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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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Stahl EA, Breen G, Forstner AJ, McQuillin A, Ripke S, Trubetskoy V, Mattheisen M, Wang Y, Coleman JRI, Gaspar HA, de Leeuw CA, Steinberg S, Pavlides JMW, Trzaskowski M, Byrne EM, Pers TH, Holmans PA, Richards AL, Abbott L, Agerbo E, Akil H, Albani D, Alliey-Rodriguez N, Als TD, Anjorin A, Antilla V, Awasthi S, Badner JA, Bækvad-Hansen M, Barchas JD, Bass N, Bauer M, Belliveau R, Bergen SE, Pedersen CB, Bøen E, Boks MP, Boocock J, Budde M, Bunney W, Burmeister M, Bybjerg-Grauholm J, Byerley W, Casas M, Cerrato F, Cervantes P, Chambert K, Charney AW, Chen D, Churchhouse C, Clarke TK, Coryell W, Craig DW, Cruceanu C, Curtis D, Czerski PM, Dale AM, de Jong S, Degenhardt F, Del-Favero J, DePaulo JR, Djurovic S, Dobbyn AL, Dumont A, Elvsåshagen T, Escott-Price V, Fan CC, Fischer SB, Flickinger M, Foroud TM, Forty L, Frank J, Fraser C, Freimer NB, Frisén L, Gade K, Gage D, Garnham J, Giambartolomei C, Pedersen MG, Goldstein J, Gordon SD, Gordon-Smith K, Green EK, Green MJ, Greenwood TA, Grove J, Guan W, Guzman-Parra J, Hamshere ML, Hautzinger M, Heilbronner U, Herms S, Hipolito M, Hoffmann P, Holland D, Huckins L, Jamain S, Johnson JS, Juréus A, Kandaswamy R, Karlsson R, Kennedy JL, Kittel-Schneider S, Knowles JA, Kogevinas M, Koller AC, Kupka R, Lavebratt C, Lawrence J, Lawson WB, Leber M, Lee PH, Levy SE, Li JZ, Liu C, Lucae S, Maaser A, MacIntyre DJ, Mahon PB, Maier W, Martinsson L, McCarroll S, McGuffin P, McInnis MG, McKay JD, Medeiros H, Medland SE, Meng F, Milani L, Montgomery GW, Morris DW, Mühleisen TW, Mullins N, Nguyen H, Nievergelt CM, Adolfsson AN, Nwulia EA, O'Donovan C, Loohuis LMO, Ori APS, Oruc L, Ösby U, Perlis RH, Perry A, Pfennig A, Potash JB, Purcell SM, Regeer EJ, Reif A, Reinbold CS, Rice JP, Rivas F, Rivera M, Roussos P, Ruderfer DM, Ryu E, Sánchez-Mora C, Schatzberg AF, Scheftner WA, Schork NJ, Shannon Weickert C, Shehktman T, Shilling PD, Sigurdsson E, Slaney C, Smeland OB, Sobell JL, Søholm Hansen C, Spijker AT, St Clair D, Steffens M, Strauss JS, Streit F, Strohmaier J, Szelinger S, Thompson RC, Thorgeirsson TE, Treutlein J, Vedder H, Wang W, Watson SJ, Weickert TW, Witt SH, Xi S, Xu W, Young AH, Zandi P, Zhang P, Zöllner S, Adolfsson R, Agartz I, Alda M, Backlund L, Baune BT, Bellivier F, Berrettini WH, Biernacka JM, Blackwood DHR, Boehnke M, Børglum AD, Corvin A, Craddock N, Daly MJ, Dannlowski U, Esko T, Etain B, Frye M, Fullerton JM, Gershon ES, Gill M, Goes F, Grigoroiu-Serbanescu M, Hauser J, Hougaard DM, Hultman CM, Jones I, Jones LA, Kahn RS, Kirov G, Landén M, Leboyer M, Lewis CM, Li QS, Lissowska J, Martin NG, Mayoral F, McElroy SL, McIntosh AM, McMahon FJ, Melle I, Metspalu A, Mitchell PB, Morken G, Mors O, Mortensen PB, Müller-Myhsok B, Myers RM, Neale BM, Nimgaonkar V, Nordentoft M, Nöthen MM, O'Donovan MC, Oedegaard KJ, Owen MJ, Paciga SA, Pato C, Pato MT, Posthuma D, Ramos-Quiroga JA, Ribasés M, Rietschel M, Rouleau GA, Schalling M, Schofield PR, Schulze TG, Serretti A, Smoller JW, Stefansson H, Stefansson K, Stordal E, Sullivan PF, Turecki G, Vaaler AE, Vieta E, Vincent JB, Werge T, Nurnberger JI, Wray NR, Di Florio A, Edenberg HJ, Cichon S, Ophoff RA, Scott LJ, Andreassen OA, Kelsoe J, Sklar P. Genome-wide association study identifies 30 loci associated with bipolar disorder. Nat Genet 2019; 51:793-803. [PMID: 31043756 PMCID: PMC6956732 DOI: 10.1038/s41588-019-0397-8] [Citation(s) in RCA: 879] [Impact Index Per Article: 175.8] [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: 03/11/2018] [Accepted: 03/18/2019] [Indexed: 12/18/2022]
Abstract
Bipolar disorder is a highly heritable psychiatric disorder. We performed a genome-wide association study (GWAS) including 20,352 cases and 31,358 controls of European descent, with follow-up analysis of 822 variants with P < 1 × 10-4 in an additional 9,412 cases and 137,760 controls. Eight of the 19 variants that were genome-wide significant (P < 5 × 10-8) in the discovery GWAS were not genome-wide significant in the combined analysis, consistent with small effect sizes and limited power but also with genetic heterogeneity. In the combined analysis, 30 loci were genome-wide significant, including 20 newly identified loci. The significant loci contain genes encoding ion channels, neurotransmitter transporters and synaptic components. Pathway analysis revealed nine significantly enriched gene sets, including regulation of insulin secretion and endocannabinoid signaling. Bipolar I disorder is strongly genetically correlated with schizophrenia, driven by psychosis, whereas bipolar II disorder is more strongly correlated with major depressive disorder. These findings address key clinical questions and provide potential biological mechanisms for bipolar disorder.
