
- Peter P Zandi
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA. .,Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.
| | - Andrew E Jaffe
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA.,Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,The Lieber Institute for Brain Development, Baltimore, MD, USA.,Center for Computational Biology, Johns Hopkins University, Baltimore, MD, USA.,McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Biostatistics, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA.,Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Fernando S Goes
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Emily E Burke
- The Lieber Institute for Brain Development, Baltimore, MD, USA
| | - Leonardo Collado-Torres
- The Lieber Institute for Brain Development, Baltimore, MD, USA.,Center for Computational Biology, Johns Hopkins University, Baltimore, MD, USA
| | | | - Arta Seyedian
- The Lieber Institute for Brain Development, Baltimore, MD, USA
| | - Yian Lin
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Fayaz Seifuddin
- The National Heart, Lung and Blood Institute, the National Institute of Health, Bethesda, MD, USA
| | - Mehdi Pirooznia
- The National Heart, Lung and Blood Institute, the National Institute of Health, Bethesda, MD, USA
| | - Christopher A Ross
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA.,Department of Neuroscience, Johns Hopkins School of Medicine, Baltimore, MD, USA.,Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA.,Department of Pharmacology and Molecular Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Joel E Kleinman
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA.,The Lieber Institute for Brain Development, Baltimore, MD, USA
| | - Daniel R Weinberger
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA.,The Lieber Institute for Brain Development, Baltimore, MD, USA.,McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA.,Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Thomas M Hyde
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA. .,The Lieber Institute for Brain Development, Baltimore, MD, USA. .,Department of Neurology, Johns Hopkins School of Medicine, Baltimore, MD, USA.
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16
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Cearns M, Amare AT, Schubert KO, Thalamuthu A, Frank J, Streit F, Adli M, Akula N, Akiyama K, Ardau R, Arias B, Aubry JM, Backlund L, Bhattacharjee AK, Bellivier F, Benabarre A, Bengesser S, Biernacka JM, Birner A, Brichant-Petitjean C, Cervantes P, Chen HC, Chillotti C, Cichon S, Cruceanu C, Czerski PM, Dalkner N, Dayer A, Degenhardt F, Zompo MD, DePaulo JR, Étain B, Falkai P, Forstner AJ, Frisen L, Frye MA, Fullerton JM, Gard S, Garnham JS, Goes FS, Grigoroiu-Serbanescu M, Grof P, Hashimoto R, Hauser J, Heilbronner U, Herms S, Hoffmann P, Hofmann A, Hou L, Hsu YH, Jamain S, Jiménez E, Kahn JP, Kassem L, Kuo PH, Kato T, Kelsoe J, Kittel-Schneider S, Kliwicki S, König B, Kusumi I, Laje G, Landén M, Lavebratt C, Leboyer M, Leckband SG, Maj M, Manchia M, Martinsson L, McCarthy MJ, McElroy S, Colom F, Mitjans M, Mondimore FM, Monteleone P, Nievergelt CM, Nöthen MM, Novák T, O'Donovan C, Ozaki N, Millischer V, Papiol S, Pfennig A, Pisanu C, Potash JB, Reif A, Reininghaus E, Rouleau GA, Rybakowski JK, Schalling M, Schofield PR, Schweizer BW, Severino G, Shekhtman T, Shilling PD, Shimoda K, Simhandl C, Slaney CM, Squassina A, Stamm T, Stopkova P, Tekola-Ayele F, Tortorella A, Turecki G, Veeh J, Vieta E, Witt SH, Roberts G, Zandi PP, Alda M, Bauer M, McMahon FJ, Mitchell PB, Schulze TG, Rietschel M, Clark SR, Baune BT. Using polygenic scores and clinical data for bipolar disorder patient stratification and lithium response prediction: machine learning approach. Br J Psychiatry 2022; 220:1-10. [PMID: 35225756 DOI: 10.1192/bjp.2022.28] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
BACKGROUND Response to lithium in patients with bipolar disorder is associated with clinical and transdiagnostic genetic factors. The predictive combination of these variables might help clinicians better predict which patients will respond to lithium treatment. AIMS To use a combination of transdiagnostic genetic and clinical factors to predict lithium response in patients with bipolar disorder. METHOD This study utilised genetic and clinical data (n = 1034) collected as part of the International Consortium on Lithium Genetics (ConLi+Gen) project. Polygenic risk scores (PRS) were computed for schizophrenia and major depressive disorder, and then combined with clinical variables using a cross-validated machine-learning regression approach. Unimodal, multimodal and genetically stratified models were trained and validated using ridge, elastic net and random forest regression on 692 patients with bipolar disorder from ten study sites using leave-site-out cross-validation. All models were then tested on an independent test set of 342 patients. The best performing models were then tested in a classification framework. RESULTS The best performing linear model explained 5.1% (P = 0.0001) of variance in lithium response and was composed of clinical variables, PRS variables and interaction terms between them. The best performing non-linear model used only clinical variables and explained 8.1% (P = 0.0001) of variance in lithium response. A priori genomic stratification improved non-linear model performance to 13.7% (P = 0.0001) and improved the binary classification of lithium response. This model stratified patients based on their meta-polygenic loadings for major depressive disorder and schizophrenia and was then trained using clinical data. CONCLUSIONS Using PRS to first stratify patients genetically and then train machine-learning models with clinical predictors led to large improvements in lithium response prediction. When used with other PRS and biological markers in the future this approach may help inform which patients are most likely to respond to lithium treatment.
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Affiliation(s)
- Micah Cearns
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Australia
| | - Azmeraw T Amare
- South Australian Academic Health Science and Translation Centre, South Australian Health and Medical Research Institute (SAHMRI), Australia and Program for Quantitative Genomics, Harvard School of Public Health, USA
| | - Klaus Oliver Schubert
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Australia and Northern Adelaide Local Health Network, Mental Health Services, Australia
| | - Anbupalam Thalamuthu
- Centre for Healthy Brain Ageing (CHeBA), School of Psychiatry, University of New South Wales, Australia
| | - Joseph Frank
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany
| | - Fabian Streit
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany
| | - Mazda Adli
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Campus Charité Mitte, Germany
| | - Nirmala Akula
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health, US Department of Health & Human Services, USA
| | - Kazufumi Akiyama
- Department of Biological Psychiatry and Neuroscience, Dokkyo Medical University School of Medicine, Japan
| | - Raffaella Ardau
- Unit of Clinical Pharmacology, Hospital University Agency of Cagliari, Italy
| | - Bárbara Arias
- Unitat de Zoologia i Antropologia Biològica (Dpt. Biologia Evolutiva, Ecologia i Ciències Ambientals), Facultat de Biologia and Institut de Biomedicina (IBUB), University of Barcelona, CIBERSAM, Spain
| | - Jean-Michel Aubry
- Department of Psychiatry, Mood Disorders Unit, HUG - Geneva University Hospitals, Switzerland
| | - Lena Backlund
- Department of Molecular Medicine and Surgery, Karolinska Institute, Sweden and Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | | | - Frank Bellivier
- INSERM UMR-S 1144, Université Paris Diderot, Département de Psychiatrie et de Médecine Addictologique, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-F.Widal, France
| | - Antonio Benabarre
- Bipolar Disorder Program, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Spain
| | - Susanne Bengesser
- Department of Psychiatry and Psychotherapeutic Medicine, Research Unit for Bipolar Affective Disorder, Medical University of Graz, Austria
| | - Joanna M Biernacka
- Department of Health Sciences Research, Mayo Clinic, USA and Department of Psychiatry and Psychology, Mayo Clinic, USA
| | - Armin Birner
- Department of Psychiatry and Psychotherapeutic Medicine, Research Unit for Bipolar Affective Disorder, Medical University of Graz, Austria
| | - Clara Brichant-Petitjean
- INSERM UMR-S 1144, Université Paris Diderot, Département de Psychiatrie et de Médecine Addictologique, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-F.Widal, France
| | - Pablo Cervantes
- The Neuromodulation Unit, McGill University Health Centre, Canada
| | - Hsi-Chung Chen
- Department of Psychiatry & Center of Sleep Disorders, National Taiwan University Hospital, Taiwan
| | - Caterina Chillotti
- Unit of Clinical Pharmacology, Hospital University Agency of Cagliari, Italy
| | - Sven Cichon
- Institute of Human Genetics, University of Bonn and Department of Genomics, Life & Brain Center, Germany; and Human Genomics Research Group, Department of Biomedicine, University Hospital Basel, Switzerland
| | | | - Piotr M Czerski
- Psychiatric Genetic Unit, Poznan University of Medical Sciences, Poland
| | - Nina Dalkner
- Department of Psychiatry and Psychotherapeutic Medicine, Research Unit for Bipolar Affective Disorder, Medical University of Graz, Austria
| | - Alexandre Dayer
- Department of Psychiatry, Mood Disorders Unit, HUG - Geneva University Hospitals, Switzerland
| | - Franziska Degenhardt
- Institute of Human Genetics, University of Bonn and Department of Genomics, Life & Brain Center, Germany
| | - Maria Del Zompo
- Department of Biomedical Sciences, University of Cagliari, Italy
| | - J Raymond DePaulo
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, USA
| | - Bruno Étain
- INSERM UMR-S 1144, Université Paris Diderot, Département de Psychiatrie et de Médecine Addictologique, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-F.Widal, France
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University Munich, Germany
| | - Andreas J Forstner
- Institute of Human Genetics, University of Bonn and Department of Genomics, Life & Brain Center, Germany; Human Genomics Research Group, Department of Biomedicine, University Hospital Basel, Switzerland and Department of Psychiatry (UPK), University of Basel, Switzerland
| | - Louise Frisen
- Department of Molecular Medicine and Surgery, Karolinska Institute, Sweden and Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Mark A Frye
- Department of Psychiatry and Psychology, Mayo Clinic, USA
| | - Janice M Fullerton
- Neuroscience Research Australia, Australia and School of Medical Sciences, University of New South Wales, Australia
| | | | | | - Fernando S Goes
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, USA
| | | | - Paul Grof
- Mood Disorders Center of Ottawa, Canada
| | - Ryota Hashimoto
- Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Japan and Department of Psychiatry, Osaka University Graduate School of Medicine, Japan
| | - Joanna Hauser
- Psychiatric Genetic Unit, Poznan University of Medical Sciences, Poland
| | - Urs Heilbronner
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Germany and Department of Psychiatry and Psychotherapy, University Medical Center (UMG), Georg-August University Göttingen, Germany
| | - Stefan Herms
- Institute of Human Genetics, University of Bonn and Department of Genomics, Life & Brain Center, Germany and Human Genomics Research Group, Department of Biomedicine, University Hospital Basel, Switzerland
| | - Per Hoffmann
- Institute of Human Genetics, University of Bonn and Department of Genomics, Life & Brain Center, Germany and Human Genomics Research Group, Department of Biomedicine, University Hospital Basel, Switzerland
| | - Andrea Hofmann
- Institute of Human Genetics, University of Bonn and Department of Genomics, Life & Brain Center, Germany
| | - Liping Hou
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health, US Department of Health & Human Services, USA
| | - Yi-Hsiang Hsu
- Program for Quantitative Genomics, Harvard School of Public Health, USA and HSL Institute for Aging Research, Harvard Medical School, USA
| | - Stephane Jamain
- Univ Paris Est Créteil, INSERM, IMRB, Translational Neuropsychiatry, Fondation FondaMental, France
| | - Esther Jiménez
- Bipolar Disorder Program, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Spain
| | - Jean-Pierre Kahn
- Service de Psychiatrie et Psychologie Clinique, Centre Psychothérapique de Nancy - Université de Lorraine, France
| | - Layla Kassem
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health, US Department of Health & Human Services, USA
| | - Po-Hsiu Kuo
- Department of Public Health & Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taiwan
| | - Tadafumi Kato
- Department of Psychiatry & Behavioral Science, Juntendo University, Graduate School of Medicine, Japan
| | - John Kelsoe
- Department of Psychiatry, University of California San Diego, USA
| | - Sarah Kittel-Schneider
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Germany
| | - Sebastian Kliwicki
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poland
| | - Barbara König
- Department of Psychiatry and Psychotherapeutic Medicine, Landesklinikum Neunkirchen, Austria
| | - Ichiro Kusumi
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Japan
| | - Gonzalo Laje
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health, US Department of Health & Human Services, USA
| | - Mikael Landén
- Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the Gothenburg University, Sweden and Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden
| | - Catharina Lavebratt
- Department of Molecular Medicine and Surgery, Karolinska Institute, Sweden and Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Marion Leboyer
- Univ Paris Est Créteil, INSERM, IMRB, Translational Neuropsychiatry, AP-HP, Mondor University Hospital, DMU Impact, Fondation FondaMental, France
| | | | - Mario Maj
- Department of Psychiatry, University of Campania 'Luigi Vanvitelli', Italy; ,for a full list of Major Depressive Disorder Working Group of the PGC Investigators, see the Supplementary Material
| | - Mirko Manchia
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Italy and Department of Pharmacology, Dalhousie University, Canada
| | - Lina Martinsson
- Department of Clinical Neurosciences, Karolinska Institutet, Sweden
| | - Michael J McCarthy
- Department of Psychiatry, University of California San Diego, USA and Department of Psychiatry, VA San Diego Healthcare System, USA
| | - Susan McElroy
- Department of Psychiatry, Lindner Center of Hope / University of Cincinnati, USA
| | - Francesc Colom
- Mental Health Research Group, IMIM-Hospital del Mar, Spain and Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Spain
| | - Marina Mitjans
- Mental Health Research Group, IMIM-Hospital del Mar, Spain and Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Spain
| | - Francis M Mondimore
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, USA
| | - Palmiero Monteleone
- Department of Medicine, Surgery and Dentistry 'Scuola Medica Salernitana', University of Salerno, Italy
| | | | - Markus M Nöthen
- Institute of Human Genetics, University of Bonn and Department of Genomics, Life & Brain Center, Germany
| | - Tomas Novák
- National Institute of Mental Health, Czech Republic
| | | | - Norio Ozaki
- Department of Psychiatry & Department of Child and Adolescent Psychiatry, Nagoya University Graduate School of Medicine, Japan
| | - Vincent Millischer
- Department of Molecular Medicine and Surgery, Karolinska Institute, Sweden and Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden and Department of Psychiatry and Psychotherapy, Medical University of Vienna, Austria
| | - Sergi Papiol
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Germany and Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University Munich, Germany
| | - Andrea Pfennig
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Medical Faculty, Technische Universität Dresden, Germany
| | - Claudia Pisanu
- Department of Biomedical Sciences, University of Cagliari, Italy
| | - James B Potash
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, USA
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Germany
| | - Eva Reininghaus
- Department of Psychiatry and Psychotherapeutic Medicine, Research Unit for Bipolar Affective Disorder, Medical University of Graz, Austria
| | - Guy A Rouleau
- Montreal Neurological Institute and Hospital, McGill University, Canada
| | - Janusz K Rybakowski
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poland
| | - Martin Schalling
- Department of Molecular Medicine and Surgery, Karolinska Institute, Sweden and Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Peter R Schofield
- Neuroscience Research Australia, Australia and School of Medical Sciences, University of New South Wales, Australia
| | - Barbara W Schweizer
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, USA
| | | | | | - Paul D Shilling
- Department of Psychiatry, University of California San Diego, USA
| | - Katzutaka Shimoda
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Japan
| | - Christian Simhandl
- Bipolar Center Wiener Neustadt, Sigmund Freud University, Medical Faculty, Austria
| | | | | | - Thomas Stamm
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Campus Charité Mitte, Germany
| | | | - Fasil Tekola-Ayele
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, USA
| | | | - Gustavo Turecki
- Douglas Mental Health University Institute, McGill University, Canada
| | - Julia Veeh
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Germany
| | - Eduard Vieta
- Bipolar Disorder Program, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Spain
| | - Stephanie H Witt
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany
| | - Gloria Roberts
- School of Psychiatry, University of New South Wales, Australia
| | - Peter P Zandi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, USA
| | - Martin Alda
- Department of Psychiatry, Dalhousie University, Canada
| | - Michael Bauer
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Medical Faculty, Technische Universität Dresden, Germany
| | - Francis J McMahon
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health, US Department of Health & Human Services, USA
| | | | - Thomas G Schulze
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany; Intramural Research Program, National Institute of Mental Health, National Institutes of Health, US Department of Health & Human Services, USA, Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, USA; Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Germany and Department of Psychiatry and Psychotherapy, University Medical Center (UMG), Georg-August University Göttingen, Germany
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Germany
| | - Scott R Clark
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Australia
| | - Bernhard T Baune
- Department of Psychiatry and Psychotherapy, University of Münster, Germany; Department of Psychiatry, Melbourne Medical School, University of Melbourne, Australia and The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Australia
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17
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Avramopoulos D, Kapogiannis D, Leoutsakos JM, Lyketsos CG, Mahairaki V, Nowrangi M, Oishi K, Oh ES, Rosenberg PB, Samus Q, Smith GS, Witwer K, Yasar S, Zandi PP. Developing Treatments for Alzheimer's and Related Disorders with Precision Medicine: A Vision. Adv Exp Med Biol 2022; 1339:395-402. [PMID: 35023131 DOI: 10.1007/978-3-030-78787-5_49] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
Precision medicine, also known as personalized medicine, is concerned with finding the right treatment for the right patient at the right time. It is a way of thinking focused on parsing heterogeneity ultimately down to the level of the individual. Its main mission is to identify characteristics of heterogeneous clinical conditions so as to target tailored therapies to individuals. Precision Medicine however is not an agnostic collection of all manner of clinical, genetic and other biologic data in select cohorts. This is an important point. Simply collecting as much information as possible on individuals without applying this way of thinking should not be considered Precision Medicine.
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Affiliation(s)
- Dimitrios Avramopoulos
- Department of Genetic Medicine, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Dimitrios Kapogiannis
- Department of Neurology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.,Intramural Research Program, National Institute on Aging (NIA/NIH), Baltimore, MD, USA
| | - Jeannie-Marie Leoutsakos
- Departments of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Constantine G Lyketsos
- Departments of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
| | - Vasiliki Mahairaki
- Department of Neurology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Milap Nowrangi
- Departments of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Kenichi Oishi
- Departments of Radiology and Radiological Sciences, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Esther S Oh
- Departments of Medicine (Geriatric Medicine and Gerontology), School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Paul B Rosenberg
- Departments of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Quincy Samus
- Departments of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Gwenn S Smith
- Departments of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Kenneth Witwer
- Departments of Molecular and Comparative Pathobiology, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Sevil Yasar
- Departments of Medicine (Geriatric Medicine and Gerontology), School of Medicine, Johns Hopkins University, Baltimore, MD, USA
| | - Peter P Zandi
- Departments of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, MD, USA
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18
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Lyketsos CG, Roberts SB, Swift EK, Quina A, Moon G, Kremer I, Tariot P, Fillit H, Bovenkamp DE, Zandi PP, Haaga JG. Standardizing Electronic Health Record Data on AD/ADRD to Accelerate Health Equity in Prevention, Detection, and Treatment. J Prev Alzheimers Dis 2022; 9:556-560. [PMID: 35841257 DOI: 10.14283/jpad.2022.47] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Improving the prevention, detection, and treatment of Alzheimer's disease and Alzheimer's disease related dementias (AD/ADRD) across racial, ethnic, and other diverse populations is a national priority. To this end, this paper proposes the development of the Standard Health Record for Dementia (SHRD, pronounced "shared") for collecting and sharing AD/ADRD real-world data (RWD). SHRD would replace the current unstandardized, fragmented, or missing state of key RWD with an open source, consensus-based, and interoperable common data standard. This paper describes how SHRD could leverage the best practices of the Minimal Common Oncology Data Elements (mCODETM) initiative to advance prevention, detection, and treatment; gain adoption by clinicians and electronic health record (EHR) vendors; and establish sustainable business and governance models. It describes a range of potential use cases to advance equity, including strengthening public health surveillance by facilitating AD/ADRD registry reporting; improving case detection and staging; and diversifying participation in clinical trials.
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Affiliation(s)
- C G Lyketsos
- Elaine K. Swift, PhD, The MITRE Corporation, McLean, VA, USA,
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19
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Kalman JL, Yoshida T, Andlauer TFM, Schulte EC, Adorjan K, Alda M, Ardau R, Aubry JM, Brosch K, Budde M, Chillotti C, Czerski PM, DePaulo RJ, Forstner A, Goes FS, Grigoroiu-Serbanescu M, Grof P, Grotegerd D, Hahn T, Heilbronner M, Hasler R, Heilbronner U, Heilmann-Heimbach S, Kapelski P, Kato T, Kohshour MO, Meinert S, Meller T, Nenadić I, Nöthen MM, Novak T, Opel N, Pawlak J, Pfarr JK, Potash JB, Reich-Erkelenz D, Repple J, Richard-Lepouriel H, Rietschel M, Ringwald KG, Rouleau G, Schaupp S, Senner F, Severino G, Squassina A, Stein F, Stopkova P, Streit F, Thiel K, Thomas-Odenthal F, Turecki G, Twarowska-Hauser J, Winter A, Zandi PP, Kelsoe JR, Falkai P, Dannlowski U, Kircher T, Schulze TG, Papiol S. Investigating the phenotypic and genetic associations between personality traits and suicidal behavior across major mental health diagnoses. Eur Arch Psychiatry Clin Neurosci 2022; 272:1611-1620. [PMID: 35146571 PMCID: PMC9653330 DOI: 10.1007/s00406-021-01366-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/12/2021] [Accepted: 11/24/2021] [Indexed: 12/18/2022]
Abstract
Personality traits influence risk for suicidal behavior. We examined phenotype- and genotype-level associations between the Big Five personality traits and suicidal ideation and attempt in major depressive, bipolar and schizoaffective disorder, and schizophrenia patients (N = 3012) using fixed- and random-effects inverse variance-weighted meta-analyses. Suicidal ideations were more likely to be reported by patients with higher neuroticism and lower extraversion phenotypic scores, but showed no significant association with polygenic load for these personality traits. Our findings provide new insights into the association between personality and suicidal behavior across mental illnesses and suggest that the genetic component of personality traits is unlikely to have strong causal effects on suicidal behavior.
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Affiliation(s)
- Janos L. Kalman
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Nussbaumstr. 7, 80336 Munich, Germany ,Department of Psychiatry and Psychotherapy, University Hospital Munich, Munich, Germany ,International Max Planck Research School for Translational Psychiatry, Munich, Germany
| | - Tomoya Yoshida
- National Center for Global Health and Medicine, Tokyo, Japan
| | - Till F. M. Andlauer
- Department of Neurology, Klinikum Rechts Der Isar, School of Medicine, Technical University of Munich, Munich, Germany ,Global Computational Biology and Data Sciences, Boehringer Ingelheim Pharma GmbH & Co. KG, 88397 Biberach an der Riß, Germany
| | - Eva C. Schulte
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Nussbaumstr. 7, 80336 Munich, Germany ,Department of Psychiatry and Psychotherapy, University Hospital Munich, Munich, Germany
| | - Kristina Adorjan
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Nussbaumstr. 7, 80336 Munich, Germany ,Department of Psychiatry and Psychotherapy, University Hospital Munich, Munich, Germany
| | - Martin Alda
- Department of Psychiatry, Dalhousie University, Halifax, Canada
| | - Raffaela Ardau
- Unit of Clinical Pharmacology, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Jean-Michel Aubry
- Department of Psychiatry, Geneva University Hospitals, Geneva, Switzerland ,Faculty of Medicine, University of Geneva, Geneva, Switzerland
| | - Katharina Brosch
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany ,Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany
| | - Monika Budde
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Nussbaumstr. 7, 80336 Munich, Germany
| | - Caterina Chillotti
- Unit of Clinical Pharmacology, University Hospital Agency of Cagliari, Cagliari, Italy
| | - Piotr M. Czerski
- Department of Psychiatric Genetics, Poznan University of Medical Sciences, Poznan, Poland
| | - Raymond J. DePaulo
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD USA
| | - Andreas Forstner
- Centre for Human Genetics, University of Marburg, Marburg, Germany ,Institute of Human Genetics, School of Medicine &, University of Bonn, University Hospital Bonn, Bonn, Germany ,Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany
| | - Fernando S. Goes
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD USA
| | | | - Paul Grof
- Mood Disorders Clinic of Ottawa, Ottawa, ON Canada ,Department of Psychiatry, University of Toronto, Toronto, ON Canada
| | - Dominik Grotegerd
- Institute for Translational Psychiatry, University of Munster, Munster, Germany
| | - Tim Hahn
- Institute for Translational Psychiatry, University of Munster, Munster, Germany
| | - Maria Heilbronner
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Nussbaumstr. 7, 80336 Munich, Germany
| | - Roland Hasler
- Department of Psychiatry, Geneva University Hospitals, Geneva, Switzerland
| | - Urs Heilbronner
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Nussbaumstr. 7, 80336 Munich, Germany
| | - Stefanie Heilmann-Heimbach
- Institute of Human Genetics, School of Medicine &, University of Bonn, University Hospital Bonn, Bonn, Germany
| | - Pawel Kapelski
- Department of Psychiatric Genetics, Poznan University of Medical Sciences, Poznan, Poland
| | - Tadafumi Kato
- Department of Psychiatry and Behavioral Science, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - Mojtaba Oraki Kohshour
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Nussbaumstr. 7, 80336 Munich, Germany ,Department of Immunology, School of Medicine, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran
| | - Susanne Meinert
- Institute for Translational Psychiatry, University of Munster, Munster, Germany ,Institute for Translational Neuroscience, University of Münster, Munster, Germany
| | - Tina Meller
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany ,Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany
| | - Igor Nenadić
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany ,Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany
| | - Markus M. Nöthen
- Institute of Human Genetics, School of Medicine &, University of Bonn, University Hospital Bonn, Bonn, Germany
| | - Tomas Novak
- National Institute of Mental Health, Klecany, Czech Republic ,3Rd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Nils Opel
- Institute for Translational Psychiatry, University of Munster, Munster, Germany
| | - Joanna Pawlak
- Department of Psychiatric Genetics, Poznan University of Medical Sciences, Poznan, Poland
| | - Julia-Katharina Pfarr
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany ,Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany
| | - James B. Potash
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD USA
| | - Daniela Reich-Erkelenz
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Nussbaumstr. 7, 80336 Munich, Germany
| | - Jonathan Repple
- Institute for Translational Psychiatry, University of Munster, Munster, Germany
| | | | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Mannheim, Germany
| | - Kai G. Ringwald
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany ,Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany
| | - Guy Rouleau
- Montreal Neurological Institute, McGill University, Montreal, Canada
| | - Sabrina Schaupp
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Nussbaumstr. 7, 80336 Munich, Germany
| | - Fanny Senner
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Nussbaumstr. 7, 80336 Munich, Germany ,Department of Psychiatry and Psychotherapy, University Hospital Munich, Munich, Germany
| | - Giovanni Severino
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Alessio Squassina
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Frederike Stein
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany ,Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany
| | - Pavla Stopkova
- National Institute of Mental Health, Klecany, Czech Republic ,3Rd Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Fabian Streit
- Department of Genetic Epidemiology in Psychiatry, Medical Faculty Mannheim, Central Institute of Mental Health, Heidelberg University, Mannheim, Germany
| | - Katharina Thiel
- Institute for Translational Psychiatry, University of Munster, Munster, Germany
| | | | - Gustavo Turecki
- The Douglas Research Centre, McGill University, Montreal, Canada
| | | | - Alexandra Winter
- Institute for Translational Psychiatry, University of Munster, Munster, Germany
| | - Peter P. Zandi
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD USA
| | - John R. Kelsoe
- Department of Psychiatry, University of California San Diego, La Jolla, CA USA
| | | | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital Munich, Munich, Germany
| | - Udo Dannlowski
- Institute for Translational Psychiatry, University of Munster, Munster, Germany
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, University of Marburg, Marburg, Germany ,Center for Mind, Brain and Behavior, University of Marburg, Marburg, Germany
| | - Thomas G. Schulze
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Nussbaumstr. 7, 80336 Munich, Germany ,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD USA ,Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, Syracuse, NY USA
| | - Sergi Papiol
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Nussbaumstr. 7, 80336 Munich, Germany ,Department of Psychiatry and Psychotherapy, University Hospital Munich, Munich, Germany ,Centro de Investigación Biomedica en Red de Salud Mental (CIBERSAM), Barcelona, Spain
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Kalman JL, Olde Loohuis LM, Vreeker A, McQuillin A, Stahl EA, Ruderfer D, Grigoroiu-Serbanescu M, Panagiotaropoulou G, Ripke S, Bigdeli TB, Stein F, Meller T, Meinert S, Pelin H, Streit F, Papiol S, Adams MJ, Adolfsson R, Adorjan K, Agartz I, Aminoff SR, Anderson-Schmidt H, Andreassen OA, Ardau R, Aubry JM, Balaban C, Bass N, Baune BT, Bellivier F, Benabarre A, Bengesser S, Berrettini WH, Boks MP, Bromet EJ, Brosch K, Budde M, Byerley W, Cervantes P, Chillotti C, Cichon S, Clark SR, Comes AL, Corvin A, Coryell W, Craddock N, Craig DW, Croarkin PE, Cruceanu C, Czerski PM, Dalkner N, Dannlowski U, Degenhardt F, Del Zompo M, DePaulo JR, Djurovic S, Edenberg HJ, Eissa MA, Elvsåshagen T, Etain B, Fanous AH, Fellendorf F, Fiorentino A, Forstner AJ, Frye MA, Fullerton JM, Gade K, Garnham J, Gershon E, Gill M, Goes FS, Gordon-Smith K, Grof P, Guzman-Parra J, Hahn T, Hasler R, Heilbronner M, Heilbronner U, Jamain S, Jimenez E, Jones I, Jones L, Jonsson L, Kahn RS, Kelsoe JR, Kennedy JL, Kircher T, Kirov G, Kittel-Schneider S, Klöhn-Saghatolislam F, Knowles JA, Kranz TM, Lagerberg TV, Landen M, Lawson WB, Leboyer M, Li QS, Maj M, Malaspina D, Manchia M, Mayoral F, McElroy SL, McInnis MG, McIntosh AM, Medeiros H, Melle I, Milanova V, Mitchell PB, Monteleone P, Monteleone AM, Nöthen MM, Novak T, Nurnberger JI, O'Brien N, O'Connell KS, O'Donovan C, O'Donovan MC, Opel N, Ortiz A, Owen MJ, Pålsson E, Pato C, Pato MT, Pawlak J, Pfarr JK, Pisanu C, Potash JB, Rapaport MH, Reich-Erkelenz D, Reif A, Reininghaus E, Repple J, Richard-Lepouriel H, Rietschel M, Ringwald K, Roberts G, Rouleau G, Schaupp S, Scheftner WA, Schmitt S, Schofield PR, Schubert KO, Schulte EC, Schweizer B, Senner F, Severino G, Sharp S, Slaney C, Smeland OB, Sobell JL, Squassina A, Stopkova P, Strauss J, Tortorella A, Turecki G, Twarowska-Hauser J, Veldic M, Vieta E, Vincent JB, Xu W, Zai CC, Zandi PP, Di Florio A, Smoller JW, Biernacka JM, McMahon FJ, Alda M, Müller-Myhsok B, Koutsouleris N, Falkai P, Freimer NB, Andlauer TF, Schulze TG, Ophoff RA. Characterisation of age and polarity at onset in bipolar disorder. Br J Psychiatry 2021; 219:659-669. [PMID: 35048876 PMCID: PMC8636611 DOI: 10.1192/bjp.2021.102] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [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: 12/11/2020] [Revised: 05/26/2021] [Accepted: 07/01/2021] [Indexed: 01/12/2023]
Abstract
BACKGROUND Studying phenotypic and genetic characteristics of age at onset (AAO) and polarity at onset (PAO) in bipolar disorder can provide new insights into disease pathology and facilitate the development of screening tools. AIMS To examine the genetic architecture of AAO and PAO and their association with bipolar disorder disease characteristics. METHOD Genome-wide association studies (GWASs) and polygenic score (PGS) analyses of AAO (n = 12 977) and PAO (n = 6773) were conducted in patients with bipolar disorder from 34 cohorts and a replication sample (n = 2237). The association of onset with disease characteristics was investigated in two of these cohorts. RESULTS Earlier AAO was associated with a higher probability of psychotic symptoms, suicidality, lower educational attainment, not living together and fewer episodes. Depressive onset correlated with suicidality and manic onset correlated with delusions and manic episodes. Systematic differences in AAO between cohorts and continents of origin were observed. This was also reflected in single-nucleotide variant-based heritability estimates, with higher heritabilities for stricter onset definitions. Increased PGS for autism spectrum disorder (β = -0.34 years, s.e. = 0.08), major depression (β = -0.34 years, s.e. = 0.08), schizophrenia (β = -0.39 years, s.e. = 0.08), and educational attainment (β = -0.31 years, s.e. = 0.08) were associated with an earlier AAO. The AAO GWAS identified one significant locus, but this finding did not replicate. Neither GWAS nor PGS analyses yielded significant associations with PAO. CONCLUSIONS AAO and PAO are associated with indicators of bipolar disorder severity. Individuals with an earlier onset show an increased polygenic liability for a broad spectrum of psychiatric traits. Systematic differences in AAO across cohorts, continents and phenotype definitions introduce significant heterogeneity, affecting analyses.
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Affiliation(s)
- Janos L. Kalman
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Germany; Department of Psychiatry and Psychotherapy, University Hospital Munich, Germany; and International Max Planck Research School for Translational Psychiatry, Germany
| | - Loes M. Olde Loohuis
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, USA
| | - Annabel Vreeker
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus University Medical Centre–Sophia Children’s Hospital, the Netherlands
| | | | - Eli A. Stahl
- Division of Psychiatric Genomics, Mount Sinai School of Medicine, USA
| | - Douglas Ruderfer
- Division of Genetic Medicine, Department of Medicine, Vanderbilt Genetics Institute, Vanderbilt University Medical Center, USA; Department of Biomedical Informatics, Vanderbilt University Medical Center, USA; and Department of Psychiatry and Behavioral Sciences, Vanderbilt University Medical Center, USA
| | | | | | - Stephan Ripke
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, USA; and Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, USA
| | - Tim B. Bigdeli
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, USA; and VA NY Harbor Healthcare System, USA
| | - Frederike Stein
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Germany
| | - Tina Meller
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Germany; and Center for Mind, Brain and Behavior (CMBB), Germany
| | - Susanne Meinert
- Institute for Translational Psychiatry, Westfälische Wilhelms-Universität Münster, Germany; and Institute for Translational Neuroscience, University of Münster, Germany
| | - Helena Pelin
- International Max Planck Research School for Translational Psychiatry, Germany; and Max Planck Institute of Psychiatry, Germany
| | - Fabian Streit
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Sergi Papiol
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Germany; Department of Psychiatry and Psychotherapy, University Hospital Munich, Germany; and Centro de Investigación Biomedica en Red de Salud Mental (CIBERSAM), Spain
| | | | - Rolf Adolfsson
- Department of Clinical Sciences, Medical Faculty, Umeå University, Sweden
| | - Kristina Adorjan
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Germany; and Department of Psychiatry and Psychotherapy, University Hospital Munich, Germany
| | - Ingrid Agartz
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Sweden; Department of Psychiatric Research, Diakonhjemmet Hospital, Norway; and NORMENT Centre, Division of Mental Health and Addiction, Institute of Clinical Medicine, University of Oslo, Norway
| | - Sofie R. Aminoff
- Division of Mental Health and Addiction, Oslo University Hospital, Norway; and NORMENT Centre, Inst of Clinical Medicine, University of Oslo, Norway
| | - Heike Anderson-Schmidt
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Germany
| | - Ole A. Andreassen
- NORMENT Centre, Inst of Clinical Medicine, University of Oslo, Norway; and Division of Mental Health and Addiction, Oslo University Hosptial, Norway
| | - Raffaella Ardau
- Unit of Clinical Pharmacology, University Hospital Agency of Cagliari, Italy
| | - Jean-Michel Aubry
- Faculty of medicine, University of Geneva, Switzerland; and Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Germany
| | - Ceylan Balaban
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Germany
| | - Nicholas Bass
- Division of Psychiatry, University College London, UK
| | - Bernhard T. Baune
- Department of Psychiatry, University of Münster, Germany; Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Australia; The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Australia; and Discipline of Psychiatry, Adelaide Medical School, The University of Adelaide, Australia
| | - Frank Bellivier
- Universite de Paris, France; INSERM UMRS 1144, France; and DMU Neurosciences, GHU Lariboisière Fernand Widal, Departement de Psychiatrie, APHP, France
| | - Antoni Benabarre
- Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Spain
| | - Susanne Bengesser
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Austria
| | | | - Marco P. Boks
- Psychiatry, UMC Utrecht Brain Center, the Netherlands
| | | | - Katharina Brosch
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Germany
| | - Monika Budde
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Germany
| | | | | | - Catina Chillotti
- Unit of Clinical Pharmacology, University Hospital Agency of Cagliari, Italy
| | - Sven Cichon
- Department of Biomedicine, University of Basel, Switzerland; Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Germany; Institute of Medical Genetics and Pathology, University Hospital Basel, Switzerland; and Institute of Neuroscience and Medicine (INM-1), Research Centre Julich, Germany
| | - Scott R. Clark
- Discipline of Psychiatry, University of Adelaide, Australia; and Bazil Hetzel Institute, Australia
| | - Ashley L. Comes
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Germany; Department of Psychiatry and Psychotherapy, University Hospital Munich, Germany; and International Max Planck Research School for Translational Psychiatry, Germany
| | - Aiden Corvin
- Department of Psychiatry & Trinity Translational Medicine Institute, Trinity College Dublin, Ireland
| | | | - Nick Craddock
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, UK
| | | | | | - Cristiana Cruceanu
- Department of Translational Research, Max Planck Institute of Psychiatry, Germany
| | - Piotr M. Czerski
- Department of Psychiatric Genetics, Poznan University of Medical Sciences, Poland
| | - Nina Dalkner
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Austria
| | - Udo Dannlowski
- Institute for Translational Psychiatry, Westfälische Wilhelms-Universität Münster, Germany
| | - Franziska Degenhardt
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Germany; and Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Germany
| | - Maria Del Zompo
- Department of Biomedical Science, Section of Neuroscience & Clinical Pharmacology, University of Cagliari, Italy; and Unit of Clinical Pharmacology, University Hospital Agency of Cagliari, Italy
| | - J. Raymond DePaulo
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, USA
| | - Srdjan Djurovic
- Department of Medical Genetics, Oslo University Hospital Ullevål, Norway; and NORMENT, Department of Clinical Science, University of Bergen, Norway
| | - Howard J. Edenberg
- Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, USA
| | | | - Torbjørn Elvsåshagen
- NORMENT, Division of Mental Health and Addiction, Oslo University Hospital, Norway
| | - Bruno Etain
- Universite de Paris, France; INSERM UMRS 1144, France; and DMU Neurosciences, GHU Lariboisière Fernand Widal, Departement de Psychiatrie, APHP, France
| | - Ayman H. Fanous
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, USA; and VA NY Harbor Healthcare System, USA
| | - Frederike Fellendorf
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Austria
| | | | - Andreas J. Forstner
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Germany; and Centre for Human Genetics, University of Marburg, Germany
| | - Mark A. Frye
- Department of Psychiatry and Psychology, Mayo Clinic, USA
| | - Janice M. Fullerton
- Neuroscience Research Australia, Australia; and School of Medical Sciences, University of New South Wales, Australia
| | - Katrin Gade
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Germany
| | | | - Elliot Gershon
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, USA; and Department of Human Genetics, University of Chicago, USA
| | - Michael Gill
- Department of Psychiatry & Trinity Translational Medicine Institute, Trinity College Dublin, Ireland
| | - Fernando S. Goes
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, USA
| | | | - Paul Grof
- Mood Disorders Centre of Ottawa, Canada; and Department of Psychiatry, University of Toronto, Canada
| | - Jose Guzman-Parra
- Mental Health Department, University Regional Hospital, Biomedicine Institute (IBIMA), Spain
| | - Tim Hahn
- Institute for Translational Psychiatry, Westfälische Wilhelms-Universität Münster, Germany
| | - Roland Hasler
- Cell Biology, SUNY Downstate Medical Center College of Medicine, USA; and Institute for Genomic Health, SUNY Downstate Medical Center College of Medicine, USA
| | - Maria Heilbronner
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Germany
| | - Urs Heilbronner
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Germany
| | - Stephane Jamain
- Universite Paris Est Creteil, France; and INSERM U 955, Neuropsychiatrie Translationnelle, France
| | - Esther Jimenez
- Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Spain
| | - Ian Jones
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, UK
| | - Lisa Jones
- Psychological Medicine, University of Worcester, UK
| | - Lina Jonsson
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Sweden
| | - Rene S. Kahn
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, USA
| | - John R. Kelsoe
- Department of Psychiatry, University of California San Diego, USA
| | - James L. Kennedy
- Department of Psychiatry, University of Toronto, Canada; The Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Canada; and Institute of Medical Science, University of Toronto, Canada
| | - Tilo Kircher
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Germany
| | - George Kirov
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, UK
| | - Sarah Kittel-Schneider
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Germany; and Department of Psychiatry, Psychotherapy and Psychosomatics, University Hospital Wurzburg, Germany
| | | | - James A. Knowles
- Cell Biology, SUNY Downstate Medical Center College of Medicine, USA; and Institute for Genomic Health, SUNY Downstate Medical Center College of Medicine, USA
| | - Thorsten M. Kranz
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Germany
| | - Trine Vik Lagerberg
- NORMENT Centre, Division of Mental Health and Addiction, Oslo University Hosptial, Norway
| | - Mikael Landen
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Sweden; and Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Sweden
| | - William B. Lawson
- Department of Psychiatry and Behavioral Sciences, Howard University Hospital, USA
| | - Marion Leboyer
- Universite Paris Est Creteil, France; and INSERM U 955, Neuropsychiatrie Translationnelle, France
| | | | - Mario Maj
- Department of Psychiatry, University of Campania ‘Luigi Vanvitelli’, Italy
| | - Dolores Malaspina
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, USA; and Department of Genetics & Genomics, Icahn School of Medicine at Mount Sinai, USA
| | - Mirko Manchia
- Unit of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Italy and Department of Pharmacology, Dalhousie University, Canada
| | - Fermin Mayoral
- Mental Health Department, University Regional Hospital, Biomedicine Institute (IBIMA), Spain
| | | | | | | | - Helena Medeiros
- Institute for Genomic Health, SUNY Downstate Medical Center College of Medicine, USA
| | - Ingrid Melle
- NORMENT Centre, Division of Mental Health and Addiction, Institute of Clinical Medicine and Diakonhjemmet Hospital, University of Oslo, Norway; and Division of Mental Health and Addiction, Oslo University Hospital, Norway
| | - Vihra Milanova
- Psychiatric Clinic, Alexander University Hospital, Bulgaria
| | | | - Palmiero Monteleone
- Department of Medicine, Surgery and Dentistry ‘Scuola Medica Salernitana’, University of Salerno, Italy
| | | | - Markus M. Nöthen
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Germany
| | - Tomas Novak
- National Institute of Mental Health, Czech Republic
| | | | - Niamh O'Brien
- Division of Psychiatry, University College London, UK
| | - Kevin S. O'Connell
- Division of Mental Health and Addiction, Oslo University Hospital, Norway; and NORMENT Centre, Inst of Clinical Medicine, University of Oslo, Norway
| | | | - Michael C. O'Donovan
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, UK
| | - Nils Opel
- Institute for Translational Psychiatry, Westfälische Wilhelms-Universität Münster, Germany
| | - Abigail Ortiz
- Department of Psychiatry, University of Toronto, Toronto, Canada; and Centre for Addiction and Mental Health, Toronto, Canada
| | - Michael J. Owen
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, UK
| | - Erik Pålsson
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, Sweden
| | - Carlos Pato
- Institute for Genomic Health, SUNY Downstate Medical Center College of Medicine, USA
| | - Michele T. Pato
- Institute for Genomic Health, SUNY Downstate Medical Center College of Medicine, USA
| | - Joanna Pawlak
- Department of Psychiatric Genetics, Poznan University of Medical Sciences, Poland
| | | | - Claudia Pisanu
- Department of Biomedical Science, Section of Neuroscience & Clinical Pharmacology, University of Cagliari, Italy
| | - James B. Potash
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, USA
| | - Mark H Rapaport
- Department of Psychiatry and Behavioral Sciences, Emory University, USA
| | - Daniela Reich-Erkelenz
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Germany
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Germany
| | - Eva Reininghaus
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University Graz, Austria
| | - Jonathan Repple
- Institute for Translational Psychiatry, Westfälische Wilhelms-Universität Münster, Germany
| | | | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany
| | - Kai Ringwald
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Germany
| | - Gloria Roberts
- School of Psychiatry, University of New South Wales, Australia
| | - Guy Rouleau
- Montreal Neurological Institute, Canada and Department of Neurology, McGill University, Canada
| | - Sabrina Schaupp
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Germany
| | | | - Simon Schmitt
- Department of Psychiatry and Psychotherapy, Philipps-University Marburg, Germany
| | - Peter R. Schofield
- Neuroscience Research Australia, Australia; and School of Medical Sciences, University of New South Wales, Australia
| | - K. Oliver Schubert
- Discipline of Psychiatry, University of Adelaide, Australia; and Northern Adelaide Mental Health Service, SA Health, Australia
| | - Eva C. Schulte
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Germany; and Department of Psychiatry and Psychotherapy, University Hospital Munich, Germany
| | - Barbara Schweizer
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, USA
| | - Fanny Senner
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Germany; and Department of Psychiatry and Psychotherapy, University Hospital Munich, Germany
| | - Giovanni Severino
- Department of Biomedical Science, Section of Neuroscience & Clinical Pharmacology, University of Cagliari, Italy
| | - Sally Sharp
- Division of Psychiatry, University College London, UK
| | | | - Olav B. Smeland
- Division of Mental Health and Addiction, Oslo University Hospital, Norway; and NORMENT Centre, Inst of Clinical Medicine, University of Oslo, Norway
| | - Janet L. Sobell
- Psychiatry and the Behavioral Sciences, University of Southern California, USA
| | - Alessio Squassina
- Department of Psychiatry, Dalhousie University, Canada; and Department of Biomedical Science, Section of Neuroscience & Clinical Pharmacology, University of Cagliari, Italy
| | | | - John Strauss
- Department of Psychiatry, University of Toronto, Canada; The Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Canada; and Institute of Medical Science, University of Toronto, Canada
| | | | - Gustavo Turecki
- Department of Psychiatry, McGill University, Canada; and Douglas Institute, McGill University, Canada
| | | | - Marin Veldic
- Department of Psychiatry and Psychology, Mayo Clinic, USA
| | - Eduard Vieta
- Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Spain
| | - John B. Vincent
- Department of Psychiatry, University of Toronto, Canada; The Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Canada; and Institute of Medical Science, University of Toronto, Canada
| | - Wei Xu
- Dalla Lana School of Public Health, Biostatistics Division, University of Toronto, Canada
| | - Clement C. Zai
- Department of Psychiatry, University of Toronto, Canada; The Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Canada; Institute of Medical Science, University of Toronto, Canada; Laboratory Medicine and Pathobiology, University of Toronto, Canada; and Harvard T.H. Chan School of Public Health, USA
| | - Peter P. Zandi
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, USA
| | - Arianna Di Florio
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, UK
| | - Jordan W. Smoller
- Psychiatric and Neurodevelopmental Genetics Unit, Department of Psychiatry and Center for Genomic Medicine, Massachusetts General Hospital, USA; and Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, USA
| | - Joanna M. Biernacka
- Department of Psychiatry and Psychology, Mayo Clinic, USA; and Department of Health Sciences Research, Mayo Clinic, USA
| | - Francis J. McMahon
- Human Genetics Branch, Intramural Research Program, National Institute of Mental Health, USA
| | - Martin Alda
- National Institute of Mental Health, Czech Republic; and Department of Psychiatry, Dalhousie University, Canada
| | | | - Nikolaos Koutsouleris
- Department of Psychiatry and Psychotherapy, University Hospital Munich, Germany; Max Planck Institute of Psychiatry, Germany; and Institute of Psychiatry, Psychology and Neuroscience, Kings College London, UK
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, University Hospital Munich, Germany
| | - Nelson B. Freimer
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, USA; and Human Genetics, University of California Los Angeles, USA
| | - Till F.M. Andlauer
- Department of Neurology, Klinikum rechts der Isar, School of Medicine, Technical University of Munich, Germany
| | - Thomas G. Schulze
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Germany; Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Germany; Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Germany; Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, USA; and Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, USA
| | - Roel A. Ophoff
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, University of California Los Angeles, USA; Human Genetics, University of California Los Angeles, USA; and Psychiatry, Erasmus University Medical Center, the Netherlands
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Lin Y, Maihofer AX, Stapp E, Ritchey M, Alliey-Rodriguez N, Anand A, Balaraman Y, Berrettini WH, Bertram H, Bhattacharjee A, Calkin CV, Conroy C, Coryell W, D'Arcangelo N, DeModena A, Biernacka JM, Fisher C, Frazier N, Frye M, Gao K, Garnham J, Gershon E, Glazer K, Goes FS, Goto T, Karberg E, Harrington G, Jakobsen P, Kamali M, Kelly M, Leckband SG, Lohoff FW, Stautland A, McCarthy MJ, McInnis MG, Mondimore F, Morken G, Nurnberger JI, Oedegaard KJ, Syrstad VEG, Ryan K, Schinagle M, Schoeyen H, Andreassen OA, Shaw M, Shilling PD, Slaney C, Tarwater B, Calabrese JR, Alda M, Nievergelt CM, Zandi PP, Kelsoe JR. Clinical predictors of non-response to lithium treatment in the Pharmacogenomics of Bipolar Disorder (PGBD) study. Bipolar Disord 2021; 23:821-831. [PMID: 33797828 DOI: 10.1111/bdi.13078] [Citation(s) in RCA: 12] [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] [Indexed: 01/05/2023]
Abstract
BACKGROUND Lithium is regarded as a first-line treatment for bipolar disorder (BD), but partial response and non-response commonly occurs. There exists a need to identify lithium non-responders prior to initiating treatment. The Pharmacogenomics of Bipolar Disorder (PGBD) Study was designed to identify predictors of lithium response. METHODS The PGBD Study was an eleven site prospective trial of lithium treatment in bipolar I disorder. Subjects were stabilized on lithium monotherapy over 4 months and gradually discontinued from all other psychotropic medications. After ensuring a sustained clinical remission (defined by a score of ≤3 on the CGI for 4 weeks) had been achieved, subjects were followed for up to 2 years to monitor clinical response. Cox proportional hazard models were used to examine the relationship between clinical measures and time until failure to remit or relapse. RESULTS A total of 345 individuals were enrolled into the study and included in the analysis. Of these, 101 subjects failed to remit or relapsed, 88 achieved remission and continued to study completion, and 156 were terminated from the study for other reasons. Significant clinical predictors of treatment failure (p < 0.05) included baseline anxiety symptoms, functional impairments, negative life events and lifetime clinical features such as a history of migraine, suicidal ideation/attempts, and mixed episodes, as well as a chronic course of illness. CONCLUSIONS In this PGBD Study of lithium response, several clinical features were found to be associated with failure to respond to lithium. Future validation is needed to confirm these clinical predictors of treatment failure and their use clinically to distinguish who will do well on lithium before starting pharmacotherapy.
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Affiliation(s)
- Yian Lin
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Adam X Maihofer
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Emma Stapp
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Megan Ritchey
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Amit Anand
- Center for Behavioral Health, Cleveland Clinic, Cleveland, OH, USA
| | - Yokesh Balaraman
- Department of Psychiatry, Indiana University, Indianapolis, IN, USA
| | - Wade H Berrettini
- University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | | | | | | | - Carla Conroy
- Department of Psychiatry, Case Western Reserve University, Cleveland, OH, USA
| | | | - Nicole D'Arcangelo
- Department of Psychiatry, Case Western Reserve University, Cleveland, OH, USA
| | - Anna DeModena
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | | | - Carrie Fisher
- Department of Psychiatry, Indiana University, Indianapolis, IN, USA
| | | | | | - Keming Gao
- Department of Psychiatry, Case Western Reserve University, Cleveland, OH, USA
| | | | | | - Kara Glazer
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Fernando S Goes
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Toyomi Goto
- Department of Psychiatry, Case Western Reserve University, Cleveland, OH, USA
| | - Elizabeth Karberg
- Department of Psychiatry, Case Western Reserve University, Cleveland, OH, USA
| | | | - Petter Jakobsen
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Masoud Kamali
- University of Michigan, Ann Arbor, MI, USA.,Department of Psychiatry, Massachusetts General Hospital and Harvard University, Boston, MA, USA
| | | | - Susan G Leckband
- Department of Psychiatry, VA San Diego Healthcare System, La Jolla, CA, USA
| | - Falk W Lohoff
- National Institute of Alcohol Abuse and Alcoholism, NIH, Bethesda, MD, USA
| | - Andrea Stautland
- Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen and Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Michael J McCarthy
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA.,Department of Psychiatry, VA San Diego Healthcare System, La Jolla, CA, USA
| | | | - Francis Mondimore
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Gunnar Morken
- Division of Psychiatry, St. Olav University Hospital of Trondheim and Department of Neuroscience, Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | | | - Ketil J Oedegaard
- Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen and Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Vigdis Elin Giever Syrstad
- Department of Clinical Medicine, Faculty of Medicine and Dentistry, University of Bergen and Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Kelly Ryan
- University of Michigan, Ann Arbor, MI, USA
| | - Martha Schinagle
- Department of Psychiatry, Case Western Reserve University, Cleveland, OH, USA
| | - Helle Schoeyen
- Division of Psychiatry, Faculty of Medicine and Dentistry, Stavanger University Hospital, University of Bergen, Stavanger, Norway
| | - Ole A Andreassen
- Norwegian Centre for Mental Disorders Research (NORMENT), Institute of Clinical Medicine, University of Oslo, Oslo, Norway.,Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | | | - Paul D Shilling
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | | | | | - Joseph R Calabrese
- Department of Psychiatry, Case Western Reserve University, Cleveland, OH, USA
| | - Martin Alda
- Dalhousie University, Halifax, Canada.,National Institute of Mental Health, Klecany, Czech Republic
| | | | - Peter P Zandi
- Department of Psychiatry and Behavioral Sciences, The Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - John R Kelsoe
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
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22
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Coombes BJ, Millischer V, Batzler A, Larrabee B, Hou L, Papiol S, Heilbronner U, Adli M, Akiyama K, Akula N, Amare AT, Ardau R, Arias B, Aubry JM, Backlund L, Bauer M, Baune BT, Bellivier F, Benabarre A, Bengesser S, Bhattacharjee AK, Cervantes P, Chen HC, Chillotti C, Cichon S, Clark SR, Colom F, Cruceanu C, Czerski PM, Dalkner N, Degenhardt F, Del Zompo M, DePaulo JR, Étain B, Falkai P, Ferensztajn-Rochowiak E, Forstner AJ, Frisen L, Gard S, Garnham JS, Goes FS, Grigoroiu-Serbanescu M, Grof P, Hashimoto R, Hauser J, Herms S, Hoffmann P, Jamain S, Jiménez E, Kahn JP, Kassem L, Kato T, Kelsoe JR, Kittel-Schneider S, König B, Kuo PH, Kusumi I, Laje G, Landén M, Lavebratt C, Leboyer M, Leckband SG, Maj M, Manchia M, Martinsson L, McCarthy MJ, McElroy SL, Mitchell PB, Mitjans M, Mondimore FM, Monteleone P, Nievergelt CM, Nöthen MM, Novák T, O'Donovan C, Osby U, Ozaki N, Pfennig A, Pisanu C, Potash JB, Reif A, Reininghaus E, Rietschel M, Rouleau GA, Rybakowski JK, Schalling M, Schofield PR, Schubert KO, Schweizer BW, Severino G, Shekhtman T, Shilling PD, Shimoda K, Simhandl C, Slaney CM, Squassina A, Stamm T, Stopkova P, Tortorella A, Turecki G, Vieta E, Witt SH, Zandi PP, Fullerton JM, Alda M, Frye MA, Schulze TG, McMahon FJ, Biernacka JM. Association of Attention-Deficit/Hyperactivity Disorder and Depression Polygenic Scores with Lithium Response: A Consortium for Lithium Genetics Study. Complex Psychiatry 2021; 7:80-89. [PMID: 36408127 PMCID: PMC8740189 DOI: 10.1159/000519707] [Citation(s) in RCA: 5] [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] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Accepted: 07/09/2021] [Indexed: 07/28/2023] Open
Abstract
Response to lithium varies widely between individuals with bipolar disorder (BD). Polygenic risk scores (PRSs) can uncover pharmacogenomics effects and may help predict drug response. Patients (N = 2,510) with BD were assessed for long-term lithium response in the Consortium on Lithium Genetics using the Retrospective Criteria of Long-Term Treatment Response in Research Subjects with Bipolar Disorder score. PRSs for attention-deficit/hyperactivity disorder (ADHD), major depressive disorder (MDD), and schizophrenia (SCZ) were computed using lassosum and in a model including all three PRSs and other covariates, and the PRS of ADHD (β = -0.14; 95% confidence interval [CI]: -0.24 to -0.03; p value = 0.010) and MDD (β = -0.16; 95% CI: -0.27 to -0.04; p value = 0.005) predicted worse quantitative lithium response. A higher SCZ PRS was associated with higher rates of medication nonadherence (OR = 1.61; 95% CI: 1.34-1.93; p value = 2e-7). This study indicates that genetic risk for ADHD and depression may influence lithium treatment response. Interestingly, a higher SCZ PRS was associated with poor adherence, which can negatively impact treatment response. Incorporating genetic risk of ADHD, depression, and SCZ in combination with clinical risk may lead to better clinical care for patients with BD.
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Affiliation(s)
- Brandon J Coombes
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
| | - Vincent Millischer
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
- Department for Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
| | - Anthony Batzler
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
| | - Beth Larrabee
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
| | - Liping Hou
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health, US Department of Health & Human Services, Bethesda, Maryland, USA
| | - Sergi Papiol
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, Munich, Germany
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University Munich, Munich, Germany
| | - Urs Heilbronner
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, Munich, Germany
| | - Mazda Adli
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Germany
| | - Kazufumi Akiyama
- Department of Biological Psychiatry and Neuroscience, Dokkyo Medical University School of Medicine, Mibu, Japan
| | - Nirmala Akula
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health, US Department of Health & Human Services, Bethesda, Maryland, USA
| | - Azmeraw T Amare
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
- South Australian Academic Health Science and Translation Centre, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, South Australia, Australia
| | - Raffaella Ardau
- Unit of Clinical Pharmacology, Hospital University Agency of Cagliari, Cagliari, Italy
| | - Barbara Arias
- Unitat de Zoologia i Antropologia Biològica (Dpt. Biologia Evolutiva, Ecologia i Ciències Ambientals), Facultat de Biologia and Institut de Biomedicina (IBUB), University of Barcelona, CIBERSAM, Barcelona, Spain
| | - Jean-Michel Aubry
- Department of Psychiatry, Mood Disorders Unit, HUG-Geneva University Hospitals, Geneva, Switzerland
| | - Lena Backlund
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Michael Bauer
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Medical Faculty, Technische Universität Dresden, Dresden, Germany
| | - Bernhard T Baune
- Department of Psychiatry, University of Münster, Münster, Germany
- Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne Parkville, Parkville, Victoria, Australia
| | - Frank Bellivier
- INSERM UMR-S 1144, Université Paris Diderot, Département de Psychiatrie et de Médecine Addictologique, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-F.Widal, Paris, France
| | - Antoni Benabarre
- Bipolar Disorder Program, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - Susanne Bengesser
- Department of Psychiatry and Psychotherapeutic Medicine, Research Unit for Bipolar Affective Disorder, Medical University of Graz, Graz, Austria
| | | | - Pablo Cervantes
- The Neuromodulation Unit, McGill University Health Centre, Montreal, Québec, Canada
| | - Hsi-Chung Chen
- Department of Psychiatry & Center of Sleep Disorders, National Taiwan University Hospital, Taipei, Taiwan
| | - Caterina Chillotti
- Unit of Clinical Pharmacology, Hospital University Agency of Cagliari, Cagliari, Italy
| | - Sven Cichon
- Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
- Institute of Neuroscience and Medicine (INM-1), Research Center Jülich, Jülich, Germany
- Human Genomics Research Group, Department of Biomedicine, University Hospital Basel, Basel, Switzerland
| | - Scott R Clark
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
| | - Francesc Colom
- Mental Health Research Group, IMIM-Hospital del Mar, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Cristiana Cruceanu
- Douglas Mental Health University Institute, McGill University, Montreal, Québec, Canada
| | - Piotr M Czerski
- Psychiatric Genetic Unit, Poznan University of Medical Sciences, Poznan, Poland
| | - Nina Dalkner
- Department of Psychiatry and Psychotherapeutic Medicine, Research Unit for Bipolar Affective Disorder, Medical University of Graz, Graz, Austria
| | - Franziska Degenhardt
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Maria Del Zompo
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - J Raymond DePaulo
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, Maryland, USA
| | - Bruno Étain
- INSERM UMR-S 1144, Université Paris Diderot, Département de Psychiatrie et de Médecine Addictologique, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-F.Widal, Paris, France
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University Munich, Munich, Germany
| | | | - Andreas J Forstner
- Institute of Neuroscience and Medicine (INM-1), Research Center Jülich, Jülich, Germany
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
- Centre for Human Genetics, University of Marburg, Marburg, Germany
| | - Louise Frisen
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Sébastien Gard
- Service de Psychiatrie, Hôpital Charles Perrens, Bordeaux, France
| | - Julie S Garnham
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Fernando S Goes
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, Maryland, USA
| | - Maria Grigoroiu-Serbanescu
- Biometric Psychiatric Genetics Research Unit, Alexandru Obregia Clinical Psychiatric Hospital, Bucharest, Romania
| | - Paul Grof
- Mood Disorders Center of Ottawa, Ottawa, Ontario, Canada
| | - Ryota Hashimoto
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
- Department of Psychiatry, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Joanna Hauser
- Psychiatric Genetic Unit, Poznan University of Medical Sciences, Poznan, Poland
| | - Stefan Herms
- Human Genomics Research Group, Department of Biomedicine, University Hospital Basel, Basel, Switzerland
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Per Hoffmann
- Human Genomics Research Group, Department of Biomedicine, University Hospital Basel, Basel, Switzerland
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Stephane Jamain
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University Munich, Munich, Germany
| | - Esther Jiménez
- Bipolar Disorder Program, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - Jean-Pierre Kahn
- Service de Psychiatrie et Psychologie Clinique, Centre Psychothérapique de Nancy-Université de Lorraine, Nancy, France
| | - Layla Kassem
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health, US Department of Health & Human Services, Bethesda, Maryland, USA
| | - Tadafumi Kato
- Department of Psychiatry and Behavioral Science, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - John R Kelsoe
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Sarah Kittel-Schneider
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - Barbara König
- Department of Psychiatry and Psychotherapeutic Medicine, Landesklinikum Neunkirchen, Neunkirchen, Austria
| | - Po-Hsiu Kuo
- Department of Public Health & Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Ichiro Kusumi
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Gonzalo Laje
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health, US Department of Health & Human Services, Bethesda, Maryland, USA
| | - Mikael Landén
- Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the Gothenburg University, Gothenburg, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Catharina Lavebratt
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Marion Leboyer
- AP-HP, Hôpital Henri Mondor, Département Médico-Universitaire de Psychiatrie et d'Addictologie (DMU IMPACT), Fédération Hospitalo-Universitaire de Médecine de Précision (FHU ADAPT), Créteil, France
- Université Paris Est Créteil, INSERM U955, IMRB, Laboratoire Neuro-Psychiatrie Translationnelle, Créteil, France
- Fondation FondaMental, Créteil, France
| | - Susan G Leckband
- Office of Mental Health, VA San Diego Healthcare System, San Diego, California, USA
| | - Mario Maj
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Mirko Manchia
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Department of Pharmacology, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Lina Martinsson
- Department of Clinical Neurosciences, Karolinska Institutet, Stockholm, Sweden
| | - Michael J McCarthy
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
- Department of Psychiatry, VA San Diego Healthcare System, San Diego, California, USA
| | - Susan L McElroy
- Department of Psychiatry, Lindner Center of Hope/University of Cincinnati, Mason, Ohio, USA
| | - Philip B Mitchell
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Marina Mitjans
- Departament de Genètica, Microbiologia i Estadística, Facultat de Biologia, Universitat de Barcelona, Barcelona, Spain
- Institut de Biomedicina de la Universitat de Barcelona (IBUB), Barcelona, Spain
- Centro de Investigación Biomédica en Salud Mental (CIBERSAM), Madrid, Spain
| | - Francis M Mondimore
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, Maryland, USA
| | - Palmiero Monteleone
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
- Neurosciences Section, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
| | - Caroline M Nievergelt
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Markus M Nöthen
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Tomas Novák
- National Institute of Mental Health, Klecany, Czechia
| | - Claire O'Donovan
- Centre for Human Genetics, University of Marburg, Marburg, Germany
| | - Urban Osby
- Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet and Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Norio Ozaki
- Department of Psychiatry & Child and Adolescent Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Andrea Pfennig
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Medical Faculty, Technische Universität Dresden, Dresden, Germany
| | - Claudia Pisanu
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - James B Potash
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, Maryland, USA
| | - Andreas Reif
- Service de Psychiatrie et Psychologie Clinique, Centre Psychothérapique de Nancy-Université de Lorraine, Nancy, France
| | - Eva Reininghaus
- Department of Psychiatry and Psychotherapeutic Medicine, Research Unit for Bipolar Affective Disorder, Medical University of Graz, Graz, Austria
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Guy A Rouleau
- Montreal Neurological Institute and Hospital, McGill University, Montreal, Québec, Canada
| | - Janusz K Rybakowski
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Martin Schalling
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Peter R Schofield
- Neuroscience Research Australia, Sydney, New South Wales, Australia
- School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Klaus Oliver Schubert
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, South Australia, Australia
- Northern Adelaide Local Health Network, Mental Health Services, Adelaide, South Australia, Australia
| | - Barbara W Schweizer
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, Maryland, USA
| | - Giovanni Severino
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Tatyana Shekhtman
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Paul D Shilling
- Department of Psychiatry, University of California San Diego, La Jolla, California, USA
| | - Katzutaka Shimoda
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Mibu, Japan
| | - Christian Simhandl
- Bipolar Center Wiener Neustadt, Sigmund Freud University, Medical Faculty, Vienna, Austria
| | - Claire M Slaney
- Centre for Human Genetics, University of Marburg, Marburg, Germany
| | - Alessio Squassina
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Thomas Stamm
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Germany
| | | | | | - Gustavo Turecki
- Douglas Mental Health University Institute, McGill University, Montreal, Québec, Canada
| | - Eduard Vieta
- Bipolar Disorder Program, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - Stephanie H Witt
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Peter P Zandi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA
| | - Janice M Fullerton
- Neuroscience Research Australia, Sydney, New South Wales, Australia
- School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Martin Alda
- Centre for Human Genetics, University of Marburg, Marburg, Germany
| | - Mark A Frye
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
| | - Thomas G Schulze
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health, US Department of Health & Human Services, Bethesda, Maryland, USA
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, Munich, Germany
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, Maryland, USA
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center (UMG), Georg-August University Göttingen, Göttingen, Germany
| | - Francis J McMahon
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health, US Department of Health & Human Services, Bethesda, Maryland, USA
| | - Joanna M Biernacka
- Department of Quantitative Health Sciences, Mayo Clinic, Rochester, Minnesota, USA
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota, USA
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23
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Lee RS, Zandi PP, Santos A, Aulinas A, Carey JL, Webb SM, McCaul ME, Resmini E, Wand GS. Cross-species Association Between Telomere Length and Glucocorticoid Exposure. J Clin Endocrinol Metab 2021; 106:e5124-e5135. [PMID: 34265046 PMCID: PMC8787853 DOI: 10.1210/clinem/dgab519] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Indexed: 12/12/2022]
Abstract
CONTEXT Chronic exposure to glucocorticoids (GCs) or stress increases the risk of medical disorders, including cardiovascular and neuropsychiatric disorders. GCs contribute to accelerated aging; however, while the link between chronic GC exposure and disease onset is well established, the underpinning mechanisms are not clear. OBJECTIVE We explored the potential nexus between GCs or stress exposure and telomere length. METHODS In addition to rats exposed to 3 weeks of chronic stress, an iatrogenic mouse model of Cushing syndrome (CS), and a mouse neuronal cell line, we studied 32 patients with CS and age-matched controls and another cohort of 75 healthy humans. RESULTS (1) Exposure to stress in rats was associated with a 54.5% (P = 0.036) reduction in telomere length in T cells. Genomic DNA (gDNA) extracted from the dentate gyrus of stressed and unstressed rats showed 43.2% reduction in telomere length (P = 0.006). (2) Mice exposed to corticosterone had a 61.4% reduction in telomere length in blood gDNA (P = 5.75 × 10-5) and 58.8% reduction in telomere length in the dentate gyrus (P = 0.002). (3) We observed a 40.8% reduction in the telomere length in patients with active CS compared to healthy controls (P = 0.006). There was a 17.8% reduction in telomere length in cured CS patients, which was not different from that of healthy controls (P = 0.08). For both cured and active CS, telomere length correlated significantly with duration of hypercortisolism (R2 = 0.22, P = 0.007). (4) There was a 27.6% reduction in telomere length between low and high tertiles in bedtime cortisol levels of healthy participants (P = 0.019). CONCLUSION Our findings demonstrate that exposure to stress and/or GCs is associated with shortened telomeres, which may be partially reversible.
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Affiliation(s)
- Richard S Lee
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
| | - Peter P Zandi
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
- Department of Mental Health, Johns Hopkins School of Public Health, Baltimore, MD 21205, USA
| | - Alicia Santos
- Endocrinology/Medicine Department, Hospital Sant Pau, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBER-ER, Unit747), IIB-Sant Pau, ISCIII and Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Anna Aulinas
- Endocrinology/Medicine Department, Hospital Sant Pau, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBER-ER, Unit747), IIB-Sant Pau, ISCIII and Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Jenny L Carey
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
| | - Susan M Webb
- Endocrinology/Medicine Department, Hospital Sant Pau, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBER-ER, Unit747), IIB-Sant Pau, ISCIII and Universitat Autònoma de Barcelona (UAB), Barcelona, Spain
| | - Mary E McCaul
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA
| | - Eugenia Resmini
- Correspondence: Eugenia Resmini, MD, PhD, Endocrinology/Medicine Department, Hospital Sant Pau, CIBER-ER, Unit747, IIB-Sant Pau, ISCIII, Universitat Autònoma de Barcelona (UAB), Barcelona, Spain.
| | - Gary S Wand
- Gary S. Wand, MD, Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD 21205, USA.
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24
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Lee RS, Zandi PP, Lin Y, Seifuddin F, Benke KS, McCaul ME, Reitz K, Wand GS. Methylomic and transcriptomic predictors of one-month exposure to cortisol in healthy individuals. Stress 2021; 24:840-848. [PMID: 34279166 DOI: 10.1080/10253890.2021.1946509] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
Abstract
Allostatic load (AL) refers to the cumulative "wear and tear" on an organism throughout its lifetime. One of the primary contributing factors to AL is prolonged exposure to stress or its primary catabolic agent cortisol. Chronic exposure to stress or cortisol is associated with numerous diseases, including cardiovascular disease, metabolic disorders, and psychiatric disorders. Therefore, a molecular marker capable of integrating a past history of cortisol exposure would be of great utility for assessing disease risk. To this end, we recruited 87 healthy males and females of European ancestry between 18 and 60 years old, extracted genomic DNA and RNA from leukocytes, and implemented a gene-centric DNA enrichment method coupled with bisulfite sequencing and RNA-Seq of total RNA for the determination of genome-wide methylation and gene transcription, respectively. Sequencing data were analyzed against awakening and bedtime cortisol data to identify differentially methylated regions (DMRs) and CpGs (DMCs) and differentially expressed genes (DEGs). Six candidate DMCs (punadjusted < 0.005) and nine DEGs (punadjusted < 0.0005) were used to construct a prediction model that could capture past 30+ days of both bedtime and awakening cortisol levels. Utilizing a cross-validation approach, we obtained a regression coefficient of R2 = 0.308 for predicting continuous awakening cortisol and an area under the curve (AUC) = 0.753 for dichotomous (high vs. low tertile) awakening cortisol, and R2 = 0.224 and AUC = 0.723 for continuous and dichotomous bedtime cortisol levels, respectively. To our knowledge, the current study represents the first attempt to identify genome-wide predictors of cortisol exposure that utilizes both methylation and transcription targets. The utility of our approach needs to be replicated in an independent cohort of samples for which similar cortisol metrics are available.
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Affiliation(s)
- Richard S Lee
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Peter P Zandi
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Yian Lin
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Fayaz Seifuddin
- Bioinformatics and Computational Biology Core, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA
| | - Kelly S Benke
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Mary E McCaul
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Kendall Reitz
- Department of and Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Gary S Wand
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
- Department of and Medicine, Johns Hopkins School of Medicine, Baltimore, MD, USA
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25
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Le Clerc S, Lombardi L, Baune BT, Amare AT, Schubert KO, Hou L, Clark SR, Papiol S, Cearns M, Heilbronner U, Degenhardt F, Tekola-Ayele F, Hsu YH, Shekhtman T, Adli M, Akula N, Akiyama K, Ardau R, Arias B, Aubry JM, Backlund L, Bhattacharjee AK, Bellivier F, Benabarre A, Bengesser S, Biernacka JM, Birner A, Brichant-Petitjean C, Cervantes P, Chen HC, Chillotti C, Cichon S, Cruceanu C, Czerski PM, Dalkner N, Dayer A, Del Zompo M, DePaulo JR, Étain B, Jamain S, Falkai P, Forstner AJ, Frisen L, Frye MA, Fullerton JM, Gard S, Garnham JS, Goes FS, Grigoroiu-Serbanescu M, Grof P, Hashimoto R, Hauser J, Herms S, Hoffmann P, Jiménez E, Kahn JP, Kassem L, Kuo PH, Kato T, Kelsoe JR, Kittel-Schneider S, Ferensztajn-Rochowiak E, König B, Kusumi I, Laje G, Landén M, Lavebratt C, Leckband SG, Tortorella A, Manchia M, Martinsson L, McCarthy MJ, McElroy SL, Colom F, Millischer V, Mitjans M, Mondimore FM, Monteleone P, Nievergelt CM, Nöthen MM, Novák T, O'Donovan C, Ozaki N, Ösby U, Pfennig A, Potash JB, Reif A, Reininghaus E, Rouleau GA, Rybakowski JK, Schalling M, Schofield PR, Schweizer BW, Severino G, Shilling PD, Shimoda K, Simhandl C, Slaney CM, Pisanu C, Squassina A, Stamm T, Stopkova P, Maj M, Turecki G, Vieta E, Veeh J, Witt SH, Wright A, Zandi PP, Mitchell PB, Bauer M, Alda M, Rietschel M, McMahon FJ, Schulze TG, Spadoni JL, Boukouaci W, Richard JR, Le Corvoisier P, Barrau C, Zagury JF, Leboyer M, Tamouza R. HLA-DRB1 and HLA-DQB1 genetic diversity modulates response to lithium in bipolar affective disorders. Sci Rep 2021; 11:17823. [PMID: 34497278 PMCID: PMC8426488 DOI: 10.1038/s41598-021-97140-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2021] [Accepted: 08/13/2021] [Indexed: 01/21/2023] Open
Abstract
Bipolar affective disorder (BD) is a severe psychiatric illness, for which lithium (Li) is the gold standard for acute and maintenance therapies. The therapeutic response to Li in BD is heterogeneous and reliable biomarkers allowing patients stratification are still needed. A GWAS performed by the International Consortium on Lithium Genetics (ConLiGen) has recently identified genetic markers associated with treatment responses to Li in the human leukocyte antigens (HLA) region. To better understand the molecular mechanisms underlying this association, we have genetically imputed the classical alleles of the HLA region in the European patients of the ConLiGen cohort. We found our best signal for amino-acid variants belonging to the HLA-DRB1*11:01 classical allele, associated with a better response to Li (p < 1 × 10-3; FDR < 0.09 in the recessive model). Alanine or Leucine at position 74 of the HLA-DRB1 heavy chain was associated with a good response while Arginine or Glutamic acid with a poor response. As these variants have been implicated in common inflammatory/autoimmune processes, our findings strongly suggest that HLA-mediated low inflammatory background may contribute to the efficient response to Li in BD patients, while an inflammatory status overriding Li anti-inflammatory properties would favor a weak response.
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Affiliation(s)
- Sigrid Le Clerc
- Laboratoire Génomique, Bio-Informatique et Chimie Moléculaire (EA7528), Conservatoire National des Arts et Métiers, HESAM Université, 292, rue Saint Martin, 75003, Paris, France
| | - Laura Lombardi
- AP-HP, Hôpital Henri Mondor, Département Médico-Universitaire de Psychiatrie et D'Addictologie (DMU IMPACT), Fédération Hospitalo-Universitaire de Médecine de Précision (FHU ADAPT), 94010, Créteil, France
- INSERM U955, IMRB, Laboratoire Neuro-Psychiatrie Translationnelle, Université Paris Est Créteil, 94010, Créteil, France
- Fondation FondaMental, Créteil, France
| | - Bernhard T Baune
- Department of Psychiatry, University of Münster, Münster, Germany
- Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Melbourne, Australia
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne Parkville, Parkville, VIC, Australia
| | - Azmeraw T Amare
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, SA, Australia
- South Australian Academic Health Science and Translation Centre, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia
| | - Klaus Oliver Schubert
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, SA, Australia
- Mental Health Services, Northern Adelaide Local Health Network, Adelaide, SA, Australia
| | - Liping Hou
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health, US Department of Health & Human Services, Bethesda, MD, USA
| | - Scott R Clark
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, SA, Australia
| | - Sergi Papiol
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Nußbaumstr. 7, 80336, Munich, Germany
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University Munich, Munich, Germany
| | - Micah Cearns
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, SA, Australia
| | - Urs Heilbronner
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Nußbaumstr. 7, 80336, Munich, Germany
| | - Franziska Degenhardt
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Fasil Tekola-Ayele
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Yi-Hsiang Hsu
- HSL Institute for Aging Research, Harvard Medical School, Boston, MA, USA
- Program for Quantitative Genomics, Harvard School of Public Health, Boston, MA, USA
| | - Tatyana Shekhtman
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Mazda Adli
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Germany
| | - Nirmala Akula
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health, US Department of Health & Human Services, Bethesda, MD, USA
| | - Kazufumi Akiyama
- Department of Biological Psychiatry and Neuroscience, Dokkyo Medical University School of Medicine, Mibu, Tochigi, Japan
| | - Raffaella Ardau
- Unit of Clinical Pharmacology, Hospital University Agency of Cagliari, Cagliari, Italy
| | - Bárbara Arias
- Unitat de Zoologia I Antropologia Biològica (Dpt. Biologia Evolutiva, Ecologia I Ciències Ambientals), Facultat de Biologia and Institut de Biomedicina (IBUB), University of Barcelona, CIBERSAM, Barcelona, Spain
| | - Jean-Michel Aubry
- Department of Psychiatry, Mood Disorders Unit, HUG - Geneva University Hospitals, Geneva, Switzerland
| | - Lena Backlund
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | | | - Frank Bellivier
- INSERM UMR-S 1144, Département de Psychiatrie et de Médecine Addictologique, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-F.Widal, Université Paris Diderot, Paris, France
| | - Antonio Benabarre
- Bipolar Disorder Program, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Susanne Bengesser
- Department of Psychiatry and Psychotherapeutic Medicine, Research Unit for Bipolar Affective Disorder, Medical University of Graz, Graz, Austria
| | - Joanna M Biernacka
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Armin Birner
- Department of Psychiatry and Psychotherapeutic Medicine, Research Unit for Bipolar Affective Disorder, Medical University of Graz, Graz, Austria
| | - Clara Brichant-Petitjean
- INSERM UMR-S 1144, Département de Psychiatrie et de Médecine Addictologique, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-F.Widal, Université Paris Diderot, Paris, France
| | - Pablo Cervantes
- The Neuromodulation Unit, McGill University Health Centre, Montreal, QC, Canada
| | - Hsi-Chung Chen
- Department of Psychiatry & Center of Sleep Disorders, National Taiwan University Hospital, Taipei, Taiwan
| | - Caterina Chillotti
- Unit of Clinical Pharmacology, Hospital University Agency of Cagliari, Cagliari, Italy
| | - Sven Cichon
- Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
- Institute of Neuroscience and Medicine (INM-1), Research Center Jülich, Jülich, Germany
- Human Genomics Research Group, Department of Biomedicine, University Hospital Basel, Basel, Switzerland
| | - Cristiana Cruceanu
- Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | - Piotr M Czerski
- Psychiatric Genetic Unit, Poznan University of Medical Sciences, Poznan, Poland
| | - Nina Dalkner
- Department of Psychiatry and Psychotherapeutic Medicine, Research Unit for Bipolar Affective Disorder, Medical University of Graz, Graz, Austria
| | - Alexandre Dayer
- Department of Psychiatry, Mood Disorders Unit, HUG - Geneva University Hospitals, Geneva, Switzerland
| | - Maria Del Zompo
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - J Raymond DePaulo
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Bruno Étain
- INSERM UMR-S 1144, Département de Psychiatrie et de Médecine Addictologique, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-F.Widal, Université Paris Diderot, Paris, France
| | - Stephane Jamain
- Univ Paris Est Créteil, INSERM, IMRB, Translational Neuropsychiatry, Fondation FondaMental, Créteil, France
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University Munich, Munich, Germany
| | - Andreas J Forstner
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
- Institute of Neuroscience and Medicine (INM-1), Research Center Jülich, Jülich, Germany
- Centre for Human Genetics, University of Marburg, Marburg, Germany
| | - Louise Frisen
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Mark A Frye
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Janice M Fullerton
- Neuroscience Research Australia, Sydney, NSW, Australia
- School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Sébastien Gard
- Service de Psychiatrie, Hôpital Charles Perrens, Bordeaux, France
| | - Julie S Garnham
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Fernando S Goes
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Maria Grigoroiu-Serbanescu
- Biometric Psychiatric Genetics Research Unit, Alexandru Obregia Clinical Psychiatric Hospital, Bucharest, Romania
| | - Paul Grof
- Mood Disorders Center of Ottawa, Ottawa, ON, Canada
| | - Ryota Hashimoto
- Department of Pathology of Mental Diseases, National Institute of Mental Health, National Center of Neurology and Psychiatry, Tokyo, Japan
- Department of Psychiatry, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Joanna Hauser
- Psychiatric Genetic Unit, Poznan University of Medical Sciences, Poznan, Poland
| | - Stefan Herms
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
- Human Genomics Research Group, Department of Biomedicine, University Hospital Basel, Basel, Switzerland
| | - Per Hoffmann
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
- Human Genomics Research Group, Department of Biomedicine, University Hospital Basel, Basel, Switzerland
| | - Esther Jiménez
- Bipolar Disorder Program, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Jean-Pierre Kahn
- Service de Psychiatrie Et Psychologie Clinique, Centre Psychothérapique de Nancy - Université de Lorraine, Nancy, France
| | - Layla Kassem
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health, US Department of Health & Human Services, Bethesda, MD, USA
| | - Po-Hsiu Kuo
- Department of Public Health & Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Tadafumi Kato
- Department of Psychiatry and Behavioral Science, Juntendo University Graduate School of Medicine, Tokyo, Japan
| | - John R Kelsoe
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Sarah Kittel-Schneider
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | | | - Barbara König
- Department of Psychiatry and Psychotherapeutic Medicine, Landesklinikum Neunkirchen, Neunkirchen, Austria
| | - Ichiro Kusumi
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Gonzalo Laje
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health, US Department of Health & Human Services, Bethesda, MD, USA
| | - Mikael Landén
- Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the Gothenburg University, Gothenburg, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Catharina Lavebratt
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Susan G Leckband
- Office of Mental Health, VA San Diego Healthcare System, San Diego, CA, USA
| | | | - Mirko Manchia
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Department of Pharmacology, Dalhousie University, Halifax, NS, Canada
| | - Lina Martinsson
- Department of Clinical Neurosciences, Karolinska Institutet, Stockholm, Sweden
| | - Michael J McCarthy
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Department of Psychiatry, VA San Diego Healthcare System, San Diego, CA, USA
| | - Susan L McElroy
- Department of Psychiatry, Lindner Center of Hope/University of Cincinnati, Mason, OH, USA
| | - Francesc Colom
- Mental Health Research Group, IMIM-Hospital del Mar, Barcelona, Catalonia, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Vincent Millischer
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Marina Mitjans
- Departament de Genètica, Microbiologia i Estadística, Facultat de Biologia, Universitat de Barcelona, Barcelona, Spain
- Institut de Biomedicina de la Universitat de Barcelona (IBUB), Barcelona, Spain
- Centro de Investigación Biomédica en Salud Mental (CIBERSAM), Madrid, Spain
| | - Francis M Mondimore
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Palmiero Monteleone
- Neurosciences Section, Department of Medicine, Surgery and Dentistry 'Scuola Medica Salernitana', University of Salerno, Salerno, Italy
- Department of Psychiatry, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | | | - Markus M Nöthen
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Tomas Novák
- National Institute of Mental Health, Klecany, Czech Republic
| | - Claire O'Donovan
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Norio Ozaki
- Department of Psychiatry & Department of Child and Adolescent Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Urban Ösby
- Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet and Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Andrea Pfennig
- Department of Psychiatry and Psychotherapy, Medical Faculty, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - James B Potash
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - Eva Reininghaus
- Department of Psychiatry and Psychotherapeutic Medicine, Research Unit for Bipolar Affective Disorder, Medical University of Graz, Graz, Austria
| | - Guy A Rouleau
- Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Janusz K Rybakowski
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Martin Schalling
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Peter R Schofield
- Neuroscience Research Australia, Sydney, NSW, Australia
- School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Barbara W Schweizer
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Giovanni Severino
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Paul D Shilling
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Katzutaka Shimoda
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Mibu, Tochigi, Japan
| | - Christian Simhandl
- Bipolar Center Wiener Neustadt, Medical Faculty, Sigmund Freud University, Vienna, Austria
| | - Claire M Slaney
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Claudia Pisanu
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Alessio Squassina
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Thomas Stamm
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Germany
| | - Pavla Stopkova
- National Institute of Mental Health, Klecany, Czech Republic
| | - Mario Maj
- Department of Psychiatry, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Gustavo Turecki
- Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | - Eduard Vieta
- Bipolar Disorder Program, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Julia Veeh
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - Stephanie H Witt
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Adam Wright
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Peter P Zandi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Philip B Mitchell
- School of Psychiatry, University of New South Wales, Sydney, NSW, Australia
| | - Michael Bauer
- Department of Psychiatry and Psychotherapy, Medical Faculty, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Martin Alda
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Francis J McMahon
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health, US Department of Health & Human Services, Bethesda, MD, USA
| | - Thomas G Schulze
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health, US Department of Health & Human Services, Bethesda, MD, USA
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Nußbaumstr. 7, 80336, Munich, Germany
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center (UMG), Georg-August University Göttingen, Göttingen, Germany
| | - Jean-Louis Spadoni
- Laboratoire Génomique, Bio-Informatique et Chimie Moléculaire (EA7528), Conservatoire National des Arts et Métiers, HESAM Université, 292, rue Saint Martin, 75003, Paris, France
| | - Wahid Boukouaci
- INSERM U955, IMRB, Laboratoire Neuro-Psychiatrie Translationnelle, Université Paris Est Créteil, 94010, Créteil, France
- Fondation FondaMental, Créteil, France
| | - Jean-Romain Richard
- INSERM U955, IMRB, Laboratoire Neuro-Psychiatrie Translationnelle, Université Paris Est Créteil, 94010, Créteil, France
| | - Philippe Le Corvoisier
- Centre Investigation Clinique, CIC Henri Mondor, Université Paris Est Créteil, 94010, Créteil, France
| | - Caroline Barrau
- Plateforme de Ressources Biologiques, HU Henri Mondor, 94010, Créteil, France
| | - Jean-François Zagury
- Laboratoire Génomique, Bio-Informatique et Chimie Moléculaire (EA7528), Conservatoire National des Arts et Métiers, HESAM Université, 292, rue Saint Martin, 75003, Paris, France
| | - Marion Leboyer
- AP-HP, Hôpital Henri Mondor, Département Médico-Universitaire de Psychiatrie et D'Addictologie (DMU IMPACT), Fédération Hospitalo-Universitaire de Médecine de Précision (FHU ADAPT), 94010, Créteil, France
- INSERM U955, IMRB, Laboratoire Neuro-Psychiatrie Translationnelle, Université Paris Est Créteil, 94010, Créteil, France
- Fondation FondaMental, Créteil, France
| | - Ryad Tamouza
- AP-HP, Hôpital Henri Mondor, Département Médico-Universitaire de Psychiatrie et D'Addictologie (DMU IMPACT), Fédération Hospitalo-Universitaire de Médecine de Précision (FHU ADAPT), 94010, Créteil, France.
- INSERM U955, IMRB, Laboratoire Neuro-Psychiatrie Translationnelle, Université Paris Est Créteil, 94010, Créteil, France.
- Fondation FondaMental, Créteil, France.
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26
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Jia X, Goes FS, Locke AE, Palmer D, Wang W, Cohen-Woods S, Genovese G, Jackson AU, Jiang C, Kvale M, Mullins N, Nguyen H, Pirooznia M, Rivera M, Ruderfer DM, Shen L, Thai K, Zawistowski M, Zhuang Y, Abecasis G, Akil H, Bergen S, Burmeister M, Chapman S, DelaBastide M, Juréus A, Kang HM, Kwok PY, Li JZ, Levy SE, Monson ET, Moran J, Sobell J, Watson S, Willour V, Zöllner S, Adolfsson R, Blackwood D, Boehnke M, Breen G, Corvin A, Craddock N, DiFlorio A, Hultman CM, Landen M, Lewis C, McCarroll SA, Richard McCombie W, McGuffin P, McIntosh A, McQuillin A, Morris D, Myers RM, O'Donovan M, Ophoff R, Boks M, Kahn R, Ouwehand W, Owen M, Pato C, Pato M, Posthuma D, Potash JB, Reif A, Sklar P, Smoller J, Sullivan PF, Vincent J, Walters J, Neale B, Purcell S, Risch N, Schaefer C, Stahl EA, Zandi PP, Scott LJ. Investigating rare pathogenic/likely pathogenic exonic variation in bipolar disorder. Mol Psychiatry 2021; 26:5239-5250. [PMID: 33483695 PMCID: PMC8295400 DOI: 10.1038/s41380-020-01006-9] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 11/02/2019] [Revised: 12/14/2020] [Accepted: 12/16/2020] [Indexed: 01/30/2023]
Abstract
Bipolar disorder (BD) is a serious mental illness with substantial common variant heritability. However, the role of rare coding variation in BD is not well established. We examined the protein-coding (exonic) sequences of 3,987 unrelated individuals with BD and 5,322 controls of predominantly European ancestry across four cohorts from the Bipolar Sequencing Consortium (BSC). We assessed the burden of rare, protein-altering, single nucleotide variants classified as pathogenic or likely pathogenic (P-LP) both exome-wide and within several groups of genes with phenotypic or biologic plausibility in BD. While we observed an increased burden of rare coding P-LP variants within 165 genes identified as BD GWAS regions in 3,987 BD cases (meta-analysis OR = 1.9, 95% CI = 1.3-2.8, one-sided p = 6.0 × 10-4), this enrichment did not replicate in an additional 9,929 BD cases and 14,018 controls (OR = 0.9, one-side p = 0.70). Although BD shares common variant heritability with schizophrenia, in the BSC sample we did not observe a significant enrichment of P-LP variants in SCZ GWAS genes, in two classes of neuronal synaptic genes (RBFOX2 and FMRP) associated with SCZ or in loss-of-function intolerant genes. In this study, the largest analysis of exonic variation in BD, individuals with BD do not carry a replicable enrichment of rare P-LP variants across the exome or in any of several groups of genes with biologic plausibility. Moreover, despite a strong shared susceptibility between BD and SCZ through common genetic variation, we do not observe an association between BD risk and rare P-LP coding variants in genes known to modulate risk for SCZ.