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Affiliation(s)
- 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.
| | - Gerome Breen
- MRC Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK
- NIHR BRC for Mental Health, King's College London, London, UK
| | - Andreas J Forstner
- Department of Biomedicine, University of Basel, Basel, Switzerland
- Department of Psychiatry (UPK), University of Basel, Basel, Switzerland
- Institute of Human Genetics, University of Bonn School of Medicine & University Hospital Bonn, Bonn, Germany
- Centre for Human Genetics, University of Marburg, Marburg, Germany
- Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
| | | | - 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
| | - Vassily Trubetskoy
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin, Berlin, Germany
| | - Manuel Mattheisen
- iSEQ, Center for Integrative Sequencing, Aarhus University, Aarhus, Denmark
- Department of Biomedicine-Human Genetics, Aarhus University, Aarhus, Denmark
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
- Department of Psychiatry, Psychosomatics and Psychotherapy, Center of Mental Health, University Hospital Würzburg, Würzburg, Germany
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
| | - Yunpeng Wang
- Institute of Biological Psychiatry, Mental Health Centre Sct. Hans, Copenhagen, Denmark
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Jonathan R I Coleman
- MRC Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK
- NIHR BRC for Mental Health, King's College London, London, UK
| | - Héléna A Gaspar
- MRC Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK
- NIHR BRC for Mental Health, King's College London, London, UK
| | - Christiaan A de Leeuw
- Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, the Netherlands
| | | | | | - Maciej Trzaskowski
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland, Australia
| | - Enda M Byrne
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland, Australia
| | - Tune H Pers
- Medical and Population Genetics, Broad Institute, Cambridge, MA, USA
- Division of Endocrinology and Center for Basic and Translational Obesity Research, Boston Children's Hospital, Boston, MA, USA
| | - Peter A Holmans
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, England
| | - Alexander L Richards
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, England
| | - Liam Abbott
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA, USA
| | - Esben Agerbo
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- National Centre for Register-based Research and Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark
| | - Huda Akil
- Molecular & Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI, USA
| | - 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
| | - 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
| | - Adebayo Anjorin
- Department of Psychiatry, Berkshire Healthcare NHS Foundation Trust, Bracknell, UK
| | - Verneri Antilla
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Swapnil Awasthi
- Department of Psychiatry and Psychotherapy, Charité-Universitätsmedizin, Berlin, Germany
| | - Judith A Badner
- Department of Psychiatry, Rush University Medical Center, Chicago, IL, USA
| | - 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
| | - Jack D Barchas
- Department of Psychiatry, Weill Cornell Medical College, New York, NY, USA
| | - 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
| | - Richard Belliveau
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA, USA
| | - Sarah E Bergen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Carsten Bøcker Pedersen
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- National Centre for Register-based Research and Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark
| | - Erlend Bøen
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
| | - Marco P Boks
- Psychiatry, UMC Utrecht Brain Center Rudolf Magnus, Utrecht, the Netherlands
| | - James Boocock
- Human Genetics, University of California, Los Angeles, Los Angeles, CA, USA
| | - Monika Budde
- Institute of Psychiatric Phenomics and Genomics, University Hospital, LMU Munich, Munich, Germany
| | - William Bunney
- Department of Psychiatry and Human Behavior, University of California, Irvine, Irvine, CA, USA
| | - Margit Burmeister
- Molecular & Behavioral Neuroscience Institute and Department of Computational Medicine & Bioinformatics, University of Michigan, Ann Arbor, MI, USA
| | - 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
- Department of Psychiatry, University of California, San Francisco, San Francisco, CA, USA
| | - 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, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Felecia Cerrato
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA, USA
| | - Pablo Cervantes
- Department of Psychiatry, Mood Disorders Program, McGill University Health Center, Montreal, Quebec, Canada
| | - Kimberly Chambert
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA, USA
| | - Alexander W Charney
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Danfeng Chen
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA, USA
| | - Claire Churchhouse
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA, USA
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Toni-Kim Clarke
- Division of Psychiatry, University of Edinburgh, Edinburgh, Scotland
| | - William Coryell
- University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | | | - Cristiana Cruceanu
- Department of Psychiatry, Mood Disorders Program, McGill University Health Center, Montreal, Quebec, Canada
- Department of Translational Research in Psychiatry, Max Planck Institute of Psychiatry, Munich, Germany
| | - 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
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
- Department of Cognitive Science, University of California, San Diego, La Jolla, CA, USA
| | - Simone de Jong
- MRC Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK
- NIHR BRC for Mental Health, King's College London, London, UK
| | - Franziska Degenhardt
- Institute of Human Genetics, University of Bonn School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Jurgen Del-Favero
- Applied Molecular Genomics Unit, VIB Department of Molecular Genetics, University of Antwerp, Antwerp, Belgium
| | - J Raymond DePaulo
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Srdjan Djurovic
- Department of Medical Genetics, Oslo University Hospital Ullevål, Oslo, Norway
- NORMENT, KG Jebsen Centre for Psychosis Research, Department of Clinical Science, University of Bergen, Bergen, Norway
| | - 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
| | - Ashley Dumont
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA, USA
| | - Torbjørn Elvsåshagen
- 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, England
| | - Chun Chieh Fan
- Department of Cognitive Science, University of California, San Diego, La Jolla, CA, USA
| | - Sascha B Fischer
- Department of Biomedicine, University of Basel, Basel, Switzerland
- Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
| | - Matthew Flickinger
- Center for Statistical Genetics and Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
| | - Tatiana M Foroud
- Department of Medical & 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, England
| | - Josef Frank
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Christine Fraser
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, England
| | - Nelson B Freimer
- Center for Neurobehavioral Genetics, University of California, Los Angeles, Los Angeles, CA, USA
| | - 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
| | - Katrin Gade
- Institute of Psychiatric Phenomics and Genomics, University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and Psychotherapy, University Medical Center Göttingen, Göttingen, Germany
| | - Diane Gage
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA, USA
| | - Julie Garnham
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Claudia Giambartolomei
- Department of Pathology and Laboratory Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Marianne Giørtz Pedersen
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- National Centre for Register-based Research and Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark
| | - Jaqueline Goldstein
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA, USA
| | - Scott D Gordon
- Genetics and Computational Biology, QIMR Berghofer Medical Research Institute, Brisbane, Queensland, Australia
| | | | - Elaine K Green
- School of Biomedical Sciences, Plymouth University Peninsula Schools of Medicine and Dentistry, University of Plymouth, Plymouth, UK
| | - Melissa J Green
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
- Neuroscience Research Australia, Sydney, New South Wales, 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
| | - Weihua Guan
- Biostatistics, University of Minnesota System, Minneapolis, MN, USA
| | - José Guzman-Parra
- Mental Health Department, University Regional Hospital, Biomedicine Institute (IBIMA), Málaga, Spain