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Affiliation(s)
- Xiaoming Jia
- Weill Institute for Neurosciences, University of California San Francisco, San Francisco, CA, 94158, USA
| | - Fernando S Goes
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, 21287, USA
| | - Adam E Locke
- Division of Genomics & Bioinformatics, Department of Medicine and McDonnell Genome Institute, Washington University School of Medicine, St. Louis, MO, 63108, USA
| | - Duncan Palmer
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, 02142, USA
| | - Weiqing Wang
- Division of Psychiatric Genomics, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Sarah Cohen-Woods
- Discipline of Psychology and Flinders Centre for Innovation in Cancer, Flinders University, Adelaide, SA, Australia
- Medical Research Council Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Giulio Genovese
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, 02142, USA
| | - Anne U Jackson
- Department of Biostatistics and Center for Statistical Genetics, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Chen Jiang
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, 94611, USA
| | - Mark Kvale
- Institute for Human Genetics, University of California San Francisco, San Francisco, CA, 94143, USA
| | - Niamh Mullins
- Pamela Sklar Division of Psychiatric Genomics, Department of Genetics and Genomic Science, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Hoang Nguyen
- Division of Psychiatric Genomics, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Mehdi Pirooznia
- Bioinformatics and Computational Core, National Heart, Lung, and Blood Institute, Bethesda, MD, 20892, USA
| | - Margarita Rivera
- Medical Research Council Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Biochemistry and Molecular Biology II, Institute of Neurosciences, Center for Biomedical Research, University of Granada, Granada, Spain
| | - Douglas M Ruderfer
- Departments of Medicine, Psychiatry, and Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, 37232, USA
| | - Ling Shen
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, 94611, USA
| | - Khanh Thai
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, 94611, USA
| | - Matthew Zawistowski
- Department of Biostatistics and Center for Statistical Genetics, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Yongwen Zhuang
- Department of Biostatistics and Center for Statistical Genetics, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Gonçalo Abecasis
- Department of Biostatistics and Center for Statistical Genetics, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Huda Akil
- Molecular & Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Sarah Bergen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Margit Burmeister
- Molecular & Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI, 48109, USA
- Department of Computational Medicine & Bioinformatics, University of Michigan, Ann Arbor, MI, 48109, USA
- Department of Human Genetics, University of Michigan, Ann Arbor, MI, 48109, USA
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Sinéad Chapman
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, 02142, USA
| | - Melissa DelaBastide
- Division of Research, Cold Spring Harbor Laboratory, Cold Spring, Harbor, NY, 11797, USA
| | - Anders Juréus
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Hyun Min Kang
- Department of Biostatistics and Center for Statistical Genetics, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Pui-Yan Kwok
- Institute for Human Genetics, University of California San Francisco, San Francisco, CA, 94143, USA
| | - Jun Z Li
- Department of Computational Medicine & Bioinformatics, University of Michigan, Ann Arbor, MI, 48109, USA
- Department of Human Genetics, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Shawn E Levy
- HudsonAlpha Institute for Biotechnology, Huntsville, AL, 35806, USA
| | - Eric T Monson
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA, 52242, USA
| | - Jennifer Moran
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Janet Sobell
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, CA, 90033, USA
| | - Stanley Watson
- Molecular & Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Virginia Willour
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA, 52242, USA
| | - Sebastian Zöllner
- Department of Biostatistics and Center for Statistical Genetics, University of Michigan, Ann Arbor, MI, 48109, USA
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Rolf Adolfsson
- Departments of Clinical Sciences and Psychiatry, Umea University, Umea, Sweden
| | | | - Michael Boehnke
- Department of Biostatistics and Center for Statistical Genetics, University of Michigan, Ann Arbor, MI, 48109, USA
| | - Gerome Breen
- Medical Research Council Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- NIHR BRC for Mental Health, King's College London, London, UK
| | - Aiden Corvin
- Department of Psychiatry and Trinity Translational Medicine Institute, Trinity College Dublin, Dublin, Ireland
| | - Nick Craddock
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
| | - Arianna DiFlorio
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
| | - Christina M Hultman
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Mikael Landen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Cathryn Lewis
- Medical Research Council Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- Department of Medical & Molecular Genetics, King's College London, London, UK
| | | | - W Richard McCombie
- Division of Research, Cold Spring Harbor Laboratory, Cold Spring, Harbor, NY, 11797, USA
| | - Peter McGuffin
- Medical Research Council Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Andrew McIntosh
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
| | | | - Derek Morris
- Department of Psychiatry and Trinity Translational Medicine Institute, Trinity College Dublin, Dublin, Ireland
- Discipline of Biochemistry, Neuroimaging and Cognitive Genomics (NICOG) Centre, National University of Ireland Galway, Galway, Ireland
| | - Richard M Myers
- HudsonAlpha Institute for Biotechnology, Huntsville, AL, 35806, USA
| | - Michael O'Donovan
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
| | - Roel Ophoff
- Center for Neurobehavioral Genetics, University of California Los Angeles, Los Angeles, CA, 90095, USA
- Department of Psychiatry, UMC Utrecht Brain Center Rudolf Magnus, Utrecht, the Netherlands
| | - Marco Boks
- Department of Psychiatry, UMC Utrecht Brain Center Rudolf Magnus, Utrecht, the Netherlands
| | - Rene Kahn
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Willem Ouwehand
- Department of Haematology, School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Michael Owen
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
| | - Carlos Pato
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, CA, 90033, USA
- SUNY Downstate Medical Center, Brooklyn, NY, 11203, USA
| | - Michele Pato
- Department of Psychiatry and Behavioral Sciences, University of Southern California, Los Angeles, CA, 90033, USA
- Department of Psychiatry, SUNY Downstate Medical Center, Brooklyn, NY, 11203, USA
| | - Danielle Posthuma
- Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Department of Clinical Genetics, Amsterdam Neuroscience, Vrije Universiteit Medical Center, Amsterdam, the Netherlands
| | - James B Potash
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, 21287, USA
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Pamela Sklar
- Division of Psychiatric Genomics, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Jordan Smoller
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, 02142, USA
- Department of Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Patrick F Sullivan
- Departments of Genetics and Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - John Vincent
- Molecular Neuropsychiatry and Development Laboratory, Campbell Family Mental Health Research Institute, Center for Addiction & Mental Health, Toronto, ON, Canada
- Department of Psychiatry and Institute of Medical Sciences, University of Toronto, Toronto, ON, Canada
| | - James Walters
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Cardiff, UK
| | - Benjamin Neale
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, MA, 02142, USA
- Analytical and Translational Genetics Unit, Department of Medicine, Massachusetts General Hospital, Boston, MA, 02114, USA
| | - Shaun Purcell
- Division of Sleep and Circadian Disorders, Brigham and Women's Hospital and Harvard Medical School, Boston, MA, 02115, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, MA, 02142, USA
| | - Neil Risch
- Institute for Human Genetics, University of California San Francisco, San Francisco, CA, 94143, USA
| | - Catherine Schaefer
- Division of Research, Kaiser Permanente Northern California, Oakland, CA, 94611, USA
| | - Eli A Stahl
- Division of Psychiatric Genomics, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA
| | - Peter P Zandi
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, 21287, USA.
| | - Laura J Scott
- Department of Biostatistics and Center for Statistical Genetics, University of Michigan, Ann Arbor, MI, 48109, USA.
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27
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Goes FS, Pirooznia M, Tehan M, Zandi PP, McGrath J, Wolyniec P, Nestadt G, Pulver AE. De novo variation in bipolar disorder. Mol Psychiatry 2021; 26:4127-4136. [PMID: 31776463 PMCID: PMC10754065 DOI: 10.1038/s41380-019-0611-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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] [Received: 06/30/2019] [Revised: 11/10/2019] [Accepted: 11/14/2019] [Indexed: 11/09/2022]
Abstract
Bipolar disorder (BD) is a common, highly heritable disorder that affects 1-2% of the world's population. To date, most genetic studies of BD have focused on common gene variation, and while robustly associated loci have been identified, a substantial proportion of the heritability remains missing and could be partially attributable to rare variation. In this study, we apply a de novo paradigm in BD to identify newly arisen variants that have yet to undergo natural selection and may represent highly pathogenic variants. We performed whole genome sequencing of 97 trios of Ashkenazi Jewish descent, selecting "simplex" families with no family history of BD and an early age of onset. We found a total of 6882 de novo variants (an average of 70.9 ± 12.9 S.D. variants per trio), including 107 variants within protein-coding genes. We combined our exonic variations with the results of 79 previously published BD trios, identifying 20 loss-of-function (LoF) and 77 missense damaging de novo variants in BD. These variants showed significant enrichment for constrained genes and for genes located to the postsynaptic density (PSD) (all Bonferroni corrected p < 0.05). Pathway analyses showed enrichment in several pathways, including "Phosphoinositides (PI) and their downstream targets" (Bonferroni p = 4.2 × 10-6), a pathway prominently featured in lithium's hypothesized mechanism of action. In addition, while we found overall evidence for transmission of common variant polygenic risk of BD in our full sample (pTDT p = 2.21 × 10-4), specific trios with LoF variants showed no evidence of polygenic transmission. In sum, our findings support the de novo paradigm as a contributor to the genetic architecture of BD and provide evidence that constrained genes, as well as genes within the PSD and PI pathway harbor rare variation associated with BD.
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Affiliation(s)
- Fernando S Goes
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 550 N. Broadway, Suite 202, Baltimore, MD, 21287, USA.
| | - Mehdi Pirooznia
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 550 N. Broadway, Suite 202, Baltimore, MD, 21287, USA
| | - Martin Tehan
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 550 N. Broadway, Suite 202, Baltimore, MD, 21287, USA
| | - Peter P Zandi
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 550 N. Broadway, Suite 202, Baltimore, MD, 21287, USA
| | - John McGrath
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 550 N. Broadway, Suite 202, Baltimore, MD, 21287, USA
| | - Paula Wolyniec
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 550 N. Broadway, Suite 202, Baltimore, MD, 21287, USA
| | - Gerald Nestadt
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 550 N. Broadway, Suite 202, Baltimore, MD, 21287, USA
| | - Ann E Pulver
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, 550 N. Broadway, Suite 202, Baltimore, MD, 21287, USA
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28
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Mullins N, Forstner AJ, O'Connell KS, Coombes B, Coleman JRI, Qiao Z, Als TD, Bigdeli TB, Børte S, Bryois J, Charney AW, Drange OK, Gandal MJ, Hagenaars SP, Ikeda M, Kamitaki N, Kim M, Krebs K, Panagiotaropoulou G, Schilder BM, Sloofman LG, Steinberg S, Trubetskoy V, Winsvold BS, Won HH, Abramova L, Adorjan K, Agerbo E, Al Eissa M, Albani D, Alliey-Rodriguez N, Anjorin A, Antilla V, Antoniou A, Awasthi S, Baek JH, Bækvad-Hansen M, Bass N, Bauer M, Beins EC, Bergen SE, Birner A, Bøcker Pedersen C, Bøen E, Boks MP, Bosch R, Brum M, Brumpton BM, Brunkhorst-Kanaan N, Budde M, Bybjerg-Grauholm J, Byerley W, Cairns M, Casas M, Cervantes P, Clarke TK, Cruceanu C, Cuellar-Barboza A, Cunningham J, Curtis D, Czerski PM, Dale AM, Dalkner N, David FS, Degenhardt F, Djurovic S, Dobbyn AL, Douzenis A, Elvsåshagen T, Escott-Price V, Ferrier IN, Fiorentino A, Foroud TM, Forty L, Frank J, Frei O, Freimer NB, Frisén L, Gade K, Garnham J, Gelernter J, Giørtz Pedersen M, Gizer IR, Gordon SD, Gordon-Smith K, Greenwood TA, Grove J, Guzman-Parra J, Ha K, Haraldsson M, Hautzinger M, Heilbronner U, Hellgren D, Herms S, Hoffmann P, Holmans PA, Huckins L, Jamain S, Johnson JS, Kalman JL, Kamatani Y, Kennedy JL, Kittel-Schneider S, Knowles JA, Kogevinas M, Koromina M, Kranz TM, Kranzler HR, Kubo M, Kupka R, Kushner SA, Lavebratt C, Lawrence J, Leber M, Lee HJ, Lee PH, Levy SE, Lewis C, Liao C, Lucae S, Lundberg M, MacIntyre DJ, Magnusson SH, Maier W, Maihofer A, Malaspina D, Maratou E, Martinsson L, Mattheisen M, McCarroll SA, McGregor NW, McGuffin P, McKay JD, Medeiros H, Medland SE, Millischer V, Montgomery GW, Moran JL, Morris DW, Mühleisen TW, O'Brien N, O'Donovan C, Olde Loohuis LM, Oruc L, Papiol S, Pardiñas AF, Perry A, Pfennig A, Porichi E, Potash JB, Quested D, Raj T, Rapaport MH, DePaulo JR, Regeer EJ, Rice JP, Rivas F, Rivera M, Roth J, Roussos P, Ruderfer DM, Sánchez-Mora C, Schulte EC, Senner F, Sharp S, Shilling PD, Sigurdsson E, Sirignano L, Slaney C, Smeland OB, Smith DJ, Sobell JL, Søholm Hansen C, Soler Artigas M, Spijker AT, Stein DJ, Strauss JS, Świątkowska B, Terao C, Thorgeirsson TE, Toma C, Tooney P, Tsermpini EE, Vawter MP, Vedder H, Walters JTR, Witt SH, Xi S, Xu W, Yang JMK, Young AH, Young H, Zandi PP, Zhou H, Zillich L, Adolfsson R, Agartz I, Alda M, Alfredsson L, Babadjanova G, Backlund L, Baune BT, Bellivier F, Bengesser S, Berrettini WH, Blackwood DHR, Boehnke M, Børglum AD, Breen G, Carr VJ, Catts S, Corvin A, Craddock N, Dannlowski U, Dikeos D, Esko T, Etain B, Ferentinos P, Frye M, Fullerton JM, Gawlik M, Gershon ES, Goes FS, Green MJ, Grigoroiu-Serbanescu M, Hauser J, Henskens F, Hillert J, Hong KS, Hougaard DM, Hultman CM, Hveem K, Iwata N, Jablensky AV, Jones I, Jones LA, Kahn RS, Kelsoe JR, Kirov G, Landén M, Leboyer M, Lewis CM, Li QS, Lissowska J, Lochner C, Loughland C, Martin NG, Mathews CA, Mayoral F, McElroy SL, McIntosh AM, McMahon FJ, Melle I, Michie P, Milani L, Mitchell PB, Morken G, Mors O, Mortensen PB, Mowry B, Müller-Myhsok B, Myers RM, Neale BM, Nievergelt CM, Nordentoft M, Nöthen MM, O'Donovan MC, Oedegaard KJ, Olsson T, Owen MJ, Paciga SA, Pantelis C, Pato C, Pato MT, Patrinos GP, Perlis RH, Posthuma D, Ramos-Quiroga JA, Reif A, Reininghaus EZ, Ribasés M, Rietschel M, Ripke S, Rouleau GA, Saito T, Schall U, Schalling M, Schofield PR, Schulze TG, Scott LJ, Scott RJ, Serretti A, Shannon Weickert C, Smoller JW, Stefansson H, Stefansson K, Stordal E, Streit F, Sullivan PF, Turecki G, Vaaler AE, Vieta E, Vincent JB, Waldman ID, Weickert TW, Werge T, Wray NR, Zwart JA, Biernacka JM, Nurnberger JI, Cichon S, Edenberg HJ, Stahl EA, McQuillin A, Di Florio A, Ophoff RA, Andreassen OA. Genome-wide association study of more than 40,000 bipolar disorder cases provides new insights into the underlying biology. Nat Genet 2021; 53:817-829. [PMID: 34002096 PMCID: PMC8192451 DOI: 10.1038/s41588-021-00857-4] [Citation(s) in RCA: 475] [Impact Index Per Article: 158.3] [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] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 03/25/2021] [Indexed: 12/14/2022]
Abstract
Bipolar disorder is a heritable mental illness with complex etiology. We performed a genome-wide association study of 41,917 bipolar disorder cases and 371,549 controls of European ancestry, which identified 64 associated genomic loci. Bipolar disorder risk alleles were enriched in genes in synaptic signaling pathways and brain-expressed genes, particularly those with high specificity of expression in neurons of the prefrontal cortex and hippocampus. Significant signal enrichment was found in genes encoding targets of antipsychotics, calcium channel blockers, antiepileptics and anesthetics. Integrating expression quantitative trait locus data implicated 15 genes robustly linked to bipolar disorder via gene expression, encoding druggable targets such as HTR6, MCHR1, DCLK3 and FURIN. Analyses of bipolar disorder subtypes indicated high but imperfect genetic correlation between bipolar disorder type I and II and identified additional associated loci. Together, these results advance our understanding of the biological etiology of bipolar disorder, identify novel therapeutic leads and prioritize genes for functional follow-up studies.
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Affiliation(s)
- Niamh Mullins
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
| | - Andreas J Forstner
- Institute of Human Genetics, University of Bonn, School of Medicine and University Hospital Bonn, Bonn, Germany
- Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany
- Centre for Human Genetics, University of Marburg, Marburg, Germany
| | - Kevin S O'Connell
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- NORMENT, University of Oslo, Oslo, Norway
| | - Brandon Coombes
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
| | - Jonathan R I Coleman
- Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK
- NIHR Maudsley BRC, King's College London, London, UK
| | - Zhen Qiao
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland, Australia
| | - Thomas D Als
- iSEQ, Center for Integrative Sequencing, Aarhus University, Aarhus, Denmark
- Department of Biomedicine - Human Genetics, Aarhus University, Aarhus, Denmark
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
| | - Tim B Bigdeli
- Department of Psychiatry and Behavioral Sciences, SUNY Downstate Health Sciences University, Brooklyn, NY, USA
- VA NY Harbor Healthcare System, Brooklyn, NY, USA
| | - Sigrid Børte
- Research and Communication Unit for Musculoskeletal Health, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Julien Bryois
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Alexander W Charney
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ole Kristian Drange
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Department of Østmarka, Division of Mental Health Care, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Michael J Gandal
- Department of Psychiatry and Biobehavioral Science, Semel Institute, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Saskia P Hagenaars
- Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK
- NIHR Maudsley BRC, King's College London, London, UK
| | - Masashi Ikeda
- Department of Psychiatry, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Nolan Kamitaki
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA, USA
- Department of Genetics, Harvard Medical School, Boston, MA, USA
| | - Minsoo Kim
- Department of Psychiatry and Biobehavioral Science, Semel Institute, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Kristi Krebs
- Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia
| | | | - Brian M Schilder
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Ronald M. Loeb Center for Alzheimer's Disease, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Estelle and Daniel Maggin Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Laura G Sloofman
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | | | - Vassily Trubetskoy
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin, Berlin, Germany
| | - Bendik S Winsvold
- K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Research, Innovation and Education, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway
| | - Hong-Hee Won
- Samsung Advanced Institute for Health Sciences and Technology (SAIHST), Samsung Medical Center, Sungkyunkwan University, Seoul, South Korea
| | - Liliya Abramova
- Russian Academy of Medical Sciences, Mental Health Research Center, Moscow, Russian Federation
| | - Kristina Adorjan
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Esben Agerbo
- 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, Aarhus University, Aarhus, Denmark
| | - Mariam Al Eissa
- Division of Psychiatry, University College London, London, UK
| | - Diego Albani
- Department of Neuroscience, Istituto Di Ricerche Farmacologiche Mario Negri IRCCS, Milan, Italy
| | - Ney Alliey-Rodriguez
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
- Northwestern University, Chicago, IL, USA
| | - Adebayo Anjorin
- Psychiatry, Berkshire Healthcare NHS Foundation Trust, Bracknell, UK
| | - Verneri Antilla
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Anastasia Antoniou
- 2nd Department of Psychiatry, Attikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Swapnil Awasthi
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin, Berlin, Germany
| | - Ji Hyun Baek
- Department of Psychiatry, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, South Korea
| | - Marie Bækvad-Hansen
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- Center for Neonatal Screening, Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | - Nicholas Bass
- Division of Psychiatry, University College London, London, UK
| | - Michael Bauer
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Eva C Beins
- Institute of Human Genetics, University of Bonn, School of Medicine and University Hospital Bonn, Bonn, Germany
| | - Sarah E Bergen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Armin Birner
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Carsten Bøcker Pedersen
- 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, Aarhus University, Aarhus, Denmark
| | - Erlend Bøen
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Marco P Boks
- Psychiatry, Brain Center UMC Utrecht, Utrecht, the Netherlands
| | - Rosa Bosch
- Instituto de Salud Carlos III, Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Hospital Universitari Vall d´Hebron, Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- Psychiatric Genetics Unit, Group of Psychiatry Mental Health and Addictions, Vall d´Hebron Research Institut (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Murielle Brum
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Ben M Brumpton
- K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Nathalie Brunkhorst-Kanaan
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Monika Budde
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
| | - Jonas Bybjerg-Grauholm
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- Center for Neonatal Screening, Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | - William Byerley
- Psychiatry, University of California San Francisco, San Francisco, CA, USA
| | - Murray Cairns
- University of Newcastle, Newcastle, New South Wales, Australia
| | - Miquel Casas
- Instituto de Salud Carlos III, Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Hospital Universitari Vall d´Hebron, Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- Psychiatric Genetics Unit, Group of Psychiatry Mental Health and Addictions, Vall d´Hebron Research Institut (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Pablo Cervantes
- Mood Disorders Program, Department of Psychiatry, McGill University Health Center, Montreal, Quebec, Canada
| | - Toni-Kim Clarke
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - Cristiana Cruceanu
- Mood Disorders Program, Department of Psychiatry, McGill University Health Center, Montreal, Quebec, Canada
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| | - Alfredo Cuellar-Barboza
- Department of Psychiatry, Universidad Autonoma de Nuevo Leon, Monterrey, Mexico
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Julie Cunningham
- Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - David Curtis
- Centre for Psychiatry, Queen Mary University of London, London, UK
- UCL Genetics Institute, University College London, London, UK
| | - Piotr M Czerski
- Department of Psychiatry, Laboratory of Psychiatric Genetics, Poznan University of Medical Sciences, Poznan, Poland
| | - Anders M Dale
- Center for Multimodal Imaging and Genetics, Departments of Neurosciences, Radiology, and Psychiatry, University of California, San Diego, CA, USA
| | - Nina Dalkner
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Friederike S David
- Institute of Human Genetics, University of Bonn, School of Medicine and University Hospital Bonn, Bonn, Germany
| | - Franziska Degenhardt
- Institute of Human Genetics, University of Bonn, School of Medicine and University Hospital Bonn, Bonn, Germany
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Essen, University of Duisburg-Essen, Duisburg, Germany
| | - Srdjan Djurovic
- Department of Medical Genetics, Oslo University Hospital, Oslo, Norway
- NORMENT, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Amanda L Dobbyn
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Athanassios Douzenis
- 2nd Department of Psychiatry, Attikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Torbjørn Elvsåshagen
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Neurology, Oslo University Hospital, Oslo, Norway
- NORMENT, KG Jebsen Centre for Psychosis Research, Oslo University Hospital, Oslo, Norway
| | - Valentina Escott-Price
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - I Nicol Ferrier
- Academic Psychiatry, Newcastle University, Newcastle upon Tyne, UK
| | | | - Tatiana M Foroud
- Department of Medical and Molecular Genetics, Indiana University, Indianapolis, IN, USA
| | - Liz Forty
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Josef Frank
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Oleksandr Frei
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Nelson B Freimer
- Department of Psychiatry and Biobehavioral Science, Semel Institute, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA
| | - Louise Frisén
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Katrin Gade
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Julie Garnham
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Joel Gelernter
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA
- Departments of Genetics and Neuroscience, Yale University School of Medicine, New Haven, CT, USA
| | - Marianne Giørtz Pedersen
- 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, Aarhus University, Aarhus, Denmark
| | - Ian R Gizer
- Department of Psychological Sciences, University of Missouri, Columbia, MO, USA
| | - Scott D Gordon
- Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | | | - Tiffany A Greenwood
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Jakob Grove
- iSEQ, Center for Integrative Sequencing, Aarhus University, Aarhus, Denmark
- Department of Biomedicine - Human Genetics, Aarhus University, Aarhus, Denmark
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- Bioinformatics Research Centre, Aarhus University, Aarhus, Denmark
| | - José Guzman-Parra
- Mental Health Department, University Regional Hospital, Biomedicine Institute (IBIMA), Málaga, Spain
| | - Kyooseob Ha
- Department of Psychiatry, Seoul National University College of Medicine, Seoul, South Korea
| | | | - Martin Hautzinger
- Department of Psychology, Eberhard Karls Universität Tübingen, Tübingen, Germany
| | - Urs Heilbronner
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
| | - Dennis Hellgren
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Stefan Herms
- Institute of Human Genetics, University of Bonn, School of Medicine and University Hospital Bonn, Bonn, Germany
- Department of Biomedicine, University of Basel, Basel, Switzerland
- Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
| | - Per Hoffmann
- Institute of Human Genetics, University of Bonn, School of Medicine and University Hospital Bonn, Bonn, Germany
- Department of Biomedicine, University of Basel, Basel, Switzerland
- Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
| | - Peter A Holmans
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Laura Huckins
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Stéphane Jamain
- Neuropsychiatrie Translationnelle, Inserm U955, Créteil, France
- Faculté de Santé, Université Paris Est, Créteil, France
| | - Jessica S Johnson
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Janos L Kalman
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
- International Max Planck Research School for Translational Psychiatry (IMPRS-TP), Munich, Germany
| | - Yoichiro Kamatani
- Laboratory of Complex Trait Genomics, Department of Computational Biology and Medical Sciences, Graduate School of Frontier Sciences, The University of Tokyo, Tokyo, Japan
- Laboratory for Statistical and Translational Genetics, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - James L Kennedy
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Neurogenetics Section, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Institute of Medical Sciences, University of Toronto, Toronto, Ontario, Canada
| | - Sarah Kittel-Schneider
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt am Main, Germany
- Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital Würzburg, Würzburg, Germany
| | - James A Knowles
- Cell Biology, SUNY Downstate Medical Center College of Medicine, Brooklyn, NY, USA
- Institute for Genomic Health, SUNY Downstate Medical Center College of Medicine, Brooklyn, NY, USA
| | | | - Maria Koromina
- Laboratory of Pharmacogenomics and Individualized Therapy, Department of Pharmacy, School of Health Sciences, University of Patras, Patras, Greece
| | - Thorsten M Kranz
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Henry R Kranzler
- Mental Illness Research, Education and Clinical Center, Crescenz VAMC, Philadelphia, PA, USA
- Center for Studies of Addiction, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA
| | - Michiaki Kubo
- RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | - Ralph Kupka
- Psychiatry, Altrecht, Utrecht, the Netherlands
- Psychiatry, GGZ inGeest, Amsterdam, the Netherlands
- Psychiatry, VU Medisch Centrum, Amsterdam, the Netherlands
| | - Steven A Kushner
- Department of Psychiatry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
| | - Catharina Lavebratt
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Jacob Lawrence
- Psychiatry, North East London NHS Foundation Trust, Ilford, UK
| | - Markus Leber
- Clinic for Psychiatry and Psychotherapy, University Hospital Cologne, Cologne, Germany
| | - Heon-Jeong Lee
- Department of Psychiatry, Korea University College of Medicine, Seoul, South Korea
| | - Phil H Lee
- Psychiatric and Neurodevelopmental Genetics Unit, Center for Genomic Medicine, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA
| | - Shawn E Levy
- HudsonAlpha Institute for Biotechnology, Huntsville, AL, USA
| | - Catrin Lewis
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Calwing Liao
- Department of Human Genetics, McGill University, Montréal, Quebec, Canada
- Montreal Neurological Institute and Hospital, McGill University, Montréal, Quebec, Canada
| | - Susanne Lucae
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| | - Martin Lundberg
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Donald J MacIntyre
- Division of Psychiatry, Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
| | | | - Wolfgang Maier
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Adam Maihofer
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Dolores Malaspina
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Eirini Maratou
- Clinical Biochemistry Laboratory, Attikon General Hospital, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Lina Martinsson
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Manuel Mattheisen
- iSEQ, Center for Integrative Sequencing, Aarhus University, Aarhus, Denmark
- Department of Biomedicine - Human Genetics, Aarhus University, Aarhus, Denmark
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital Würzburg, Würzburg, Germany
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | - Steven A McCarroll
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA, USA
- Department of Genetics, Harvard Medical School, Boston, MA, USA
| | - Nathaniel W McGregor
- Systems Genetics Working Group, Department of Genetics, Stellenbosch University, Stellenbosch, South Africa
| | - Peter McGuffin
- Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK
| | - James D McKay
- Genetic Cancer Susceptibility Group, International Agency for Research on Cancer, Lyon, France
| | - Helena Medeiros
- Institute for Genomic Health, SUNY Downstate Medical Center College of Medicine, Brooklyn, NY, USA
| | - Sarah E Medland
- Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | - Vincent Millischer
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Grant W Montgomery
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland, Australia
| | - Jennifer L Moran
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
| | - Derek W Morris
- Centre for Neuroimaging and Cognitive Genomics (NICOG), National University of Ireland Galway, Galway, Ireland
| | - Thomas W Mühleisen
- Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany
- Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Niamh O'Brien
- Division of Psychiatry, University College London, London, UK
| | - Claire O'Donovan
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Loes M Olde Loohuis
- Department of Psychiatry and Biobehavioral Science, Semel Institute, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA
| | - Lilijana Oruc
- Medical Faculty, School of Science and Technology, University Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Sergi Papiol
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Antonio F Pardiñas
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Amy Perry
- Psychological Medicine, University of Worcester, Worcester, UK
| | - Andrea Pfennig
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Evgenia Porichi
- 2nd Department of Psychiatry, Attikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - James B Potash
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Digby Quested
- Oxford Health NHS Foundation Trust, Warneford Hospital, Oxford, UK
- Department of Psychiatry, University of Oxford, Warneford Hospital, Oxford, UK
| | - Towfique Raj
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Ronald M. Loeb Center for Alzheimer's Disease, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Estelle and Daniel Maggin Department of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Mark H Rapaport
- Department of Psychiatry and Behavioral Sciences, Emory University School of Medicine, Atlanta, GA, USA
| | - J Raymond DePaulo
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Eline J Regeer
- Outpatient Clinic for Bipolar Disorder, Altrecht, Utrecht, the Netherlands
| | - John P Rice
- Department of Psychiatry, Washington University in Saint Louis, Saint Louis, MO, USA
| | - Fabio Rivas
- Mental Health Department, University Regional Hospital, Biomedicine Institute (IBIMA), Málaga, Spain
| | - Margarita Rivera
- Department of Biochemistry and Molecular Biology II, Faculty of Pharmacy, University of Granada, Granada, Spain
- Institute of Neurosciences, Biomedical Research Center (CIBM), University of Granada, Granada, Spain
| | - Julian Roth
- Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital Würzburg, Würzburg, Germany
| | - Panos Roussos
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Douglas M Ruderfer
- Medicine, Psychiatry, Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN, USA
| | - Cristina Sánchez-Mora
- Instituto de Salud Carlos III, Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Hospital Universitari Vall d´Hebron, Barcelona, Spain
- Psychiatric Genetics Unit, Group of Psychiatry Mental Health and Addictions, Vall d´Hebron Research Institut (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
- Department of Genetics, Microbiology and Statistics, Faculty of Biology, Universitat de Barcelona, Barcelona, Spain
| | - Eva C Schulte
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Fanny Senner
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich, Germany
| | - Sally Sharp
- Division of Psychiatry, University College London, London, UK
| | - Paul D Shilling
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - Engilbert Sigurdsson
- Landspitali University Hospital, Reykjavik, Iceland
- Faculty of Medicine, Department of Psychiatry, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Lea Sirignano
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Claire Slaney
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Olav B Smeland
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- NORMENT, University of Oslo, Oslo, Norway
| | - Daniel J Smith
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Janet L Sobell
- Psychiatry and the Behavioral Sciences, University of Southern California, Los Angeles, CA, USA
| | - Christine Søholm Hansen
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- Center for Neonatal Screening, Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | - Maria Soler Artigas
- Instituto de Salud Carlos III, Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Hospital Universitari Vall d´Hebron, Barcelona, Spain
- Psychiatric Genetics Unit, Group of Psychiatry Mental Health and Addictions, Vall d´Hebron Research Institut (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
- Department of Genetics, Microbiology and Statistics, Faculty of Biology, Universitat de Barcelona, Barcelona, Spain
| | | | - Dan J Stein
- SAMRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry and Neuroscience Institute, University of Cape Town, Cape Town, South Africa
| | - John S Strauss
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Beata Świątkowska
- Department of Environmental Epidemiology, Nofer Institute of Occupational Medicine, Lodz, Poland
| | - Chikashi Terao
- Laboratory for Statistical and Translational Genetics, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
| | | | - Claudio Toma
- Neuroscience Research Australia, Sydney, New South Wales, Australia
- School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia
- Centro de Biología Molecular Severo Ochoa, Universidad Autónoma de Madrid and CSIC, Madrid, Spain
| | - Paul Tooney
- University of Newcastle, Newcastle, New South Wales, Australia
| | - Evangelia-Eirini Tsermpini
- Laboratory of Pharmacogenomics and Individualized Therapy, Department of Pharmacy, School of Health Sciences, University of Patras, Patras, Greece
| | - Marquis P Vawter
- Department of Psychiatry and Human Behavior, School of Medicine, University of California, Irvine, Irvine, CA, USA
| | - Helmut Vedder
- Psychiatry, Psychiatrisches Zentrum Nordbaden, Wiesloch, Germany
| | - James T R Walters
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Stephanie H Witt
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Simon Xi
- Computational Sciences Center of Emphasis, Pfizer Global Research and Development, Cambridge, MA, USA
| | - Wei Xu
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Jessica Mei Kay Yang
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Allan H Young
- Department of Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- South London and Maudsley NHS Foundation Trust, Bethlem Royal Hospital, Beckenham, UK
| | - Hannah Young
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Peter P Zandi
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Hang Zhou
- Department of Psychiatry, Yale School of Medicine, New Haven, CT, USA
- Veterans Affairs Connecticut Healthcare System, West Haven, CT, USA
| | - Lea Zillich
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Rolf Adolfsson
- Department of Clinical Sciences, Psychiatry, Umeå University Medical Faculty, Umeå, Sweden
| | - Ingrid Agartz
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
- NORMENT, KG Jebsen Centre for Psychosis Research, Division of Mental Health and Addiction, Institute of Clinical Medicine and Diakonhjemmet Hospital, University of Oslo, Oslo, Norway
| | - Martin Alda
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
- National Institute of Mental Health, Klecany, Czech Republic
| | - Lars Alfredsson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Gulja Babadjanova
- Institute of Pulmonology, Russian State Medical University, Moscow, Russian Federation
| | - Lena Backlund
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Bernhard T Baune
- Department of Psychiatry, University of Münster, Münster, Germany
- Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Melbourne, Victoria, Australia
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Victoria, Australia
| | - Frank Bellivier
- Université de Paris, INSERM, Optimisation Thérapeutique en Neuropsychopharmacologie, UMRS 1144, Paris, France
- APHP Nord, DMU Neurosciences, Département de Psychiatrie et de Médecine Addictologique, GHU Saint Louis-Lariboisière-Fernand Widal, Paris, France
| | - Susanne Bengesser
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | | | | | - Michael Boehnke
- Center for Statistical Genetics and Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
| | - Anders D Børglum
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- Department of Biomedicine and the iSEQ Center, Aarhus University, Aarhus, Denmark
- Center for Genomics and Personalized Medicine, CGPM, Aarhus, Denmark
| | - Gerome Breen
- Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK
- NIHR Maudsley BRC, King's College London, London, UK
| | - Vaughan J Carr
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Stanley Catts
- University of Queensland, Brisbane, Queensland, Australia
| | - Aiden Corvin
- Neuropsychiatric Genetics Research Group, Department of Psychiatry and Trinity Translational Medicine Institute, Trinity College Dublin, Dublin, Ireland
| | - Nicholas Craddock
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Udo Dannlowski
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Dimitris Dikeos
- 1st Department of Psychiatry, Eginition Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Tõnu Esko
- Department of Genetics, Harvard Medical School, Boston, MA, USA
- Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia
- Medical and Population Genetics, Broad Institute, Cambridge, MA, USA
- Division of Endocrinology, Children's Hospital Boston, Boston, MA, USA
| | - Bruno Etain
- Université de Paris, INSERM, Optimisation Thérapeutique en Neuropsychopharmacologie, UMRS 1144, Paris, France
- APHP Nord, DMU Neurosciences, Département de Psychiatrie et de Médecine Addictologique, GHU Saint Louis-Lariboisière-Fernand Widal, Paris, France
| | - Panagiotis Ferentinos
- Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK
- 2nd Department of Psychiatry, Attikon General Hospital, National and Kapodistrian University of Athens, Athens, Greece
| | - Mark Frye
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Janice M Fullerton
- Neuroscience Research Australia, Sydney, New South Wales, Australia
- School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Micha Gawlik
- Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital Würzburg, Würzburg, Germany
| | - Elliot S Gershon
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
- Department of Human Genetics, University of Chicago, Chicago, IL, USA
| | - Fernando S Goes
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Melissa J Green
- Neuroscience Research Australia, Sydney, New South Wales, Australia
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Maria Grigoroiu-Serbanescu
- Biometric Psychiatric Genetics Research Unit, Alexandru Obregia Clinical Psychiatric Hospital, Bucharest, Romania
| | - Joanna Hauser
- Department of Psychiatry, Laboratory of Psychiatric Genetics, Poznan University of Medical Sciences, Poznan, Poland
| | - Frans Henskens
- University of Newcastle, Newcastle, New South Wales, Australia
| | - Jan Hillert
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Kyung Sue Hong
- Department of Psychiatry, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, South Korea
| | - David M Hougaard
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- Center for Neonatal Screening, Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | - Christina M Hultman
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Kristian Hveem
- K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- HUNT Research Center, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
| | - Nakao Iwata
- Department of Psychiatry, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Assen V Jablensky
- University of Western Australia, Nedlands, Western Australia, Australia
| | - Ian Jones
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Lisa A Jones
- Psychological Medicine, University of Worcester, Worcester, UK
| | - René S Kahn
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Psychiatry, Brain Center UMC Utrecht, Utrecht, the Netherlands
| | - John R Kelsoe
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | - George Kirov
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Mikael Landén
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Marion Leboyer
- Neuropsychiatrie Translationnelle, Inserm U955, Créteil, France
- Faculté de Santé, Université Paris Est, Créteil, France
- Department of Psychiatry and Addiction Medicine, Assistance Publique - Hôpitaux de Paris, Paris, France
| | - Cathryn M Lewis
- Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK
- NIHR Maudsley BRC, King's College London, London, UK
- Department of Medical and Molecular Genetics, King's College London, London, UK
| | - Qingqin S Li
- Neuroscience Therapeutic Area, Janssen Research and Development, LLC, Titusville, NJ, USA
| | - Jolanta Lissowska
- Cancer Epidemiology and Prevention, M. Sklodowska-Curie National Research Institute of Oncology, Warsaw, Poland
| | - Christine Lochner
- SA MRC Unit on Risk and Resilience in Mental Disorders, Department of Psychiatry, Stellenbosch University, Stellenbosch, South Africa
| | | | - Nicholas G Martin
- Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
- School of Psychology, The University of Queensland, Brisbane, Queensland, Australia
| | - Carol A Mathews
- Department of Psychiatry and Genetics Institute, University of Florida, Gainesville, FL, USA
| | - Fermin Mayoral
- Mental Health Department, University Regional Hospital, Biomedicine Institute (IBIMA), Málaga, Spain
| | | | - Andrew M McIntosh
- Division of Psychiatry, Centre for Clinical Brain Sciences, The University of Edinburgh, Edinburgh, UK
- Centre for Cognitive Ageing and Cognitive Epidemiology, University of Edinburgh, Edinburgh, UK
| | - Francis J McMahon
- Human Genetics Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
| | - Ingrid Melle
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- Division of Mental Health and Addiction, University of Oslo, Institute of Clinical Medicine, Oslo, Norway
| | - Patricia Michie
- University of Newcastle, Newcastle, New South Wales, Australia
| | - Lili Milani
- Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Philip B Mitchell
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Gunnar Morken
- Department of Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology (NTNU), Trondheim, Norway
- Psychiatry, St Olavs University Hospital, Trondheim, Norway
| | - Ole Mors
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- Psychosis Research Unit, Aarhus University Hospital - Psychiatry, Risskov, Denmark
| | - Preben Bo Mortensen
- iSEQ, Center for Integrative Sequencing, Aarhus University, Aarhus, Denmark
- 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, Aarhus University, Aarhus, Denmark
| | - Bryan Mowry
- University of Queensland, Brisbane, Queensland, Australia
| | - Bertram 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
| | - Richard M Myers
- HudsonAlpha Institute for Biotechnology, Huntsville, AL, USA
| | - Benjamin M Neale
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA, USA
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
- Medical and Population Genetics, Broad Institute, Cambridge, MA, USA
| | - Caroline M Nievergelt
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
- Research/Psychiatry, Veterans Affairs San Diego Healthcare System, San Diego, CA, USA
| | - Merete Nordentoft
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, University of Copenhagen, Copenhagen, Denmark
| | - Markus M Nöthen
- Institute of Human Genetics, University of Bonn, School of Medicine and University Hospital Bonn, Bonn, Germany
| | - Michael C O'Donovan
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Ketil J Oedegaard
- Division of Psychiatry, Haukeland Universitetssjukehus, Bergen, Norway
- Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
| | - Tomas Olsson
- Department of Clinical Neuroscience and Center for Molecular Medicine, Karolinska Institutet at Karolinska University Hospital, Solna, Sweden
| | - Michael J Owen
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
| | - Sara A Paciga
- Human Genetics and Computational Biomedicine, Pfizer Global Research and Development, Groton, CT, USA
| | | | - Carlos Pato
- Institute for Genomic Health, SUNY Downstate Medical Center College of Medicine, Brooklyn, NY, USA
| | - Michele T Pato
- Institute for Genomic Health, SUNY Downstate Medical Center College of Medicine, Brooklyn, NY, USA
| | - George P Patrinos
- Laboratory of Pharmacogenomics and Individualized Therapy, Department of Pharmacy, School of Health Sciences, University of Patras, Patras, Greece
- Department of Pathology, College of Medicine and Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
- Zayed Center of Health Sciences, United Arab Emirates University, Al-Ain, United Arab Emirates
| | - Roy H Perlis
- Psychiatry, Harvard Medical School, Boston, MA, USA
- Division of Clinical Research, Massachusetts General Hospital, Boston, MA, USA
| | - Danielle Posthuma
- Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
- Department of Clinical Genetics, Amsterdam Neuroscience, Vrije Universiteit Medical Center, Amsterdam, the Netherlands
| | - Josep Antoni Ramos-Quiroga
- Instituto de Salud Carlos III, Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Hospital Universitari Vall d´Hebron, Barcelona, Spain
- Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
- Psychiatric Genetics Unit, Group of Psychiatry Mental Health and Addictions, Vall d´Hebron Research Institut (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Eva Z Reininghaus
- Department of Psychiatry and Psychotherapeutic Medicine, Medical University of Graz, Graz, Austria
| | - Marta Ribasés
- Instituto de Salud Carlos III, Biomedical Network Research Centre on Mental Health (CIBERSAM), Madrid, Spain
- Department of Psychiatry, Hospital Universitari Vall d´Hebron, Barcelona, Spain
- Psychiatric Genetics Unit, Group of Psychiatry Mental Health and Addictions, Vall d´Hebron Research Institut (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
- Department of Genetics, Microbiology and Statistics, Faculty of Biology, Universitat de Barcelona, Barcelona, Spain
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Stephan Ripke
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA, USA
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin, Berlin, Germany
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Guy A Rouleau
- Montreal Neurological Institute and Hospital, McGill University, Montréal, Quebec, Canada
- Department of Neurology and Neurosurgery, Faculty of Medicine, McGill University, Montreal, Quebec, Canada
| | - Takeo Saito
- Department of Psychiatry, School of Medicine, Fujita Health University, Toyoake, Japan
| | - Ulrich Schall
- University of Newcastle, Newcastle, New South Wales, Australia
| | - Martin Schalling
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Peter R Schofield
- Neuroscience Research Australia, Sydney, New South Wales, Australia
- School of Medical Sciences, University of New South Wales, Sydney, New South Wales, Australia
| | - Thomas G Schulze
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Laura J Scott
- Center for Statistical Genetics and Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
| | - Rodney J Scott
- University of Newcastle, Newcastle, New South Wales, Australia
| | - Alessandro Serretti
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy
| | - Cynthia Shannon Weickert
- Neuroscience Research Australia, Sydney, New South Wales, Australia
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
- Department of Neuroscience, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Jordan W Smoller
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA, USA
- Department of Psychiatry, Massachusetts General Hospital, Boston, MA, USA
- Psychiatric and Neurodevelopmental Genetics Unit (PNGU), Massachusetts General Hospital, Boston, MA, USA
| | | | - Kari Stefansson
- deCODE Genetics/Amgen, Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavik, Iceland
| | - Eystein Stordal
- Department of Psychiatry, Hospital Namsos, Namsos, Norway
- Department of Neuroscience, Norges Teknisk Naturvitenskapelige Universitet Fakultet for Naturvitenskap og Teknologi, Trondheim, Norway
| | - Fabian Streit
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Patrick F Sullivan
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Gustavo Turecki
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Arne E Vaaler
- Department of Psychiatry, Sankt Olavs Hospital Universitetssykehuset i Trondheim, Trondheim, Norway
| | - Eduard Vieta
- Clinical Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - John B Vincent
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Ontario, Canada
| | - Irwin D Waldman
- Department of Psychology, Emory University, Atlanta, GA, USA
| | - Thomas W Weickert
- Neuroscience Research Australia, Sydney, New South Wales, Australia
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
- Department of Neuroscience, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Thomas Werge
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- Institute of Biological Psychiatry, Mental Health Services, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen, Denmark
| | - Naomi R Wray
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland, Australia
- Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia
| | - John-Anker Zwart
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- K. G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology, Trondheim, Norway
- Department of Research, Innovation and Education, Division of Clinical Neuroscience, Oslo University Hospital, Oslo, Norway
| | - Joanna M Biernacka
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - John I Nurnberger
- Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Sven Cichon
- Institute of Human Genetics, University of Bonn, School of Medicine and University Hospital Bonn, Bonn, Germany
- Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany
- Department of Biomedicine, University of Basel, Basel, Switzerland
- Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
| | - Howard J Edenberg
- Department of Medical and Molecular Genetics, Indiana University, Indianapolis, IN, USA
- Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Eli A Stahl
- Department of Genetics and Genomic Sciences, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Medical and Population Genetics, Broad Institute, Cambridge, MA, USA
| | | | - Arianna Di Florio
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, UK
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Roel A Ophoff
- Department of Psychiatry and Biobehavioral Science, Semel Institute, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience and Human Behavior, Los Angeles, CA, USA
- Department of Psychiatry, Erasmus MC, University Medical Center Rotterdam, Rotterdam, the Netherlands
- Department of Human Genetics, David Geffen School of Medicine, University of California Los Angeles, Los Angeles, CA, USA
| | - Ole A Andreassen
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway.
- NORMENT, University of Oslo, Oslo, Norway.
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Amare AT, Schubert KO, Hou L, Clark SR, Papiol S, Cearns M, Heilbronner U, Degenhardt F, Tekola-Ayele F, Hsu YH, Shekhtman T, Adli M, Akula N, Akiyama K, Ardau R, Arias B, Aubry JM, Backlund L, Bhattacharjee AK, Bellivier F, Benabarre A, Bengesser S, Biernacka JM, Birner A, Brichant-Petitjean C, Cervantes P, Chen HC, Chillotti C, Cichon S, Cruceanu C, Czerski PM, Dalkner N, Dayer A, Del Zompo M, DePaulo JR, Étain B, Jamain S, Falkai P, Forstner AJ, Frisen L, Frye MA, Fullerton JM, Gard S, Garnham JS, Goes FS, Grigoroiu-Serbanescu M, Grof P, Hashimoto R, Hauser J, Herms S, Hoffmann P, Hofmann A, Jiménez E, Kahn JP, Kassem L, Kuo PH, Kato T, Kelsoe JR, Kittel-Schneider S, Kliwicki S, König B, Kusumi I, Laje G, Landén M, Lavebratt C, Leboyer M, Leckband SG, Tortorella A, Manchia M, Martinsson L, McCarthy MJ, McElroy SL, Colom F, Mitjans M, Mondimore FM, Monteleone P, Nievergelt CM, Nöthen MM, Novák T, O'Donovan C, Ozaki N, Ösby U, Pfennig A, Potash JB, Reif A, Reininghaus E, Rouleau GA, Rybakowski JK, Schalling M, Schofield PR, Schweizer BW, Severino G, Shilling PD, Shimoda K, Simhandl C, Slaney CM, Squassina A, Stamm T, Stopkova P, Maj M, Turecki G, Vieta E, Veeh J, Witt SH, Wright A, Zandi PP, Mitchell PB, Bauer M, Alda M, Rietschel M, McMahon FJ, Schulze TG, Baune BT. Association of polygenic score for major depression with response to lithium in patients with bipolar disorder. Mol Psychiatry 2021; 26:2457-2470. [PMID: 32203155 DOI: 10.1038/s41380-020-0689-5] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [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] [Received: 11/22/2018] [Revised: 01/28/2020] [Accepted: 02/13/2020] [Indexed: 11/09/2022]
Abstract
Lithium is a first-line medication for bipolar disorder (BD), but only one in three patients respond optimally to the drug. Since evidence shows a strong clinical and genetic overlap between depression and bipolar disorder, we investigated whether a polygenic susceptibility to major depression is associated with response to lithium treatment in patients with BD. Weighted polygenic scores (PGSs) were computed for major depression (MD) at different GWAS p value thresholds using genetic data obtained from 2586 bipolar patients who received lithium treatment and took part in the Consortium on Lithium Genetics (ConLi+Gen) study. Summary statistics from genome-wide association studies in MD (135,458 cases and 344,901 controls) from the Psychiatric Genomics Consortium (PGC) were used for PGS weighting. Response to lithium treatment was defined by continuous scores and categorical outcome (responders versus non-responders) using measurements on the Alda scale. Associations between PGSs of MD and lithium treatment response were assessed using a linear and binary logistic regression modeling for the continuous and categorical outcomes, respectively. The analysis was performed for the entire cohort, and for European and Asian sub-samples. The PGSs for MD were significantly associated with lithium treatment response in multi-ethnic, European or Asian populations, at various p value thresholds. Bipolar patients with a low polygenic load for MD were more likely to respond well to lithium, compared to those patients with high polygenic load [lowest vs highest PGS quartiles, multi-ethnic sample: OR = 1.54 (95% CI: 1.18-2.01) and European sample: OR = 1.75 (95% CI: 1.30-2.36)]. While our analysis in the Asian sample found equivalent effect size in the same direction: OR = 1.71 (95% CI: 0.61-4.90), this was not statistically significant. Using PGS decile comparison, we found a similar trend of association between a high genetic loading for MD and lower response to lithium. Our findings underscore the genetic contribution to lithium response in BD and support the emerging concept of a lithium-responsive biotype in BD.
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Affiliation(s)
- Azmeraw T Amare
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, SA, Australia
- South Australian Academic Health Science and Translation Centre, South Australian Health and Medical Research Institute (SAHMRI), Adelaide, SA, Australia
| | - Klaus Oliver Schubert
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, SA, Australia
- Northern Adelaide Local Health Network, Mental Health Services, Adelaide, SA, Australia
| | - Liping Hou
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health, US Department of Health & Human Services, Bethesda, MD, USA
| | - Scott R Clark
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, SA, Australia
| | - Sergi Papiol
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University Munich, Munich, Germany
| | - Micah Cearns
- Discipline of Psychiatry, School of Medicine, University of Adelaide, Adelaide, SA, Australia
| | - Urs Heilbronner
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center (UMG), Georg-August University Göttingen, Göttingen, Germany
| | - Franziska Degenhardt
- Institute of Human Genetics, University of Bonn and Department of Genomics, Life & Brain Center, Bonn, Germany
| | - Fasil Tekola-Ayele
- Epidemiology Branch, Division of Intramural Population Health Research, Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, MD, USA
| | - Yi-Hsiang Hsu
- HSL Institute for Aging Research, Harvard Medical School, Boston, MA, USA
- Program for Quantitative Genomics, Harvard School of Public Health, Boston, MA, USA
| | - Tatyana Shekhtman
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Mazda Adli
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Germany
| | - Nirmala Akula
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health, US Department of Health & Human Services, Bethesda, MD, USA
| | - Kazufumi Akiyama
- Department of Biological Psychiatry and Neuroscience, Dokkyo Medical University School of Medicine, Mibu, Tochigi, Japan
| | - Raffaella Ardau
- Unit of Clinical Pharmacology, Hospital University Agency of Cagliari, Cagliari, Italy
| | - Bárbara Arias
- Unitat de Zoologia i Antropologia Biològica (Dpt. Biologia Evolutiva, Ecologia i Ciències Ambientals), Facultat de Biologia and Institut de Biomedicina (IBUB), University of Barcelona, CIBERSAM, Barcelona, Spain
| | - Jean-Michel Aubry
- Department of Psychiatry, Mood Disorders Unit, HUG - Geneva University Hospitals, Geneva, Switzerland
| | - Lena Backlund
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | | | - Frank Bellivier
- INSERM UMR-S 1144, Université Paris Diderot, Département de Psychiatrie et de Médecine Addictologique, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-F.Widal, Paris, France
| | - Antonio Benabarre
- Bipolar Disorder Program, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Susanne Bengesser
- Department of Psychiatry and Psychotherapeutic Medicine, Research Unit for bipolar affective disorder, Medical University of Graz, Graz, Austria
| | - Joanna M Biernacka
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, USA
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Armin Birner
- Department of Psychiatry and Psychotherapeutic Medicine, Research Unit for bipolar affective disorder, Medical University of Graz, Graz, Austria
| | - Clara Brichant-Petitjean
- INSERM UMR-S 1144, Université Paris Diderot, Département de Psychiatrie et de Médecine Addictologique, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-F.Widal, Paris, France
| | - Pablo Cervantes
- The Neuromodulation Unit, McGill University Health Centre, Montreal, QC, Canada
| | - Hsi-Chung Chen
- Department of Psychiatry & Center of Sleep Disorders, National Taiwan University Hospital, Taipei, Taiwan
| | - Caterina Chillotti
- Unit of Clinical Pharmacology, Hospital University Agency of Cagliari, Cagliari, Italy
| | - Sven Cichon
- Institute of Human Genetics, University of Bonn and Department of Genomics, Life & Brain Center, Bonn, Germany
- Human Genomics Research Group, Department of Biomedicine, University Hospital Basel, Basel, Switzerland
| | - Cristiana Cruceanu
- Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | - Piotr M Czerski
- Psychiatric Genetic Unit, Poznan University of Medical Sciences, Poznan, Poland
| | - Nina Dalkner
- Department of Psychiatry and Psychotherapeutic Medicine, Research Unit for bipolar affective disorder, Medical University of Graz, Graz, Austria
| | - Alexandre Dayer
- Department of Psychiatry, Mood Disorders Unit, HUG - Geneva University Hospitals, Geneva, Switzerland
| | - Maria Del Zompo
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - J Raymond DePaulo
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Bruno Étain
- INSERM UMR-S 1144, Université Paris Diderot, Département de Psychiatrie et de Médecine Addictologique, AP-HP, Groupe Hospitalier Saint-Louis-Lariboisière-F.Widal, Paris, France
| | - Stephane Jamain
- Inserm U955, Translational Psychiatry laboratory, Fondation FondaMental, Créteil, France
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University Munich, Munich, Germany
| | - Andreas J Forstner
- Institute of Human Genetics, University of Bonn and Department of Genomics, Life & Brain Center, Bonn, Germany
- Human Genomics Research Group, Department of Biomedicine, University Hospital Basel, Basel, Switzerland
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
| | - Louise Frisen
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Mark A Frye
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Janice M Fullerton
- Neuroscience Research Australia, Sydney, NSW, Australia
- School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Sébastien Gard
- Service de psychiatrie, Hôpital Charles Perrens, Bordeaux, France
| | - Julie S Garnham
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Fernando S Goes
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Maria Grigoroiu-Serbanescu
- Biometric Psychiatric Genetics Research Unit, Alexandru Obregia Clinical Psychiatric Hospital, Bucharest, Romania
| | - Paul Grof
- Mood Disorders Center of Ottawa, Ottawa, ON, Canada
| | - Ryota Hashimoto
- Molecular Research Center for Children's Mental Development, United Graduate School of Child Development, Osaka University, Osaka, Japan
- Department of Psychiatry, Osaka University Graduate School of Medicine, Osaka, Japan
| | - Joanna Hauser
- Psychiatric Genetic Unit, Poznan University of Medical Sciences, Poznan, Poland
| | - Stefan Herms
- Institute of Human Genetics, University of Bonn and Department of Genomics, Life & Brain Center, Bonn, Germany
- Human Genomics Research Group, Department of Biomedicine, University Hospital Basel, Basel, Switzerland
| | - Per Hoffmann
- Institute of Human Genetics, University of Bonn and Department of Genomics, Life & Brain Center, Bonn, Germany
- Human Genomics Research Group, Department of Biomedicine, University Hospital Basel, Basel, Switzerland
| | - Andrea Hofmann
- Institute of Human Genetics, University of Bonn and Department of Genomics, Life & Brain Center, Bonn, Germany
| | - Esther Jiménez
- Bipolar Disorder Program, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Jean-Pierre Kahn
- Service de Psychiatrie et Psychologie Clinique, Centre Psychothérapique de Nancy - Université de Lorraine, Nancy, France
| | - Layla Kassem
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health, US Department of Health & Human Services, Bethesda, MD, USA
| | - Po-Hsiu Kuo
- Department of Public Health & Institute of Epidemiology and Preventive Medicine, College of Public Health, National Taiwan University, Taipei, Taiwan
| | - Tadafumi Kato
- Laboratory for Molecular Dynamics of Mental Disorders, RIKEN Center for Brain Science, Saitama, Japan
| | - John R Kelsoe
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Sarah Kittel-Schneider
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - Sebastian Kliwicki
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Barbara König
- Department of Psychiatry and Psychotherapeutic Medicine, Landesklinikum Neunkirchen, Neunkirchen, Austria
| | - Ichiro Kusumi
- Department of Psychiatry, Hokkaido University Graduate School of Medicine, Sapporo, Japan
| | - Gonzalo Laje
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health, US Department of Health & Human Services, Bethesda, MD, USA
| | - Mikael Landén
- Institute of Neuroscience and Physiology, the Sahlgrenska Academy at the Gothenburg University, Gothenburg, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Catharina Lavebratt
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Marion Leboyer
- Inserm U955, Translational Psychiatry laboratory, Université Paris-Est-Créteil, Department of Psychiatry and Addictology of Mondor University Hospital, AP-HP, Fondation FondaMental, Créteil, France
| | - Susan G Leckband
- Office of Mental Health, VA San Diego Healthcare System, San Diego, CA, USA
| | | | - Mirko Manchia
- Section of Psychiatry, Department of Medical Sciences and Public Health, University of Cagliari, Cagliari, Italy
- Department of Pharmacology, Dalhousie University, Halifax, NS, Canada
| | - Lina Martinsson
- Department of Clinical Neurosciences, Karolinska Institutet, Stockholm, Sweden
| | - Michael J McCarthy
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
- Department of Psychiatry, VA San Diego Healthcare System, San Diego, CA, USA
| | - Susan L McElroy
- Department of Psychiatry, Lindner Center of Hope / University of Cincinnati, Mason, OH, USA
| | - Francesc Colom
- Mental Health Research Group, IMIM-Hospital del Mar, Barcelona, Catalonia, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Marina Mitjans
- Unitat de Zoologia i Antropologia Biològica (Dpt. Biologia Evolutiva, Ecologia i Ciències Ambientals), Facultat de Biologia and Institut de Biomedicina (IBUB), University of Barcelona, CIBERSAM, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Clinical Neuroscience, Max Planck Institute of Experimental Medicine, Göttingen, Germany
| | - Francis M Mondimore
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Palmiero Monteleone
- Neurosciences Section, Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno, Salerno, Italy
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | | | - Markus M Nöthen
- Institute of Human Genetics, University of Bonn and Department of Genomics, Life & Brain Center, Bonn, Germany
| | - Tomas Novák
- National Institute of Mental Health, Klecany, Czech Republic
| | - Claire O'Donovan
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Norio Ozaki
- Department of Psychiatry & Department of Child and Adolescent Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - Urban Ösby
- Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet and Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Andrea Pfennig
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Medical Faculty, Technische Universität Dresden, Dresden, Germany
| | - James B Potash
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - Eva Reininghaus
- Department of Psychiatry and Psychotherapeutic Medicine, Research Unit for bipolar affective disorder, Medical University of Graz, Graz, Austria
| | - Guy A Rouleau
- Montreal Neurological Institute and Hospital, McGill University, Montreal, QC, Canada
| | - Janusz K Rybakowski
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Martin Schalling
- Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Peter R Schofield
- Neuroscience Research Australia, Sydney, NSW, Australia
- School of Medical Sciences, University of New South Wales, Sydney, NSW, Australia
| | - Barbara W Schweizer
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Giovanni Severino
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Paul D Shilling
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Katzutaka Shimoda
- Department of Psychiatry, Dokkyo Medical University School of Medicine, Mibu, Tochigi, Japan
| | - Christian Simhandl
- Bipolar Center Wiener Neustadt, Sigmund Freud University, Medical Faculty, Vienna, Austria
| | - Claire M Slaney
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
| | - Alessio Squassina
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Thomas Stamm
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Germany
| | - Pavla Stopkova
- National Institute of Mental Health, Klecany, Czech Republic
| | - Mario Maj
- Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy
| | - Gustavo Turecki
- Douglas Mental Health University Institute, McGill University, Montreal, QC, Canada
| | - Eduard Vieta
- Bipolar Disorder Program, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Julia Veeh
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - Stephanie H Witt
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Adam Wright
- School of Psychiatry, University of New South Wales, and Black Dog Institute, Sydney, NSW, Australia
| | - Peter P Zandi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Philip B Mitchell
- School of Psychiatry, University of New South Wales, and Black Dog Institute, Sydney, NSW, Australia
| | - Michael Bauer
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Medical Faculty, Technische Universität Dresden, Dresden, Germany
| | - Martin Alda
- Department of Psychiatry, Dalhousie University, Halifax, NS, Canada
- National Institute of Mental Health, Klecany, Czech Republic
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Francis J McMahon
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health, US Department of Health & Human Services, Bethesda, MD, USA
| | - Thomas G Schulze
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health, US Department of Health & Human Services, Bethesda, MD, USA
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center (UMG), Georg-August University Göttingen, Göttingen, Germany
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Bernhard T Baune
- Department of Psychiatry and Psychotherapy, University of Münster, Münster, Germany.
- Department of Psychiatry, Melbourne Medical School, University of Melbourne, Parkville, VIC, Australia.
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, VIC, Australia.
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Fojo AT, Lesko CR, Benke KS, Chander G, Lau B, Moore RD, Zandi PP, Zeger SL. A learning algorithm for predicting mental health symptoms and substance use. J Psychiatr Res 2021; 134:22-29. [PMID: 33360220 PMCID: PMC8323478 DOI: 10.1016/j.jpsychires.2020.12.049] [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] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/29/2020] [Revised: 12/14/2020] [Accepted: 12/17/2020] [Indexed: 10/22/2022]
Abstract
Learning health systems use data to generate knowledge that informs clinical care, but few studies have evaluated how to leverage patient-reported mental health symptoms and substance use data to make patient-specific predictions. We developed a general Bayesian prediction algorithm that uses self-reported psychiatric symptoms and substance use within a population to predict future symptoms and substance use for individuals in that population. We validated our approach in 2444 participants from two clinical cohorts - the National Network of Depression Centers and the Johns Hopkins HIV Clinical Cohort - by predicting symptoms of depression, anxiety, and mania as well as alcohol, heroin, and cocaine use and comparing our predictions to observed symptoms and substance use. When we dichotomized mental health symptoms as moderate-severe vs. none-mild, individual predictions yielded areas under the ROC curve (AUCs) of 0.84 [95% confidence interval 0.80-0.88] and 0.85 [0.82-0.88] for symptoms of depression in the two cohorts, AUCs of 0.84 [0.79-0.88] and 0.85 [0.82-0.88] for symptoms of anxiety, and an AUC of 0.77 [0.72-0.82] for manic symptoms. Predictions of substance use yielded an AUC of 0.92 [0.88-0.97] for heroin use, 0.90 [0.82-0.97] for cocaine use, and 0.90 [0.88-092] for alcohol misuse. This rigorous, mathematically grounded approach could provide patient-specific predictions at the point of care. It can be applied to other psychiatric symptoms and substance use indicators, and is customizable to specific health systems. Such approaches can realize the potential of a learning health system to transform ever-increasing quantities of data into tangible guidance for patient care.
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Affiliation(s)
- Anthony T Fojo
- School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
| | - Catherine R Lesko
- Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Baltimore, MD, USA.
| | - Kelly S Benke
- Johns Hopkins Bloomberg School of Public Health, Department of Mental Health, Baltimore, MD, USA.
| | | | - Bryan Lau
- Johns Hopkins Bloomberg School of Public Health, Department of Epidemiology, Baltimore, MD, USA.
| | - Richard D Moore
- School of Medicine, Johns Hopkins University, Baltimore, MD, USA.
| | - Peter P Zandi
- Johns Hopkins Bloomberg School of Public Health, Department of Mental Health, Baltimore, MD, USA.
| | - Scott L Zeger
- Johns Hopkins Bloomberg School of Public Health, Department of Biostatistics, Baltimore, MD, USA.
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Athey TL, Ceritoglu C, Tward DJ, Kutten KS, DePaulo JR, Glazer K, Goes FS, Kelsoe JR, Mondimore F, Nievergelt CM, Rootes-Murdy K, Zandi PP, Ratnanather JT, Mahon PB. A 7 Tesla Amygdalar-Hippocampal Shape Analysis of Lithium Response in Bipolar Disorder. Front Psychiatry 2021; 12:614010. [PMID: 33664682 PMCID: PMC7920967 DOI: 10.3389/fpsyt.2021.614010] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/20/2020] [Accepted: 01/19/2021] [Indexed: 11/15/2022] Open
Abstract
Research to discover clinically useful predictors of lithium response in patients with bipolar disorder has largely found them to be elusive. We demonstrate here that detailed neuroimaging may have the potential to fill this important gap in mood disorder therapeutics. Lithium treatment and bipolar disorder have both been shown to affect anatomy of the hippocampi and amygdalae but there is no consensus on the nature of their effects. We aimed to investigate structural surface anatomy changes in amygdala and hippocampus correlated with treatment response in bipolar disorder. Patients with bipolar disorder (N = 14) underwent lithium treatment, were classified by response status at acute and long-term time points, and scanned with 7 Tesla structural MRI. Large Deformation Diffeomorphic Metric Mapping was applied to detect local differences in hippocampal and amygdalar anatomy between lithium responders and non-responders. Anatomy was also compared to 21 healthy comparison participants. A patch of the ventral surface of the left hippocampus was found to be significantly atrophied in non-responders as compared to responders at the acute time point and was associated at a trend-level with long-term response status. We did not detect an association between response status and surface anatomy of the right hippocampus or amygdala. To the best of our knowledge, this is the first shape analysis of hippocampus and amygdala in bipolar disorder using 7 Tesla MRI. These results can inform future work investigating possible neuroimaging predictors of lithium response in bipolar disorder.
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Affiliation(s)
- Thomas L Athey
- Center for Imaging Science, Johns Hopkins University, Baltimore, MD, United States.,Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD, United States.,Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, United States
| | - Can Ceritoglu
- Center for Imaging Science, Johns Hopkins University, Baltimore, MD, United States
| | - Daniel J Tward
- Center for Imaging Science, Johns Hopkins University, Baltimore, MD, United States.,Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD, United States.,Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, United States
| | - Kwame S Kutten
- Center for Imaging Science, Johns Hopkins University, Baltimore, MD, United States
| | - J Raymond DePaulo
- Department of Psychiatry and Behavioral Science, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Kara Glazer
- Department of Occupational Therapy, Boston University, Boston, MA, United States
| | - Fernando S Goes
- Department of Psychiatry and Behavioral Science, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - John R Kelsoe
- Department of Psychiatry, VA San Diego Healthcare System, La Jolla, CA, United States.,Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States
| | - Francis Mondimore
- Department of Psychiatry and Behavioral Science, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Caroline M Nievergelt
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, United States
| | - Kelly Rootes-Murdy
- Department of Psychology, Georgia State University, Atlanta, GA, United States
| | - Peter P Zandi
- Department of Psychiatry and Behavioral Science, Johns Hopkins School of Medicine, Baltimore, MD, United States.,Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - J Tilak Ratnanather
- Center for Imaging Science, Johns Hopkins University, Baltimore, MD, United States.,Institute for Computational Medicine, Johns Hopkins University, Baltimore, MD, United States.,Department of Biomedical Engineering, Johns Hopkins University, Baltimore, MD, United States
| | - Pamela B Mahon
- Department of Psychiatry and Behavioral Science, Johns Hopkins School of Medicine, Baltimore, MD, United States.,Department of Psychiatry, Brigham & Women's Hospital, Boston, MA, United States.,Department of Psychiatry, Harvard School of Medicine, Boston, MA, United States
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32
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Lin Y, Mojtabai R, Goes FS, Zandi PP. Trends in prescriptions of lithium and other medications for patients with bipolar disorder in office-based practices in the United States: 1996-2015. J Affect Disord 2020; 276:883-889. [PMID: 32739706 DOI: 10.1016/j.jad.2020.07.063] [Citation(s) in RCA: 16] [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] [Received: 01/18/2020] [Revised: 05/09/2020] [Accepted: 07/05/2020] [Indexed: 01/28/2023]
Abstract
BACKGROUND Studies have shown that rates of lithium use for bipolar disorder in the United States declined through the 1990s as other mood stabilizing anticonvulsants and second-generation antipsychotics (SGAs) became more popular. We examined trends of medications for bipolar disorder from 1996 to 2015. METHODS Twenty years of data from the National Ambulatory Medical Care Survey (NAMCS) were used. Weighted percentages of reported use of lithium, anticonvulsants, SGAs and antidepressants were calculated over two-year intervals. Logistic regression was used to examine factors related to polytherapy. RESULTS Reported use of lithium declined from 38.1% (95%CI: 29.8% - 46.3%) in 1996-97 to 14.3% (95%CI: 10.6% - 18.1%) in 2006-07 and has remained stable since. During this time, reports of SGAs more than doubled. SGAs and/or anticonvulsants were reported in 75.4% (95%CI: 69.5% - 81.3%) of visits with bipolar diagnoses in 2014-15. Polytherapy increased by approximately 3% every two years and in 2014-15 occurred in over 30% of visits. Antidepressants were reported in 40-50% of visits, but their reported use without other mood stabilizers decreased from 18.2% (95%CI: 11.7% - 24.8%) in 1998-99 to 7.5% (95%CI: 4.2% - 10.9%) in 2014-15. LIMITATIONS The sample had limited power to study the effect of individual medications or the potential for differing effects in certain sub-groups of patients. CONCLUSIONS This study further documents the declining use of lithium for bipolar disorder, and corresponding increase in use of anticonvulsants and SGAs, despite the fact that lithium is typically recommended as a first line therapy for bipolar disorder.
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Affiliation(s)
- Yian Lin
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Ramin Mojtabai
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States
| | - Fernando S Goes
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States
| | - Peter P Zandi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, United States; Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, United States.
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33
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Musliner KL, Krebs MD, Albiñana C, Vilhjalmsson B, Agerbo E, Zandi PP, Hougaard DM, Nordentoft M, Børglum AD, Werge T, Mortensen PB, Østergaard SD. Polygenic Risk and Progression to Bipolar or Psychotic Disorders Among Individuals Diagnosed With Unipolar Depression in Early Life. Am J Psychiatry 2020; 177:936-943. [PMID: 32660297 DOI: 10.1176/appi.ajp.2020.19111195] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [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] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The authors investigated the associations between polygenic liability and progression to bipolar disorder or psychotic disorders among individuals diagnosed with unipolar depression in early life. METHODS A cohort comprising 16,949 individuals (69% female, 10-35 years old at the first depression diagnosis) from the iPSYCH Danish case-cohort study (iPSYCH2012) who were diagnosed with depression in Danish psychiatric hospitals from 1994 to 2016 was examined. Polygenic risk scores (PRSs) for major depression, bipolar disorder, and schizophrenia were generated using the most recent results from the Psychiatric Genomics Consortium. Hazard ratios for each disorder-specific PRS were estimated using Cox regressions with adjustment for the other two PRSs. Absolute risk of progression was estimated using the cumulative hazard. RESULTS Patients were followed for up to 21 years (median=7 years, interquartile range, 5-10 years). The absolute risks of progression to bipolar disorder and psychotic disorders were 7.3% and 13.8%, respectively. After mutual adjustment for the other PRSs, only the PRS for bipolar disorder predicted progression to bipolar disorder (adjusted hazard ratio for a one-standard-deviation increase in PRS=1.11, 95% CI=1.03, 1.21), and only the PRS for schizophrenia predicted progression to psychotic disorders (adjusted hazard ratio=1.10, 95% CI=1.04, 1.16). After adjusting for PRSs, parental history still strongly predicted progression to bipolar disorder (adjusted hazard ratio=5.02, 95% CI=3.53, 7.14) and psychotic disorders (adjusted hazard ratio=1.63, 95% CI=1.30, 2.06). CONCLUSIONS PRSs for bipolar disorder and schizophrenia are associated with risk for progression to bipolar disorder or psychotic disorders, respectively, among individuals diagnosed with depression; however, the effects are small compared with parental history, particularly for bipolar disorder.
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Affiliation(s)
- Katherine L Musliner
- Department of Economics and Business Economics, National Center for Register-Based Research, Aarhus University, Aarhus, Denmark (Musliner, Albiñana, Vilhjalmsson, Agerbo, Mortensen); Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark (Musliner, Krebs, Albiñana, Hougaard, Vilhjalmsson, Agerbo, Nordentoft, Børglum, Werge, Mortensen, Østergaard); Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services, Roskilde, Denmark (Krebs, Werge); Center for Integrated Register-Based Research, Aarhus University, Aarhus (Agerbo, Mortensen); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Zandi); Department for Congenital Disorders, Danish Center for Neonatal Screening, Statens Serum Institut, Copenhagen (Hougaard); Department of Clinical Medicine, Copenhagen Research Center for Mental Health, Copenhagen University Hospital, Copenhagen (Nordentoft); Center for Genomics and Personalized Medicine, Aarhus (Børglum); Department of Biomedicine and the Center for Integrative Sequencing (Børglum), and Department of Clinical Medicine (Østergaard), Aarhus University, Aarhus; and Department of Affective Disorders, Aarhus University Hospital-Psychiatry, Aarhus (Østergaard)
| | - Morten D Krebs
- Department of Economics and Business Economics, National Center for Register-Based Research, Aarhus University, Aarhus, Denmark (Musliner, Albiñana, Vilhjalmsson, Agerbo, Mortensen); Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark (Musliner, Krebs, Albiñana, Hougaard, Vilhjalmsson, Agerbo, Nordentoft, Børglum, Werge, Mortensen, Østergaard); Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services, Roskilde, Denmark (Krebs, Werge); Center for Integrated Register-Based Research, Aarhus University, Aarhus (Agerbo, Mortensen); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Zandi); Department for Congenital Disorders, Danish Center for Neonatal Screening, Statens Serum Institut, Copenhagen (Hougaard); Department of Clinical Medicine, Copenhagen Research Center for Mental Health, Copenhagen University Hospital, Copenhagen (Nordentoft); Center for Genomics and Personalized Medicine, Aarhus (Børglum); Department of Biomedicine and the Center for Integrative Sequencing (Børglum), and Department of Clinical Medicine (Østergaard), Aarhus University, Aarhus; and Department of Affective Disorders, Aarhus University Hospital-Psychiatry, Aarhus (Østergaard)
| | - Clara Albiñana
- Department of Economics and Business Economics, National Center for Register-Based Research, Aarhus University, Aarhus, Denmark (Musliner, Albiñana, Vilhjalmsson, Agerbo, Mortensen); Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark (Musliner, Krebs, Albiñana, Hougaard, Vilhjalmsson, Agerbo, Nordentoft, Børglum, Werge, Mortensen, Østergaard); Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services, Roskilde, Denmark (Krebs, Werge); Center for Integrated Register-Based Research, Aarhus University, Aarhus (Agerbo, Mortensen); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Zandi); Department for Congenital Disorders, Danish Center for Neonatal Screening, Statens Serum Institut, Copenhagen (Hougaard); Department of Clinical Medicine, Copenhagen Research Center for Mental Health, Copenhagen University Hospital, Copenhagen (Nordentoft); Center for Genomics and Personalized Medicine, Aarhus (Børglum); Department of Biomedicine and the Center for Integrative Sequencing (Børglum), and Department of Clinical Medicine (Østergaard), Aarhus University, Aarhus; and Department of Affective Disorders, Aarhus University Hospital-Psychiatry, Aarhus (Østergaard)
| | - Bjarni Vilhjalmsson
- Department of Economics and Business Economics, National Center for Register-Based Research, Aarhus University, Aarhus, Denmark (Musliner, Albiñana, Vilhjalmsson, Agerbo, Mortensen); Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark (Musliner, Krebs, Albiñana, Hougaard, Vilhjalmsson, Agerbo, Nordentoft, Børglum, Werge, Mortensen, Østergaard); Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services, Roskilde, Denmark (Krebs, Werge); Center for Integrated Register-Based Research, Aarhus University, Aarhus (Agerbo, Mortensen); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Zandi); Department for Congenital Disorders, Danish Center for Neonatal Screening, Statens Serum Institut, Copenhagen (Hougaard); Department of Clinical Medicine, Copenhagen Research Center for Mental Health, Copenhagen University Hospital, Copenhagen (Nordentoft); Center for Genomics and Personalized Medicine, Aarhus (Børglum); Department of Biomedicine and the Center for Integrative Sequencing (Børglum), and Department of Clinical Medicine (Østergaard), Aarhus University, Aarhus; and Department of Affective Disorders, Aarhus University Hospital-Psychiatry, Aarhus (Østergaard)
| | - Esben Agerbo
- Department of Economics and Business Economics, National Center for Register-Based Research, Aarhus University, Aarhus, Denmark (Musliner, Albiñana, Vilhjalmsson, Agerbo, Mortensen); Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark (Musliner, Krebs, Albiñana, Hougaard, Vilhjalmsson, Agerbo, Nordentoft, Børglum, Werge, Mortensen, Østergaard); Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services, Roskilde, Denmark (Krebs, Werge); Center for Integrated Register-Based Research, Aarhus University, Aarhus (Agerbo, Mortensen); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Zandi); Department for Congenital Disorders, Danish Center for Neonatal Screening, Statens Serum Institut, Copenhagen (Hougaard); Department of Clinical Medicine, Copenhagen Research Center for Mental Health, Copenhagen University Hospital, Copenhagen (Nordentoft); Center for Genomics and Personalized Medicine, Aarhus (Børglum); Department of Biomedicine and the Center for Integrative Sequencing (Børglum), and Department of Clinical Medicine (Østergaard), Aarhus University, Aarhus; and Department of Affective Disorders, Aarhus University Hospital-Psychiatry, Aarhus (Østergaard)
| | - Peter P Zandi
- Department of Economics and Business Economics, National Center for Register-Based Research, Aarhus University, Aarhus, Denmark (Musliner, Albiñana, Vilhjalmsson, Agerbo, Mortensen); Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark (Musliner, Krebs, Albiñana, Hougaard, Vilhjalmsson, Agerbo, Nordentoft, Børglum, Werge, Mortensen, Østergaard); Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services, Roskilde, Denmark (Krebs, Werge); Center for Integrated Register-Based Research, Aarhus University, Aarhus (Agerbo, Mortensen); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Zandi); Department for Congenital Disorders, Danish Center for Neonatal Screening, Statens Serum Institut, Copenhagen (Hougaard); Department of Clinical Medicine, Copenhagen Research Center for Mental Health, Copenhagen University Hospital, Copenhagen (Nordentoft); Center for Genomics and Personalized Medicine, Aarhus (Børglum); Department of Biomedicine and the Center for Integrative Sequencing (Børglum), and Department of Clinical Medicine (Østergaard), Aarhus University, Aarhus; and Department of Affective Disorders, Aarhus University Hospital-Psychiatry, Aarhus (Østergaard)
| | - David M Hougaard
- Department of Economics and Business Economics, National Center for Register-Based Research, Aarhus University, Aarhus, Denmark (Musliner, Albiñana, Vilhjalmsson, Agerbo, Mortensen); Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark (Musliner, Krebs, Albiñana, Hougaard, Vilhjalmsson, Agerbo, Nordentoft, Børglum, Werge, Mortensen, Østergaard); Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services, Roskilde, Denmark (Krebs, Werge); Center for Integrated Register-Based Research, Aarhus University, Aarhus (Agerbo, Mortensen); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Zandi); Department for Congenital Disorders, Danish Center for Neonatal Screening, Statens Serum Institut, Copenhagen (Hougaard); Department of Clinical Medicine, Copenhagen Research Center for Mental Health, Copenhagen University Hospital, Copenhagen (Nordentoft); Center for Genomics and Personalized Medicine, Aarhus (Børglum); Department of Biomedicine and the Center for Integrative Sequencing (Børglum), and Department of Clinical Medicine (Østergaard), Aarhus University, Aarhus; and Department of Affective Disorders, Aarhus University Hospital-Psychiatry, Aarhus (Østergaard)
| | - Merete Nordentoft
- Department of Economics and Business Economics, National Center for Register-Based Research, Aarhus University, Aarhus, Denmark (Musliner, Albiñana, Vilhjalmsson, Agerbo, Mortensen); Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark (Musliner, Krebs, Albiñana, Hougaard, Vilhjalmsson, Agerbo, Nordentoft, Børglum, Werge, Mortensen, Østergaard); Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services, Roskilde, Denmark (Krebs, Werge); Center for Integrated Register-Based Research, Aarhus University, Aarhus (Agerbo, Mortensen); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Zandi); Department for Congenital Disorders, Danish Center for Neonatal Screening, Statens Serum Institut, Copenhagen (Hougaard); Department of Clinical Medicine, Copenhagen Research Center for Mental Health, Copenhagen University Hospital, Copenhagen (Nordentoft); Center for Genomics and Personalized Medicine, Aarhus (Børglum); Department of Biomedicine and the Center for Integrative Sequencing (Børglum), and Department of Clinical Medicine (Østergaard), Aarhus University, Aarhus; and Department of Affective Disorders, Aarhus University Hospital-Psychiatry, Aarhus (Østergaard)
| | - Anders D Børglum
- Department of Economics and Business Economics, National Center for Register-Based Research, Aarhus University, Aarhus, Denmark (Musliner, Albiñana, Vilhjalmsson, Agerbo, Mortensen); Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark (Musliner, Krebs, Albiñana, Hougaard, Vilhjalmsson, Agerbo, Nordentoft, Børglum, Werge, Mortensen, Østergaard); Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services, Roskilde, Denmark (Krebs, Werge); Center for Integrated Register-Based Research, Aarhus University, Aarhus (Agerbo, Mortensen); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Zandi); Department for Congenital Disorders, Danish Center for Neonatal Screening, Statens Serum Institut, Copenhagen (Hougaard); Department of Clinical Medicine, Copenhagen Research Center for Mental Health, Copenhagen University Hospital, Copenhagen (Nordentoft); Center for Genomics and Personalized Medicine, Aarhus (Børglum); Department of Biomedicine and the Center for Integrative Sequencing (Børglum), and Department of Clinical Medicine (Østergaard), Aarhus University, Aarhus; and Department of Affective Disorders, Aarhus University Hospital-Psychiatry, Aarhus (Østergaard)
| | - Thomas Werge
- Department of Economics and Business Economics, National Center for Register-Based Research, Aarhus University, Aarhus, Denmark (Musliner, Albiñana, Vilhjalmsson, Agerbo, Mortensen); Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark (Musliner, Krebs, Albiñana, Hougaard, Vilhjalmsson, Agerbo, Nordentoft, Børglum, Werge, Mortensen, Østergaard); Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services, Roskilde, Denmark (Krebs, Werge); Center for Integrated Register-Based Research, Aarhus University, Aarhus (Agerbo, Mortensen); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Zandi); Department for Congenital Disorders, Danish Center for Neonatal Screening, Statens Serum Institut, Copenhagen (Hougaard); Department of Clinical Medicine, Copenhagen Research Center for Mental Health, Copenhagen University Hospital, Copenhagen (Nordentoft); Center for Genomics and Personalized Medicine, Aarhus (Børglum); Department of Biomedicine and the Center for Integrative Sequencing (Børglum), and Department of Clinical Medicine (Østergaard), Aarhus University, Aarhus; and Department of Affective Disorders, Aarhus University Hospital-Psychiatry, Aarhus (Østergaard)
| | - Preben B Mortensen
- Department of Economics and Business Economics, National Center for Register-Based Research, Aarhus University, Aarhus, Denmark (Musliner, Albiñana, Vilhjalmsson, Agerbo, Mortensen); Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark (Musliner, Krebs, Albiñana, Hougaard, Vilhjalmsson, Agerbo, Nordentoft, Børglum, Werge, Mortensen, Østergaard); Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services, Roskilde, Denmark (Krebs, Werge); Center for Integrated Register-Based Research, Aarhus University, Aarhus (Agerbo, Mortensen); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Zandi); Department for Congenital Disorders, Danish Center for Neonatal Screening, Statens Serum Institut, Copenhagen (Hougaard); Department of Clinical Medicine, Copenhagen Research Center for Mental Health, Copenhagen University Hospital, Copenhagen (Nordentoft); Center for Genomics and Personalized Medicine, Aarhus (Børglum); Department of Biomedicine and the Center for Integrative Sequencing (Børglum), and Department of Clinical Medicine (Østergaard), Aarhus University, Aarhus; and Department of Affective Disorders, Aarhus University Hospital-Psychiatry, Aarhus (Østergaard)
| | - Søren D Østergaard
- Department of Economics and Business Economics, National Center for Register-Based Research, Aarhus University, Aarhus, Denmark (Musliner, Albiñana, Vilhjalmsson, Agerbo, Mortensen); Lundbeck Foundation Initiative for Integrative Psychiatric Research, Denmark (Musliner, Krebs, Albiñana, Hougaard, Vilhjalmsson, Agerbo, Nordentoft, Børglum, Werge, Mortensen, Østergaard); Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services, Roskilde, Denmark (Krebs, Werge); Center for Integrated Register-Based Research, Aarhus University, Aarhus (Agerbo, Mortensen); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Zandi); Department for Congenital Disorders, Danish Center for Neonatal Screening, Statens Serum Institut, Copenhagen (Hougaard); Department of Clinical Medicine, Copenhagen Research Center for Mental Health, Copenhagen University Hospital, Copenhagen (Nordentoft); Center for Genomics and Personalized Medicine, Aarhus (Børglum); Department of Biomedicine and the Center for Integrative Sequencing (Børglum), and Department of Clinical Medicine (Østergaard), Aarhus University, Aarhus; and Department of Affective Disorders, Aarhus University Hospital-Psychiatry, Aarhus (Østergaard)
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34
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Soda T, McLoughlin DM, Clark SR, Oltedal L, Kessler U, Haavik J, Bousman C, Smith DJ, Bioque M, Clements CC, Loo C, Vila-Rodriguez F, Minelli A, Mickey BJ, Milev R, Docherty AR, Langan Martin J, Achtyes ED, Arolt V, Redlich R, Dannlowski U, Cardoner N, Clare E, Craddock N, Di Florio A, Dmitrzak-Weglarz M, Forty L, Gordon-Smith K, Husain M, Ingram WM, Jones L, Jones I, Juruena M, Kirov G, Landén M, Müller DJ, Nordensköld A, Pålsson E, Paul M, Permoda A, Pliszka B, Rea J, Schubert KO, Sonnen JA, Soria V, Stageman W, Takamiya A, Urretavizacaya M, Watson S, Zavorotny M, Young AH, Vieta E, Rybakowski JK, Gennarelli M, Zandi PP, Sullivan PF, Baune BT. International Consortium on the Genetics of Electroconvulsive Therapy and Severe Depressive Disorders (Gen-ECT-ic). Eur Arch Psychiatry Clin Neurosci 2020; 270:921-932. [PMID: 31802253 PMCID: PMC7385979 DOI: 10.1007/s00406-019-01087-w] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2019] [Accepted: 11/16/2019] [Indexed: 02/05/2023]
Abstract
Recent genome-wide association studies have demonstrated that the genetic burden associated with depression correlates with depression severity. Therefore, conducting genetic studies of patients at the most severe end of the depressive disorder spectrum, those with treatment-resistant depression and who are prescribed electroconvulsive therapy (ECT), could lead to a better understanding of the genetic underpinnings of depression. Despite ECT being one of the most effective forms of treatment for severe depressive disorders, it is usually placed at the end of treatment algorithms of current guidelines. This is perhaps because ECT has controlled risk and logistical demands including use of general anaesthesia and muscle relaxants and side-effects such as short-term memory impairment. Better understanding of the genetics and biology of ECT response and of cognitive side-effects could lead to more personalized treatment decisions. To enhance the understanding of the genomics of severe depression and ECT response, researchers and ECT providers from around the world and from various depression or ECT networks, but not limited to, such as the Psychiatric Genomics Consortium, the Clinical Alliance and Research in ECT, and the National Network of Depression Centers have formed the Genetics of ECT International Consortium (Gen-ECT-ic). Gen-ECT-ic will organize the largest clinical and genetic collection to date to study the genomics of severe depressive disorders and response to ECT, aiming for 30,000 patients worldwide using a GWAS approach. At this stage it will be the largest genomic study on treatment response in depression. Retrospective data abstraction and prospective data collection will be facilitated by a uniform data collection approach that is flexible and will incorporate data from many clinical practices. Gen-ECT-ic invites all ECT providers and researchers to join its efforts.