| | - Marian L Hamshere
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, England
| | - Martin Hautzinger
- Department of Psychology, Eberhard Karls Universität Tübingen, Tubingen, Germany
| | - Urs Heilbronner
- Institute of Psychiatric Phenomics and Genomics, University Hospital, LMU Munich, Munich, Germany
| | - Stefan Herms
- Department of Biomedicine, University of Basel, Basel, Switzerland
- Institute of Human Genetics, University of Bonn School of Medicine & University Hospital Bonn, Bonn, Germany
- Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
| | - Maria Hipolito
- Department of Psychiatry and Behavioral Sciences, Howard University Hospital, Washington, DC, USA
| | - Per Hoffmann
- Department of Biomedicine, University of Basel, Basel, Switzerland
- Institute of Human Genetics, University of Bonn School of Medicine & University Hospital Bonn, Bonn, Germany
- Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
| | - Dominic Holland
- Department of Neurosciences, University of California, San Diego, La Jolla, CA, USA
- Center for Multimodal Imaging and Genetics, University of California, San Diego, La Jolla, CA, USA
| | - 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
- Psychiatrie Translationnelle, Inserm U955, Créteil, France
- Faculté de Médecine, 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
| | - Anders Juréus
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Radhika Kandaswamy
- MRC Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK
| | - Robert Karlsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - James L Kennedy
- Campbell Family Mental Health Research Institute, Centre for Addiction and Mental Health, Toronto, Onatario, 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
| | - 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
| | | | - Anna C Koller
- Institute of Human Genetics, University of Bonn School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Ralph Kupka
- Psychiatry, Altrecht, Utrecht, the Netherlands
- Psychiatry, GGZ inGeest, Amsterdam, the Netherlands
- Psychiatry, VU Medisch Centrum, Amsterdam, the Netherlands
| | - Catharina Lavebratt
- Department of Molecular Medicine and Surgery, Karolinska Institutet and Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Jacob Lawrence
- Department of, rth East London NHS Foundation Trust, Ilford, UK
| | - William B Lawson
- Department of Psychiatry and Behavioral Sciences, Howard University Hospital, Washington, DC, USA
| | - Markus Leber
- Department of Neurodegenerative Diseases and Geropsychiatry, University Hospital Bonn, Bonn, Germany
| | - Phil H Lee
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA, USA
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
- Psychiatric and Neurodevelopmental Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Shawn E Levy
- HudsonAlpha Institute for Biotechnology, Huntsville, AL, USA
| | - Jun Z Li
- Department of Human Genetics, University of Michigan, Ann Arbor, MI, USA
| | - Chunyu Liu
- Department of Psychiatry, University of Illinois at Chicago College of Medicine, Chicago, IL, USA
| | | | - Anna Maaser
- Institute of Human Genetics, University of Bonn School of Medicine & University Hospital Bonn, Bonn, Germany
| | - Donald J MacIntyre
- Mental Health, NHS 24, Glasgow, UK
- Division of Psychiatry, Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK
| | - Pamela B Mahon
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA
| | - Wolfgang Maier
- Department of Psychiatry and Psychotherapy, University of Bonn, Bonn, Germany
| | - Lina Martinsson
- Department of Clinical Neuroscience, Karolinska Institutet and Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Steve McCarroll
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA, USA
- Department of Genetics, Harvard Medical School, Boston, MA, USA
| | - Peter McGuffin
- MRC Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK
| | - Melvin G McInnis
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - 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
| | - Fan Meng
- Molecular & Behavioral Neuroscience Institute, University of Michigan, Ann Arbor, MI, USA
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Lili Milani
- Estonian Genome Center, University of Tartu, Tartu, Estonia
| | - Grant W Montgomery
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland, Australia
| | - Derek W Morris
- Discipline of Biochemistry, Neuroimaging and Cognitive Genomics (NICOG) Centre, National University of Ireland, Galway, Galway, Ireland
- Neuropsychiatric Genetics Research Group, Department of Psychiatry and Trinity Translational Medicine Institute, Trinity College Dublin, Dublin, Ireland
| | - Thomas W Mühleisen
- Department of Biomedicine, University of Basel, Basel, Switzerland
- Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany
| | - Niamh Mullins
- MRC Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK
| | - Hoang Nguyen
- 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
| | - 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
| | | | - Evaristus A Nwulia
- Department of Psychiatry and Behavioral Sciences, Howard University Hospital, Washington, DC, USA
| | - Claire O'Donovan
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Loes M Olde Loohuis
- Center for Neurobehavioral Genetics, University of California, Los Angeles, Los Angeles, CA, USA
| | - Anil P S Ori
- Center for Neurobehavioral Genetics, University of California, Los Angeles, Los Angeles, CA, USA
| | - Lilijana Oruc
- Department of Clinical Psychiatry, Psychiatry Clinic, Clinical Center University of Sarajevo, Sarajevo, Bosnia and Herzegovina
| | - Urban Ösby
- Department of Neurobiology, Care Sciences, and Society, Karolinska Institutet and Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Roy H Perlis
- Department of Psychiatry, Harvard Medical School, Boston, MA, USA
- Division of Clinical Research, Massachusetts General Hospital, Boston, MA, USA
| | - Amy Perry
- Department of Psychological Medicine, University of Worcester, Worcester, UK
| | - Andrea Pfennig
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - James B Potash
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Shaun M Purcell
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Psychiatry, Brigham and Women's Hospital, Boston, MA, USA
| | - Eline J Regeer
- Outpatient Clinic for Bipolar Disorder, Altrecht, Utrecht, the Netherlands
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt am Main, Germany
| | - Céline S Reinbold
- Department of Biomedicine, University of Basel, Basel, Switzerland
- Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
| | - 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
- MRC Social, Genetic and Developmental Psychiatry Centre, 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
| | - 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
| | - Euijung Ryu
- Department of Health Sciences Research, Mayo Clinic, Rochester, MN, 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, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Alan F Schatzberg
- Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Stanford, CA, USA
| | | | | | - Cynthia Shannon Weickert
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
- Neuroscience Research Australia, Sydney, New South Wales, Australia
| | - Tatyana Shehktman
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Paul D Shilling
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - Engilbert Sigurdsson
- Faculty of Medicine, Department of Psychiatry, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - 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
| | - 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
| | | | - David St Clair
- Institute for Medical Sciences, University of Aberdeen, Aberdeen, UK
| | - Michael Steffens
- Research Division, Federal Institute for Drugs and Medical Devices (BfArM), Bonn, Germany
| | - John S Strauss
- Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada
- Centre for Addiction and Mental Health, Toronto, Onatario, Canada
| | - Fabian Streit
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Jana Strohmaier
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | | | - Robert C Thompson
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | | | - Jens Treutlein
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Helmut Vedder
- Department of Psychiatry, Psychiatrisches Zentrum Nordbaden, Wiesloch, Germany
| | - Weiqing Wang
- 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
| | - Stanley J Watson
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Thomas W Weickert
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
- Neuroscience Research Australia, Sydney, New South Wales, Australia
| | - 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
- Department of Biostatistics, Princess Margaret Cancer Centre, Toronto, Onatario, Canada
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
| | - Allan H Young
- Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Peter Zandi
- Department of Mental Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, USA
| | - Peng Zhang
- Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Sebastian Zöllner
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Rolf Adolfsson
- Department of Clinical Sciences, Psychiatry, Umeå University Medical Faculty, Umeå, Sweden
| | - Ingrid Agartz
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
- Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway
- 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
| | - Lena Backlund
- Department of Clinical Neuroscience, Karolinska Institutet and Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - Bernhard T Baune
- Department of Psychiatry, University of Melbourne, Melbourne, Victoria, Australia
- Department of Psychiatry, University of Munster, Munster, Germany
| | - Frank Bellivier
- Department of Psychiatry and Addiction Medicine, Assistance Publique-Hopitaux de Paris, Paris, France
- Paris Bipolar and TRD Expert Centres, FondaMental Foundation, Paris, France
- UMR-S1144 Team 1: Biomarkers of relapse and therapeutic response in addiction and mood disorders, INSERM, Paris, France
- Department of Psychiatry, Université Paris Diderot, Paris, France
| | - Wade H Berrettini
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | | | | | - Michael Boehnke
- Center for Statistical Genetics and Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
| | - Anders D Børglum
- 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
| | - 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, England
| | - Mark J Daly
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA, USA
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, USA
| | - Udo Dannlowski
- Department of Psychiatry, University of Munster, Munster, Germany
| | - Tõnu Esko
- Medical and Population Genetics, Broad Institute, Cambridge, MA, USA
- Department of Genetics, Harvard Medical School, Boston, MA, USA
- Estonian Genome Center, University of Tartu, Tartu, Estonia
- Division of Endocrinology, Children's Hospital Boston, Boston, MA, USA
| | - Bruno Etain
- Department of Psychiatry and Addiction Medicine, Assistance Publique-Hopitaux de Paris, Paris, France
- UMR-S1144 Team 1: Biomarkers of relapse and therapeutic response in addiction and mood disorders, INSERM, Paris, France
- Department of Psychiatry, Université Paris Diderot, Paris, France
- Centre for Affective Disorders, Institute of Psychiatry, Psychology and Neuroscience, London, UK
| | - Mark Frye
- Department of Psychiatry & 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
| | - 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
| | - Michael Gill
- Neuropsychiatric Genetics Research Group, Department of Psychiatry and Trinity Translational Medicine Institute, Trinity College Dublin, Dublin, Ireland
| | - Fernando Goes
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - 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
| | - 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
| | - Ian Jones
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, England
| | - Lisa A Jones
- Department of 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, UMC Utrecht Brain Center Rudolf Magnus, Utrecht, the Netherlands
| | - George Kirov
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, England
| | - Mikael Landén
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Institute of Neuroscience and Physiology, University of Gothenburg, Gothenburg, Sweden
| | - Marion Leboyer
- Faculté de Médecine, Université Paris Est, Créteil, France
- Department of Psychiatry and Addiction Medicine, Assistance Publique-Hopitaux de Paris, Paris, France
- INSERM, Paris, France
| | - Cathryn M Lewis
- MRC Social, Genetic and Developmental Psychiatry Centre, King's College London, London, UK
- NIHR BRC for Mental Health, King's College London, London, UK
- Department of Medical & 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 Cancer Center and Institute of Oncology, Warsaw, Poland
| | - 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
| | - Fermin Mayoral
- Mental Health Department, University Regional Hospital, Biomedicine Institute (IBIMA), Málaga, Spain
| | | | - Andrew M McIntosh
- Division of Psychiatry, University of Edinburgh, Edinburgh, Scotland
- 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 and Institute of Clinical Medicine, Oslo University Hospital and University of Oslo, Oslo, Norway
| | - Andres Metspalu
- Estonian Genome Center, University of Tartu, Tartu, Estonia
- Institute of Molecular and Cell Biology, University of Tartu, Tartu, Estonia
| | - Philip B Mitchell
- School of Psychiatry, University of New South Wales, Sydney, New South Wales, Australia
| | - Gunnar Morken
- Mental Health, Faculty of Medicine and Health Sciences, Norwegian University of Science and Technology-NTNU, Trondheim, Norway
- Department of 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, 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 and Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark
| | - 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
- Medical and Population Genetics, Broad Institute, Cambridge, MA, USA
- Stanley Center for Psychiatric Research, Broad Institute, Cambridge, MA, USA
- Analytic and Translational Genetics Unit, Massachusetts General Hospital, Boston, MA, 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 & 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, England
| | - Ketil J Oedegaard
- Division of Psychiatry, Haukeland Universitetssjukehus, Bergen, Norway
- Faculty of Medicine and Dentistry, University of Bergen, Bergen, Norway
| | - Michael J Owen
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, England
| | - 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
- College of Medicine 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
| | - 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, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - 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, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Marcella Rietschel
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Guy A Rouleau
- Department of Neurology and Neurosurgery, McGill University, Faculty of Medicine, Montreal, Quebec, Canada
- Montreal Neurological Institute and Hospital, Montreal, Quebec, Canada
| | - Martin Schalling
- Department of Molecular Medicine and Surgery, Karolinska Institutet and 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, University Hospital, LMU Munich, Munich, Germany
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
- 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
- Human Genetics Branch, Intramural Research Program, National Institute of Mental Health, Bethesda, MD, USA
| | - Alessandro Serretti
- Department of Biomedical and NeuroMotor Sciences, University of Bologna, Bologna, Italy
| | - 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, Massachusetts General Hospital, Boston, MA, USA
| | | | - Kari Stefansson
- deCODE Genetics/Amgen, Reykjavik, Iceland
- Faculty of Medicine, Department of Psychiatry, School of Health Sciences, University of Iceland, Reykjavik, Iceland
| | - Eystein Stordal
- Department of Psychiatry, Hospital Namsos, Namsos, Norway
- Department of Mental Health, Norwegian University of Science and Technology, Trondheim, Norway
| | - 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
- Centre for Addiction and Mental Health, Toronto, Onatario, Canada
| | - Thomas Werge
- iPSYCH, The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Aarhus, Denmark
- Institute of Biological Psychiatry, MHC Sct. Hans, Mental Health Services Copenhagen, Roskilde, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
| | - John I Nurnberger
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Naomi R Wray
- Queensland Brain Institute, The University of Queensland, Brisbane, Queensland, Australia
- Institute for Molecular Bioscience, The University of Queensland, Brisbane, Queensland, Australia
| | - Arianna Di Florio
- Medical Research Council Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, Cardiff University, Cardiff, England
- Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA
| | - Howard J Edenberg
- Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Sven Cichon
- Department of Biomedicine, University of Basel, Basel, Switzerland
- Institute of Human Genetics, University of Bonn School of Medicine & University Hospital Bonn, Bonn, Germany
- Institute of Medical Genetics and Pathology, University Hospital Basel, Basel, Switzerland
- Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Jülich, Germany
| | - Roel A Ophoff
- Psychiatry, UMC Utrecht Brain Center Rudolf Magnus, Utrecht, the Netherlands
- Human Genetics, University of California, Los Angeles, Los Angeles, CA, USA
- Center for Neurobehavioral Genetics, University of California, Los Angeles, Los Angeles, CA, USA
| | - Laura J Scott
- Center for Statistical Genetics and Department of Biostatistics, University of Michigan, Ann Arbor, MI, USA
| | - Ole A Andreassen
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
- NORMENT, University of Oslo, Oslo, Norway
| | - John Kelsoe
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA.