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Affiliation(s)
- Takahiro Soda
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
| | - Declan M McLoughlin
- Department of Psychiatry and Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
| | - Scott R Clark
- Discipline of Psychiatry, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
| | - Leif Oltedal
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
- Department of Radiology, Mohn Medical Imaging and Visualization Centre, Haukeland University Hospital, Bergen, Norway
| | - Ute Kessler
- Department of Clinical Medicine, University of Bergen, Bergen, Norway
- Haukeland University Hospital, Bergen, Norway
| | - Jan Haavik
- Haukeland University Hospital, Bergen, Norway
- Department of Biomedicine, University of Bergen, Bergen, Norway
| | - Chad Bousman
- Department of Medical Genetics, Cumming School of Medicine, University of Calgary, Calgary, AB, Canada
| | - Daniel J Smith
- Institute of Health and Wellbeing, University of Glasgow, Glasgow, UK
| | - Miquel Bioque
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | | | - Colleen Loo
- School of Psychiatry, UNSW Sydney, Sydney, NSW, Australia
- Sydney Neurostimulation Centre, Black Dog Institute, Randwick, NSW, Australia
| | - Fidel Vila-Rodriguez
- Non-Invasive Neurostimulation Therapies Laboratory, Department of Psychiatry, University of British Columbia, Vancouver, BC, Canada
| | - Alessandra Minelli
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
| | - Brian J Mickey
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, USA
| | - Roumen Milev
- Departments of Psychiatry and Psychology, Queen's University, Kingston, ON, Canada
- Providence Care Hospital, Kingston, ON, Canada
| | - Anna R Docherty
- Department of Psychiatry, University of Utah School of Medicine, Salt Lake City, UT, USA
| | | | - Eric D Achtyes
- Pine Rest Christian Mental Health Services, Grand Rapids, MI, USA
| | - Volker Arolt
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Ronny Redlich
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Udo Dannlowski
- Department of Psychiatry, University of Münster, Münster, Germany
| | - Narcis Cardoner
- Department of Mental Health, Parc Taulí Hospital Universitari, Institut D'INVESTIGACIÓ i Innovació Parc Taulí I3PT, Universitat Autònoma de Barcelona, Sabadell, Spain
| | - Emily Clare
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Nick Craddock
- Division of Psychological Medicine and Clinical Neuroscience, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Arianna Di Florio
- Division of Psychological Medicine and Clinical Neuroscience, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | | | - Liz Forty
- Division of Psychological Medicine and Clinical Neuroscience, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | | | | | - Wendy M Ingram
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Lisa Jones
- Psychological Medicine, University of Worcester, Worcester, UK
| | - Ian Jones
- Division of Psychological Medicine and Clinical Neuroscience, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Mario Juruena
- Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - George Kirov
- Division of Psychological Medicine and Clinical Neuroscience, National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Mikael Landén
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the Gothenburg University, Gothenburg, Sweden
| | - Daniel J Müller
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Axel Nordensköld
- Faculty of Medicine and Health, University Health Care Research Centre, Örebro University, Örebro, Sweden
| | - Erik Pålsson
- Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, Sahlgrenska Academy at the Gothenburg University, Gothenburg, Sweden
| | - Meethu Paul
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Agnieszka Permoda
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Bartlomiej Pliszka
- Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Jamie Rea
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Klaus O Schubert
- Discipline of Psychiatry, Adelaide Medical School, University of Adelaide, Adelaide, SA, Australia
- Northern Adelaide Mental Health Service, Salisbury, SA, Australia
| | - Joshua A Sonnen
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Virginia Soria
- Department of Pathology, University of Utah, Salt Lake City, UT, USA
| | - Will Stageman
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
- Institute of Neuroscience, Newcastle University and NTW NHS Trust, Newcastle, UK
| | - Akihiro Takamiya
- Department of Neuropsychiatry, Keio University School of Medicine, Tokyo, Japan
| | | | - Stuart Watson
- Cumbria, Northumberland, Tyne and Wear NHS Foundation Trust, Newcastle upon Tyne, UK
- Institute of Neuroscience, Newcastle University and NTW NHS Trust, Newcastle, UK
| | - Maxim Zavorotny
- Department of Psychiatry, University of Marburg, Marburg, Germany
| | - Allan H Young
- Psychological Medicine, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Eduard Vieta
- Department of Psychiatry and Psychology, Institute of Neuroscience, Hospital Clínic de Barcelona, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Spain
| | - Janusz K Rybakowski
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
- Department of Psychiatric Nursing, Poznan University of Medical Sciences, Poznan, Poland
| | - Massimo Gennarelli
- Department of Molecular and Translational Medicine, University of Brescia, Brescia, Italy
- Genetic Unit, IRCCS Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Peter P Zandi
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Patrick F Sullivan
- Department of Psychiatry, University of North Carolina, Chapel Hill, NC, USA
- Genetics, University of North Carolina at Chapel Hill, Chapel Hill, NC, 27514, USA
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Bernhard T Baune
- Department of Psychiatry, University of Münster, Münster, Germany.
- Department of Psychiatry, Melbourne Medical School, The University of Melbourne, Parkville, Australia.
- The Florey Institute of Neuroscience and Mental Health, The University of Melbourne, Parkville, Australia.
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35
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Zandi PP, Wang YH, Patel PD, Katzelnick D, Turvey CL, Wright JH, Ajilore O, Coryell W, Schneck CD, Guille C, Saunders EFH, Lazarus SA, Cuellar VA, Selvaraj S, Dill Rinvelt P, Greden JF, DePaulo JR. Development of the National Network of Depression Centers Mood Outcomes Program: A Multisite Platform for Measurement-Based Care. Psychiatr Serv 2020; 71:456-464. [PMID: 31960777 DOI: 10.1176/appi.ps.201900481] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [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: 12/01/2022]
Abstract
OBJECTIVES Mood disorders are among the most burdensome public health concerns. The National Network of Depression Centers (NNDC) is a nonprofit consortium of 26 leading clinical and academic member centers in the United States providing care for patients with mood disorders, including depression and bipolar disorder. The NNDC has established a measurement-based care program called the Mood Outcomes Program whereby participating sites follow a standard protocol to electronically collect patient-reported outcome assessments on depression, anxiety, and suicidal ideation in routine clinical care. This article describes the approaches taken to develop and implement the program. METHODS Since 2015, eight pilot sites have implemented the program and followed more than 10,000 patients. This pilot study presents descriptive statistics based on the first 24-month period of data collection. RESULTS In this sample, 58.6% of patients with bipolar disorder (N=849) and 57.5% of patients with unipolar depression (N=3,998) remained symptomatic at follow-up. Lifetime rates of planned or actual suicide attempts were high, ranging from 27.6% for patients with unipolar mood disorders to 33.5% for patients with bipolar disorder. Men, unmarried individuals, and those with comorbid anxiety had a poorer longitudinal course. This initial snapshot of clinical burden is consistent with public health data indicating that mood disorders are severely debilitating. CONCLUSIONS This study demonstrates the potential of the Mood Outcomes Program to create a nationwide "learning health system" for mood disorders. This goal will be further realized as the program expands in reach and scope across additional NNDC sites.
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Affiliation(s)
- Peter P Zandi
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (Zandi, DePaulo); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Zandi, Wang); Department of Psychiatry (Patel) and Comprehensive Depression Center (Greden), both at University of Michigan, Ann Arbor; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota (Katzelnick); Department of Psychiatry, University of Iowa Healthcare, Iowa City (Turvey); Depression Center, University of Louisville, Louisville, Kentucky (Wright); Department of Psychiatry, University of Illinois at Chicago, Chicago (Ajilore); Department of Psychiatry, University of Iowa College of Medicine, Iowa City (Coryell); Department of Psychiatry, University of Colorado, Boulder (Schneck); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston (Guille); Department of Psychiatry, Penn State Hershey Medical Center, Hershey, Pennsylvania (Saunders); Department of Psychology, Ohio State University, Columbus (Lazarus); Center of Excellence on Mood Disorders (Cuellar) and Department of Psychiatry and Behavioral Sciences (Selvaraj), both at University of Texas Health Science Center, Houston; National Network of Mood Disorders, Ann Arbor, Michigan (Dill Rinvelt)
| | - Yu-Hsun Wang
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (Zandi, DePaulo); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Zandi, Wang); Department of Psychiatry (Patel) and Comprehensive Depression Center (Greden), both at University of Michigan, Ann Arbor; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota (Katzelnick); Department of Psychiatry, University of Iowa Healthcare, Iowa City (Turvey); Depression Center, University of Louisville, Louisville, Kentucky (Wright); Department of Psychiatry, University of Illinois at Chicago, Chicago (Ajilore); Department of Psychiatry, University of Iowa College of Medicine, Iowa City (Coryell); Department of Psychiatry, University of Colorado, Boulder (Schneck); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston (Guille); Department of Psychiatry, Penn State Hershey Medical Center, Hershey, Pennsylvania (Saunders); Department of Psychology, Ohio State University, Columbus (Lazarus); Center of Excellence on Mood Disorders (Cuellar) and Department of Psychiatry and Behavioral Sciences (Selvaraj), both at University of Texas Health Science Center, Houston; National Network of Mood Disorders, Ann Arbor, Michigan (Dill Rinvelt)
| | - Paresh D Patel
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (Zandi, DePaulo); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Zandi, Wang); Department of Psychiatry (Patel) and Comprehensive Depression Center (Greden), both at University of Michigan, Ann Arbor; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota (Katzelnick); Department of Psychiatry, University of Iowa Healthcare, Iowa City (Turvey); Depression Center, University of Louisville, Louisville, Kentucky (Wright); Department of Psychiatry, University of Illinois at Chicago, Chicago (Ajilore); Department of Psychiatry, University of Iowa College of Medicine, Iowa City (Coryell); Department of Psychiatry, University of Colorado, Boulder (Schneck); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston (Guille); Department of Psychiatry, Penn State Hershey Medical Center, Hershey, Pennsylvania (Saunders); Department of Psychology, Ohio State University, Columbus (Lazarus); Center of Excellence on Mood Disorders (Cuellar) and Department of Psychiatry and Behavioral Sciences (Selvaraj), both at University of Texas Health Science Center, Houston; National Network of Mood Disorders, Ann Arbor, Michigan (Dill Rinvelt)
| | - David Katzelnick
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (Zandi, DePaulo); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Zandi, Wang); Department of Psychiatry (Patel) and Comprehensive Depression Center (Greden), both at University of Michigan, Ann Arbor; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota (Katzelnick); Department of Psychiatry, University of Iowa Healthcare, Iowa City (Turvey); Depression Center, University of Louisville, Louisville, Kentucky (Wright); Department of Psychiatry, University of Illinois at Chicago, Chicago (Ajilore); Department of Psychiatry, University of Iowa College of Medicine, Iowa City (Coryell); Department of Psychiatry, University of Colorado, Boulder (Schneck); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston (Guille); Department of Psychiatry, Penn State Hershey Medical Center, Hershey, Pennsylvania (Saunders); Department of Psychology, Ohio State University, Columbus (Lazarus); Center of Excellence on Mood Disorders (Cuellar) and Department of Psychiatry and Behavioral Sciences (Selvaraj), both at University of Texas Health Science Center, Houston; National Network of Mood Disorders, Ann Arbor, Michigan (Dill Rinvelt)
| | - Carolyn L Turvey
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (Zandi, DePaulo); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Zandi, Wang); Department of Psychiatry (Patel) and Comprehensive Depression Center (Greden), both at University of Michigan, Ann Arbor; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota (Katzelnick); Department of Psychiatry, University of Iowa Healthcare, Iowa City (Turvey); Depression Center, University of Louisville, Louisville, Kentucky (Wright); Department of Psychiatry, University of Illinois at Chicago, Chicago (Ajilore); Department of Psychiatry, University of Iowa College of Medicine, Iowa City (Coryell); Department of Psychiatry, University of Colorado, Boulder (Schneck); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston (Guille); Department of Psychiatry, Penn State Hershey Medical Center, Hershey, Pennsylvania (Saunders); Department of Psychology, Ohio State University, Columbus (Lazarus); Center of Excellence on Mood Disorders (Cuellar) and Department of Psychiatry and Behavioral Sciences (Selvaraj), both at University of Texas Health Science Center, Houston; National Network of Mood Disorders, Ann Arbor, Michigan (Dill Rinvelt)
| | - Jesse H Wright
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (Zandi, DePaulo); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Zandi, Wang); Department of Psychiatry (Patel) and Comprehensive Depression Center (Greden), both at University of Michigan, Ann Arbor; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota (Katzelnick); Department of Psychiatry, University of Iowa Healthcare, Iowa City (Turvey); Depression Center, University of Louisville, Louisville, Kentucky (Wright); Department of Psychiatry, University of Illinois at Chicago, Chicago (Ajilore); Department of Psychiatry, University of Iowa College of Medicine, Iowa City (Coryell); Department of Psychiatry, University of Colorado, Boulder (Schneck); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston (Guille); Department of Psychiatry, Penn State Hershey Medical Center, Hershey, Pennsylvania (Saunders); Department of Psychology, Ohio State University, Columbus (Lazarus); Center of Excellence on Mood Disorders (Cuellar) and Department of Psychiatry and Behavioral Sciences (Selvaraj), both at University of Texas Health Science Center, Houston; National Network of Mood Disorders, Ann Arbor, Michigan (Dill Rinvelt)
| | - Olusola Ajilore
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (Zandi, DePaulo); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Zandi, Wang); Department of Psychiatry (Patel) and Comprehensive Depression Center (Greden), both at University of Michigan, Ann Arbor; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota (Katzelnick); Department of Psychiatry, University of Iowa Healthcare, Iowa City (Turvey); Depression Center, University of Louisville, Louisville, Kentucky (Wright); Department of Psychiatry, University of Illinois at Chicago, Chicago (Ajilore); Department of Psychiatry, University of Iowa College of Medicine, Iowa City (Coryell); Department of Psychiatry, University of Colorado, Boulder (Schneck); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston (Guille); Department of Psychiatry, Penn State Hershey Medical Center, Hershey, Pennsylvania (Saunders); Department of Psychology, Ohio State University, Columbus (Lazarus); Center of Excellence on Mood Disorders (Cuellar) and Department of Psychiatry and Behavioral Sciences (Selvaraj), both at University of Texas Health Science Center, Houston; National Network of Mood Disorders, Ann Arbor, Michigan (Dill Rinvelt)
| | - William Coryell
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (Zandi, DePaulo); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Zandi, Wang); Department of Psychiatry (Patel) and Comprehensive Depression Center (Greden), both at University of Michigan, Ann Arbor; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota (Katzelnick); Department of Psychiatry, University of Iowa Healthcare, Iowa City (Turvey); Depression Center, University of Louisville, Louisville, Kentucky (Wright); Department of Psychiatry, University of Illinois at Chicago, Chicago (Ajilore); Department of Psychiatry, University of Iowa College of Medicine, Iowa City (Coryell); Department of Psychiatry, University of Colorado, Boulder (Schneck); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston (Guille); Department of Psychiatry, Penn State Hershey Medical Center, Hershey, Pennsylvania (Saunders); Department of Psychology, Ohio State University, Columbus (Lazarus); Center of Excellence on Mood Disorders (Cuellar) and Department of Psychiatry and Behavioral Sciences (Selvaraj), both at University of Texas Health Science Center, Houston; National Network of Mood Disorders, Ann Arbor, Michigan (Dill Rinvelt)
| | - Christopher D Schneck
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (Zandi, DePaulo); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Zandi, Wang); Department of Psychiatry (Patel) and Comprehensive Depression Center (Greden), both at University of Michigan, Ann Arbor; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota (Katzelnick); Department of Psychiatry, University of Iowa Healthcare, Iowa City (Turvey); Depression Center, University of Louisville, Louisville, Kentucky (Wright); Department of Psychiatry, University of Illinois at Chicago, Chicago (Ajilore); Department of Psychiatry, University of Iowa College of Medicine, Iowa City (Coryell); Department of Psychiatry, University of Colorado, Boulder (Schneck); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston (Guille); Department of Psychiatry, Penn State Hershey Medical Center, Hershey, Pennsylvania (Saunders); Department of Psychology, Ohio State University, Columbus (Lazarus); Center of Excellence on Mood Disorders (Cuellar) and Department of Psychiatry and Behavioral Sciences (Selvaraj), both at University of Texas Health Science Center, Houston; National Network of Mood Disorders, Ann Arbor, Michigan (Dill Rinvelt)
| | - Constance Guille
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (Zandi, DePaulo); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Zandi, Wang); Department of Psychiatry (Patel) and Comprehensive Depression Center (Greden), both at University of Michigan, Ann Arbor; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota (Katzelnick); Department of Psychiatry, University of Iowa Healthcare, Iowa City (Turvey); Depression Center, University of Louisville, Louisville, Kentucky (Wright); Department of Psychiatry, University of Illinois at Chicago, Chicago (Ajilore); Department of Psychiatry, University of Iowa College of Medicine, Iowa City (Coryell); Department of Psychiatry, University of Colorado, Boulder (Schneck); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston (Guille); Department of Psychiatry, Penn State Hershey Medical Center, Hershey, Pennsylvania (Saunders); Department of Psychology, Ohio State University, Columbus (Lazarus); Center of Excellence on Mood Disorders (Cuellar) and Department of Psychiatry and Behavioral Sciences (Selvaraj), both at University of Texas Health Science Center, Houston; National Network of Mood Disorders, Ann Arbor, Michigan (Dill Rinvelt)
| | - Erika F H Saunders
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (Zandi, DePaulo); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Zandi, Wang); Department of Psychiatry (Patel) and Comprehensive Depression Center (Greden), both at University of Michigan, Ann Arbor; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota (Katzelnick); Department of Psychiatry, University of Iowa Healthcare, Iowa City (Turvey); Depression Center, University of Louisville, Louisville, Kentucky (Wright); Department of Psychiatry, University of Illinois at Chicago, Chicago (Ajilore); Department of Psychiatry, University of Iowa College of Medicine, Iowa City (Coryell); Department of Psychiatry, University of Colorado, Boulder (Schneck); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston (Guille); Department of Psychiatry, Penn State Hershey Medical Center, Hershey, Pennsylvania (Saunders); Department of Psychology, Ohio State University, Columbus (Lazarus); Center of Excellence on Mood Disorders (Cuellar) and Department of Psychiatry and Behavioral Sciences (Selvaraj), both at University of Texas Health Science Center, Houston; National Network of Mood Disorders, Ann Arbor, Michigan (Dill Rinvelt)
| | - Sophie A Lazarus
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (Zandi, DePaulo); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Zandi, Wang); Department of Psychiatry (Patel) and Comprehensive Depression Center (Greden), both at University of Michigan, Ann Arbor; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota (Katzelnick); Department of Psychiatry, University of Iowa Healthcare, Iowa City (Turvey); Depression Center, University of Louisville, Louisville, Kentucky (Wright); Department of Psychiatry, University of Illinois at Chicago, Chicago (Ajilore); Department of Psychiatry, University of Iowa College of Medicine, Iowa City (Coryell); Department of Psychiatry, University of Colorado, Boulder (Schneck); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston (Guille); Department of Psychiatry, Penn State Hershey Medical Center, Hershey, Pennsylvania (Saunders); Department of Psychology, Ohio State University, Columbus (Lazarus); Center of Excellence on Mood Disorders (Cuellar) and Department of Psychiatry and Behavioral Sciences (Selvaraj), both at University of Texas Health Science Center, Houston; National Network of Mood Disorders, Ann Arbor, Michigan (Dill Rinvelt)
| | - Valeria A Cuellar
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (Zandi, DePaulo); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Zandi, Wang); Department of Psychiatry (Patel) and Comprehensive Depression Center (Greden), both at University of Michigan, Ann Arbor; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota (Katzelnick); Department of Psychiatry, University of Iowa Healthcare, Iowa City (Turvey); Depression Center, University of Louisville, Louisville, Kentucky (Wright); Department of Psychiatry, University of Illinois at Chicago, Chicago (Ajilore); Department of Psychiatry, University of Iowa College of Medicine, Iowa City (Coryell); Department of Psychiatry, University of Colorado, Boulder (Schneck); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston (Guille); Department of Psychiatry, Penn State Hershey Medical Center, Hershey, Pennsylvania (Saunders); Department of Psychology, Ohio State University, Columbus (Lazarus); Center of Excellence on Mood Disorders (Cuellar) and Department of Psychiatry and Behavioral Sciences (Selvaraj), both at University of Texas Health Science Center, Houston; National Network of Mood Disorders, Ann Arbor, Michigan (Dill Rinvelt)
| | - Sudhakar Selvaraj
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (Zandi, DePaulo); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Zandi, Wang); Department of Psychiatry (Patel) and Comprehensive Depression Center (Greden), both at University of Michigan, Ann Arbor; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota (Katzelnick); Department of Psychiatry, University of Iowa Healthcare, Iowa City (Turvey); Depression Center, University of Louisville, Louisville, Kentucky (Wright); Department of Psychiatry, University of Illinois at Chicago, Chicago (Ajilore); Department of Psychiatry, University of Iowa College of Medicine, Iowa City (Coryell); Department of Psychiatry, University of Colorado, Boulder (Schneck); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston (Guille); Department of Psychiatry, Penn State Hershey Medical Center, Hershey, Pennsylvania (Saunders); Department of Psychology, Ohio State University, Columbus (Lazarus); Center of Excellence on Mood Disorders (Cuellar) and Department of Psychiatry and Behavioral Sciences (Selvaraj), both at University of Texas Health Science Center, Houston; National Network of Mood Disorders, Ann Arbor, Michigan (Dill Rinvelt)
| | - Patricia Dill Rinvelt
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (Zandi, DePaulo); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Zandi, Wang); Department of Psychiatry (Patel) and Comprehensive Depression Center (Greden), both at University of Michigan, Ann Arbor; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota (Katzelnick); Department of Psychiatry, University of Iowa Healthcare, Iowa City (Turvey); Depression Center, University of Louisville, Louisville, Kentucky (Wright); Department of Psychiatry, University of Illinois at Chicago, Chicago (Ajilore); Department of Psychiatry, University of Iowa College of Medicine, Iowa City (Coryell); Department of Psychiatry, University of Colorado, Boulder (Schneck); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston (Guille); Department of Psychiatry, Penn State Hershey Medical Center, Hershey, Pennsylvania (Saunders); Department of Psychology, Ohio State University, Columbus (Lazarus); Center of Excellence on Mood Disorders (Cuellar) and Department of Psychiatry and Behavioral Sciences (Selvaraj), both at University of Texas Health Science Center, Houston; National Network of Mood Disorders, Ann Arbor, Michigan (Dill Rinvelt)
| | - John F Greden
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (Zandi, DePaulo); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Zandi, Wang); Department of Psychiatry (Patel) and Comprehensive Depression Center (Greden), both at University of Michigan, Ann Arbor; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota (Katzelnick); Department of Psychiatry, University of Iowa Healthcare, Iowa City (Turvey); Depression Center, University of Louisville, Louisville, Kentucky (Wright); Department of Psychiatry, University of Illinois at Chicago, Chicago (Ajilore); Department of Psychiatry, University of Iowa College of Medicine, Iowa City (Coryell); Department of Psychiatry, University of Colorado, Boulder (Schneck); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston (Guille); Department of Psychiatry, Penn State Hershey Medical Center, Hershey, Pennsylvania (Saunders); Department of Psychology, Ohio State University, Columbus (Lazarus); Center of Excellence on Mood Disorders (Cuellar) and Department of Psychiatry and Behavioral Sciences (Selvaraj), both at University of Texas Health Science Center, Houston; National Network of Mood Disorders, Ann Arbor, Michigan (Dill Rinvelt)
| | - J Raymond DePaulo
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore (Zandi, DePaulo); Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore (Zandi, Wang); Department of Psychiatry (Patel) and Comprehensive Depression Center (Greden), both at University of Michigan, Ann Arbor; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, Minnesota (Katzelnick); Department of Psychiatry, University of Iowa Healthcare, Iowa City (Turvey); Depression Center, University of Louisville, Louisville, Kentucky (Wright); Department of Psychiatry, University of Illinois at Chicago, Chicago (Ajilore); Department of Psychiatry, University of Iowa College of Medicine, Iowa City (Coryell); Department of Psychiatry, University of Colorado, Boulder (Schneck); Department of Psychiatry and Behavioral Sciences, Medical University of South Carolina, Charleston (Guille); Department of Psychiatry, Penn State Hershey Medical Center, Hershey, Pennsylvania (Saunders); Department of Psychology, Ohio State University, Columbus (Lazarus); Center of Excellence on Mood Disorders (Cuellar) and Department of Psychiatry and Behavioral Sciences (Selvaraj), both at University of Texas Health Science Center, Houston; National Network of Mood Disorders, Ann Arbor, Michigan (Dill Rinvelt)
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Reichman RD, Gaynor SC, Monson ET, Gaine ME, Parsons MG, Zandi PP, Potash JB, Willour VL. Targeted sequencing of the LRRTM gene family in suicide attempters with bipolar disorder. Am J Med Genet B Neuropsychiatr Genet 2020; 183:128-139. [PMID: 31854516 PMCID: PMC8380126 DOI: 10.1002/ajmg.b.32767] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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] [Received: 07/30/2019] [Revised: 09/17/2019] [Accepted: 09/30/2019] [Indexed: 12/12/2022]
Abstract
Glutamatergic signaling is the primary excitatory neurotransmission pathway in the brain, and its relationship to neuropsychiatric disorders is of considerable interest. Our previous attempted suicide genome-wide association study, and numerous studies investigating gene expression, genetic variation, and DNA methylation have implicated aberrant glutamatergic signaling in suicide risk. The glutamatergic pathway gene LRRTM4 was an associated gene identified in our attempted suicide genome-wide association study, with association support seen primarily in females. Recent evidence has also shown that glutamatergic signaling is partly regulated by sex-related hormones. The LRRTM gene family encodes neuronal leucine-rich transmembrane proteins that localize to and promote glutamatergic synapse development. In this study, we sequenced the coding and regulatory regions of all four LRRTM gene members plus a large intronic region of LRRTM4 in 476 bipolar disorder suicide attempters and 473 bipolar disorder nonattempters. We identified two male-specific variants, one female- and five male-specific haplotypes significantly associated with attempted suicide in LRRTM4. Furthermore, variants within significant haplotypes may be brain expression quantitative trait loci for LRRTM4 and some of these variants overlap with predicted hormone response elements. Overall, these results provide supporting evidence for a sex-specific association of genetic variation in LRRTM4 with attempted suicide.
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Affiliation(s)
- Rachel D. Reichman
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Sophia C. Gaynor
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Eric T. Monson
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Marie E. Gaine
- Molecular Physiology and Biophysics, Iowa Neuroscience Institute, Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Meredith G. Parsons
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Peter P. Zandi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - James B. Potash
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Virginia L. Willour
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa
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Gaynor SC, Monson ET, Gaine ME, Chimenti MS, Reichman RD, Parsons M, Oonthonpan L, Zandi PP, Potash JB, Willour VL. Male-specific association of the 2p25 region with suicide attempt in bipolar disorder. J Psychiatr Res 2020; 121:151-158. [PMID: 31830721 PMCID: PMC8344384 DOI: 10.1016/j.jpsychires.2019.11.009] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/18/2019] [Revised: 11/15/2019] [Accepted: 11/15/2019] [Indexed: 01/20/2023]
Abstract
We previously conducted a genome-wide association study (GWAS) of attempted suicide within bipolar disorder, which implicated common variation in the 2p25 region primarily in males. The top association signal from our GWAS occurred in an intergenic region of 2p25 (p = 5.07 × 10-8) and was supported by two independent studies. In the current study, to better characterize the association of the 2p25 region with attempted suicide, we sequenced the entire 350kb 2p25 region in 476 bipolar suicide attempters and 473 bipolar non-attempters using targeted next-generation sequencing. This fine-mapping project identified 4,681 variants in the 2p25 region. We performed both gene-level and individual-variant tests on our sequencing results and identified 375 variants which were nominally significant (p < 0.05) and three common variants that were significantly associated with attempted suicide in males (corrected p = 0.035, odds ratio (OR) = 2.13). These three variants are in strong linkage disequilibrium with the top variant from our GWAS. Our top five variants are also predicted expression quantitative trait loci (eQTL) for three genes in the 2p25 region based on publicly available brain expression databases. Our sequencing and eQTL data implicate these three genes - SH3YL1, ACP1, and FAM150B - and three additional pathways - androgen receptor, Wnt signaling, and glutamatergic/GABAergic signaling - in the association of the 2p25 region with suicide. The current study provides additional support for an association of the 2p25 region with attempted suicide in males and identifies several candidate genes and pathways that warrant further investigation to understand their role in suicidal behavior.
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Affiliation(s)
- Sophia C. Gaynor
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA, 52242, USA
| | - Eric T. Monson
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA, 52242, USA
| | - Marie E. Gaine
- Molecular Physiology and Biophysics, Iowa Neuroscience Institute, Carver College of Medicine, University of Iowa, Iowa City, IA, 52242, USA
| | - Michael S. Chimenti
- Bioinformatics Division, Iowa Institute of Human Genetics, University of Iowa Carver College of Medicine, Iowa City, IA, 52242, USA
| | - Rachel D. Reichman
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA, 52242, USA
| | - Meredith Parsons
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA, 52242, USA
| | - Lalita Oonthonpan
- Department of Biochemistry, University of Iowa Carver College of Medicine, Iowa City, IA, 52242, USA
| | - Peter P. Zandi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - James B. Potash
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, 21287, USA
| | - Virginia L. Willour
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, IA, 52242, USA
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Kano SI, Hodgkinson CA, Jones-Brando L, Eastwood S, Ishizuka K, Niwa M, Choi EY, Chang DJ, Chen Y, Velivela SD, Leister F, Wood J, Chowdari K, Ducci F, Caycedo DA, Heinz E, Newman ER, Cascella N, Mortensen PB, Zandi PP, Dickerson F, Nimgaonkar V, Goldman D, Harrison PJ, Yolken RH, Sawa A. Host-parasite interaction associated with major mental illness. Mol Psychiatry 2020; 25:194-205. [PMID: 30127472 PMCID: PMC6382596 DOI: 10.1038/s41380-018-0217-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [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: 12/17/2015] [Revised: 04/16/2018] [Accepted: 06/20/2018] [Indexed: 11/23/2022]
Abstract
Clinical studies frequently report that patients with major mental illness such as schizophrenia and bipolar disorder have co-morbid physical conditions, suggesting that systemic alterations affecting both brain and peripheral tissues might underlie the disorders. Numerous studies have reported elevated levels of anti-Toxoplasma gondii (T. gondii) antibodies in patients with major mental illnesses, but the underlying mechanism was unclear. Using multidisciplinary epidemiological, cell biological, and gene expression profiling approaches, we report here multiple lines of evidence suggesting that a major mental illness-related susceptibility factor, Disrupted in schizophrenia (DISC1), is involved in host immune responses against T. gondii infection. Specifically, our cell biology and gene expression studies have revealed that DISC1 Leu607Phe variation, which changes DISC1 interaction with activating transcription factor 4 (ATF4), modifies gene expression patterns upon T. gondii infection. Our epidemiological data have also shown that DISC1 607 Phe/Phe genotype was associated with higher T. gondii antibody levels in sera. Although further studies are required, our study provides mechanistic insight into one of the few well-replicated serological observations in major mental illness.
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Affiliation(s)
- Shin-Ichi Kano
- Departments of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Colin A Hodgkinson
- Laboratory of Neurogenetics, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, 20892, USA
| | - Lorraine Jones-Brando
- Stanley Division of Developmental Neurovirology, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Sharon Eastwood
- Department of Psychiatry, University of Oxford, Oxford, OX3 7JX, United Kingdom
| | - Koko Ishizuka
- Departments of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Minae Niwa
- Departments of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Eric Y Choi
- Departments of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Daniel J Chang
- Departments of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Yian Chen
- Departments of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Swetha D Velivela
- Departments of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Flora Leister
- Departments of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Joel Wood
- Departments of Psychiatry and Human Genetics, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15213, USA
| | - Kodavali Chowdari
- Departments of Psychiatry and Human Genetics, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15213, USA
| | - Francesca Ducci
- Laboratory of Neurogenetics, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, 20892, USA
| | - Daniel A Caycedo
- Laboratory of Neurogenetics, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, 20892, USA
| | - Elizabeth Heinz
- Laboratory of Neurogenetics, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, 20892, USA
| | - Emily R Newman
- Laboratory of Neurogenetics, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, 20892, USA
| | - Nicola Cascella
- Departments of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Preben B Mortensen
- National Centre for Register-Based Research, University of Aarhus, Aarhus, 8000, Denmark
| | - Peter P Zandi
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, 21205, USA
| | - Faith Dickerson
- Stanley Research Program, Sheppard Pratt Health System, Baltimore, MD, 21204, USA
| | - Vishwajit Nimgaonkar
- Departments of Psychiatry and Human Genetics, University of Pittsburgh School of Medicine, Pittsburgh, PA, 15213, USA
| | - David Goldman
- Laboratory of Neurogenetics, National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, 20892, USA
| | - Paul J Harrison
- Department of Psychiatry, University of Oxford, Oxford, OX3 7JX, United Kingdom
| | - Robert H Yolken
- Stanley Division of Developmental Neurovirology, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA
| | - Akira Sawa
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, 21205, USA.
- Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, 21287, USA.
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Pirooznia M, Niranjan T, Chen YC, Tunc I, Goes FS, Avramopoulos D, Potash JB, Huganir RL, Zandi PP, Wang T. Affected Sib-Pair Analyses Identify Signaling Networks Associated With Social Behavioral Deficits in Autism. Front Genet 2019; 10:1186. [PMID: 31827489 PMCID: PMC6892440 DOI: 10.3389/fgene.2019.01186] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 06/03/2019] [Accepted: 10/25/2019] [Indexed: 11/29/2022] Open
Abstract
Autism spectrum disorders (ASDs) are characterized by deficits in three core behavioral domains: reciprocal social interactions, communication, and restricted interests and/or repetitive behaviors. Several hundreds of risk genes for autism have been identified, however, it remains a challenge to associate these genes with specific core behavioral deficits. In multiplex autism families, affected sibs often show significant differences in severity of individual core phenotypes. We hypothesize that a higher mutation burden contributes to a larger difference in the severity of specific core phenotypes between affected sibs. We tested this hypothesis on social behavioral deficits in autism. We sequenced synaptome genes (n = 1,886) in affected male sib-pairs (n = 274) in families from the Autism Genetics Research Exchange (AGRE) and identified rare (MAF ≤ 1%) and predicted functional variants. We selected affected sib-pairs with a large (≥10; n = 92 pairs) or a small (≤4; n = 108 pairs) difference in total cumulative Autism Diagnostic Interview-Revised (ADI-R) social scores (SOCT_CS). We compared burdens of unshared variants present only in sibs with severe social deficits and found a higher burden in SOCT_CS≥10 compared to SOCT_CS ≤ 4 (SOCT_CS≥10: 705.1 ± 16.2; SOCT_CS ≤ 4, 668.3 ± 9.0; p = 0.025). Unshared SOCT_CS≥10 genes only in sibs with severe social deficits are significantly enriched in the SFARI gene set. Network analyses of these genes using InWeb_IM, molecular signatures database (MSigDB), and GeNetMeta identified enrichment for phosphoinositide 3-kinase (PI3K)-AKT-mammalian target of rapamycin (mTOR) (Enrichment Score [eScore] p value = 3.36E−07; n = 8 genes) and Nerve growth factor (NGF) (eScore p value = 8.94E−07; n = 9 genes) networks. These studies support a key role for these signaling networks in social behavioral deficits and present a novel approach to associate risk genes and signaling networks with core behavioral domains in autism.
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Affiliation(s)
- Mehdi Pirooznia
- Bioinformatics and Computational Biology Core Facility, National Heart Lung and Blood Institute, NIH, Bethesda, MD, United States.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Tejasvi Niranjan
- McKusick-Nathans Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Yun-Ching Chen
- Bioinformatics and Computational Biology Core Facility, National Heart Lung and Blood Institute, NIH, Bethesda, MD, United States
| | - Ilker Tunc
- Bioinformatics and Computational Biology Core Facility, National Heart Lung and Blood Institute, NIH, Bethesda, MD, United States
| | - Fernando S Goes
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Dimitrios Avramopoulos
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States.,McKusick-Nathans Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - James B Potash
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Richard L Huganir
- Department of Neuroscience, Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Peter P Zandi
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, United States.,Department of Mental Health and Epidemiology, Johns Hopkins University School of Public Health, Baltimore, MD, United States
| | - Tao Wang
- McKusick-Nathans Department of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, United States
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40
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Gaine ME, Seifuddin F, Sabunciyan S, Lee RS, Benke KS, Monson ET, Zandi PP, Potash JB, Willour VL. Differentially methylated regions in bipolar disorder and suicide. Am J Med Genet B Neuropsychiatr Genet 2019; 180:496-507. [PMID: 31350827 PMCID: PMC8375453 DOI: 10.1002/ajmg.b.32754] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 06/24/2019] [Accepted: 07/15/2019] [Indexed: 12/29/2022]
Abstract
The addition of a methyl group to, typically, a cytosine-guanine dinucleotide (CpG) creates distinct DNA methylation patterns across the genome that can regulate gene expression. Aberrant DNA methylation of CpG sites has been associated with many psychiatric disorders including bipolar disorder (BD) and suicide. Using the SureSelectXT system, Methyl-Seq, we investigated the DNA methylation status of CpG sites throughout the genome in 50 BD individuals (23 subjects who died by suicide and 27 subjects who died from other causes) and 31 nonpsychiatric controls. We identified differentially methylated regions (DMRs) from three analyses: (a) BD subjects compared to nonpsychiatric controls (BD-NC), (b) BD subjects who died by suicide compared to nonpsychiatric controls (BDS-NC), and (c) BDS subjects compared to BD subjects who died from other causes (BDS-BDNS). One DMR from the BDS-NC analysis, located in ARHGEF38, was significantly hypomethylated (23.4%) in BDS subjects. This finding remained significant after multiple testing (PBootstrapped = 9.0 × 10-3 ), was validated using pyrosequencing, and was more significant in males. A secondary analysis utilized Ingenuity Pathway Analysis to identify enrichment in nominally significant DMRs. This identified an association with several pathways including axonal guidance signaling, calcium signaling, β-adrenergic signaling, and opioid signaling. Our comprehensive study provides further support that DNA methylation alterations influence the risk for BD and suicide. However, further investigation is required to confirm these associations and identify their functional consequences.
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Affiliation(s)
- Marie E. Gaine
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Fayaz Seifuddin
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Sarven Sabunciyan
- Center for Epigenetics, Johns Hopkins School of Medicine, Baltimore, Maryland,Department of Pediatrics, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Richard S. Lee
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Kelly S. Benke
- Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - Eric T. Monson
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa
| | - Peter P. Zandi
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland,Department of Mental Health, Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
| | - James B. Potash
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, Maryland
| | - Virginia L. Willour
- Department of Psychiatry, University of Iowa Carver College of Medicine, Iowa City, Iowa
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41
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Rootes-Murdy K, Carlucci M, Tibbs M, Wachtel LE, Sherman MF, Zandi PP, Reti IM. Non-suicidal self-injury and electroconvulsive therapy: Outcomes in adolescent and young adult populations. J Affect Disord 2019; 250:94-98. [PMID: 30844603 DOI: 10.1016/j.jad.2019.02.057] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [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] [Received: 10/15/2018] [Revised: 12/17/2018] [Accepted: 02/24/2019] [Indexed: 11/24/2022]
Abstract
BACKGROUND Electroconvulsive (ECT) therapy is a highly effective treatment for severe depression. Although the clear majority of patients respond to ECT, not all do, and we still lack good predictors for ECT outcome, especially in adolescents and young adults. One clinical variable that has been associated with reduced likelihood of ECT antidepressant response in adults is comorbid borderline personality disorder. As self-injurious behavior is often a feature of borderline personality disorder, we hypothesized that adolescent and young adult patients with a history of non-suicidal self-injury (NSSI), who were being treated for major depression with ECT, would have a poorer response than patients without such a history. METHODS We conducted a retrospective chart review of 48 patients treated with ECT for depression at The Johns Hopkins Hospital between the ages of 14 and 25. RESULTS Initial analyses showed that the presence of NSSI was not associated with ECT outcomes. However, sub-group analyses suggested that it was associated with response to ECT and overall remission among female patients. Specifically, the results suggested that in adolescent and young adult female ECT patients, the presence of NSSI was associated with lower odds of response (OR: 0.04; 95% CI: 0.0004, 0.81, p = 0.03) and remission (OR: 0.09; 95% CI: 0.0000, 0.81, p = 0.03), and a greater mean number of treatments (5.83; 95% CI: 0.27, 11.39, p = 0.04) compared with patients without NSSI. CONCLUSIONS Clearly, the finding that NSSI may be associated with poorer ECT outcomes among female patients needs to be replicated. Nonetheless, our data suggest caution when considering an adolescent or young adult woman for a course of ECT.
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Affiliation(s)
- Kelly Rootes-Murdy
- The Johns Hopkins University School of Medicine, Baltimore, MD, United States; Loyola University Maryland, Baltimore, MD, United States
| | | | - Michael Tibbs
- The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | - Lee E Wachtel
- The Johns Hopkins University School of Medicine, Baltimore, MD, United States
| | | | - Peter P Zandi
- The Johns Hopkins University School of Medicine, Baltimore, MD, United States; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, United States
| | - Irving M Reti
- The Johns Hopkins University School of Medicine, Baltimore, MD, United States.
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42
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Rootes-Murdy K, Glazer K, Mondimore FM, Goes FS, Zandi PP, Bakker A, DePaulo JR, Mahon PB. A pilot fMRI study of lithium response in bipolar disorder. Psychiatry Res Neuroimaging 2019; 286:1-3. [PMID: 30822677 PMCID: PMC6749831 DOI: 10.1016/j.pscychresns.2019.02.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Revised: 02/20/2019] [Accepted: 02/20/2019] [Indexed: 01/03/2023]
Affiliation(s)
- Kelly Rootes-Murdy
- Department of Psychology, Georgia State University, 140 Decatur Street, Atlanta, GA 30303, USA.
| | - Kara Glazer
- Department of Psychiatry & Behavioral Science, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Francis M Mondimore
- Johns Hopkins Bayview Medical Center, Community Psychiatry Program, Baltimore, MD, USA
| | - Fernando S Goes
- Department of Psychiatry & Behavioral Science, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Peter P Zandi
- Department of Psychiatry & Behavioral Science, Johns Hopkins School of Medicine, Baltimore, MD, USA; Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Arnold Bakker
- Department of Psychiatry & Behavioral Science, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - J Raymond DePaulo
- Department of Psychiatry & Behavioral Science, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Pamela B Mahon
- Department of Psychiatry & Behavioral Science, Johns Hopkins School of Medicine, Baltimore, MD, USA; Department of Psychiatry, Brigham & Women's Hospital, Boston, MA, USA; Harvard Medical School, Boston, MA, USA
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43
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Nudell V, Wei H, Nievergelt C, Maihofer AX, Shilling P, Alda M, Berrettini WH, Brennand KJ, Calabrese JR, Coryell WH, Covault JM, Frye MA, Gage F, Gershon E, McInnis MG, Nurnberger JI, Oedegaard KJ, Shekhtman T, Zandi PP, Kelsoe JR, McCarthy MJ. Entrainment of Circadian Rhythms to Temperature Reveals Amplitude Deficits in Fibroblasts from Patients with Bipolar Disorder and Possible Links to Calcium Channels. Mol Neuropsychiatry 2019; 5:115-124. [PMID: 31192224 DOI: 10.1159/000497354] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/29/2018] [Accepted: 01/29/2019] [Indexed: 11/19/2022]
Abstract
Bipolar disorder (BD) is characterized by recurrent mood episodes, and circadian rhythm disturbances. Past studies have identified calcium channel genes as risk loci for BD. CACNA1C encodes an L-type calcium channel (LTCC) involved in the entrainment of circadian rhythms to light. Another calcium channel, i.e., the ryanodine receptor (RYR), is involved in -circadian phase delays. It is unknown whether variants in CACNA1C or other calcium channels contribute to the circadian phenotype in BD. We hypothesized that, by using temperature cycles, we could model circadian entrainment in fibroblasts from BD patients and controls to interrogate the circadian functions of LTCCs. Using Per2-luc, a bioluminescent reporter, we verified that cells entrain to temperature rhythms in vitro. Under constant temperature conditions, the LTCC antagonist verapamil shortened the circadian period, and the RYR antagonist dantrolene lengthened the period. However, neither drug affected temperature entrainment. Fibroblasts from BD patients and controls also entrained to temperature. In cells from BD patients, the rhythm amplitude was lower under entrained, but not constant, conditions. Temperature entrainment was otherwise similar between BD and control cells. However, the CACNA1C genotype among BD cells predicted the degree to which cells entrained. We conclude that assessment of rhythms under entrained conditions reveals additional rhythm abnormalities in BD that are not observable under constant temperature conditions.