| | - Pamela Sklar
- 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
- Institute of Genetic Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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3
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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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4
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Hou L, Bergen SE, Akula N, Song J, Hultman CM, Landén M, Adli M, Alda M, Ardau R, Arias B, Aubry JM, Backlund L, Badner JA, Barrett TB, Bauer M, Baune BT, Bellivier F, Benabarre A, Bengesser S, Berrettini WH, Bhattacharjee AK, Biernacka JM, Birner A, Bloss CS, Brichant-Petitjean C, Bui ET, Byerley W, Cervantes P, Chillotti C, Cichon S, Colom F, Coryell W, Craig DW, Cruceanu C, Czerski PM, Davis T, Dayer A, Degenhardt F, Del Zompo M, DePaulo JR, Edenberg HJ, Étain B, Falkai P, Foroud T, Forstner AJ, Frisén L, Frye MA, Fullerton JM, Gard S, Garnham JS, Gershon ES, Goes FS, Greenwood TA, Grigoroiu-Serbanescu M, Hauser J, Heilbronner U, Heilmann-Heimbach S, Herms S, Hipolito M, Hitturlingappa S, Hoffmann P, Hofmann A, Jamain S, Jiménez E, Kahn JP, Kassem L, Kelsoe JR, Kittel-Schneider S, Kliwicki S, Koller DL, König B, Lackner N, Laje G, Lang M, Lavebratt C, Lawson WB, Leboyer M, Leckband SG, Liu C, Maaser A, Mahon PB, Maier W, Maj M, Manchia M, Martinsson L, McCarthy MJ, McElroy SL, McInnis MG, McKinney R, Mitchell PB, Mitjans M, Mondimore FM, Monteleone P, Mühleisen TW, Nievergelt CM, Nöthen MM, Novák T, Nurnberger JI, Nwulia EA, Ösby U, Pfennig A, Potash JB, Propping P, Reif A, Reininghaus E, Rice J, Rietschel M, Rouleau GA, Rybakowski JK, Schalling M, Scheftner WA, Schofield PR, Schork NJ, Schulze TG, Schumacher J, Schweizer BW, Severino G, Shekhtman T, Shilling PD, Simhandl C, Slaney CM, Smith EN, Squassina A, Stamm T, Stopkova P, Streit F, Strohmaier J, Szelinger S, Tighe SK, Tortorella A, Turecki G, Vieta E, Volkert J, Witt SH, Wright A, Zandi PP, Zhang P, Zollner S, McMahon FJ. Genome-wide association study of 40,000 individuals identifies two novel loci associated with bipolar disorder. Hum Mol Genet 2016; 25:3383-3394. [PMID: 27329760 DOI: 10.1093/hmg/ddw181] [Citation(s) in RCA: 127] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2016] [Revised: 05/23/2016] [Accepted: 06/09/2016] [Indexed: 12/31/2022] Open
Abstract
Bipolar disorder (BD) is a genetically complex mental illness characterized by severe oscillations of mood and behaviour. Genome-wide association studies (GWAS) have identified several risk loci that together account for a small portion of the heritability. To identify additional risk loci, we performed a two-stage meta-analysis of >9 million genetic variants in 9,784 bipolar disorder patients and 30,471 controls, the largest GWAS of BD to date. In this study, to increase power we used ∼2,000 lithium-treated cases with a long-term diagnosis of BD from the Consortium on Lithium Genetics, excess controls, and analytic methods optimized for markers on the X-chromosome. In addition to four known loci, results revealed genome-wide significant associations at two novel loci: an intergenic region on 9p21.3 (rs12553324, P = 5.87 × 10 - 9; odds ratio (OR) = 1.12) and markers within ERBB2 (rs2517959, P = 4.53 × 10 - 9; OR = 1.13). No significant X-chromosome associations were detected and X-linked markers explained very little BD heritability. The results add to a growing list of common autosomal variants involved in BD and illustrate the power of comparing well-characterized cases to an excess of controls in GWAS.
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Affiliation(s)
- Liping Hou
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health,U.S. Department of Health & Human Services, Bethesda, MD, USA
| | - Sarah E Bergen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.,Stanley Center for Psychiatric Research, The Broad Institute of MIT and Harvard, Cambridge, MA, USA
| | - Nirmala Akula
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health,U.S. Department of Health & Human Services, Bethesda, MD, USA
| | - Jie Song
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Christina M Hultman
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Mikael Landén
- Institute of Neuroscience and Physiology, The Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden.,Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Mazda Adli
- Department of Psychiatry and Psychotherapy, Charité - Universitätsmedizin Berlin, Campus Charité Mitte, Berlin, Germany
| | - Martin Alda
- Department of Psychiatry, Dalhousie University, Halifax, Canada
| | - Raffaella Ardau
- Unit of Clinical Pharmacology, Hospital University Agency of Cagliari, Cagliari, Italy
| | - Bárbara Arias
- Department of Biologia Animal, Unitat d'Antropologia (Dp. Biología Animal), Facultat de Biologia and Institut de Biomedicina (IBUB), Universitat de Barcelona, CIBERSAM, Barcelona, 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
| | - Judith A Badner
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, IL, USA
| | | | - Michael Bauer
- Department of Psychiatry and Psychotherapy, University Hospital Carl Gustav Carus, Technische Universität, Dresden, Germany
| | - Bernhard T Baune
- Discipline of Psychiatry, University of Adelaide, Adelaide, Australia
| | - Frank Bellivier
- INSERM UMR-S 1144 - Université Paris Diderot. Pôle de Psychiatrie, AP-HP, Groupe Hospitalier 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
- Special Outpatient Center for Bipolar Affective Disorder, Medical University of Graz, Graz, Austria
| | - Wade H Berrettini
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | | | - 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
- Special Outpatient Center for Bipolar Affective Disorder, Medical University of Graz, Graz, Austria
| | | | - Clara Brichant-Petitjean
- INSERM UMR-S 1144 - Université Paris Diderot. Pôle de Psychiatrie, AP-HP, Groupe Hospitalier Lariboisière-F. Widal, Paris, France
| | - Elise T Bui
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health,U.S. Department of Health & Human Services, Bethesda, MD, USA
| | - William Byerley
- Department of Psychiatry, University of California at San Francisco, San Francisco, CA, USA
| | - Pablo Cervantes
- McGill University Health Centre, Mood Disorders Program, Montreal, QC, Canada
| | - Caterina Chillotti
- Unit of Clinical Pharmacology, Hospital University Agency of Cagliari, Cagliari, Italy
| | - Sven Cichon
- Institute of Human Genetics, University of Bonn, Germany.,Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany.,Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Germany.,Division of Medical Genetics and Department of Biomedicine, University of Basel, Switzerland
| | - Francesc Colom
- Bipolar Disorder Program, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - William Coryell
- University of Iowa Hospitals and Clinics, Iowa City, IA, USA
| | - David W Craig
- The Translational Genomics Research Institute, Phoenix, AZ, USA
| | - Cristiana Cruceanu
- Douglas Mental Health University Institute, McGill University, Montreal, Canada
| | - Piotr M Czerski
- Psychiatric Genetic Unit, Poznan University of Medical Sciences, Poznan, Poland
| | - Tony Davis
- Discipline of Psychiatry, University of Adelaide, Adelaide, Australia
| | - Alexandre Dayer
- Department of Mental Health and Psychiatry, Mood Disorders Unit, Geneva University Hospitals, Geneva, Switzerland
| | - Franziska Degenhardt
- Institute of Human Genetics, University of Bonn, Germany.,Department of Genomics, Life & Brain Center, University of 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 School of Medicine, Baltimore, MD, USA
| | - Howard J Edenberg
- Department of Biochemistry and Molecular Biology, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Bruno Étain
- INSERM U955, Psychiatrie translationnelle, Université Paris Est Créteil, Pôle de Psychiatrie et d'Addictologie, Hôpitaux Universitaires Henri Mondor, Créteil, France
| | - Peter Falkai
- Department of Psychiatry and Psychotherapy, Ludwig-Maximilians-University Munich, Munich, Germany
| | - Tatiana Foroud
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Andreas J Forstner
- Institute of Human Genetics, University of Bonn, Germany.,Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany
| | - Louise Frisén
- Department of Clinical Neuroscience, Karolinska Institutet, 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
- Psychiatric Genetics, Neuroscience Research Australia, Sydney, Australia.,School of Medical Sciences, University of New South Wales, Sydney, NSW, 2052, Australia
| | - Sébastien Gard
- Service de Psychiatrie, Hôpital Charles Perrens, Bordeaux, France
| | - Julie S Garnham
- Department of Psychiatry, Dalhousie University, Halifax, 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 School of Medicine, Baltimore, MD, USA
| | - Tiffany A Greenwood
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Maria Grigoroiu-Serbanescu
- Biometric Psychiatric Genetics Research Unit, Alexandru Obregia Clinical Psychiatric Hospital, Bucharest, Romania
| | - Joanna Hauser
- Psychiatric Genetic Unit, Poznan University of Medical Sciences, Poznan, Poland
| | - Urs Heilbronner
- Institute of Psychiatric Phenomics and Genomics, Ludwig-Maximilians-University Munich, Munich, Germany.,Department of Psychiatry and Psychotherapy, University Medical Center (UMG), Georg-August University Göttingen, Göttingen, Germany
| | - Stefanie Heilmann-Heimbach
- Institute of Human Genetics, University of Bonn, Germany.,Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany
| | - Stefan Herms
- Institute of Human Genetics, University of Bonn, Germany.,Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany.,Division of Medical Genetics and Department of Biomedicine, University of Basel, Switzerland
| | - Maria Hipolito
- Department of Psychiatry and Behavioral Sciences, Howard University Hospital, Washington, DC, USA
| | | | - Per Hoffmann
- Institute of Human Genetics, University of Bonn, Germany.,Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany.,Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Germany.,Division of Medical Genetics and Department of Biomedicine, University of Basel, Switzerland
| | - Andrea Hofmann
- Institute of Human Genetics, University of Bonn, Germany.,Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany