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Affiliation(s)
- Victoria Nudell
- Department of Psychiatry and Center for Circadian Biology, University of California San Diego, La Jolla, California, USA
| | - Heather Wei
- VA San Diego Healthcare System Psychiatry Service, San Diego, California, USA
| | - Caroline Nievergelt
- VA San Diego Healthcare System Psychiatry Service, San Diego, California, USA.,Department of Psychiatry and Center for Circadian Biology, University of California San Diego, La Jolla, California, USA
| | - Adam X Maihofer
- Department of Psychiatry and Center for Circadian Biology, University of California San Diego, La Jolla, California, USA
| | - Paul Shilling
- Department of Psychiatry and Center for Circadian Biology, University of California San Diego, La Jolla, California, USA
| | - Martin Alda
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Wade H Berrettini
- Department of Psychiatry, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Kristen J Brennand
- Departments of Neuroscience and Psychiatry, Icahn School of Medicine at Mt. Sinai, New York, New York, USA
| | - Joseph R Calabrese
- Department of Psychiatry, Case Western Reserve University, Cleveland, Ohio, USA
| | | | - Jonathan M Covault
- Department of Psychiatry, University of Connecticut, Farmington, Connecticut, USA
| | - Mark A Frye
- Department of Psychiatry, Mayo Clinic, Rochester, Minnesota, USA
| | - Fred Gage
- Laboratory of Genetics, Salk Institute for Biological Studies, La Jolla, California, USA
| | - Elliot Gershon
- Department of Psychiatry, University of Chicago, Chicago, Illinois, USA
| | - Melvin G McInnis
- Department of Psychiatry, University of Michigan, Ann Arbor, Michigan, USA
| | - John I Nurnberger
- Department of Psychiatry, Indiana University, Indianapolis, Indiana, USA
| | - Ketil J Oedegaard
- Section for Psychiatry, University of Bergen and NORMENT and KG Jebsen Centre for Neuropsychiatry, Bergen, Norway.,Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Tatyana Shekhtman
- Department of Psychiatry and Center for Circadian Biology, University of California San Diego, La Jolla, California, USA
| | - Peter P Zandi
- Department of Psychiatry, Johns Hopkins University, Baltimore, Maryland, USA
| | - John R Kelsoe
- VA San Diego Healthcare System Psychiatry Service, San Diego, California, USA.,Department of Psychiatry and Center for Circadian Biology, University of California San Diego, La Jolla, California, USA
| | - Michael J McCarthy
- VA San Diego Healthcare System Psychiatry Service, San Diego, California, USA.,Department of Psychiatry and Center for Circadian Biology, University of California San Diego, La Jolla, California, USA
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44
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McCarthy MJ, Wei H, Nievergelt CM, Stautland A, Maihofer AX, Welsh DK, Shilling P, Alda M, Alliey-Rodriguez N, Anand A, Andreasson OA, Balaraman Y, Berrettini WH, Bertram H, Brennand KJ, Calabrese JR, Calkin CV, Claasen A, Conroy C, Coryell WH, Craig DW, D’Arcangelo N, Demodena A, Djurovic S, Feeder S, Fisher C, Frazier N, Frye MA, Gage FH, Gao K, Garnham J, Gershon ES, Glazer K, Goes F, Goto T, Harrington G, Jakobsen P, Kamali M, Karberg E, Kelly M, Leckband SG, Lohoff F, McInnis MG, Mondimore F, Morken G, Nurnberger JI, Obral S, Oedegaard KJ, Ortiz A, Ritchey M, Ryan K, Schinagle M, Schoeyen H, Schwebel C, Shaw M, Shekhtman T, Slaney C, Stapp E, Szelinger S, Tarwater B, Zandi PP, Kelsoe JR. Chronotype and cellular circadian rhythms predict the clinical response to lithium maintenance treatment in patients with bipolar disorder. Neuropsychopharmacology 2019; 44:620-628. [PMID: 30487653 PMCID: PMC6333516 DOI: 10.1038/s41386-018-0273-8] [Citation(s) in RCA: 59] [Impact Index Per Article: 11.8] [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] [Received: 07/06/2018] [Revised: 10/17/2018] [Accepted: 10/24/2018] [Indexed: 12/12/2022]
Abstract
Bipolar disorder (BD) is a serious mood disorder associated with circadian rhythm abnormalities. Risk for BD is genetically encoded and overlaps with systems that maintain circadian rhythms. Lithium is an effective mood stabilizer treatment for BD, but only a minority of patients fully respond to monotherapy. Presently, we hypothesized that lithium-responsive BD patients (Li-R) would show characteristic differences in chronotype and cellular circadian rhythms compared to lithium non-responders (Li-NR). Selecting patients from a prospective, multi-center, clinical trial of lithium monotherapy, we examined morning vs. evening preference (chronotype) as a dimension of circadian rhythm function in 193 Li-R and Li-NR BD patients. From a subset of 59 patient donors, we measured circadian rhythms in skin fibroblasts longitudinally over 5 days using a bioluminescent reporter (Per2-luc). We then estimated circadian rhythm parameters (amplitude, period, phase) and the pharmacological effects of lithium on rhythms in cells from Li-R and Li-NR donors. Compared to Li-NRs, Li-Rs showed a difference in chronotype, with higher levels of morningness. Evening chronotype was associated with increased mood symptoms at baseline, including depression, mania, and insomnia. Cells from Li-Rs were more likely to exhibit a short circadian period, a linear relationship between period and phase, and period shortening effects of lithium. Common genetic variation in the IP3 signaling pathway may account for some of the individual differences in the effects of lithium on cellular rhythms. We conclude that circadian rhythms may influence response to lithium in maintenance treatment of BD.
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Affiliation(s)
- Michael J. McCarthy
- 0000 0001 2107 4242grid.266100.3Department of Psychiatry and Center for Circadian Biology, University of California, San Diego, 3350 La Jolla Village Dr. MC 116A, San Diego, CA 92161 USA ,0000 0004 0419 2708grid.410371.0Psychiatry Service, VA San Diego Healthcare, San Diego, CA 92161 USA
| | - Heather Wei
- 0000 0004 0419 2708grid.410371.0Psychiatry Service, VA San Diego Healthcare, San Diego, CA 92161 USA
| | - Caroline M. Nievergelt
- 0000 0001 2107 4242grid.266100.3Department of Psychiatry and Center for Circadian Biology, University of California, San Diego, 3350 La Jolla Village Dr. MC 116A, San Diego, CA 92161 USA
| | - Andrea Stautland
- 0000 0004 1936 7443grid.7914.bDepartment of Clinical Medicine, Section for Psychiatry, University of Bergen, Bergen, Norway
| | - Adam X. Maihofer
- 0000 0001 2107 4242grid.266100.3Department of Psychiatry and Center for Circadian Biology, University of California, San Diego, 3350 La Jolla Village Dr. MC 116A, San Diego, CA 92161 USA
| | - David K. Welsh
- 0000 0001 2107 4242grid.266100.3Department of Psychiatry and Center for Circadian Biology, University of California, San Diego, 3350 La Jolla Village Dr. MC 116A, San Diego, CA 92161 USA ,0000 0004 0419 2708grid.410371.0Psychiatry Service, VA San Diego Healthcare, San Diego, CA 92161 USA
| | - Paul Shilling
- 0000 0001 2107 4242grid.266100.3Department of Psychiatry and Center for Circadian Biology, University of California, San Diego, 3350 La Jolla Village Dr. MC 116A, San Diego, CA 92161 USA
| | - Martin Alda
- 0000 0004 1936 8200grid.55602.34Department of Psychiatry, Dalhousie University, Halifax, Canada
| | - Ney Alliey-Rodriguez
- 0000 0004 1936 7822grid.170205.1Department of Psychiatry, University of Chicago, Chicago, USA
| | - Amit Anand
- 0000 0001 0790 959Xgrid.411377.7Department of Psychiatry, Indiana University, Bloomington, USA
| | - Ole A. Andreasson
- 0000 0004 1936 8921grid.5510.1Jebsen Centre for Psychosis Research, University of Oslo, Oslo, Norway
| | - Yokesh Balaraman
- 0000 0001 0790 959Xgrid.411377.7Department of Psychiatry, Indiana University, Bloomington, USA
| | - Wade H. Berrettini
- 0000 0004 1936 8972grid.25879.31Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104 USA
| | - Holli Bertram
- 0000000086837370grid.214458.eDepartment of Psychiatry, University of Michigan, Ann Arbor, MI USA
| | - Kristen J. Brennand
- 0000 0001 0670 2351grid.59734.3cDepartments of Neuroscience and Psychiatry, Icahn School of Medicine at Mt Sinai, New York, USA
| | - Joseph R. Calabrese
- 0000 0001 2164 3847grid.67105.35Department of Psychiatry, Case Western Reserve University, Cleveland, OH USA
| | - Cynthia V. Calkin
- 0000 0004 1936 8200grid.55602.34Department of Psychiatry, Dalhousie University, Halifax, Canada
| | - Ana Claasen
- 0000 0004 0507 3225grid.250942.8Neurogenomics Division, Translational Genomics Research Institute, Phoenix, USA
| | - Clara Conroy
- 0000 0001 2164 3847grid.67105.35Department of Psychiatry, Case Western Reserve University, Cleveland, OH USA
| | - William H. Coryell
- 0000 0004 1936 8294grid.214572.7Department of Psychiatry, University of Iowa, Iowa City, USA
| | - David W. Craig
- 0000 0004 0507 3225grid.250942.8Neurogenomics Division, Translational Genomics Research Institute, Phoenix, USA
| | - Nicole D’Arcangelo
- 0000 0001 2164 3847grid.67105.35Department of Psychiatry, Case Western Reserve University, Cleveland, OH USA
| | - Anna Demodena
- 0000 0004 0419 2708grid.410371.0Psychiatry Service, VA San Diego Healthcare, San Diego, CA 92161 USA
| | - Srdjan Djurovic
- 0000 0004 1936 8921grid.5510.1Jebsen Centre for Psychosis Research, University of Oslo, Oslo, Norway
| | - Scott Feeder
- 0000 0004 0459 167Xgrid.66875.3aDepartment of Psychiatry, The Mayo Clinic, Rochester, USA
| | - Carrie Fisher
- 0000 0001 0790 959Xgrid.411377.7Department of Psychiatry, Indiana University, Bloomington, USA
| | - Nicole Frazier
- 0000000086837370grid.214458.eDepartment of Psychiatry, University of Michigan, Ann Arbor, MI USA
| | - Mark A. Frye
- 0000 0004 0459 167Xgrid.66875.3aDepartment of Psychiatry, The Mayo Clinic, Rochester, USA
| | - Fred H. Gage
- 0000 0001 0662 7144grid.250671.7Laboratory of Genetics, Salk Institute for Biological Studies, La Jolla, USA
| | - Keming Gao
- 0000 0001 2164 3847grid.67105.35Department of Psychiatry, Case Western Reserve University, Cleveland, OH USA
| | - Julie Garnham
- 0000 0004 1936 8200grid.55602.34Department of Psychiatry, Dalhousie University, Halifax, Canada
| | - Elliot S. Gershon
- 0000 0004 1936 7822grid.170205.1Department of Psychiatry, University of Chicago, Chicago, USA
| | - Kara Glazer
- 0000 0001 2171 9311grid.21107.35Department of Psychiatry, Johns Hopkins University, Baltimore, USA
| | - Fernando Goes
- 0000 0001 2171 9311grid.21107.35Department of Psychiatry, Johns Hopkins University, Baltimore, USA
| | - Toyomi Goto
- 0000 0001 2164 3847grid.67105.35Department of Psychiatry, Case Western Reserve University, Cleveland, OH USA
| | - Gloria Harrington
- 0000000086837370grid.214458.eDepartment of Psychiatry, University of Michigan, Ann Arbor, MI USA
| | - Petter Jakobsen
- 0000 0000 9753 1393grid.412008.fNorment and KG Jebsen Centre for Neuropsychiatry, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Masoud Kamali
- 0000000086837370grid.214458.eDepartment of Psychiatry, University of Michigan, Ann Arbor, MI USA
| | - Elizabeth Karberg
- 0000 0001 2164 3847grid.67105.35Department of Psychiatry, Case Western Reserve University, Cleveland, OH USA
| | - Marisa Kelly
- 0000000086837370grid.214458.eDepartment of Psychiatry, University of Michigan, Ann Arbor, MI USA
| | - Susan G. Leckband
- 0000 0004 0419 2708grid.410371.0Psychiatry Service, VA San Diego Healthcare, San Diego, CA 92161 USA
| | - Falk Lohoff
- 0000 0004 1936 8972grid.25879.31Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104 USA
| | - Melvin G. McInnis
- 0000000086837370grid.214458.eDepartment of Psychiatry, University of Michigan, Ann Arbor, MI USA
| | - Francis Mondimore
- 0000 0001 2171 9311grid.21107.35Department of Psychiatry, Johns Hopkins University, Baltimore, USA
| | - Gunnar Morken
- 0000 0001 1516 2393grid.5947.fDivision of Psychiatry, St. Olav University Hospital of Trondheim and Department of Mental Health Faculty of Medicine, Norwegian University of Science and Technology, Trondheim, Norway
| | - John I. Nurnberger
- 0000 0001 0790 959Xgrid.411377.7Department of Psychiatry, Indiana University, Bloomington, USA
| | - Sarah Obral
- 0000 0001 2164 3847grid.67105.35Department of Psychiatry, Case Western Reserve University, Cleveland, OH USA
| | - Ketil J. Oedegaard
- 0000 0004 1936 7443grid.7914.bDepartment of Clinical Medicine, Section for Psychiatry, University of Bergen, Bergen, Norway ,0000 0000 9753 1393grid.412008.fNorment and KG Jebsen Centre for Neuropsychiatry, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Abigail Ortiz
- 0000 0001 2182 2255grid.28046.38Department of Psychiatry, University of Ottawa, Ottawa, ON Canada
| | - Megan Ritchey
- 0000 0001 2171 9311grid.21107.35Department of Psychiatry, Johns Hopkins University, Baltimore, USA
| | - Kelly Ryan
- 0000000086837370grid.214458.eDepartment of Psychiatry, University of Michigan, Ann Arbor, MI USA
| | - Martha Schinagle
- 0000 0001 2164 3847grid.67105.35Department of Psychiatry, Case Western Reserve University, Cleveland, OH USA
| | - Helle Schoeyen
- 0000 0004 1936 7443grid.7914.bDepartment of Clinical Medicine, Section for Psychiatry, University of Bergen, Bergen, Norway
| | - Candice Schwebel
- 0000 0004 1936 8972grid.25879.31Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104 USA
| | - Martha Shaw
- 0000 0004 1936 7822grid.170205.1Department of Psychiatry, University of Chicago, Chicago, USA
| | - Tatyana Shekhtman
- 0000 0001 2107 4242grid.266100.3Department of Psychiatry and Center for Circadian Biology, University of California, San Diego, 3350 La Jolla Village Dr. MC 116A, San Diego, CA 92161 USA ,0000 0004 0419 2708grid.410371.0Psychiatry Service, VA San Diego Healthcare, San Diego, CA 92161 USA
| | - Claire Slaney
- 0000 0004 1936 8200grid.55602.34Department of Psychiatry, Dalhousie University, Halifax, Canada
| | - Emma Stapp
- 0000 0001 2171 9311grid.21107.35Department of Psychiatry, Johns Hopkins University, Baltimore, USA
| | - Szabolcs Szelinger
- 0000 0004 0507 3225grid.250942.8Neurogenomics Division, Translational Genomics Research Institute, Phoenix, USA
| | - Bruce Tarwater
- 0000 0004 0507 3225grid.250942.8Neurogenomics Division, Translational Genomics Research Institute, Phoenix, USA
| | - Peter P. Zandi
- 0000 0001 2171 9311grid.21107.35Department of Psychiatry, Johns Hopkins University, Baltimore, USA
| | - John R. Kelsoe
- 0000 0001 2107 4242grid.266100.3Department of Psychiatry and Center for Circadian Biology, University of California, San Diego, 3350 La Jolla Village Dr. MC 116A, San Diego, CA 92161 USA ,0000 0004 0419 2708grid.410371.0Psychiatry Service, VA San Diego Healthcare, San Diego, CA 92161 USA
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45
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Kalman JL, Papiol S, Forstner AJ, Heilbronner U, Degenhardt F, Strohmaier J, Adli M, Adorjan K, Akula N, Alda M, Anderson‐Schmidt H, Andlauer TFM, Anghelescu I, Ardau R, Arias B, Arolt V, Aubry J, Backlund L, Bartholdi K, Bauer M, Baune BT, Becker T, Bellivier F, Benabarre A, Bengesser S, Bhattacharjee AK, Biernacka JM, Birner A, Brichant‐Petitjean C, Budde M, Cervantes P, Chillotti C, Cichon S, Clark SR, Colom F, Comes AL, Cruceanu C, Czerski PM, Dannlowski U, Dayer A, Del Zompo M, DePaulo JR, Dietrich DE, Étain B, Ethofer T, Falkai P, Fallgatter A, Figge C, Flatau L, Folkerts H, Frisen L, Frye MA, Fullerton JM, Gade K, Gard S, Garnham JS, Goes FS, Grigoroiu‐Serbanescu M, Gryaznova A, Hake M, Hauser J, Herms S, Hoffmann P, Hou L, Jäger M, Jamain S, Jiménez E, Juckel G, Kahn J, Kassem L, Kelsoe J, Kittel‐Schneider S, Kliwicki S, Klohn‐Sagatholislam F, Koller M, König B, Konrad C, Lackner N, Laje G, Landén M, Lang FU, Lavebratt C, Leboyer M, Leckband SG, Maj M, Manchia M, Martinsson L, McCarthy MJ, McElroy SL, McMahon FJ, Mitchell PB, Mitjans M, Mondimore FM, Monteleone P, Nieratschker V, Nievergelt CM, Novák T, Ösby U, Pfennig A, Potash JB, Reich‐Erkelenz D, Reif A, Reimer J, Reininghaus E, Reitt M, Ripke S, Rouleau GA, Rybakowski JK, Schalling M, Scherk H, Schmauß M, Schofield PR, Schubert KO, Schulte EC, Schulz S, Senner F, Severino G, Shekhtman T, Shilling PD, Simhandl C, Slaney CM, Spitzer C, Squassina A, Stamm T, Stegmaier S, Stierl S, Stopkova P, Thiel A, Tighe SK, Tortorella A, Turecki G, Vieta E, Veeh J, von Hagen M, Wigand ME, Wiltfang J, Witt S, Wright A, Zandi PP, Zimmermann J, Nöthen M, Rietschel M, Schulze TG. Investigating polygenic burden in age at disease onset in bipolar disorder: Findings from an international multicentric study. Bipolar Disord 2019; 21:68-75. [PMID: 29956436 PMCID: PMC6585855 DOI: 10.1111/bdi.12659] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
OBJECTIVES Bipolar disorder (BD) with early disease onset is associated with an unfavorable clinical outcome and constitutes a clinically and biologically homogenous subgroup within the heterogeneous BD spectrum. Previous studies have found an accumulation of early age at onset (AAO) in BD families and have therefore hypothesized that there is a larger genetic contribution to the early-onset cases than to late onset BD. To investigate the genetic background of this subphenotype, we evaluated whether an increased polygenic burden of BD- and schizophrenia (SCZ)-associated risk variants is associated with an earlier AAO in BD patients. METHODS A total of 1995 BD type 1 patients from the Consortium of Lithium Genetics (ConLiGen), PsyCourse and Bonn-Mannheim samples were genotyped and their BD and SCZ polygenic risk scores (PRSs) were calculated using the summary statistics of the Psychiatric Genomics Consortium as a training data set. AAO was either separated into onset groups of clinical interest (childhood and adolescence [≤18 years] vs adulthood [>18 years]) or considered as a continuous measure. The associations between BD- and SCZ-PRSs and AAO were evaluated with regression models. RESULTS BD- and SCZ-PRSs were not significantly associated with age at disease onset. Results remained the same when analyses were stratified by site of recruitment. CONCLUSIONS The current study is the largest conducted so far to investigate the association between the cumulative BD and SCZ polygenic risk and AAO in BD patients. The reported negative results suggest that such a polygenic influence, if there is any, is not large, and highlight the importance of conducting further, larger scale studies to obtain more information on the genetic architecture of this clinically relevant phenotype.
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Affiliation(s)
- Janos L Kalman
- Institute of Psychiatric Phenomics and Genomics (IPPG)University HospitalLMU MunichMunichGermany,Department of Psychiatry and PsychotherapyLudwig‐Maximilians‐University MunichMunichGermany,International Max Planck Research School for Translational Psychiatry (IMPRS‐TP)MunichGermany
| | - Sergi Papiol
- Institute of Psychiatric Phenomics and Genomics (IPPG)University HospitalLMU MunichMunichGermany,Department of Psychiatry and PsychotherapyLudwig‐Maximilians‐University MunichMunichGermany,Instituto de Salud Carlos IIIBiomedical Network Research Centre on Mental Health (CIBERSAM)BarcelonaSpain
| | - Andreas J Forstner
- Institute of Human GeneticsUniversity of Bonn and Department of GenomicsLife & Brain CenterBonnGermany,Department of Psychiatry (UPK)University of BaselBaselSwitzerland,Human Genomics Research GroupDepartment of BiomedicineUniversity of BaselBaselSwitzerland
| | - Urs Heilbronner
- Institute of Psychiatric Phenomics and Genomics (IPPG)University HospitalLMU MunichMunichGermany,Department of Psychiatry and PsychotherapyUniversity Medical Center (UMG)Georg‐August University GöttingenGöttingenGermany
| | - Franziska Degenhardt
- Institute of Human GeneticsUniversity of Bonn and Department of GenomicsLife & Brain CenterBonnGermany
| | - Jana Strohmaier
- Department of Genetic Epidemiology in PsychiatryCentral Institute of Mental HealthMedical Faculty MannheimUniversity of HeidelbergMannheimGermany
| | - Mazda Adli
- Department of Psychiatry and PsychotherapyCharité ‐ Universitätsmedizin BerlinBerlinGermany
| | - Kristina Adorjan
- Institute of Psychiatric Phenomics and Genomics (IPPG)University HospitalLMU MunichMunichGermany,Department of Psychiatry and PsychotherapyLudwig‐Maximilians‐University MunichMunichGermany
| | - Nirmala Akula
- Intramural Research ProgramNational Institute of Mental HealthNational Institutes of HealthUS Dept of Health & Human ServicesBethesdaMDUSA
| | - Martin Alda
- Department of PsychiatryDalhousie UniversityHalifaxNSCanada
| | - Heike Anderson‐Schmidt
- Institute of Psychiatric Phenomics and Genomics (IPPG)University HospitalLMU MunichMunichGermany,Department of Psychiatry and PsychotherapyUniversity Medical Center (UMG)Georg‐August University GöttingenGöttingenGermany
| | | | | | - Raffaella Ardau
- Unit of Clinical PharmacologyHospital University Agency of CagliariCagliariItaly
| | - Bárbara Arias
- Departament Biologia EvolutivaEcologia i Ciències AmbientalsFacultat de BiologiaInstitut de Biomedicina de la Universitat de Barcelona (IBUB)CIBERSAMUniversitat de BarcelonaBarcelonaSpain
| | - Volker Arolt
- Department of PsychiatryUniversity of MünsterMünsterGermany
| | - Jean‐Michel Aubry
- Mood Disorders UnitDepartment of PsychiatryHUG ‐ Geneva University HospitalsGenevaSwitzerland
| | - Lena Backlund
- Department of Molecular Medicine and SurgeryKarolinska Institutet and The Centre for Psychiatric ResearchStockholmSweden
| | - Kim Bartholdi
- Institute of Psychiatric Phenomics and Genomics (IPPG)University HospitalLMU MunichMunichGermany
| | - Michael Bauer
- Department of Psychiatry and PsychotherapyCarl Gustav Carus University HospitalTechnische Universität DresdenDresdenGermany
| | - Bernhard T Baune
- Discipline of PsychiatryRoyal Adelaide HospitalAdelaide School of Medical SchoolineThe University of AdelaideAdelaideSAAustralia
| | - Thomas Becker
- Department of Psychiatry IIUlm UniversityBezirkskrankenhaus GünzburgGünzburgGermany
| | - Frank Bellivier
- INSERM UMR‐S 1144 ‐ Université Paris DiderotPôle de PsychiatrieAP‐HP, Groupe Hospitalier Lariboisière‐F. WidalParisFrance
| | - Antonio Benabarre
- Bipolar Disorders ProgramInstitute of NeurosciencesHospital ClinicUniversity of BarcelonaIDIBAPS, CIBERSAMBarcelonaSpain
| | | | | | | | | | - Clara Brichant‐Petitjean
- INSERM UMR‐S 1144 ‐ Université Paris DiderotPôle de PsychiatrieAP‐HP, Groupe Hospitalier Lariboisière‐F. WidalParisFrance
| | - Monika Budde
- Institute of Psychiatric Phenomics and Genomics (IPPG)University HospitalLMU MunichMunichGermany
| | - Pablo Cervantes
- Mood Disorders ProgramMcGill University Health CentreMontrealQCCanada
| | - Caterina Chillotti
- Unit of Clinical PharmacologyHospital University Agency of CagliariCagliariItaly
| | - Sven Cichon
- Institute of Human GeneticsUniversity of Bonn and Department of GenomicsLife & Brain CenterBonnGermany,Human Genomics Research GroupDepartment of BiomedicineUniversity of BaselBaselSwitzerland
| | - Scott R Clark
- Discipline of PsychiatryRoyal Adelaide HospitalAdelaide School of Medical SchoolineThe University of AdelaideAdelaideSAAustralia
| | - Francesc Colom
- Mental Health ProgramIMIM (Hospital del Mar Medical Research Institute)CIBERSAM BarcelonaCatoloniaSpain
| | - Ashley L Comes
- Institute of Psychiatric Phenomics and Genomics (IPPG)University HospitalLMU MunichMunichGermany,International Max Planck Research School for Translational Psychiatry (IMPRS‐TP)MunichGermany
| | - Cristiana Cruceanu
- Max Planck Institute of PsychiatryMunichGermany,Mood Disorders ProgramMcGill University Health CentreMontrealQCCanada
| | - Piotr M Czerski
- Laboratory of Psychiatric GeneticsPoznan University of Medical SciencesPoznanPoland
| | - Udo Dannlowski
- Department of PsychiatryUniversity of MünsterMünsterGermany
| | - Alexandre Dayer
- Mood Disorders UnitDepartment of PsychiatryHUG ‐ Geneva University HospitalsGenevaSwitzerland
| | - Maria Del Zompo
- Department of Biomedical SciencesUniversity of CagliariCagliariItaly
| | - Jay Raymond DePaulo
- Department of Psychiatry and Behavioral SciencesJohns Hopkins UniversityBaltimoreMDUSA
| | | | - Bruno Étain
- INSERM UMR‐S 1144 ‐ Université Paris DiderotPôle de PsychiatrieAP‐HP, Groupe Hospitalier Lariboisière‐F. WidalParisFrance
| | - Thomas Ethofer
- Department of Psychiatry and PsychotherapyNeurophysiology & Interventional NeuropsychiatryUniversity of TübingenTübingenGermany
| | - Peter Falkai
- Department of Psychiatry and PsychotherapyLudwig‐Maximilians‐University MunichMunichGermany
| | - Andreas Fallgatter
- Department of Psychiatry and PsychotherapyNeurophysiology & Interventional NeuropsychiatryUniversity of TübingenTübingenGermany
| | - Christian Figge
- Karl‐Jaspers ClinicEuropean Medical School Oldenburg‐GroningenOldenburgGermany
| | - Laura Flatau
- Institute of Psychiatric Phenomics and Genomics (IPPG)University HospitalLMU MunichMunichGermany
| | - Here Folkerts
- Department of Psychiatry, Psychotherapy and PsychosomaticsClinical Center WilhelmshavenWilhelmshavenGermany
| | - Louise Frisen
- Department of Molecular Medicine and SurgeryKarolinska Institutet and The Centre for Psychiatric ResearchStockholmSweden
| | | | - Janice M Fullerton
- Neuroscience Research AustraliaSydneyNSWAustralia,School of Medical SciencesUniversity of New South WalesSydneyNSWAustralia
| | - Katrin Gade
- Institute of Psychiatric Phenomics and Genomics (IPPG)University HospitalLMU MunichMunichGermany,Department of Psychiatry and PsychotherapyUniversity Medical Center (UMG)Georg‐August University GöttingenGöttingenGermany
| | | | | | - Fernando S Goes
- Department of Psychiatry and Behavioral SciencesJohns Hopkins UniversityBaltimoreMDUSA
| | - Maria Grigoroiu‐Serbanescu
- Biometric Psychiatric Genetics Research UnitAlexandru Obregia Clinical Psychiatric HospitalBucharestRomania
| | - Anna Gryaznova
- Institute of Psychiatric Phenomics and Genomics (IPPG)University HospitalLMU MunichMunichGermany
| | - Maria Hake
- Institute of Psychiatric Phenomics and Genomics (IPPG)University HospitalLMU MunichMunichGermany
| | - Joanna Hauser
- Laboratory of Psychiatric GeneticsPoznan University of Medical SciencesPoznanPoland
| | - Stefan Herms
- Institute of Human GeneticsUniversity of Bonn and Department of GenomicsLife & Brain CenterBonnGermany,Human Genomics Research GroupDepartment of BiomedicineUniversity of BaselBaselSwitzerland
| | - Per Hoffmann
- Institute of Human GeneticsUniversity of Bonn and Department of GenomicsLife & Brain CenterBonnGermany,Human Genomics Research GroupDepartment of BiomedicineUniversity of BaselBaselSwitzerland
| | - Liping Hou
- Intramural Research ProgramNational Institute of Mental HealthNational Institutes of HealthUS Dept of Health & Human ServicesBethesdaMDUSA
| | - Markus Jäger
- Department of Psychiatry IIUlm UniversityBezirkskrankenhaus GünzburgGünzburgGermany
| | - Stephane Jamain
- INSERM U955 Equipe 15 ‐ Psychiatrie GenetiqueHopital Henri MondorCreteilCedexFrance
| | - Esther Jiménez
- Bipolar Disorders ProgramInstitute of NeurosciencesHospital ClinicUniversity of BarcelonaIDIBAPS, CIBERSAMBarcelonaSpain
| | - Georg Juckel
- Department of PsychiatryRuhr University BochumLWL University HospitalBochumGermany
| | - Jean‐Pierre Kahn
- Service de Psychiatrie et Psychologie CliniqueCentre Psychothérapique de Nancy ‐ Université de LorraineNancyFrance
| | - Layla Kassem
- Human Genetics BranchSection on Genetic Basis of Mood and Anxiety DisordersNational Institutes of HealthBethesdaMDUSA
| | - John Kelsoe
- Department of PsychiatryUniversity of California San DiegoSan DiegoCAUSA
| | - Sarah Kittel‐Schneider
- Department of Psychiatry, Psychosomatic Medicine and PsychotherapyUniversity Hospital FrankfurtFrankfurtGermany
| | - Sebastian Kliwicki
- Department of Adult PsychiatryPoznan University of Medical SciencesPoznanPoland
| | - Farah Klohn‐Sagatholislam
- Institute of Psychiatric Phenomics and Genomics (IPPG)University HospitalLMU MunichMunichGermany,Department of Psychiatry and PsychotherapyLudwig‐Maximilians‐University MunichMunichGermany
| | | | | | - Carsten Konrad
- Department of Psychiatry and PsychotherapyAgaplesion DiakonieklinikumRotenburgGermany
| | | | - Gonzalo Laje
- Intramural Research ProgramNational Institute of Mental HealthNational Institutes of HealthUS Dept of Health & Human ServicesBethesdaMDUSA
| | - Mikael Landén
- Gothenburg UniversitySahlgrenska AcademyGothenburgSweden,Department of Medical Epidemiology and BiostatisticsKarolinska InstitutetStockholmSweden
| | - Fabian U Lang
- Department of Psychiatry IIUlm UniversityBezirkskrankenhaus GünzburgGünzburgGermany
| | | | - Marion Leboyer
- INSERM U955 Equipe 15 ‐ Psychiatrie GenetiqueHopital Henri MondorCreteilCedexFrance,Assistance Publique‐Hôpitaux de ParisHôpital Albert Chenevier ‐ Henri MondorPôle de PsychiatrieCréteilFrance
| | - Susan G Leckband
- Department of PharmacyVA San Diego Healthcare SystemSan DiegoCAUSA
| | - Mario Maj
- Department of PsychiatryCampania University L. VanvitelliNaplesItaly
| | - Mirko Manchia
- Section of PsychiatryDepartment of Public Health, Clinical and Molecular MedicineUniversity of CagliariCagliariItaly,Department of PharmacologyDalhousie UniversityHalifaxNSCanada
| | - Lina Martinsson
- Department of Clinical NeurosciencesKarolinska InstitutetStockholmSweden
| | - Michael J McCarthy
- Department of PsychiatryUniversity of California San DiegoSan DiegoCAUSA
| | | | - Francis J McMahon
- Intramural Research ProgramNational Institute of Mental HealthNational Institutes of HealthUS Dept of Health & Human ServicesBethesdaMDUSA
| | - Philip B Mitchell
- School of PsychiatryUniversity of New South WalesSydneyNSWAustralia,Black Dog InstitutePrince of Wales HospitalSydneyNSWAustralia
| | - Marina Mitjans
- Unitat d'Antropologia (Dp. Biología Animal)Department of Biologia AnimalFacultat de Biologia and Institut de Biomedicina (IBUB)Universitat de BarcelonaCIBERSAMBarcelonaSpain
| | - Francis M Mondimore
- Department of Psychiatry and Behavioral SciencesJohns Hopkins UniversityBaltimoreMDUSA
| | - Palmiero Monteleone
- Department of PsychiatryCampania University L. VanvitelliNaplesItaly,Neurosciences SectionDepartment of Medicine and SurgeryUniversity of SalernoSalernoItaly
| | - Vanessa Nieratschker
- Department of Psychiatry and PsychotherapyNeurophysiology & Interventional NeuropsychiatryUniversity of TübingenTübingenGermany
| | | | - Tomas Novák
- National Institute of Mental HealthKlecanyCzech Republic,Third Faculty of MedicineCharles University in PraguePragueCzech Republic
| | - Urban Ösby
- Department of PsychiatryKarolinska InstitutetStockholmSweden
| | - Andrea Pfennig
- Department of Psychiatry and PsychotherapyCarl Gustav Carus University HospitalTechnische Universität DresdenDresdenGermany
| | | | - Daniela Reich‐Erkelenz
- Institute of Psychiatric Phenomics and Genomics (IPPG)University HospitalLMU MunichMunichGermany
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and PsychotherapyUniversity Hospital FrankfurtFrankfurtGermany
| | - Jens Reimer
- Department of PsychiatryKlinikum Bremen‐OstBremenGermany
| | | | - Markus Reitt
- Department of Psychiatry and PsychotherapyUniversity Medical Center (UMG)Georg‐August University GöttingenGöttingenGermany
| | - Stephan Ripke
- Department of Psychiatry and PsychotherapyCharité ‐ Universitätsmedizin BerlinBerlinGermany,Stanley Center for Psychiatric ResearchBroad InstituteCambridgeMAUSA
| | - Guy A Rouleau
- Mood Disorders ProgramMcGill University Health CentreMontrealQCCanada
| | - Janusz K Rybakowski
- Department of Adult PsychiatryPoznan University of Medical SciencesPoznanPoland
| | - Martin Schalling
- Department of Molecular Medicine and SurgeryKarolinska Institutet and The Centre for Psychiatric ResearchStockholmSweden
| | | | - Max Schmauß
- Department of Psychiatry and PsychotherapyBezirkskrankenhaus AugsburgAugsburgGermany
| | - Peter R Schofield
- Neuroscience Research AustraliaSydneyNSWAustralia,School of Medical SciencesUniversity of New South WalesSydneyNSWAustralia
| | - K Oliver Schubert
- Discipline of PsychiatryRoyal Adelaide HospitalAdelaide School of Medical SchoolineThe University of AdelaideAdelaideSAAustralia
| | - Eva C Schulte
- Institute of Psychiatric Phenomics and Genomics (IPPG)University HospitalLMU MunichMunichGermany,Department of Psychiatry and PsychotherapyLudwig‐Maximilians‐University MunichMunichGermany
| | - Sybille Schulz
- Department of PsychiatryKlinikum Bremen‐OstBremenGermany
| | - Fanny Senner
- Institute of Psychiatric Phenomics and Genomics (IPPG)University HospitalLMU MunichMunichGermany,Department of Psychiatry and PsychotherapyLudwig‐Maximilians‐University MunichMunichGermany
| | - Giovanni Severino
- Department of Biomedical SciencesUniversity of CagliariCagliariItaly
| | - Tatyana Shekhtman
- Department of PsychiatryUniversity of California San DiegoSan DiegoCAUSA
| | - Paul D Shilling
- Department of PsychiatryUniversity of California San DiegoSan DiegoCAUSA
| | - Christian Simhandl
- Sigmund Freud UniversityViennaAustria,Bipolar ZentrumWiener NeustadtAustria
| | | | | | - Alessio Squassina
- Department of Biomedical SciencesUniversity of CagliariCagliariItaly
| | - Thomas Stamm
- Department of Psychiatry and PsychotherapyCharité ‐ Universitätsmedizin BerlinBerlinGermany,Department of Psychiatry, Psychotherapy and PsychosomaticsMedical School BrandenburgNeuruppinGermany
| | - Sophia Stegmaier
- Department of Psychiatry and PsychotherapyNeurophysiology & Interventional NeuropsychiatryUniversity of TübingenTübingenGermany
| | | | - Pavla Stopkova
- National Institute of Mental HealthKlecanyCzech Republic
| | - Andreas Thiel
- Department of Psychiatry and PsychotherapyAgaplesion DiakonieklinikumRotenburgGermany
| | | | | | | | - Eduard Vieta
- Bipolar Disorders ProgramInstitute of NeurosciencesHospital ClinicUniversity of BarcelonaIDIBAPS, CIBERSAMBarcelonaSpain
| | - Julia Veeh
- Department of Psychiatry, Psychosomatic Medicine and PsychotherapyUniversity Hospital FrankfurtFrankfurtGermany
| | - Martin von Hagen
- Clinic for Psychiatry and PsychotherapyClinical Center Werra‐MeißnerEschwegeGermany
| | - Moritz E Wigand
- Department of Psychiatry IIUlm UniversityBezirkskrankenhaus GünzburgGünzburgGermany
| | - Jens Wiltfang
- Department of Psychiatry and PsychotherapyUniversity Medical Center (UMG)Georg‐August University GöttingenGöttingenGermany
| | - Stephanie Witt
- Department of Genetic Epidemiology in PsychiatryCentral Institute of Mental HealthMedical Faculty MannheimUniversity of HeidelbergMannheimGermany
| | - Adam Wright
- School of PsychiatryUniversity of New South WalesSydneyNSWAustralia,Black Dog InstitutePrince of Wales HospitalSydneyNSWAustralia
| | - Peter P Zandi
- Department of Psychiatry and Behavioral SciencesJohns Hopkins UniversityBaltimoreMDUSA
| | | | - Markus Nöthen
- Institute of Human GeneticsUniversity of Bonn and Department of GenomicsLife & Brain CenterBonnGermany
| | - Marcella Rietschel
- Department of Genetic Epidemiology in PsychiatryCentral Institute of Mental HealthMedical Faculty MannheimUniversity of HeidelbergMannheimGermany
| | - Thomas G Schulze
- Institute of Psychiatric Phenomics and Genomics (IPPG)University HospitalLMU MunichMunichGermany
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46
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Budde M, Friedrichs S, Alliey-Rodriguez N, Ament S, Badner JA, Berrettini WH, Bloss CS, Byerley W, Cichon S, Comes AL, Coryell W, Craig DW, Degenhardt F, Edenberg HJ, Foroud T, Forstner AJ, Frank J, Gershon ES, Goes FS, Greenwood TA, Guo Y, Hipolito M, Hood L, Keating BJ, Koller DL, Lawson WB, Liu C, Mahon PB, McInnis MG, McMahon FJ, Meier SM, Mühleisen TW, Murray SS, Nievergelt CM, Nurnberger JI, Nwulia EA, Potash JB, Quarless D, Rice J, Roach JC, Scheftner WA, Schork NJ, Shekhtman T, Shilling PD, Smith EN, Streit F, Strohmaier J, Szelinger S, Treutlein J, Witt SH, Zandi PP, Zhang P, Zöllner S, Bickeböller H, Falkai PG, Kelsoe JR, Nöthen MM, Rietschel M, Schulze TG, Malzahn D. Efficient region-based test strategy uncovers genetic risk factors for functional outcome in bipolar disorder. Eur Neuropsychopharmacol 2019; 29:156-170. [PMID: 30503783 DOI: 10.1016/j.euroneuro.2018.10.005] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/12/2018] [Revised: 10/16/2018] [Accepted: 10/23/2018] [Indexed: 11/21/2022]
Abstract
Genome-wide association studies of case-control status have advanced the understanding of the genetic basis of psychiatric disorders. Further progress may be gained by increasing sample size but also by new analysis strategies that advance the exploitation of existing data, especially for clinically important quantitative phenotypes. The functionally-informed efficient region-based test strategy (FIERS) introduced herein uses prior knowledge on biological function and dependence of genotypes within a powerful statistical framework with improved sensitivity and specificity for detecting consistent genetic effects across studies. As proof of concept, FIERS was used for the first genome-wide single nucleotide polymorphism (SNP)-based investigation on bipolar disorder (BD) that focuses on an important aspect of disease course, the functional outcome. FIERS identified a significantly associated locus on chromosome 15 (hg38: chr15:48965004 - 49464789 bp) with consistent effect strength between two independent studies (GAIN/TGen: European Americans, BOMA: Germans; n = 1592 BD patients in total). Protective and risk haplotypes were found on the most strongly associated SNPs. They contain a CTCF binding site (rs586758); CTCF sites are known to regulate sets of genes within a chromatin domain. The rs586758 - rs2086256 - rs1904317 haplotype is located in the promoter flanking region of the COPS2 gene, close to microRNA4716, and the EID1, SHC4, DTWD1 genes as plausible biological candidates. While implication with BD is novel, COPS2, EID1, and SHC4 are known to be relevant for neuronal differentiation and function and DTWD1 for psychopharmacological side effects. The test strategy FIERS that enabled this discovery is equally applicable for tag SNPs and sequence data.
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Affiliation(s)
- Monika Budde
- Institute of Psychiatric Phenomics and Genomics, University Hospital, LMU Munich, Nussbaumstr. 7, Munich 80336, Germany
| | - Stefanie Friedrichs
- Department of Genetic Epidemiology, University Medical Center Göttingen, Georg-August-University, Göttingen 37099, Germany
| | - Ney Alliey-Rodriguez
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL 60637, United States
| | - Seth Ament
- Institute for Systems Biology, Seattle, WA 98109, United States
| | - Judith A Badner
- Department of Psychiatry, Rush University Medical Center, Chicago, IL 60612, United States
| | - Wade H Berrettini
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA 19104, United States
| | - Cinnamon S Bloss
- University of California San Diego, La Jolla, CA 92093, United States
| | - William Byerley
- Department of Psychiatry, University of California at San Francisco, San Francisco, CA 94103, United States
| | - Sven Cichon
- Human Genomics Research Group, Department of Biomedicine, University of Basel, Basel 4031, Switzerland; Institute of Medical Genetics and Pathology, University Hospital Basel, Basel 4031, Switzerland; Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich 52425, Germany
| | - Ashley L Comes
- Institute of Psychiatric Phenomics and Genomics, University Hospital, LMU Munich, Nussbaumstr. 7, Munich 80336, Germany; International Max Planck Research School for Translational Psychiatry, Max Planck Institute of Psychiatry, Munich 80804, Germany
| | - William Coryell
- University of Iowa Hospitals and Clinics, Iowa City, IA 52242, United States
| | - David W Craig
- The Translational Genomics Research Institute, Phoenix, AZ 85004, United States
| | - Franziska Degenhardt
- Institute of Human Genetics, School of Medicine & University Hospital Bonn, University of Bonn, Bonn 53127, Germany; Department of Genomics, Life & Brain Center, University of Bonn, Bonn 53127, Germany
| | - Howard J Edenberg
- Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN 46202, United States; Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN 46202, United States
| | - Tatiana Foroud
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN 46202, United States
| | - Andreas J Forstner
- Institute of Human Genetics, School of Medicine & University Hospital Bonn, University of Bonn, Bonn 53127, Germany; Department of Genomics, Life & Brain Center, University of Bonn, Bonn 53127, Germany; Human Genomics Research Group, Department of Biomedicine, University of Basel, Basel 4031, Switzerland; Department of Psychiatry (UPK), University of Basel, Basel 4012, Switzerland
| | - Josef Frank
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim 68159, Germany
| | - Elliot S Gershon
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL 60637, United States
| | - Fernando S Goes
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD 21287, United States
| | - Tiffany A Greenwood
- Department of Psychiatry, University of California San Diego, San Diego, CA 92093, United States
| | - Yiran Guo
- Center for Applied Genomics, Children's Hospital of Philadelphia, Abramson Research Center, Philadelphia, PA 19104, United States; Beijing Genomics Institute at Shenzhen, Shenzhen 518083, China
| | - Maria Hipolito
- Department of Psychiatry and Behavioral Sciences, Howard University Hospital, Washington, DC 20060, United States
| | - Leroy Hood
- Institute for Systems Biology, Seattle, WA 98109, United States
| | - Brendan J Keating
- Cardiovascular Institute, University of Pennsylvania School of Medicine, Philadelphia, PA 19104-5159, United States; Institute for Translational Medicine and Therapeutics, School of Medicine, University of Pennsylvania, Philadelphia, PA 19104-5158, United States
| | - Daniel L Koller
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN 46202, United States
| | - William B Lawson
- Dell Medical School, University of Texas at Austin, Austin, TX 78723, United States
| | - Chunyu Liu
- SUNY Upstate Medical University, Syracuse, NY 13210, United States
| | - Pamela B Mahon
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD 21287, United States
| | - Melvin G McInnis
- Department of Psychiatry, University of Michigan, Ann Arbor, MI 48105, United States
| | - Francis J McMahon
- U.S. Department of Health & Human Services, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD 20894, United States
| | - Sandra M Meier
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim 68159, Germany; National Centre for Register-Based Research, Aarhus University, Aarhus V 8210, Denmark
| | - Thomas W Mühleisen
- Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich 52425, Germany; Human Genomics Research Group, Department of Biomedicine, University of Basel, Basel 4031, Switzerland
| | - Sarah S Murray
- Scripps Genomic Medicine & The Scripps Translational Sciences Institute (STSI), La Jolla, CA 92037, United States; Department of Pathology, University of California San Diego, La Jolla, CA 92093, United States
| | - Caroline M Nievergelt
- Department of Psychiatry, University of California San Diego, San Diego, CA 92093, United States
| | - John I Nurnberger
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN 46202, United States
| | - Evaristus A Nwulia
- Department of Psychiatry and Behavioral Sciences, Howard University Hospital, Washington, DC 20060, United States
| | - James B Potash
- Department of Psychiatry, Carver College of Medicine, University of Iowa School of Medicine, Iowa City, IA 52242, United States
| | - Danjuma Quarless
- J. Craig Venter Institute, La Jolla, CA 92037, United States; University of California San Diego, La Jolla, CA 92093, United States
| | - John Rice
- Department of Psychiatry, Washington University School of Medicine in St. Louis, St. Louis, MO 63110, United States
| | - Jared C Roach
- Institute for Systems Biology, Seattle, WA 98109, United States
| | | | - Nicholas J Schork
- J. Craig Venter Institute, La Jolla, CA 92037, United States; The Translational Genomics Research Institute, Phoenix, AZ 85004, United States; University of California San Diego, La Jolla, CA 92093, United States
| | - Tatyana Shekhtman
- Department of Psychiatry, University of California San Diego, San Diego, CA 92093, United States
| | - Paul D Shilling
- Department of Psychiatry, University of California San Diego, San Diego, CA 92093, United States
| | - Erin N Smith
- Scripps Genomic Medicine & The Scripps Translational Sciences Institute (STSI), La Jolla, CA 92037, United States; Department of Pediatrics and Rady's Children's Hospital, School of Medicine, University of California San Diego, La Jolla, CA 92037, United States
| | - Fabian Streit
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim 68159, Germany
| | - Jana Strohmaier
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim 68159, Germany
| | - Szabolcs Szelinger
- The Translational Genomics Research Institute, Phoenix, AZ 85004, United States
| | - Jens Treutlein
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim 68159, Germany
| | - Stephanie H Witt
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim 68159, Germany
| | - Peter P Zandi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD 21205, United States
| | - Peng Zhang
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI 48109, United States
| | - Sebastian Zöllner
- Department of Computational Medicine and Bioinformatics, University of Michigan, Ann Arbor, MI 48109, United States; Department of Psychiatry, University of Michigan, Ann Arbor, MI 48105, United States
| | - Heike Bickeböller
- Department of Genetic Epidemiology, University Medical Center Göttingen, Georg-August-University, Göttingen 37099, Germany
| | - Peter G Falkai
- Department of Psychiatry and Psychotherapy, University Hospital, LMU Munich, Munich 80336, Germany
| | - John R Kelsoe
- Department of Psychiatry, University of California San Diego, San Diego, CA 92093, United States
| | - Markus M Nöthen
- Institute of Human Genetics, School of Medicine & University Hospital Bonn, University of Bonn, Bonn 53127, Germany; Department of Genomics, Life & Brain Center, University of Bonn, Bonn 53127, Germany
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim 68159, Germany
| | - Thomas G Schulze
- Institute of Psychiatric Phenomics and Genomics, University Hospital, LMU Munich, Nussbaumstr. 7, Munich 80336, Germany; Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim 68159, Germany; Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD 21287, United States; U.S. Department of Health & Human Services, Intramural Research Program, National Institute of Mental Health, National Institutes of Health, Bethesda, MD 20894, United States.
| | - Dörthe Malzahn
- Department of Genetic Epidemiology, University Medical Center Göttingen, Georg-August-University, Göttingen 37099, Germany.