| | - Stephane Jamain
- INSERM U955, Psychiatrie translationnelle, Université Paris Est Créteil, Pôle de Psychiatrie et d'Addictologie, Hôpitaux Universitaires Henri Mondor, Créteil, France
| | - 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,U.S. Department of Health & Human Services, Bethesda, MD, USA
| | - 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
| | - Daniel L Koller
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Barbara König
- Department of Psychiatry and Psychotherapeuthic Medicine, Landesklinikum Neunkirchen, Neunkirchen, Austria
| | - Nina Lackner
- Special Outpatient Center for Bipolar Affective Disorder, Medical University of Graz, Graz, Austria
| | - Gonzalo Laje
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health,U.S. Department of Health & Human Services, Bethesda, MD, USA
| | - Maren Lang
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Catharina Lavebratt
- Department of Molecular Medicine and Surgery, Karolinska Institutet and Center for Molecular Medicine, Karolinska University Hospital, Stockholm, Sweden
| | - William B Lawson
- Department of Psychiatry and Behavioral Sciences, Howard University Hospital, Washington, DC, USA
| | - Marion Leboyer
- INSERM U955, Psychiatrie translationnelle, Université Paris Est Créteil, Pôle de Psychiatrie et d'Addictologie, Hôpitaux Universitaires Henri Mondor, Créteil, France
| | - Susan G Leckband
- Department of Pharmacy, VA San Diego Healthcare System, San Diego, CA, USA
| | - Chunyu Liu
- Department of Psychiatry, University of Illinois at Chicago, Chicago, IL, USA
| | - Anna Maaser
- Institute of Human Genetics, University of Bonn, Germany.,Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany
| | - Pamela B Mahon
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | | | - Mario Maj
- Department of Psychiatry, University of Naples SUN, Naples, Italy
| | - Mirko Manchia
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy.,Department of Pharmacology, Dalhousie University, Halifax, NS, Canada
| | - Lina Martinsson
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Michael J McCarthy
- Department of Psychiatry, VA San Diego Healthcare System, San Diego, CA, USA
| | - Susan L McElroy
- Lindner Center of HOPE, University of Cincinnati College of Medicine, Mason, OH, USA
| | - Melvin G McInnis
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Rebecca McKinney
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Philip B Mitchell
- School of Psychiatry, University of New South Wales, and Black Dog Institute, Sydney, Australia
| | - Marina Mitjans
- Department of Biologia Animal, Unitat d'Antropologia (Dp. Biología Animal), Facultat de Biologia and Institut de Biomedicina (IBUB), Universitat de Barcelona, CIBERSAM, Barcelona, Spain
| | - Francis M Mondimore
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Palmiero Monteleone
- Department of Psychiatry, University of Naples SUN, Naples, Italy.,Neurosciences Section, Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | - Thomas W Mühleisen
- Institute of Human Genetics, University of Bonn, Germany.,Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany.,Institute of Neuroscience and Medicine (INM-1), Research Centre Jülich, Germany
| | | | - Markus M Nöthen
- Institute of Human Genetics, University of Bonn, Germany.,Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany
| | - Tomas Novák
- National Institute of Mental Health, Klecany, Czech Republic
| | - John I Nurnberger
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - Evaristus A Nwulia
- Department of Psychiatry and Behavioral Sciences, Howard University Hospital, Washington, DC, USA
| | - 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, Technische Universität, Dresden, Germany
| | - James B Potash
- Department of Psychiatry, Carver College of Medicine, University of Iowa School of Medicine, Iowa City, IA, USA
| | - Peter Propping
- Institute of Human Genetics, University of Bonn, Germany
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Frankfurt, Germany
| | - Eva Reininghaus
- Special Outpatient Center for Bipolar Affective Disorder, Medical University of Graz, Graz, Austria
| | - John Rice
- Department of Psychiatry, Washington University School of Medicine in St. Louis
| | - 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, 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
- School of Medical Sciences, University of New South Wales, Sydney, NSW, 2052, Australia.,Mental Illness, Neuroscience Research Australia, Sydney, Australia
| | | | - Thomas G Schulze
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health,U.S. Department of Health & Human Services, Bethesda, MD, USA.,Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA.,Institute of Psychiatric Phenomics and Genomics, Ludwig-Maximilians-University 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
| | - Johannes Schumacher
- Institute of Human Genetics, University of Bonn, Germany.,Department of Genomics, Life & Brain Center, University of Bonn, Bonn, Germany
| | - Barbara W Schweizer
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - Giovanni Severino
- Department of Biomedical Sciences, University of Cagliari, Cagliari, Italy
| | - Tatyana Shekhtman
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | - Paul D Shilling
- Department of Psychiatry, University of California San Diego, San Diego, CA, USA
| | | | - Claire M Slaney
- Department of Psychiatry, Dalhousie University, Halifax, Canada
| | - Erin N Smith
- Scripps Translational Science Institute, La Jolla, CA, USA
| | - 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
| | - Fabian Streit
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | - Jana Strohmaier
- Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
| | | | - Sarah K Tighe
- Department of Psychiatry, Carver College of Medicine, University of Iowa School of Medicine, Iowa City, IA, USA
| | | | - Gustavo Turecki
- Douglas Mental Health University Institute, McGill University, Montreal, Canada
| | - Eduard Vieta
- Bipolar Disorder Program, Institute of Neuroscience, Hospital Clinic, University of Barcelona, IDIBAPS, CIBERSAM, Barcelona, Catalonia, Spain
| | - Julia Volkert
- 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
| | - Peng Zhang
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Sebastian Zollner
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - Francis J McMahon
- Intramural Research Program, National Institute of Mental Health, National Institutes of Health,U.S. Department of Health & Human Services, Bethesda, MD, USA,