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Lee RS, Mahon PB, Zandi PP, McCaul ME, Yang X, Bali U, Wand GS. DNA methylation and sex-specific expression of FKBP5 as correlates of one-month bedtime cortisol levels in healthy individuals. Psychoneuroendocrinology 2018; 97:164-173. [PMID: 30036794 PMCID: PMC6366448 DOI: 10.1016/j.psyneuen.2018.07.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 05/17/2018] [Accepted: 07/03/2018] [Indexed: 11/30/2022]
Abstract
Chronic exposure to cortisol is associated with cardiovascular, metabolic, and psychiatric disorders. Although cortisol can be readily measured from peripheral sources such as blood, urine, or saliva, multiple samplings spanning several days to weeks are necessary to reliably assess chronic cortisol exposure levels (referred to as cortisol load). Although cortisol levels in hair have been proposed as a measure of cortisol load, measurement is cumbersome and many people are not candidates due to short hair length and use of hair dyes. To date, there are no blood biomarkers that capture cortisol load. To identify a blood biomarker capable of integrating one-month cortisol exposure levels, 75 healthy participants provided 30+ days of awakening and bedtime saliva cortisol and completed psychosocial measures of anxiety, depression, and stress. Mean daily awakening and bedtime cortisol levels were then compared to CpG methylation levels, gene expression, and genotypes of the stress response gene FKBP5 obtained from blood drawn on the last day of the study. We found a correlation between FKBP5 methylation levels and mean 30+day awakening and bedtime cortisol levels (|r|≥0.32, p ≤ 0.006). We also observed a sex-specific correlation between bedtime cortisol levels and FKBP5 mRNA expression in female participants (r = 0.42, p = 0.005). Dividing the 30-day sampling period into four weekly bins showed that the correlations for both methylation and expression were not being driven by cortisol levels in the week preceding the blood draw. We also identified a female-specific association between FKBP5 mRNA expression and scores on the Beck Anxiety Inventory (r = 0.37, p = 0.013) and Beck Depression Inventory-II (r = 0.32, p = 0.033). Finally, DNA was genotyped at four SNPs, and variation in rs4713902 was shown to have an effect on FKBP5 expression under a codominant model (f = 3.41, p = 0.048) for females only. Our results suggest that blood FKBP5 DNA methylation and mRNA expression levels may be a useful marker for determining general or sex-specific 30-day cortisol load and justifies genome-wide approaches that can potentially identify additional cortisol markers with broader clinical utility.
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Affiliation(s)
- Richard S Lee
- Department of Psychiatry and Behavioral Sciences and Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, 21205, United States
| | - Pamela B Mahon
- Department of Psychiatry and Behavioral Sciences and Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, 21205, United States; Department of Psychiatry, Brigham & Women's Hospital and Harvard Medical School, Boston, MA 02115, United States
| | - Peter P Zandi
- Department of Psychiatry and Behavioral Sciences and Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, 21205, United States; Department of Mental Health, Johns Hopkins School of Public Health, Baltimore, MD, 21205, United States
| | - Mary E McCaul
- Department of Psychiatry and Behavioral Sciences and Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, 21205, United States
| | - Xiaoju Yang
- Department of Psychiatry and Behavioral Sciences and Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, 21205, United States
| | - Utsav Bali
- Sygnature Discovery, Nottingham, NG1 1GF, UK
| | - Gary S Wand
- Department of Psychiatry and Behavioral Sciences and Department of Medicine, Johns Hopkins School of Medicine, Baltimore, MD, 21205, United States.
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48
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Carey JL, Cox OH, Seifuddin F, Marque L, Tamashiro KLK, Zandi PP, Wand GS, Lee RS. A Rat Methyl-Seq Platform to Identify Epigenetic Changes Associated with Stress Exposure. J Vis Exp 2018. [PMID: 30417882 PMCID: PMC6235597 DOI: 10.3791/58617] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
As genomes of a wider variety of animals become available, there is an increasing need for tools that can capture dynamic epigenetic changes in these animal models. The rat is one particular model animal where an epigenetic tool can complement many pharmacological and behavioral studies to provide insightful mechanistic information. To this end, we adapted the SureSelect Target Capture System (referred to as Methyl-Seq) for the rat, which can assess DNA methylation levels across the rat genome. The rat design targeted promoters, CpG islands, island shores, and GC-rich regions from all RefSeq genes. To implement the platform on a rat experiment, male Sprague Dawley rats were exposed to chronic variable stress for 3 weeks, after which blood samples were collected for genomic DNA extraction. Methyl-Seq libraries were constructed from the rat DNA samples by shearing, adapter ligation, target enrichment, bisulfite conversion, and multiplexing. Libraries were sequenced on a next-generation sequencing platform and the sequenced reads were analyzed to identify DMRs between DNA of stressed and unstressed rats. Top candidate DMRs were independently validated by bisulfite pyrosequencing to confirm the robustness of the platform. Results demonstrate that the rat Methyl-Seq platform is a useful epigenetic tool that can capture methylation changes induced by exposure to stress.
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Affiliation(s)
- Jenny L Carey
- Departments of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine
| | - Olivia H Cox
- Departments of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine
| | - Fayaz Seifuddin
- Departments of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine
| | - Leonard Marque
- Departments of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine
| | - Kellie L K Tamashiro
- Departments of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine
| | - Peter P Zandi
- Departments of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine; Department of Mental Health, Johns Hopkins School of Public Health
| | - Gary S Wand
- Departments of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine; Department of Medicine, Johns Hopkins School of Medicine
| | - Richard S Lee
- Departments of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine;
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49
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Anttila V, Bulik-Sullivan B, Finucane HK, Walters RK, Bras J, Duncan L, Escott-Price V, Falcone GJ, Gormley P, Malik R, Patsopoulos NA, Ripke S, Wei Z, Yu D, Lee PH, Turley P, Grenier-Boley B, Chouraki V, Kamatani Y, Berr C, Letenneur L, Hannequin D, Amouyel P, Boland A, Deleuze JF, Duron E, Vardarajan BN, Reitz C, Goate AM, Huentelman MJ, Kamboh MI, Larson EB, Rogaeva E, St George-Hyslop P, Hakonarson H, Kukull WA, Farrer LA, Barnes LL, Beach TG, Demirci FY, Head E, Hulette CM, Jicha GA, Kauwe JSK, Kaye JA, Leverenz JB, Levey AI, Lieberman AP, Pankratz VS, Poon WW, Quinn JF, Saykin AJ, Schneider LS, Smith AG, Sonnen JA, Stern RA, Van Deerlin VM, Van Eldik LJ, Harold D, Russo G, Rubinsztein DC, Bayer A, Tsolaki M, Proitsi P, Fox NC, Hampel H, Owen MJ, Mead S, Passmore P, Morgan K, Nöthen MM, Rossor M, Lupton MK, Hoffmann P, Kornhuber J, Lawlor B, McQuillin A, Al-Chalabi A, Bis JC, Ruiz A, Boada M, Seshadri S, Beiser A, Rice K, van der Lee SJ, De Jager PL, Geschwind DH, Riemenschneider M, Riedel-Heller S, Rotter JI, Ransmayr G, Hyman BT, Cruchaga C, Alegret M, Winsvold B, Palta P, Farh KH, Cuenca-Leon E, Furlotte N, Kurth T, Ligthart L, Terwindt GM, Freilinger T, Ran C, Gordon SD, Borck G, Adams HHH, Lehtimäki T, Wedenoja J, Buring JE, Schürks M, Hrafnsdottir M, Hottenga JJ, Penninx B, Artto V, Kaunisto M, Vepsäläinen S, Martin NG, Montgomery GW, Kurki MI, Hämäläinen E, Huang H, Huang J, Sandor C, Webber C, Muller-Myhsok B, Schreiber S, Salomaa V, Loehrer E, Göbel H, Macaya A, Pozo-Rosich P, Hansen T, Werge T, Kaprio J, Metspalu A, Kubisch C, Ferrari MD, Belin AC, van den Maagdenberg AMJM, Zwart JA, Boomsma D, Eriksson N, Olesen J, Chasman DI, Nyholt DR, Avbersek A, Baum L, Berkovic S, Bradfield J, Buono RJ, Catarino CB, Cossette P, De Jonghe P, Depondt C, Dlugos D, Ferraro TN, French J, Hjalgrim H, Jamnadas-Khoda J, Kälviäinen R, Kunz WS, Lerche H, Leu C, Lindhout D, Lo W, Lowenstein D, McCormack M, Møller RS, Molloy A, Ng PW, Oliver K, Privitera M, Radtke R, Ruppert AK, Sander T, Schachter S, Schankin C, Scheffer I, Schoch S, Sisodiya SM, Smith P, Sperling M, Striano P, Surges R, Thomas GN, Visscher F, Whelan CD, Zara F, Heinzen EL, Marson A, Becker F, Stroink H, Zimprich F, Gasser T, Gibbs R, Heutink P, Martinez M, Morris HR, Sharma M, Ryten M, Mok KY, Pulit S, Bevan S, Holliday E, Attia J, Battey T, Boncoraglio G, Thijs V, Chen WM, Mitchell B, Rothwell P, Sharma P, Sudlow C, Vicente A, Markus H, Kourkoulis C, Pera J, Raffeld M, Silliman S, Boraska Perica V, Thornton LM, Huckins LM, William Rayner N, Lewis CM, Gratacos M, Rybakowski F, Keski-Rahkonen A, Raevuori A, Hudson JI, Reichborn-Kjennerud T, Monteleone P, Karwautz A, Mannik K, Baker JH, O'Toole JK, Trace SE, Davis OSP, Helder SG, Ehrlich S, Herpertz-Dahlmann B, Danner UN, van Elburg AA, Clementi M, Forzan M, Docampo E, Lissowska J, Hauser J, Tortorella A, Maj M, Gonidakis F, Tziouvas K, Papezova H, Yilmaz Z, Wagner G, Cohen-Woods S, Herms S, Julià A, Rabionet R, Dick DM, Ripatti S, Andreassen OA, Espeseth T, Lundervold AJ, Steen VM, Pinto D, Scherer SW, Aschauer H, Schosser A, Alfredsson L, Padyukov L, Halmi KA, Mitchell J, Strober M, Bergen AW, Kaye W, Szatkiewicz JP, Cormand B, Ramos-Quiroga JA, Sánchez-Mora C, Ribasés M, Casas M, Hervas A, Arranz MJ, Haavik J, Zayats T, Johansson S, Williams N, Dempfle A, Rothenberger A, Kuntsi J, Oades RD, Banaschewski T, Franke B, Buitelaar JK, Arias Vasquez A, Doyle AE, Reif A, Lesch KP, Freitag C, Rivero O, Palmason H, Romanos M, Langley K, Rietschel M, Witt SH, Dalsgaard S, Børglum AD, Waldman I, Wilmot B, Molly N, Bau CHD, Crosbie J, Schachar R, Loo SK, McGough JJ, Grevet EH, Medland SE, Robinson E, Weiss LA, Bacchelli E, Bailey A, Bal V, Battaglia A, Betancur C, Bolton P, Cantor R, Celestino-Soper P, Dawson G, De Rubeis S, Duque F, Green A, Klauck SM, Leboyer M, Levitt P, Maestrini E, Mane S, De-Luca DM, Parr J, Regan R, Reichenberg A, Sandin S, Vorstman J, Wassink T, Wijsman E, Cook E, Santangelo S, Delorme R, Rogé B, Magalhaes T, Arking D, Schulze TG, Thompson RC, Strohmaier J, Matthews K, Melle I, Morris D, Blackwood D, McIntosh A, Bergen SE, Schalling M, Jamain S, Maaser A, Fischer SB, Reinbold CS, Fullerton JM, Guzman-Parra J, Mayoral F, Schofield PR, Cichon S, Mühleisen TW, Degenhardt F, Schumacher J, Bauer M, Mitchell PB, Gershon ES, Rice J, Potash JB, Zandi PP, Craddock N, Ferrier IN, Alda M, Rouleau GA, Turecki G, Ophoff R, Pato C, Anjorin A, Stahl E, Leber M, Czerski PM, Cruceanu C, Jones IR, Posthuma D, Andlauer TFM, Forstner AJ, Streit F, Baune BT, Air T, Sinnamon G, Wray NR, MacIntyre DJ, Porteous D, Homuth G, Rivera M, Grove J, Middeldorp CM, Hickie I, Pergadia M, Mehta D, Smit JH, Jansen R, de Geus E, Dunn E, Li QS, Nauck M, Schoevers RA, Beekman AT, Knowles JA, Viktorin A, Arnold P, Barr CL, Bedoya-Berrio G, Bienvenu OJ, Brentani H, Burton C, Camarena B, Cappi C, Cath D, Cavallini M, Cusi D, Darrow S, Denys D, Derks EM, Dietrich A, Fernandez T, Figee M, Freimer N, Gerber G, Grados M, Greenberg E, Hanna GL, Hartmann A, Hirschtritt ME, Hoekstra PJ, Huang A, Huyser C, Illmann C, Jenike M, Kuperman S, Leventhal B, Lochner C, Lyon GJ, Macciardi F, Madruga-Garrido M, Malaty IA, Maras A, McGrath L, Miguel EC, Mir P, Nestadt G, Nicolini H, Okun MS, Pakstis A, Paschou P, Piacentini J, Pittenger C, Plessen K, Ramensky V, Ramos EM, Reus V, Richter MA, Riddle MA, Robertson MM, Roessner V, Rosário M, Samuels JF, Sandor P, Stein DJ, Tsetsos F, Van Nieuwerburgh F, Weatherall S, Wendland JR, Wolanczyk T, Worbe Y, Zai G, Goes FS, McLaughlin N, Nestadt PS, Grabe HJ, Depienne C, Konkashbaev A, Lanzagorta N, Valencia-Duarte A, Bramon E, Buccola N, Cahn W, Cairns M, Chong SA, Cohen D, Crespo-Facorro B, Crowley J, Davidson M, DeLisi L, Dinan T, Donohoe G, Drapeau E, Duan J, Haan L, Hougaard D, Karachanak-Yankova S, Khrunin A, Klovins J, Kučinskas V, Lee Chee Keong J, Limborska S, Loughland C, Lönnqvist J, Maher B, Mattheisen M, McDonald C, Murphy KC, Nenadic I, van Os J, Pantelis C, Pato M, Petryshen T, Quested D, Roussos P, Sanders AR, Schall U, Schwab SG, Sim K, So HC, Stögmann E, Subramaniam M, Toncheva D, Waddington J, Walters J, Weiser M, Cheng W, Cloninger R, Curtis D, Gejman PV, Henskens F, Mattingsdal M, Oh SY, Scott R, Webb B, Breen G, Churchhouse C, Bulik CM, Daly M, Dichgans M, Faraone SV, Guerreiro R, Holmans P, Kendler KS, Koeleman B, Mathews CA, Price A, Scharf J, Sklar P, Williams J, Wood NW, Cotsapas C, Palotie A, Smoller JW, Sullivan P, Rosand J, Corvin A, Neale BM, Schott JM, Anney R, Elia J, Grigoroiu-Serbanescu M, Edenberg HJ, Murray R. Analysis of shared heritability in common disorders of the brain. Science 2018; 360:eaap8757. [PMID: 29930110 PMCID: PMC6097237 DOI: 10.1126/science.aap8757] [Citation(s) in RCA: 847] [Impact Index Per Article: 141.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2016] [Revised: 02/07/2017] [Accepted: 04/24/2018] [Indexed: 01/01/2023]
Abstract
Disorders of the brain can exhibit considerable epidemiological comorbidity and often share symptoms, provoking debate about their etiologic overlap. We quantified the genetic sharing of 25 brain disorders from genome-wide association studies of 265,218 patients and 784,643 control participants and assessed their relationship to 17 phenotypes from 1,191,588 individuals. Psychiatric disorders share common variant risk, whereas neurological disorders appear more distinct from one another and from the psychiatric disorders. We also identified significant sharing between disorders and a number of brain phenotypes, including cognitive measures. Further, we conducted simulations to explore how statistical power, diagnostic misclassification, and phenotypic heterogeneity affect genetic correlations. These results highlight the importance of common genetic variation as a risk factor for brain disorders and the value of heritability-based methods in understanding their etiology.
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Affiliation(s)
- Verneri Anttila
- Analytic Translational Genetics Unit, Massachusetts General Hospital Harvard Medical School, Boston, Massachusetts, USA.
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | - Brendan Bulik-Sullivan
- Analytic Translational Genetics Unit, Massachusetts General Hospital Harvard Medical School, Boston, Massachusetts, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | - Hilary K Finucane
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Department of Mathematics, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Raymond K Walters
- Analytic Translational Genetics Unit, Massachusetts General Hospital Harvard Medical School, Boston, Massachusetts, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | - Jose Bras
- UK Dementia Research Institute, University College London, London, UK
- Department of Molecular Neuroscience, Institute of Neurology, University College London, London, UK
| | - Laramie Duncan
- Analytic Translational Genetics Unit, Massachusetts General Hospital Harvard Medical School, Boston, Massachusetts, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Department of Psychiatry and Behavioral Science, Stanford University, Stanford, California, USA
| | - Valentina Escott-Price
- Cardiff University, Medical Research Council Center for Neuropsychiatric Genetics & Genomics, Institute of Psychology, Medicine & Clinical Neuroscience, Cardiff, UK
- Dementia Research Institute, Cardiff University, Cardiff, UK
| | - Guido J Falcone
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Padhraig Gormley
- Analytic Translational Genetics Unit, Massachusetts General Hospital Harvard Medical School, Boston, Massachusetts, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Rainer Malik
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
| | - Nikolaos A Patsopoulos
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Department of Neurology, Brigham & Women's Hospital, Harvard Medical School, Boston, MA, USA
| | - Stephan Ripke
- Analytic Translational Genetics Unit, Massachusetts General Hospital Harvard Medical School, Boston, Massachusetts, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Charite Universitatsmedizin Berlin, Berlin, Germany
| | - Zhi Wei
- Department of Computer Science, New Jersey Institute of Technology, New Jersey, USA
| | - Dongmei Yu
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Phil H Lee
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Patrick Turley
- Analytic Translational Genetics Unit, Massachusetts General Hospital Harvard Medical School, Boston, Massachusetts, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | - Benjamin Grenier-Boley
- INSERM U1167 LabEx DISTALZ, Lille, France
- Institut Pasteur de Lille, U1167, Lille, France
- Université de Lille, U1167, RID-AGE, Risk Factors and Molecular Determinants of Aging-Related Diseases, Lille, France
| | - Vincent Chouraki
- INSERM U1167 LabEx DISTALZ, Lille, France
- Institut Pasteur de Lille, U1167, Lille, France
- Université de Lille, U1167, RID-AGE, Risk Factors and Molecular Determinants of Aging-Related Diseases, Lille, France
- Centre Hosp. Univ Lille, Lille, France
| | - Yoichiro Kamatani
- Laboratory for Statistical Analysis, RIKEN Center for Integrative Medical Sciences, Yokohama, Japan
- Center for Genomic Medicine, Kyoto University Graduate School of Medicine, Kyoto, Japan
| | - Claudine Berr
- INSERM U1061 - Neuropsychiatry: Epidemiological and Clinical Research, Montpellier, France
- University of Montpellier, Montpellier, France
- Memory Research and Resources Center, Department of Neurology, Montpellier University Hospital Gui de Chauliac, Montpellier, France
| | - Luc Letenneur
- INSERM, UMR 1219, Bordeaux, France
- University of Bordeaux, Bordeaux, France
| | - Didier Hannequin
- Rouen University Hospital, Rouen, France
- Inserm U1245, Rouen, France
| | - Philippe Amouyel
- INSERM U1167 LabEx DISTALZ, Lille, France
- Institut Pasteur de Lille, U1167, Lille, France
- Université de Lille, U1167, RID-AGE, Risk Factors and Molecular Determinants of Aging-Related Diseases, Lille, France
- Centre Hosp. Univ Lille, Lille, France
| | - Anne Boland
- Centre National de Recherche en Génomique Humaine (CNRGH), Institut de biologie François Jacob, CEA, Evry, France
| | - Jean-François Deleuze
- Centre National de Recherche en Génomique Humaine (CNRGH), Institut de biologie François Jacob, CEA, Evry, France
| | - Emmanuelle Duron
- Department of Gerontology, Hôpital Broca, AH-HP, Paris, France
- Hôpital Paul Brousse Université Paris Sud XI, Le Kremlin-Bicêtre, Paris, France
| | - Badri N Vardarajan
- Gertrude H. Sergievsky Center and Dept of Neurology, Columbia University, New York, NY, USA
| | | | - Alison M Goate
- Department of Neuroscience, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Matthew J Huentelman
- Translational Genomics Research Institute, Neurogenomics Division, Phoenix, AZ, USA
| | | | - Eric B Larson
- Kaiser Permanente Washington Health Research Institute, Seattle, WA, USA
- Department of Medicine, University of Washington, WA, USA
| | - Ekaterina Rogaeva
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Canada
| | - Peter St George-Hyslop
- Tanz Centre for Research in Neurodegenerative Diseases, University of Toronto, Toronto, Canada
- Cambridge Institute for Medical Research, University of Cambridge, Cambridge, UK
| | - Hakon Hakonarson
- Center for Applied Genomics of The Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Division of Human Genetics, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Department of Pediatrics, The Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Walter A Kukull
- National Alzheimer Coordinating Center (NACC), Department of Epidemiology, University of Washington, Seattle, WA, USA
| | - Lindsay A Farrer
- Department of Medicine, Boston University School of Medicine, Boston, MA, USA
| | - Lisa L Barnes
- Rush Alzheimers Disease Center, Chicago, IL, USA
- Department of Neurological Sciences, Rush Medical College, Chicago, IL, USA
- Department of Behavioral Sciences, Rush Medical College, Chicago, IL, USA
| | | | | | - Elizabeth Head
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, USA
| | - Christine M Hulette
- Department of Pathology, Duke University School of Medicine, Durham, NC, USA
| | - Gregory A Jicha
- College of Medicine, University of Kentucky, Lexington, KY, USA
| | - John S K Kauwe
- Department of Biology, Brigham Young University, Provo, UT, USA
| | - Jeffrey A Kaye
- Layton Aging & Alzheimer's Disease Center, Oregon Health & Science University, Portland, OR, USA
| | - James B Leverenz
- Lou Ruvo Center for Brain Health, Neurological Institute, Cleveland Clinic, Cleveland, OH, USA
| | - Allan I Levey
- Department of Neurology, School of Medicine, Emory University, Atlanta, GA, USA
| | - Andrew P Lieberman
- Department of Pathology, University of Michigan Medical School, Ann Arbor, MI, USA
| | - Vernon S Pankratz
- University of New Mexico Health Sciences Center, Albuquerque, NM, USA
| | - Wayne W Poon
- Institute for Memory Impairments and Neurological Disorders, University of California, Irvine, CA, USA
| | - Joseph F Quinn
- Department of Neurology, Oregon Health and Science University, Portland, OR, USA
- Department of Neurology and Parkinson's Disease Research Education and Clinical Care Center (PADRECC), Portland Veterans Affairs Medical Center, Portland, OR, USA
| | - Andrew J Saykin
- Indiana Alzheimer Disease Center, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Lon S Schneider
- Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Amanda G Smith
- Byrd Alzheimer's Institute, University of South Florida, Tampa, FL, USA
| | - Joshua A Sonnen
- Department of Pathology, University of Utah, Salt Lake City, UT, USA
- Department of Pathology, University of Washington, Seattle, WA, USA
| | | | - Vivianna M Van Deerlin
- Department of Pathology and Laboratory Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - Linda J Van Eldik
- Sanders-Brown Center on Aging, University of Kentucky, Lexington, KY, USA
| | - Denise Harold
- School of Biotechnology, Dublin City University, Glasnevin, Dublin, Ireland
| | - Giancarlo Russo
- Functional Genomics Center Zurich, ETH/UZH-Zurich, Zurich, Switzerland
| | - David C Rubinsztein
- Department of Medical Genetics, Cambridge Institute for Medical Research, Cambridge, UK
- UK Dementia Research Institute, Cambridge, UK
| | | | - Magda Tsolaki
- 1st and 3rd Departments of Neurology, Aristotle University of Thessaloniki, Thessaloniki, Greece
- Greek Association of Alzheimer's Disease and Related Disorders, Thessaloniki, Greece
| | - Petra Proitsi
- Maurice Wohl Clinical Neuroscience Institute, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Nick C Fox
- Dementia Research Centre, UCL Institute of Neurology, London, UK
- UK Dementia Research Institute, University College London, London, UK
| | - Harald Hampel
- Sorbonne University, GRC n° 21, Alzheimer Precision Medicine (APM), AP-HP, Pitié-Salpêtrière Hospital, Paris, France
- Institute of Memory and Alzheimer's Disease (IM2A), Department of Neurology, Pitié-Salpêtrière Hospital, AP-HP, Paris, France
- Brain & Spine Institute (ICM), INSERM U 1127, CNRS UMR 7225, Paris, France
- AXA Research Fund & Sorbonne University Chair, Paris, France
| | - Michael J Owen
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
- Institute of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
| | - Simon Mead
- Institute of Prion Diseases and MRC Prion Unit, University College London, London, UK
| | - Peter Passmore
- Centre for Public Health, Queens University Belfast, Belfast, UK
| | - Kevin Morgan
- Human Genetics, School of Life Sciences, University of Nottingham, Nottingham UK
| | - Markus M Nöthen
- Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany
- Institute of Human Genetics, School of Medicine, University of Bonn & University Hospital Bonn, Bonn, Germany
| | - Martin Rossor
- Department of Neurodegeneration, UCL Institute of Neurology, London, UK
| | - Michelle K Lupton
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
- Institute of Psychiatry Psychology and Neuroscience, Kings College London, UK
| | - Per Hoffmann
- Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany
- Institute of Human Genetics, School of Medicine, University of Bonn & University Hospital Bonn, Bonn, Germany
- Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
- Human Genomics Research Group, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Johannes Kornhuber
- Department of Psychiatry and Psychotherapy, Friedrich-Alexander-Universität Erlangen-Nürnberg University Hospital, Erlangen, Germany
| | - Brian Lawlor
- Department of Psychiatry and Global Brain Health Institute, Trinity College, Dublin, Ireland
| | - Andrew McQuillin
- Division of Psychiatry, Molecular Psychiatry Laboratory,University College London, London, UK
| | - Ammar Al-Chalabi
- Maurice Wohl Clinical Neuroscience Institute, Department of Basic and Clinical Neuroscience, King's College London, London, UK
- King's College Hospital, London, UK
| | - Joshua C Bis
- Cardiovascular Health Research Unit, Department of Medicine, University of Washington, Seattle, WA, USA
| | - Agustin Ruiz
- Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain and Universitat Internacional de Catalunya, Barcelona, Spain
- Facultat de Medicina i Ciències de la Salut, Universitat Internacional de Catalunya (UIC), Barcelona, Spain
| | - Mercè Boada
- Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain and Universitat Internacional de Catalunya, Barcelona, Spain
| | - Sudha Seshadri
- Glenn Biggs Institute for Alzheimer's and Neurodegenerative Diseases, University of Texas Health Sciences Center, San Antonio, Texas, USA
- Neurology and Neurogenetics Core, Framingham Heart Study, Framingham, MA, USA
- School of Medicine, Boston University, Boston, MA, USA
| | - Alexa Beiser
- School of Public Health, Boston University, Boston, MA, USA
- Framingham Heart Study, Framingham, MA, USA
- School of Medicine, Boston University, Boston, MA, USA
| | - Kenneth Rice
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Sven J van der Lee
- Department of Epidemiology, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - Philip L De Jager
- Center for Translational & Computational Neuroimmunology, Columbia University Medical Center, New York, NY, USA
| | - Daniel H Geschwind
- Neurogenetics Program, Departments of Neurology and Human Genetics, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
- Center For Autism Research and Treatment, Semel Institute, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
- Institute for Precision Health, University of California, Los Angeles, Los Angeles, CA, USA
| | | | - Steffi Riedel-Heller
- Institute of Social Medicine, Occupational Health and Public Health (ISAP), University of Leipzig, Leipzig, Germany
| | - Jerome I Rotter
- Institute for Translational Genomics and Population Sciences, Departments of Pediatrics and Medicine, LABioMed at Harbor-UCLA Medical Center, Torrance, CA, USA
| | - Gerhard Ransmayr
- Department of Neurology II, Kepler University Clinic, Johannes Kepler University, Linz, Austria
| | - Bradley T Hyman
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Carlos Cruchaga
- Washington University School of Medicine, St. Louis, MO, USA
| | - Montserrat Alegret
- Fundació ACE, Institut Català de Neurociències Aplicades, Barcelona, Spain and Universitat Internacional de Catalunya, Barcelona, Spain
| | - Bendik Winsvold
- Communication and Research Unit for Musculoskeletal Disorders (FORMI), Oslo University Hospital, Oslo, Norway
- Department of Neurology, Oslo University Hospital, Oslo, Norway
| | - Priit Palta
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
- Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Kai-How Farh
- Illumina Inc., San Diego, CA, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | - Ester Cuenca-Leon
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | | | - Tobias Kurth
- Institute of Public Health, Charité - Universitätsmedizin Berlin, Berlin, Germany
| | - Lannie Ligthart
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Gisela M Terwindt
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - Tobias Freilinger
- Institute for Stroke and Dementia Research, Klinikum der Universitaet Muenchen, Munich, Germany
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany
| | - Caroline Ran
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Scott D Gordon
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Guntram Borck
- Institute of Human Genetics, University of Ulm, Ulm, Germany
| | - Hieab H H Adams
- Department of Epidemiology, Erasmus Medical Centre, Rotterdam, the Netherlands
- Department of Radiology and Nuclear Medicine, Erasmus Medical Centre, Rotterdam, the Netherlands
| | - Terho Lehtimäki
- Department of Clinical Chemistry, Fimlab Laboratories and Finnish Cardiovascular Research Center-Tampere, Faculty of Medicine and Life Sciences, University of Tampere, Tampere, Finland
| | - Juho Wedenoja
- Department of Ophthalmology, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | | | - Markus Schürks
- Department of Neurology, University Hospital Essen, Germany
| | | | - Jouke-Jan Hottenga
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Avera Institute for Human Genetics, Sioux Falls, SD, USA
| | - Brenda Penninx
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| | - Ville Artto
- Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland
| | - Mari Kaunisto
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
| | - Salli Vepsäläinen
- Department of Neurology, Helsinki University Central Hospital, Helsinki, Finland
| | | | - Grant W Montgomery
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Australia
| | - Mitja I Kurki
- Analytic Translational Genetics Unit, Massachusetts General Hospital Harvard Medical School, Boston, Massachusetts, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
| | - Eija Hämäläinen
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
| | - Hailiang Huang
- Analytic Translational Genetics Unit, Massachusetts General Hospital Harvard Medical School, Boston, Massachusetts, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Department of Medicine, Harvard Medical School, Boston, MA, USA
| | - Jie Huang
- Boston VA Research Institute, Boston, MA, USA
- Brigham Women's Hospital Division of Aging, Harvard Medical School, Boston, MA, USA
| | - Cynthia Sandor
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, UK
| | - Caleb Webber
- Department of Physiology, Anatomy and Genetics, University of Oxford, Oxford, UK
- Dementia Research Institute, Cardiff University, Cardiff, UK
| | - Bertram Muller-Myhsok
- Max Planck Institute of Psychiatry, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
- Institute of Translational Medicine, University of Liverpool, Liverpool, UK
| | - Stefan Schreiber
- Institute of Clinical Molecular Biology, Kiel University and University Hospital Schleswig-Holstein, Kiel, Germany
- Clinic of Internal Medicine I, University Hospital Schleswig-Holstein, Kiel, Germany
| | - Veikko Salomaa
- National Institute for Health and Welfare, Helsinki, Finland
| | - Elizabeth Loehrer
- Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | | | - Alfons Macaya
- Pediatric Neurology Research Group, Vall d'Hebron Research Institute, Autonomous University of Barcelona, Barcelona, Spain
| | - Patricia Pozo-Rosich
- Headache Unit, Neurology Department, Hospital Vall d'Hebron, Barcelona, Spain
- Headache Research Group, VHIR, Autonomous University of Barcelona, Barcelona, Spain
| | - Thomas Hansen
- Danish Headache Center, Rigshospitalet Glostrup and University of Copenhagen, Copenhagen, Denmark
- Institute of Biological Psychiatry, Roskilde, Denmark
| | - Thomas Werge
- Institute of Biological Psychiatry, Roskilde, Denmark
- Department of Clinical Sciences, University of Copenhagen, Copenhagen, Denmark
- Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
| | - Jaakko Kaprio
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
| | - Andres Metspalu
- Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia
| | - Christian Kubisch
- Institute of Human Genetics, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | - Michel D Ferrari
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - Andrea C Belin
- Department of Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Arn M J M van den Maagdenberg
- Department of Human Genetics, Leiden University Medical Center, Leiden, The Netherlands
- Department of Neurology, Leiden University Medical Center, Leiden, The Netherlands
| | - John-Anker Zwart
- Division of Clinical Neuroscience, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Dorret Boomsma
- Netherlands Twin Register, Vrije Universiteit, Amsterdam, the Netherlands
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | | | - Jes Olesen
- Danish Headache Center, Rigshospitalet Glostrup and University of Copenhagen, Copenhagen, Denmark
| | - Daniel I Chasman
- Division of Preventive Medicine, Brigham and Women's Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Dale R Nyholt
- Statistical and Genomic Epidemiology Laboratory, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Queensland, Australia
| | - Andreja Avbersek
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK
| | - Larry Baum
- Centre for Genomic Sciences, University of Hong Kong, Hong Kong
| | - Samuel Berkovic
- Epilepsy Research Centre, University of Melbourne, Heidelberg, Australia
| | | | - Russell J Buono
- Cooper Medical School of Rowan University, Camden, NJ, USA
- Thomas Jefferson University Hospital, Philadelphia, PA, USA
- Children's Hospital of Philadelphia, Philadelphia, PA, USA
| | - Claudia B Catarino
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK
- Epilepsy Society, Chalfont-St-Peter, Bucks, UK
| | - Patrick Cossette
- Centre de Recherche du Centre Hospitalier de l'Universite de Montreal and Department of Neurosciences, Université de Montréal, Montréal, Canada
| | - Peter De Jonghe
- Neurogenetics Group, VIB-CMN, Antwerp, Belgium
- University of Antwerp, Antwerp, Belgium
- Department of Neurology, Antwerp University Hospital, Antwerp, Belgium
| | - Chantal Depondt
- Department of Neurology, Hôpital Erasme, Université Libre de Bruxelles, Brussels, Belgium
| | - Dennis Dlugos
- Division of Neurology, Children's Hospital of Philadelphia, Philadelphia, PA, USA
- Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | - Thomas N Ferraro
- Department of Biomedical Sciences, Cooper Medical School of Rowan University, Camden, NJ, USA
- Department of Psychiatry, Center for Neurobiology and Behavior, Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA, USA
| | | | | | - Jennifer Jamnadas-Khoda
- Department of Clinical and Experimental Epilepsy, UCL Institute of Neurology, London, UK
- Institute of Mental Health, University of Nottingham, Nottingham, UK
| | - Reetta Kälviäinen
- Epilepsy Center/Neurocenter, Kuopio University Hospital, Kuopio, Finland
- Institute of Clinical Medicine, School of Medicine, Faculty of Health Sciences, University of Eastern Finland, Kuopio, Finland
| | - Wolfram S Kunz
- Department of Epileptology, University Bonn Medical Center, Bonn, Germany
- Institute of Experimental Epileptology and Cognition Research, University Bonn Medical Center, Bonn, Germany
| | - Holger Lerche
- Department of Neurology and Epileptology, Hertie Institute for Clinical Brain Research, University of Tuebingen, Tuebingen, Germany
| | - Costin Leu
- Department of Clinical and Experimental Epilepsy, NIHR University College London Hospitals Biomedical Research Centre, UCL Institute of Neurology, London
| | - Dick Lindhout
- Department of Genetics, University Medical Center Utrecht, the Netherlands
- Epilepsy Foundation in the Netherlands (SEIN), Heemstede, the Netherlands
| | - Warren Lo
- Departments of Pediatrics and Neurology, Ohio State University, Columbus, OH, USA
- Nationwide Children's Hospital, Columbus, OH, USA
| | - Daniel Lowenstein
- Department of Neurology, University of California, San Francisco, CA, USA
| | - Mark McCormack
- Department of Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland
- Center for Molecular Medicine, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Rikke S Møller
- Danish Epilepsy Centre, Filadelfia, Dianalund, Denmark
- Institute for Regional Health Services, University of Southern Denmark, Odense, Denmark
| | | | - Ping-Wing Ng
- United Christian Hospital, Hong Kong
- Hong Kong Sanatorium and Hospital, Hong Kong
| | - Karen Oliver
- Epilepsy Research Centre, University of Melbourne, Austin Health, Heidelberg, Australia
| | - Michael Privitera
- Department of Neurology, University of Cincinnati, Cincinnati, OH, USA
- UC Gardner Neuroscience Institute, Cincinnati, OH, USA
| | - Rodney Radtke
- Department of Neurology, Duke University School of Medicine, Durham, NC, USA
| | | | - Thomas Sander
- Cologne Center for Genomics (CCG), University of Cologne, Cologne, Germany
| | - Steven Schachter
- Department of Neurology, Beth Israel Deaconess Medical Center, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Christoph Schankin
- Department of Neurology, Inselspital, Bern University Hospital, University of Bern, Switzerland
- Department of Neurology, University of Munich Hospital, Grosshadern, University of Munich, Germany
| | - Ingrid Scheffer
- Department of Medicine, The University of Melbourne, Austin Health, Melbourne, Victoria, Australia
- Department of Paediatrics, Royal Children's Hospital, The University of Melbourne, Melbourne, Victoria, Australia
- Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia
| | - Susanne Schoch
- Institute of Neuropathology, Bonn University Medical School, Bonn, Germany
| | - Sanjay M Sisodiya
- UCL Institute of Neurology, London, UK
- Chalfont Centre for Epilepsy, Bucks, UK
| | | | - Michael Sperling
- Department of Neurology, Thomas Jefferson University, Philadelphia, PA, USA
| | - Pasquale Striano
- Pediatric Neurology and Muscular Diseases Unit-Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health University of Genoa, "G. Gaslini" Institute, Genova, Italy
| | - Rainer Surges
- Department of Epileptology, University Hospital Bonn, Bonn, Germany
- Section of Epileptology, Department of Neurology, University Hospital RWTH Aachen, Aachen, Germany
| | - G Neil Thomas
- Institute of Applied Health Research, University of Birmingham, UK
| | - Frank Visscher
- Department of Neurology, Admiraal De Ruyter Hospital, Goes, The Netherlands
| | - Christopher D Whelan
- Department of Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Federico Zara
- Laboratory of Neurogenetics, G. Gaslini Institute, Genova, Italy
| | - Erin L Heinzen
- Institute for Genomic Medicine, Columbia University Medical Center, New York, NY, USA
| | - Anthony Marson
- University of Liverpool, Liverpool, UK
- Walton Centre NHS Foundation Trust, Liverpool, UK
| | - Felicitas Becker
- Department of Neurology and Epileptology, University Hospital Tuebingen, Tuebingen, Germany
- Department of Neurology, University of Ulm, Ulm, Germany
| | | | - Fritz Zimprich
- Department of Neurology, Medical University of Vienna, Austria
| | - Thomas Gasser
- Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
| | - Raphael Gibbs
- Laboratory of Neurogenetics, National Institute on Aging, National Institutes of Health, Bethesda, MD, USA
| | - Peter Heutink
- German Center for Neurodegenerative Diseases (DZNE), Tübingen, Germany
- Hertie-Institute for Clinical Brain Research, University of Tübingen, Tübingen, Germany
| | - Maria Martinez
- INSERM U1220, IRSD, Toulouse, France
- Université Paul Sabatier, Toulouse, France
| | | | - Manu Sharma
- Centre for Genetic Epidemiology, Institute for Clinical Epidemiology and Applied Biometery, University of Tubingen, Germany
| | | | - Kin Y Mok
- Department of Molecular Neuroscience, Institute of Neurology, University College London, London, UK
- Division of Life Science, Hong Kong University of Science and Technology, Hong Kong Special Administrative Region, China
| | - Sara Pulit
- Department of Genetics, Center for Molecular Medicine, University Medical Center Utrecht, Utrecht, The Netherlands
- Big Data Institute, Li Ka Shing Centre for Health Information and Discovery, University of Oxford, Oxford, UK
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | | | - Elizabeth Holliday
- Faculty of Health and Medicine, University of Newcastle, Callaghan, Australia
| | - John Attia
- University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, Newcastle, Australia
| | - Thomas Battey
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Division of Neurocritical Care and Emergency Neurology, Massachusetts General Hospital, Boston, MA, USA
| | - Giorgio Boncoraglio
- Department of Cerebrovascular Diseases, Fondazione IRCCS Istituto Neurologico Carlo Besta, Milano, Italy
- PhD Program in Neuroscience, University Milano-Bicocca, Monza, Italy
| | - Vincent Thijs
- Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia
- Austin Health, Heidelberg, Australia
| | - Wei-Min Chen
- University of Virginia Center for Public Health Genomics, University of Virginia, Charlottesville, VA, USA
| | - Braxton Mitchell
- Dept of Medicine, University of Maryland School of Medicine, Baltimore, MD, USA
- Geriatrics Research and Education Clinical Center, Baltimore Veterans Administration Medical Center, Baltimore, MD, USA
| | - Peter Rothwell
- Centre for Prevention of Stroke and Dementia, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, UK
| | - Pankaj Sharma
- Institute of Cardiovascular Research, Royal Holloway University of London, London, UK
- Ashford & St Peters NHS Foundation Trust, Surrey, UK
| | | | - Astrid Vicente
- Instituto Nacional de Saúde Doutor Ricardo Jorge, Lisboa, Portugal
- Biosystems and Integrative Sciences Institute - BioISI, University of Lisboa, Lisboa, Portugal
| | - Hugh Markus
- Department of Clinical Neurosciences, University of Cambridge, Cambridge, UK
| | - Christina Kourkoulis
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Massachusetts General Hospital, Boston, MA, USA
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Joana Pera
- Department of Neurology, Jagiellonian University Medical College, Kraków, Poland
| | - Miriam Raffeld
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Massachusetts General Hospital, Boston, MA, USA
- The Warren Alpert Medical School of Brown University, Providence, RI, USA
| | - Scott Silliman
- Department of Neurology, College of Medicine-Jacksonville, University of Florida, Jacksonville, FL, USA
| | | | - Laura M Thornton
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - N William Rayner
- Wellcome Centre for Human Genetics, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Oxford Centre for Diabetes, Endocrinology and Metabolism, Nuffield Department of Medicine, University of Oxford, Oxford, UK
- Department of Human Genetics, Wellcome Sanger Institute, Hinxton, Cambridgeshire, UK
| | - Cathryn M Lewis
- MRC Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK
| | - Monica Gratacos
- Genes and Disease Programme, Centre for Genomic Regulation (CRG), Barcelona, Spain
| | - Filip Rybakowski
- Department of Adult Psychiatry, Poznan University of Medical Sciences, Poland
| | | | - Anu Raevuori
- Department of Adolescent Psychiatry, Helsinki University Central Hospital, Helsinki, Finland
- Clinicum, Department of Public Health, University of Helsinki, Finland
| | - James I Hudson
- Harvard Medical School/McLean Hospital, Belmont, MA, USA
| | | | - Palmiero Monteleone
- Department of Medicine, Surgery and Dentistry "Scuola Medica Salernitana", University of Salerno,Italy
| | - Andreas Karwautz
- Eating Disorders Unit, Department of Child and Adolescent Psychiatry, Medical University of Vienna, Vienna, Austria
| | - Katrin Mannik
- Estonian Genome Center, Institute of Genomics, University of Tartu, Tartu, Estonia
- Center for Integrative Genomics, University of Lausanne, Lausanne, Switzerland
| | - Jessica H Baker
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | - Sara E Trace
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Oliver S P Davis
- MRC Integrative Epidemiology Unit and Bristol Medical School, University of Bristol, Bristol, UK
| | - Sietske G Helder
- Zorg op Orde BV, Leidschendam, The Netherlands
- MRC Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK
| | - Stefan Ehrlich
- Division of Psychological & Social Medicine and Developmental Neurosciences, Faculty of Medicine, Technischen Universität Dresden, Dresden, Germany
| | - Beate Herpertz-Dahlmann
- Department of Child & Adolescent Psychiatry & Psychosomatic Medicine of University Clinics, RWTH Aachen, Aachen, Germany
| | - Unna N Danner
- Altrecht Eating Disorders Rintveld, Altrecht Mental Health Institute, Zeist, The Netherlands
- Faculty of Social Sciences, University of Utrecht, Utrecht, the Netherlands
| | - Annemarie A van Elburg
- Altrecht Eating Disorders Rintveld, Altrecht Mental Health Institute, Zeist, The Netherlands
- Faculty of Social Sciences, University of Utrecht, Utrecht, the Netherlands
| | - Maurizio Clementi
- Medical Genetics Unit, Department SDB, University of Padova, Padova, Italy
| | - Monica Forzan
- UOC Genetica ed Epidemiologica Clinica Az. Ospedaliera, Padova, Italy
| | - Elisa Docampo
- Department of Human Genetics, CHU Sart-Tilman, University of Liège, Liège, Belgium
- Department of Rheumatology, CHU Sart-Tilman, University of Liège, Liège, Belgium
| | - Jolanta Lissowska
- Department of Cancer Epidemiology and Prevention, Cancer Center and M. Sklodowska-Curie Institute of Oncology, Warsaw, Poland
| | - Joanna Hauser
- Department of Psychiatry, University of Medical Sciences, Poznan, Poland
| | | | - Mario Maj
- Department of Mental and Physical Health and Preventive Medicine, University of Campania "luigi Vanvitelli", Naples, Italy
| | - Fragiskos Gonidakis
- Eating Disorders Unit, 1st Psychiatric Department, National and Kapodistrian University of Athens, Athens, Greece
| | | | - Hana Papezova
- Eating Disorders Unit, Department of Psychiatry, First Faculty of Medicine, Charles University, Prague, Czech Republic
- General University Hospital, Prague, Czech Republic
| | - Zeynep Yilmaz
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | | | | | - Stefan Herms
- Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany
- Institute of Human Genetics, School of Medicine, University of Bonn & University Hospital Bonn, Bonn, Germany
- Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
- Human Genomics Research Group, Department of Biomedicine, University of Basel, Basel, Switzerland
| | | | - Raquel Rabionet
- Institut de Recerca Sant Joan de Déu, Barcelona, Spain
- Institut de Biomedicina de la Universitat de Barcelona (IBUB), Barcelona, Spain
- Department of Genetics, Microbiology & Statistics, Faculty of Biology, University of Barcelona, Barcelona, Spain
- Centre for Genomic Regulation (CRG), Barcelona, Spain
| | - Danielle M Dick
- Departments of Psychology and Human & Molecular Genetics, College Behavioral and Emotional Health Institute, Virginia Commonwealth University, Richmond, Virginia
| | - Samuli Ripatti
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
- Department of Public Health, University of Helsinki, Helsinki, Finland
- Broad Institute of MIT and Harvard, Cambridge, USA
| | - Ole A Andreassen
- NORMENT, Div. of Mental Health and Addiction, University of Oslo, Oslo, Norway
- Oslo University Hospital, Oslo, Norway
| | - Thomas Espeseth
- NORMENT, Div. of Mental Health and Addiction, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Norway
- K. G. Jebsen Centre for Research on Neuropsychiatric Disorders, University of Bergen, Bergen, Norway
| | - Astri J Lundervold
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
- K. G. Jebsen Centre for Research on Neuropsychiatric Disorders, University of Bergen, Bergen, Norway
| | - Vidar M Steen
- NORMENT, K.G. Jebsen Center for Psychosis Research, Department of Clinical Science, University of Bergen, Norway
- Department of Medical Genetics, Haukeland University Hospital, Bergen, Norway
| | - Dalila Pinto
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Genetics and Genomic Sciences, and Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- The Mindich Child Health & Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Stephen W Scherer
- McLaughlin Centre and Department of Molecular Genetics, University of Toronto, Toronto, Canada
- The Centre for Applied Genomics, Hospital for Sick Children, Toronto, Canada
| | | | - Alexandra Schosser
- Department of Psychiatry and Psychotherapy, Medical University of Vienna, Vienna, Austria
- Zentren für Seelische Gesundheit, BBRZ-Med, Vienna, Austria
| | - Lars Alfredsson
- Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Leonid Padyukov
- Rheumatology Unit, Department of Medicine, Karolinska Institutet and Karolinska University Hospital, Solna, Sweden
| | | | - James Mitchell
- School of Medicine, University of North Dakota, Grand Forks, ND, USA
- Neuropsychiatric Research Institute, Fargo, ND, USA
| | - Michael Strober
- Department of Psychiatry & Biobehavioral Sciences, Semel Institute for Neuroscience & Human Behavior, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, USA
| | - Andrew W Bergen
- BioRealm, Walnut, California, USA
- Oregon Research Institute, Eugene, OR, USA
| | - Walter Kaye
- Department of Psychiatry, University of California San Diego, La Jolla, CA, USA
| | | | - Bru Cormand
- Institut de Recerca Sant Joan de Déu, Barcelona, Spain
- Institut de Biomedicina de la Universitat de Barcelona (IBUB), Barcelona, Spain
- Department of Genetics, Microbiology & Statistics, Faculty of Biology, University of Barcelona, Barcelona, Spain
- Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Josep Antoni Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Cristina Sánchez-Mora
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Marta Ribasés
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - Miguel Casas
- Universitat Autònoma de Barcelona, Barcelona, Spain
- Programa Corporatiu "Neurodevelopment Disorders along Life Span", Institut Català de la Salut, Barcelona, Spain
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
- Clinica Galatea y PAIMM, Mental Health Program for Impaired Physicians, Barcelona, Spain
| | - Amaia Hervas
- Child and Adolescent Mental Health Unit, Hospital Universitario Mútua de Terrassa, Barcelona, Spain
| | | | - Jan Haavik
- K.G. Jebsen Centre for Neuropsychiatric Disorders, Department of Biomedicine, University of Bergen, Norway
- Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Tetyana Zayats
- K.G. Jebsen Centre for Neuropsychiatric Disorders, Department of Biomedicine, University of Bergen, Norway
- Analytic Translational Genetics Unit, Massachusetts General Hospital Harvard Medical School, Boston, Massachusetts, USA
| | - Stefan Johansson
- K.G. Jebsen Centre for Neuropsychiatric Disorders, Department of Clinical Science, University of Bergen, Norway
- Department of Medical Genetics, Haukeland University Hospital, Bergen, Norway
| | - Nigel Williams
- Cardiff University, Medical Research Council Center for Neuropsychiatric Genetics & Genomics, Institute of Psychology, Medicine & Clinical Neuroscience, Cardiff, UK
| | - Astrid Dempfle
- Institute of Medical Informatics and Statistics, Kiel University, Kiel, Germany
| | - Aribert Rothenberger
- Child and Adolescent Psychiatry/Psychotherapy, University Medical Center, Goettingen, Germany
| | - Jonna Kuntsi
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Robert D Oades
- Clinic for Child and Adolescent Psychiatry and Psychotherapy, University of Duisburg-Essen, Essen, Germany
| | - Tobias Banaschewski
- Child and Adolescent Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Barbara Franke
- Department of Human Genetics, Radboud University Medical Center, Nijmegen, The Netherlands
- Department of Psychiatry, Radboud University Medical Center, Nijmegen, The Netherlands
- Donders Institute for Brain, Cognition and Behaviour, Radboud University, Nijmegen, The Netherlands
| | - Jan K Buitelaar
- Department of Cognitive Neuroscience, Donders Institute for Brain, Cognition and Behavior, Radboud University Medical Centre, Nijmegen, The Netherlands
- Karakter Child and Adolescent Psychiatry University Center, Nijmegen, The Netherlands
| | - Alejandro Arias Vasquez
- Department of Psychiatry & Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Alysa E Doyle
- Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Klaus-Peter Lesch
- Laboratory of Psychiatric Neurobiology, Institute of Molecular Medicine, I.M. Sechenov First Moscow State Medical University, Moscow, Russia
- Department of Translational Psychiatry, School for Mental Health and Neuroscience (MHeNS), Maastricht University, Maastricht, The Netherlands
- Division of Molecular Psychiatry, Center of Mental Health, University of Wuerzburg, Wuerzburg, Germany
| | - Christine Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Olga Rivero
- Division of Molecular Psychiatry, Center of Mental Health, University of Wuerzburg, Wuerzburg, Germany
| | - Haukur Palmason
- Landspitali National University Hospital, Reykjavik, Iceland
| | - Marcel Romanos
- Center of Mental Health, Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital of Wuerzburg, Wuerzburg, Germany
| | - Kate Langley
- School of Psychology, Cardiff University, UK
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Marcella Rietschel
- Central Institute of Mental Health, Department of Genetic Epidemiology in Psychiatry, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Stephanie H Witt
- Central Institute of Mental Health, Department of Genetic Epidemiology in Psychiatry, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Soeren Dalsgaard
- National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
- Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Hospital of Telemark, Kragerø, Norway
| | - Anders D Børglum
- Department of Biomedicine and Human Genetics, Aarhus University, Aarhus, Denmark
- Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Center for Integrative Sequencing (iSEQ), Aarhus University, Aarhus, Denmark
- Aarhus Genome Center, Aarhus, Denmark
| | - Irwin Waldman
- Department of Psychology, Emory University, Atlanta, GA, USA
| | - Beth Wilmot
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health & Science University, Portland, OR, USA
| | - Nikolas Molly
- Department of Psychological and Brain Sciences, University of Iowa, Iowa City, IA, USA
| | - Claiton H D Bau
- Departamento de Genética, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
- ADHD Outpatient Clinic, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
| | - Jennifer Crosbie
- Neurosciences and Mental Health Program, Research Institute, Hospital for Sick Children, Toronto, Canada
- University of Toronto, Toronto, Canada
| | - Russell Schachar
- Hospital for Sick Children, Toronto, Canada
- University of Toronto, Toronto, Canada
| | - Sandra K Loo
- Department of Psychiatry, University of California, Los Angeles, Los Angeles, CA, USA
| | - James J McGough
- Semel Institute for Neuroscience & Human Behavior, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, USA
| | - Eugenio H Grevet
- ADHD Outpatient Clinic, Hospital de Clínicas de Porto Alegre, Porto Alegre, Brazil
- Department of Psychiatry, Faculdade de Medicina, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil
| | - Sarah E Medland
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Elise Robinson
- Analytic Translational Genetics Unit, Massachusetts General Hospital Harvard Medical School, Boston, Massachusetts, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Lauren A Weiss
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA
- Institute for Human Genetics, University of California, San Francisco, San Francisco, CA, USA
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Elena Bacchelli
- Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy
| | - Anthony Bailey
- Department of Psychiatry, University of British Columbia, Vancouver, Canada
- Institute of Mental Health, University of British Columbia, Vancouver, Canada
| | - Vanessa Bal
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA
- Institute for Human Genetics, University of California, San Francisco, San Francisco, CA, USA
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Agatino Battaglia
- Stella Maris Clinical Research Institute for Child and Adolescent Neuropsychiatry, Pisa, Italy
| | - Catalina Betancur
- Sorbonne Université, INSERM, CNRS, Neuroscience Paris Seine, Institut de Biologie Paris Seine, Paris, France
| | - Patrick Bolton
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
- NIHR Biomedical Research Centre in Mental Health Maudsley Hospital, London, UK
| | - Rita Cantor
- Department of Human Genetics, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, USA
| | | | - Geraldine Dawson
- Department of Psychiatry and Behavioral Sciences, Duke University, Durham, NC, USA
| | - Silvia De Rubeis
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Mindich Child Health and Development Institute, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Frederico Duque
- Child Developmental Center, Hospital Pediátrico, Centro Hospitalar e Universitário de Coimbra, Coimbra, Portugal
- University Clinic of Pediatrics, Faculty of Medicine, University of Coimbra, Coimbra, Portugal
| | - Andrew Green
- Dept of Clinical Genetics, Our Lady's Children's Hospital, Crumlin, Dublin, Ireland
- School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
| | - Sabine M Klauck
- Division of Molecular Genome Analysis and Division of Cancer Genome Research, German Cancer Research Center (DKFZ), Heidelberg, Germany
| | - Marion Leboyer
- Inserm U955, Psychiatrie Translationnelle, Créteil, France
- Faculté de Médecine, Université Paris Est, Créteil, France
- Fondation FondaMental, Créteil, France
| | - Pat Levitt
- Children's Hospital Los Angeles, Los Angeles, CA, USA
- Keck School of Medicine of the University of Southern California, Los Angeles, CA, USA
| | - Elena Maestrini
- Department of Pharmacy and Biotechnology, University of Bologna, Bologna, Italy
| | - Shrikant Mane
- Yale Center for Genome Analysis, Yale University, New Haven, CT, USA
- Department of Genetics, Yale University School of Medicine, New Haven, CT, USA
| | - Daniel Moreno- De-Luca
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Human Behavior, Brown University, Providence, RI, USA
| | - Jeremy Parr
- Institute of Neuroscience, Newcastle University, Newcastle, UK
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle, UK
- Northumberland, Tyne & Wear NHS Foundation Trust, Northumberland, UK
| | - Regina Regan
- School of Medicine and Medical Science, University College Dublin, Dublin, Ireland
- Genomics Medicine Ireland, Dublin, Ireland
| | | | - Sven Sandin
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Jacob Vorstman
- Department of Psychiatry, Hospital for Sick Children and University of Toronto, Toronto, Canada
- Program in Genetics and Genome Biology, Hospital for Sick Children, Toronto, Canada
| | - Thomas Wassink
- Department of Psychiatry, Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | - Ellen Wijsman
- Division of Medical Genetics, Department of Medicine, University of Washington, Seattle, WA, USA
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Edwin Cook
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - Susan Santangelo
- Center for Psychiatric Research, Maine Medical Center Research Institute, Portland, ME, USA
- Department of Psychiatry, Tufts University School of Medicine, Boston, MA, USA
| | - Richard Delorme
- Child and Adolescent Psychiatry Department, Robert Debre Hospital, APHP, Paris, France
- Human Genetics and Cognitive Functions, Institut Pasteur, Paris, France
| | - Bernadette Rogé
- Centre d'Etudes et de Recherches en Psychopathologie et Psychologie de la Santé (CERPPS), Université Toulouse Jean Jaurès, Toulouse, France
- CERESA, Toulouse, France
- Institut Universitaire de France, Paris, France
| | - Tiago Magalhaes
- Genomics Medicine Ireland, Dublin, Ireland
- Academic Centre on Rare Diseases University College Dublin (ACoRD/UCD), Dublin, Ireland
| | - Dan Arking
- McKusick-Nathans Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Thomas G Schulze
- Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
- Central Institute of Mental Health, Department of Genetic Epidemiology in Psychiatry, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
- Human Genetics Branch, National Institute of Mental Health, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD, USA
| | - Robert C Thompson
- Molecular and Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI, USA
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Jana Strohmaier
- Central Institute of Mental Health, Department of Genetic Epidemiology in Psychiatry, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
- SRH University Heidelberg, Academy for Psychotherapy, Heidelberg, Germany
| | - Keith Matthews
- Division of Neuroscience, School of Medicine, University of Dundee, Dundee, UK
- Advanced Interventions Service, NHS Tayside, Dundee, UK
| | - Ingrid Melle
- NORMENT, K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Derek Morris
- Cognitive Genetics and Cognitive Therapy Group, Neuroimaging, Cognition and Genomics (NICOG) Centre, School of Psychology and Discipline of Biochemistry, National University of Ireland Galway, Galway, Ireland
| | | | - Andrew McIntosh
- Division of Psychiatry, University of Edinburgh, Edinburgh, UK
| | - Sarah E Bergen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Martin Schalling
- Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden
- Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Stéphane Jamain
- Inserm U955, Psychiatrie Translationnelle, Créteil, France
- Faculté de Médecine, Université Paris Est, Créteil, France
- Fondation FondaMental, Créteil, France
| | - Anna Maaser
- Institute of Human Genetics, School of Medicine, University of Bonn & University Hospital Bonn, Bonn, Germany
- Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany
| | - Sascha B Fischer
- Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
- Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Céline S Reinbold
- Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
- Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Janice M Fullerton
- Neuroscience Research Australia, Sydney, Australia
- School of Medical Sciences, University of New South Wales, Sydney, Australia
| | - José Guzman-Parra
- Unidad de Salud Mental, Hospital Regional Universitario de Malaga, Malaga, Spain
- Instituto de Investigación Biomédica de Málaga (IBIMA), Malaga, Spain
| | - Fermin Mayoral
- Unidad de Salud Mental, Hospital Regional Universitario de Malaga, Malaga, Spain
- Instituto de Investigación Biomédica de Málaga (IBIMA), Malaga, Spain
| | - Peter R Schofield
- Neuroscience Research Australia, Sydney, Australia
- School of Medical Sciences, University of New South Wales, Sydney, Australia
| | - Sven Cichon
- Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
- Department of Biomedicine, University of Basel, Basel, Switzerland
- Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany
| | - Thomas W Mühleisen
- Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany
- Department of Biomedicine, University of Basel, Basel, Switzerland
| | | | | | - Michael Bauer
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - Philip B Mitchell
- School of Psychiatry, University of New South Wales, Sydney, Australia
- Black Dog Institute, Sydney, Australia
| | | | - John Rice
- Washington University, St. Louis, MO, USA
| | - James B Potash
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Peter P Zandi
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Nick Craddock
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - I Nicol Ferrier
- Institute of Neuroscience, Newcastle University, Newcastle, UK
| | - Martin Alda
- Department of Psychiatry, Dalhousie University, Halifax, Canada
- National Institute of Mental Health, Klecany, Czech Republic
| | - Guy A Rouleau
- Montreal Neurological Institute, McGill University, Montréal, Canada
- Department of Neurology and Neurosurgery, McGill University, Montréal, Canada
| | - Gustavo Turecki
- Department of Psychiatry, McGill University, Montréal, Canada
| | - Roel Ophoff
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience & Human Behavior, University of California at Los Angeles, Los Angeles, CA, USA
- UMC Utrecht, Utrecht, The Netherlands
| | - Carlos Pato
- SUNY Downstate Medical Center, Brooklyn, NY, USA
| | | | - Eli Stahl
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Broad Institute of MIT and Harvard, Cambridge, USA
| | - Markus Leber
- Hospital for Psychiatry and Psychotherapy, Cologne, Germany
| | - Piotr M Czerski
- Laboratory of Psychiatric Genetics, Department of Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Cristiana Cruceanu
- Douglas Mental Health University Institute, McGill University, Montreal, Canada
- Department of Translational Research in Psychiatry, Max-Planck Institute of Psychiatry, Munich, Germany
| | - Ian R Jones
- National Centre for Mental Health, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
| | - Danielle Posthuma
- Department Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, VU University, Amsterdam, The Netherlands
- Department Clinical Genetics, VU University Medical Center, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Till F M Andlauer
- Max Planck Institute of Psychiatry, Munich, Germany
- Department of Neurology, Klinikum rechts der Isar, Technical University of Munich, Munich, Germany
| | - Andreas J Forstner
- Institute of Human Genetics, School of Medicine, University of Bonn & University Hospital Bonn, Bonn, Germany
- Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany
- Human Genomics Research Group, Department of Biomedicine, University of Basel, Basel, Switzerland
- Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
| | - Fabian Streit
- Central Institute of Mental Health, Department of Genetic Epidemiology in Psychiatry, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Bernhard T Baune
- Discipline of Psychiatry, University of Adelaide, Adelaide, Australia
| | - Tracy Air
- Discipline of Psychiatry, University of Adelaide, Adelaide, Australia
| | - Grant Sinnamon
- Bela Menso Brain and Behaviour Centre, James Cook University, Varsity Lakes, Australia
- Bond University, Faculty of Society and Design, Robina, Australia
| | - Naomi R Wray
- Institute for Molecular Bioscience, University of Queensland, Brisbane, Australia
- Queensland Brain Institute, University of Queensland, Brisbane, Australia
| | - Donald J MacIntyre
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - David Porteous
- Centre for Genomic and Experimental Medicine, University of Edinburgh, Edinburgh, UK
| | - Georg Homuth
- Interfaculty Institute for Genetics and Functional Genomics, University Medicine Greifswald, Greifswald, Germany
| | - Margarita Rivera
- Department of Biochemistry and Molecular Biology II, Institute of Neurosciences, Center for Biomedical Research, University of Granada, Granada, Spain
- MRC Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK
| | - Jakob Grove
- Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Center for Integrative Sequencing (iSEQ), Aarhus University, Aarhus, Denmark
- Department of Biomedicine and Human Genetics, Aarhus University, Aarhus, Denmark
- Bioinformatics Research Centre, Aarhus University, Aarhus, Denmark
| | - Christel M Middeldorp
- Child Health Research Centre, University of Queensland, Brisbane, Australia
- Child and Youth Mental Health Service, Children's Health Queensland Health and Hospital Service, Brisbane, Australia
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Ian Hickie
- Brain and Mind Centre, University of Sydney, Sydney, Australia
| | | | - Divya Mehta
- School of Psychology and Counselling, Faculty of Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Queensland, Australia
- University of Queensland, Brisbane, Australia
| | - Johannes H Smit
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, VU Medical Center, Amsterdam, the Netherlands
- Department of Research and Innovation, GGZ Ingeest, Specialized Mental Health Care, Amsterdam, the Netherlands
| | - Rick Jansen
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
| | - Eco de Geus
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, VU Medical Center, Amsterdam, the Netherlands
| | - Erin Dunn
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
| | - Qingqin S Li
- Janssen Research & Development LLC, Titusville, NJ, USA
| | - Matthias Nauck
- Institute of Clinical Chemistry and Laboratory Medicine, University Medicine Greifswald, Greifswald, Germany
- German Centre for Cardiovascular Research (DZHK e.V.), Partner Site Greifswald, Greifswald, Germany
| | - Robert A Schoevers
- Research School of Behavioural and Cognitive Neurosciences, Department of Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, the Netherlands
| | - Aartjan Tf Beekman
- Department of Psychiatry, VU University Medical Center, Amsterdam, The Netherlands
- Department of Psychiatry GGZ INGEEST, Amsterdam, the Netherlands
| | - James A Knowles
- Department of Cell Biology, SUNY Downstate Medical Center, Brooklyn, NY, USA
| | - Alexander Viktorin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Paul Arnold
- Mathison Centre for Mental Health Research & Education, Hotchkiss Brain Institute, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Departments of Psychiatry and Medical Genetics, Cumming School of Medicine, University of Calgary, Calgary, Canada
- Program in Genetics and Genome Biology, Hospital for Sick Children, Toronto, Canada
| | - Cathy L Barr
- Krembil Research Institute, University Health Network, Toronto, Canada
- Hospital for Sick Children, Toronto, Canada
- University of Toronto, Toronto, Canada
| | - Gabriel Bedoya-Berrio
- Grupo de Genética Molecular, Instituto de Biología, Facultad de Ciencias Exactas y Naturales, Universidad de Antioquia, Medellín, Colombia
| | | | - Helena Brentani
- Department of Psychiatry, Sao Paulo Medical School, University of Sao Paulo, Sao Paulo, Brazil
| | | | - Beatriz Camarena
- Depto. Farmacogenética, Instituto Nacional de Psiquiatria Ramon de la Fuente Muñiz, Mexico City, Mexico
| | - Carolina Cappi
- Department of Psychiatry, Sao Paulo Medical School, University of Sao Paulo, Sao Paulo, Brazil
| | - Danielle Cath
- Department of Psychiatry, University of Groningen and University Medical Center, Groningen, the Netherlands
- Department of Specialized Trainings, GGZ Drenthe Mental Health Care Services, Assen, the Netherlands
| | | | | | | | - Damiaan Denys
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
- Netherlands Institute for Neuroscience, Royal Netherlands Academy of Arts and Sciences, Amsterdam, the Netherlands
| | - Eske M Derks
- QIMR Berghofer Medical Research Institute, Brisbane, Australia
| | - Andrea Dietrich
- University of Groningen, Groningen, the Netherlands
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | | | - Martijn Figee
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Nelson Freimer
- Center for Neurobehavioral Genetics, Semel Institute for Neuroscience & Human Behavior, University of California at Los Angeles, Los Angeles, CA, USA
| | - Gloria Gerber
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Marco Grados
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
| | | | - Gregory L Hanna
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Andreas Hartmann
- Centre National Maladie 'Syndrome Rare Gilles de la Tourette', Groupe Hospitalier Pitié-Salpêtrière, Paris, France
- Assistance Publique-Hôpitaux de Paris, Départment de Neurologie, Groupe Hospitalier Pitié-Salpêtrière, Paris, France
- Sorbonne Universités, UPMC Université Paris 06, UMR S 1127, CNRS UMR 7225, ICM, Paris, France
| | - Matthew E Hirschtritt
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Pieter J Hoekstra
- Department of Child and Adolescent Psychiatry, University Medical Center Groningen, University of Groningen, Groningen, The Netherlands
| | - Alden Huang
- Bioinformatics Interdepartmental Program, University of California, Los Angeles, Los Angeles, CA, USA
- Semel Institute for Neuroscience & Human Behavior, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, USA
| | - Chaim Huyser
- De Bascule, Amsterdam, The Netherlands
- Department of Child and Adolescent Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | | | | | - Samuel Kuperman
- Carver College of Medicine, University of Iowa, Iowa City, IA, USA
| | | | - Christine Lochner
- MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry, University of Cape Town, Cape Town, South Africa
| | - Gholson J Lyon
- Cold Spring Harbor Laboratory, Cold Spring Harbor, NY, USA
| | - Fabio Macciardi
- Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA, USA
| | - Marcos Madruga-Garrido
- Sección de Neuropediatría, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain
| | - Irene A Malaty
- Department of Neurology, University of Florida, Gainesville, FL, USA
| | - Athanasios Maras
- Yulius Academy, Yulius Mental Health Organization, Barendrecht, The Netherlands
| | - Lauren McGrath
- Department of Psychology, University of Denver, Denver, CO, USA
| | - Eurípedes C Miguel
- Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo, Brazil
| | - Pablo Mir
- Unidad de Trastornos del Movimiento, Servicio de Neurología y Neurofisiología Clínica, Instituto de Biomedicina de Sevilla, Hospital Universitario Virgen del Rocío/CSIC/Universidad de Sevilla, Seville, Spain
- Centro de Investigación Biomédica en Red sobre Enfermedades Neurodegenerativas (CIBERNED), Madrid, Spain
| | - Gerald Nestadt
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Humberto Nicolini
- National Institute of Genomic Medicine (INMEGEN), Ciudad de México, Mexico
- Clinical Research, Grupo Médico Carracci, Mexico City, Mexico
| | - Michael S Okun
- Departments of Neurology and Neurosurgery, University of Florida, Gainesville, FL, USA
- Fixel Center for Neurological Diseases, University of Florida, Gainesville, FL, USA
- McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Andrew Pakstis
- Department of Genetics, Yale University School of Medicine, New Haven, CT, USA
| | - Peristera Paschou
- Department of Biological Sciences, Purdue University, West Lafayette, Indiana, USA
| | - John Piacentini
- Semel Institute for Neuroscience & Human Behavior, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, USA
| | | | - Kerstin Plessen
- Division of Adolescent and Child Psychiatry, Department of Psychiatry, Lausanne University Hospital, Lausanne, Switzerland
- Child and Adolescent Mental Health Centre, Mental Health Services Capital Region Copenhagen, University of Copenhagen, Copenhagen, Denmark
| | - Vasily Ramensky
- Moscow Institute of Physics and Technology, Dolgoprudny, Institusky 9, Moscow, Russia
| | - Eliana M Ramos
- Department of Psychiatry, David Geffen School of Medicine, University of California at Los Angeles, Los Angeles, CA, USA
| | - Victor Reus
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA
- Weill Institute for Neurosciences, University of California, San Francisco, San Francisco, CA, USA
| | - Margaret A Richter
- Frederick W. Thompson Anxiety Disorders Centre, Sunnybrook Health Sciences Centre, Toronto, Canada
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Mark A Riddle
- Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Mary M Robertson
- Division of Neuropsychiatry, University College London, London, UK
| | - Veit Roessner
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Technischen Universität Dresden, Dresden, Germany
| | - Maria Rosário
- Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, Federal University of São Paulo, Brazil
- Yale Child Study Center, Yale University School of Medicine, New Haven, CT, USA
| | - Jack F Samuels
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Paul Sandor
- Department of Psychiatry, University of Toronto, Toronto, Canada
- University Health Network, University of Toronto, Toronto, Canada
- Youthdale Treatment Centers, Toronto, Canada
| | - Dan J Stein
- Groote Schuur Hospital, Cape Town, South Africa
- MRC Unit on Risk & Resilience in Mental Disorders, Department of Psychiatry, University of Cape Town, Cape Town, South Africa
| | - Fotis Tsetsos
- Department of Molecular Biology and Genetics, Democritus University of Thrace, Alexandroupolis, Greece
| | | | - Sarah Weatherall
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | | | - Tomasz Wolanczyk
- Department of Child Psychiatry, Medical University of Warsaw, Warsaw, Poland
| | - Yulia Worbe
- Sorbonne Université, Faculty of Médecine, Paris, France
- Reference center for Gilles de la Tourette syndrome, Pitie-Salpetriere Hospital, Paris, France
- Department of Physiology, Saint Antoine Hospital, Paris, France
| | - Gwyneth Zai
- Department of Psychiatry, University of Toronto, Toronto, Canada
| | - Fernando S Goes
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Nicole McLaughlin
- Butler Hospital, Providence, RI, USA
- Alpert Medical School of Brown University, Providence, RI, USA
| | - Paul S Nestadt
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University, Baltimore, MD, USA
| | - Hans-Jorgen Grabe
- Department of Psychiatry and Psychotherapy, University Medicine Greifswald, Greifswald, Germany
| | - Christel Depienne
- Institute of Human Genetics, University Hospital Essen, University Duisburg-Essen, Essen, Germany
- INSERM, U 1127, CNRS UMR 7225, Sorbonne Universités, UPMC Univ Paris 06 UMR S 1127, Paris, France
- IGBMC, CNRS UMR 7104/INSERM U964/Université de Strasbourg, Illkirch, France
| | | | | | - Ana Valencia-Duarte
- Escuela de Ciencias de la Salud, Universidad Pontificia Bolivariana, Medellín, Colombia
- Laboratorio de Genética Molecular, SIU, Universidad de Antioquia, Medellín, Colombia
| | - Elvira Bramon
- Division of Psychiatry, Molecular Psychiatry Laboratory,University College London, London, UK
| | - Nancy Buccola
- School of Nursing, Louisiana State University Health Sciences Center, New Orleans, LA, USA
| | - Wiepke Cahn
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Murray Cairns
- School of Biomedical Sciences and Pharmacy, The University of Newcastle, Callaghan, Australia
- Priority Research Centre for Brain and Mental Health Research, Hunter Medical Research Institute, Newcastle, Australia
- Schizophrenia Research Institute, Sydney, Australia
| | - Siow A Chong
- Institute of Mental Health, Singapore, Singapore
| | - David Cohen
- Assistance Publique - Hopitaux de Paris, GH Pitié-Salpêtrière, Paris, France
- Sorbonne Université, CNRS UMR 7222 Institut des Systèmes Intelligents et Robotiques, Paris, France
| | - Benedicto Crespo-Facorro
- Departments of Medicine and Psychiatry, School of Medicine University of Cantabria-IDIVAL, University Hospital Marqués de Valdecilla, Santander, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain
| | - James Crowley
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Michael Davidson
- Minerva Neurosciences Inc., Waltham, MA, USA
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
| | - Lynn DeLisi
- VA Boston Healthcare System, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Timothy Dinan
- APC Microbiome Ireland, University College Cork, Cork, Ireland
- Department of Psychiatry, University College Cork, Cork, Ireland
| | - Gary Donohoe
- Neuroimaging, Cognition and Genomics (NICOG) Centre, School of Psychology, National University of Ireland Galway, Galway, Ireland
| | - Elodie Drapeau
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jubao Duan
- Center for Psychiatric Genetics, NorthShore University HealthSystem Research Institute, Evanston, IL, USA
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | - Lieuwe Haan
- Department of Psychiatry, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
- Arkin, Amsterdam, the Netherlands
| | - David Hougaard
- Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | | | - Andrey Khrunin
- Department of Molecular Bases of Human Genetics, Institute of Molecular Genetics, Russian Academy of Sciences, Moscow, Russia
| | - Janis Klovins
- Latvian Biomedical Research and Study Centre, Riga, Latvia
| | | | - Jimmy Lee Chee Keong
- Institute of Mental Health, Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Svetlana Limborska
- Department of Human Genetics, Institute of Molecular Genetics, Russian Academy of Sciences, Moscow, Russia
| | - Carmel Loughland
- Hunter New England Local Health District, Newcastle, Australia
- University of Newcastle, Callaghan, Australia
| | - Jouko Lönnqvist
- National Institute for Health and Welfare, Helsinki, Finland
- Department of Psychiatry, University of Helsinki, Helsinki, Finland
| | - Brion Maher
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Manuel Mattheisen
- Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital Wuerzburg, Wuerzburg, Germany
- Department of Biomedicine, Aarhus University, Aarhus, Denmark
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | - Colm McDonald
- Centre for Neuroimaging and Cognitive Genomics (NICOG), National University of Ireland, Galway, Galway, Ireland
- NCBES Galway Neuroscience Centre, National University of Ireland, Galway, Galway, Ireland
| | - Kieran C Murphy
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Igor Nenadic
- Philipps-Universität Marburg and Marburg University Hospital UKGM, Marburg, Germany
- Department of Psychiatry and Psychotherapy, Jena University Hospital, Jena, Germany
| | - Jim van Os
- Brain Center Rudolf Magnus, University Medical Center Utrecht, Utrecht, The Netherlands
- Maastricht University Medical Centre, Maastricht, the Netherlands
- Department of Psychosis Studies, Institute of Psychiatry, King's College London, London, UK
| | - Christos Pantelis
- Melbourne Neuropsychiatry Centre, Department of Psychiatry, University of Melbourne & Melbourne Health, Victoria, Australia
- Centre for Neural Engineering, Department of Electrical and Electronic Engineering, University of Melbourne, Victoria, Australia
- Florey Institute of Neuroscience and Mental Health, Melbourne, Victoria, Australia
| | - Michele Pato
- SUNY Downstate Medical Center, Brooklyn, NY, USA
| | - Tracey Petryshen
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Digby Quested
- Oxford Health NHS Foundation Trust, Oxford, UK
- Department of Psychiatry, University of Oxford, Oxford, UK
| | - Panos Roussos
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alan R Sanders
- Department of Psychiatry and Behavioral Sciences, NorthShore University HealthSystem Research Institute, Evanston, IL, USA
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | | | - Sibylle G Schwab
- Faculty of Science, Medicine and Health, University of Wollongong, Wollongong, Australia
| | - Kang Sim
- Yong Loo Lin School of Medicine, National University of Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
- Institute of Mental Health, Singapore, Singapore
| | - Hon-Cheong So
- School of Biomedical Sciences, Chinese University of Hong Kong, Shatin, Hong Kong
- KIZ-CUHK Joint Laboratory of Bioresources and Molecular Research of Common Diseases, Kunming Institute of Zoology, Chinese Academy of Sciences, Kunming, China
- Chinese University of Hong Kong, Hong Kong
| | | | - Mythily Subramaniam
- Institute of Mental Health, Singapore, Singapore
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, Singapore
| | - Draga Toncheva
- Department of Medical Genetics, Medical University, Sofia, Bulgaria
| | - John Waddington
- Department of Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - James Walters
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
- Institute of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
| | - Mark Weiser
- Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel
- Sheba Medical Center, Ramat Gan, Israel
| | - Wei Cheng
- University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Robert Cloninger
- Departments of Psychiatry and Genetics, Washington University School of Medicine, St. Louis, MO, USA
| | - David Curtis
- UCL Genetics Institute, University College London, London, UK
- Centre for Psychiatry, Barts and the London School of Medicine and Dentistry, London, UK
| | - Pablo V Gejman
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
- Department of Psychiatry and Behavioral Sciences, NorthShore University HealthSystem Research Institute, Evanston, IL, USA
| | - Frans Henskens
- School of Medicine & Public Health, University of Newcastle, Callaghan, Australia
- Priority Research Centre for Health Behaviour, University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, Newcastle, Australia
| | - Morten Mattingsdal
- NORMENT, K.G. Jebsen Centre for Psychosis Research, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Research Unit, Sørlandet Hospital, Kristiansand, Norway
| | - Sang-Yun Oh
- Department of Statistics and Applied Probability, University of California, Santa Barbara, CA, USA
- Computational Research Division, Lawrence Berkeley National Laboratory, University of California at Berkeley, Berkeley, CA, USA
| | - Rodney Scott
- University of Newcastle, Callaghan, Australia
- Hunter Medical Research Institute, Newcastle, Australia
- NSW Health Pathology, Newcastle, Australia
| | - Bradley Webb
- Virginia Institute for Psychiatric and Behavioral Genetics, Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Gerome Breen
- Institute of Psychiatry, Psychology & Neuroscience, Social Genetics & Developmental Psychiatry Center, MRC, Kings College London, London, UK
- NIHR Maudsley Biomedical Research Centre, South London & Maudsley NHS Trust & King's College London, London, UK
| | - Claire Churchhouse
- Analytic Translational Genetics Unit, Massachusetts General Hospital Harvard Medical School, Boston, Massachusetts, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | - Cynthia M Bulik
- Departments of Psychiatry and Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Mark Daly
- Analytic Translational Genetics Unit, Massachusetts General Hospital Harvard Medical School, Boston, Massachusetts, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | - Martin Dichgans
- Institute for Stroke and Dementia Research (ISD), University Hospital, LMU Munich, Munich, Germany
- Munich Cluster for Systems Neurology (SyNergy), Munich, Germany
| | - Stephen V Faraone
- Departments of Psychiatry and of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Rita Guerreiro
- UK Dementia Research Institute, University College London, London, UK
- Department of Molecular Neuroscience, Institute of Neurology, University College London, London, UK
| | - Peter Holmans
- Cardiff University, Medical Research Council Center for Neuropsychiatric Genetics & Genomics, Institute of Psychology, Medicine & Clinical Neuroscience, Cardiff, UK
| | - Kenneth S Kendler
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Bobby Koeleman
- Division Biomedical Genetics, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Carol A Mathews
- Department of Psychiatry and UF Genetics Institute, University of Florida, Gainesville, FL, USA
- McKnight Brain Institute, University of Florida, Gainesville, FL, USA
| | - Alkes Price
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Jeremiah Scharf
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Division of Cognitive and Behavioral Neurology, Brigham and Women's Hospital, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Pamela Sklar
- Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Julie Williams
- Cardiff University, Medical Research Council Center for Neuropsychiatric Genetics & Genomics, Institute of Psychology, Medicine & Clinical Neuroscience, Cardiff, UK
- Dementia Research Institute, Cardiff University, Cardiff, UK
| | - Nicholas W Wood
- Department of Molecular Neuroscience, Institute of Neurology, University College London, London, UK
- UCL Genetics Institute, University College London, London, UK
| | - Chris Cotsapas
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Department of Neurology, Yale School of Medicine, New Haven, CT, USA
| | - Aarno Palotie
- Analytic Translational Genetics Unit, Massachusetts General Hospital Harvard Medical School, Boston, Massachusetts, USA
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
- Institute for Molecular Medicine Finland (FIMM), HiLIFE, University of Helsinki, Helsinki, Finland
| | - Jordan W Smoller
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
| | - Patrick Sullivan
- Departments of Psychiatry and Nutrition, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
- Department of Genetics and Psychiatry, University of North Carolina School of Medicine, Chapel Hill, North Carolina, USA
| | - Jonathan Rosand
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Center for Genomic Medicine, Massachusetts General Hospital, Boston, MA, USA
- Department of Neurology, Massachusetts General Hospital, Boston, MA, USA
- Harvard Medical School, Boston, MA, USA
| | - Aiden Corvin
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA.
- Neuropsychiatric Genetics Research Group, Department of Psychiatry, Trinity College Dublin, Dublin, Ireland
| | - Benjamin M Neale
- Analytic Translational Genetics Unit, Massachusetts General Hospital Harvard Medical School, Boston, Massachusetts, USA.
- Stanley Center for Psychiatric Research, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
- Program in Medical and Population Genetics, Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | | | - Richard Anney
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
- Institute of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, UK
| | - Josephine Elia
- Department of Pediatrics, Nemours A.I. duPont Hospital for Children, Wilmington, DE, USA
- Department of Psychiatry, Sidney Kimmel Medical College, Thomas Jefferson University, Philadelphia, PA, USA
| | - Maria Grigoroiu-Serbanescu
- Alexandru Obregia Clinical Psychiatric Hospital, Biometric Psychiatric Genetics Research Unit, Bucharest, Romania
| | - Howard J Edenberg
- Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Robin Murray
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Na PJ, Yaramala SR, Kim JA, Kim H, Goes FS, Zandi PP, Vande Voort JL, Sutor B, Croarkin P, Bobo WV. The PHQ-9 Item 9 based screening for suicide risk: a validation study of the Patient Health Questionnaire (PHQ)-9 Item 9 with the Columbia Suicide Severity Rating Scale (C-SSRS). J Affect Disord 2018; 232:34-40. [PMID: 29477096 DOI: 10.1016/j.jad.2018.02.045] [Citation(s) in RCA: 102] [Impact Index Per Article: 17.0] [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] [Received: 05/12/2017] [Revised: 02/14/2018] [Accepted: 02/16/2018] [Indexed: 12/13/2022]
Abstract
BACKGROUND Item 9 of the Patient Health Questionnaire (PHQ) evaluates passive thoughts of death or self-injury within the last two weeks, and is often used to screen depressed patients for suicide risk. We aimed to validate the PHQ-9 item 9 with a brief electronic version of the Columbia Suicide Severity Rating Scale (eC-SSRS). METHODS We analyzed data from 841 patients enrolled in the National Network of Depression Centers Clinical Care Registry. We performed a validation analysis of PHQ-9 item 9 for suicide risk and ideation, using the eC-SSRS as a gold standard (defined as positive response to suicidal ideation with intent to act or recent suicidal behavior). RESULTS Of the 841 patients, 13.4% and 41.1% were assessed as being positive for suicide risk by the eC-SSRS and PHQ-9 item 9, respectively. For the overall cohort, sensitivity was 87.6% (95%CI 80.2-92.5%), specificity was 66.1% (95%CI 62.6-69.4%), PPV was 28.6% (95%CI 24.1-33.6%), and NPV was 97.2% (95%CI 95.3-98.3%) for the PHQ-9 suicide item. These performance measures varied within subgroups defined by demographic and clinical characteristics. In addition, the validity of PHQ-9 item 9 (cutoff score of 1) with eC-SSRS-defined suicide ideation showed overall poor results. LIMITATIONS The gold standard used in our study was a surrogate measure of suicidality based on eC-SSRS scores. CONCLUSIONS The results of our study suggest that item 9 of the PHQ-9 is an insufficient assessment tool for suicide risk and suicide ideation, with limited utility in certain demographic and clinical subgroups that requires further investigation.
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Affiliation(s)
- Peter J Na
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA.
| | | | - Jihoon A Kim
- Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Hyelee Kim
- Seoul National University College of Medicine, Seoul, Republic of Korea
| | - Fernando S Goes
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Peter P Zandi
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | | | - Bruce Sutor
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - Paul Croarkin
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
| | - William V Bobo
- Department of Psychiatry and Psychology, Mayo Clinic, Rochester, MN, USA
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