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Maier R, Moser G, Chen GB, Ripke S, Coryell W, Potash JB, Scheftner WA, Shi J, Weissman MM, Hultman CM, Landén M, Levinson DF, Kendler KS, Smoller JW, Wray NR, Lee SH, Absher D, Agartz I, Akil H, Amin F, Andreassen O, Anjorin A, Anney R, Arking D, Asherson P, Azevedo M, Backlund L, Badner J, Bailey A, Banaschewski T, Barchas J, Barnes M, Barrett T, Bass N, Battaglia A, Bauer M, Bayés M, Bellivier F, Bergen S, Berrettini W, Betancur C, Bettecken T, Biederman J, Binder E, Black D, Blackwood D, Bloss C, Boehnke M, Boomsma D, Breen G, Breuer R, Bruggeman R, Buccola N, Buitelaar J, Bunney W, Buxbaum J, Byerley W, Caesar S, Cahn W, Cantor R, Casas M, Chakravarti A, Chambert K, Choudhury K, Cichon S, Cloninger C, Collier D, Cook E, Coon H, Cormand B, Cormican P, Corvin A, Coryell W, Craddock N, Craig D, Craig I, Crosbie J, Cuccaro M, Curtis D, Czamara D, Daly M, Datta S, Dawson G, Day R, De Geus E, Degenhardt F, Devlin B, Djurovic S, Donohoe G, Doyle A, Duan J, Dudbridge F, Duketis E, Ebstein R, Edenberg H, Elia J, Ennis S, Etain B, Fanous A, Faraone S, Farmer A, Ferrier I, Flickinger M, Fombonne E, Foroud T, Frank J, Franke B, Fraser C, Freedman R, Freimer N, Freitag C, Friedl M, Frisén L, Gallagher L, Gejman P, Georgieva L, Gershon E, Geschwind D, Giegling I, Gill M, Gordon S, Gordon-Smith K, Green E, Greenwood T, Grice D, Gross M, Grozeva D, Guan W, Gurling H, De Haan L, Haines J, Hakonarson H, Hallmayer J, Hamilton S, Hamshere M, Hansen T, Hartmann A, Hautzinger M, Heath A, Henders A, Herms S, Hickie I, Hipolito M, Hoefels S, Holmans P, Holsboer F, Hoogendijk W, Hottenga JJ, Hultman C, Hus V, Ingason A, Ising M, Jamain S, Jones I, Jones L, Kähler A, Kahn R, Kandaswamy R, Keller M, Kelsoe J, Kendler K, Kennedy J, Kenny E, Kent L, Kim Y, Kirov G, Klauck S, Klei L, Knowles J, Kohli M, Koller D, Konte B, Korszun A, Krabbendam L, Krasucki R, Kuntsi J, Kwan P, Landén M, Långström N, Lathrop M, Lawrence J, Lawson W, Leboyer M, Ledbetter D, Lee P, Lencz T, Lesch KP, Levinson D, Lewis C, Li J, Lichtenstein P, Lieberman J, Lin DY, Linszen D, Liu C, Lohoff F, Loo S, Lord C, Lowe J, Lucae S, MacIntyre D, Madden P, Maestrini E, Magnusson P, Mahon P, Maier W, Malhotra A, Mane S, Martin C, Martin N, Mattheisen M, Matthews K, Mattingsdal M, McCarroll S, McGhee K, McGough J, McGrath P, McGuffin P, McInnis M, McIntosh A, McKinney R, McLean A, McMahon F, McMahon W, McQuillin A, Medeiros H, Medland S, Meier S, Melle I, Meng F, Meyer J, Middeldorp C, Middleton L, Milanova V, Miranda A, Monaco A, Montgomery G, Moran J, Moreno-De-Luca D, Morken G, Morris D, Morrow E, Moskvina V, Mowry B, Muglia P, Mühleisen T, Müller-Myhsok B, Murtha M, Myers R, Myin-Germeys I, Neale B, Nelson S, Nievergelt C, Nikolov I, Nimgaonkar V, Nolen W, Nöthen M, Nurnberger J, Nwulia E, Nyholt D, O’Donovan M, O’Dushlaine C, Oades R, Olincy A, Oliveira G, Olsen L, Ophoff R, Osby U, Owen M, Palotie A, Parr J, Paterson A, Pato C, Pato M, Penninx B, Pergadia M, Pericak-Vance M, Perlis R, Pickard B, Pimm J, Piven J, Posthuma D, Potash J, Poustka F, Propping P, Purcell S, Puri V, Quested D, Quinn E, Ramos-Quiroga J, Rasmussen H, Raychaudhuri S, Rehnström K, Reif A, Ribasés M, Rice J, Rietschel M, Ripke S, Roeder K, Roeyers H, Rossin L, Rothenberger A, Rouleau G, Ruderfer D, Rujescu D, Sanders A, Sanders S, Santangelo S, Schachar R, Schalling M, Schatzberg A, Scheftner W, Schellenberg G, Scherer S, Schork N, Schulze T, Schumacher J, Schwarz M, Scolnick E, Scott L, Sergeant J, Shi J, Shilling P, Shyn S, Silverman J, Sklar P, Slager S, Smalley S, Smit J, Smith E, Smoller J, Sonuga-Barke E, St Clair D, State M, Steffens M, Steinhausen HC, Strauss J, Strohmaier J, Stroup T, Sullivan P, Sutcliffe J, Szatmari P, Szelinger S, Thapar A, Thirumalai S, Thompson R, Todorov A, Tozzi F, Treutlein J, Tzeng JY, Uhr M, van den Oord E, Van Grootheest G, Van Os J, Vicente A, Vieland V, Vincent J, Visscher P, Walsh C, Wassink T, Watson S, Weiss L, Weissman M, Werge T, Wienker T, Wiersma D, Wijsman E, Willemsen G, Williams N, Willsey A, Witt S, Wray N, Xu W, Young A, Yu T, Zammit S, Zandi P, Zhang P, Zitman F, Zöllner S. Joint analysis of psychiatric disorders increases accuracy of risk prediction for schizophrenia, bipolar disorder, and major depressive disorder. Am J Hum Genet 2015; 96:283-94. [PMID: 25640677 PMCID: PMC4320268 DOI: 10.1016/j.ajhg.2014.12.006] [Citation(s) in RCA: 163] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2014] [Accepted: 12/08/2014] [Indexed: 12/11/2022] Open
Abstract
Genetic risk prediction has several potential applications in medical research and clinical practice and could be used, for example, to stratify a heterogeneous population of patients by their predicted genetic risk. However, for polygenic traits, such as psychiatric disorders, the accuracy of risk prediction is low. Here we use a multivariate linear mixed model and apply multi-trait genomic best linear unbiased prediction for genetic risk prediction. This method exploits correlations between disorders and simultaneously evaluates individual risk for each disorder. We show that the multivariate approach significantly increases the prediction accuracy for schizophrenia, bipolar disorder, and major depressive disorder in the discovery as well as in independent validation datasets. By grouping SNPs based on genome annotation and fitting multiple random effects, we show that the prediction accuracy could be further improved. The gain in prediction accuracy of the multivariate approach is equivalent to an increase in sample size of 34% for schizophrenia, 68% for bipolar disorder, and 76% for major depressive disorders using single trait models. Because our approach can be readily applied to any number of GWAS datasets of correlated traits, it is a flexible and powerful tool to maximize prediction accuracy. With current sample size, risk predictors are not useful in a clinical setting but already are a valuable research tool, for example in experimental designs comparing cases with high and low polygenic risk.
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Gamazon ER, Badner JA, Cheng L, Zhang C, Zhang D, Cox NJ, Gershon ES, Kelsoe JR, Greenwood TA, Nievergelt CM, Chen C, McKinney R, Shilling PD, Schork NJ, Smith EN, Bloss CS, Nurnberger JI, Edenberg HJ, Foroud T, Koller DL, Scheftner WA, Coryell W, Rice J, Lawson WB, Nwulia EA, Hipolito M, Byerley W, McMahon FJ, Schulze TG, Berrettini WH, Potash JB, Zandi PP, Mahon PB, McInnis MG, Zöllner S, Zhang P, Craig DW, Szelinger S, Barrett TB, Liu C. Enrichment of cis-regulatory gene expression SNPs and methylation quantitative trait loci among bipolar disorder susceptibility variants. Mol Psychiatry 2013; 18:340-6. [PMID: 22212596 PMCID: PMC3601550 DOI: 10.1038/mp.2011.174] [Citation(s) in RCA: 140] [Impact Index Per Article: 12.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
We conducted a systematic study of top susceptibility variants from a genome-wide association (GWA) study of bipolar disorder to gain insight into the functional consequences of genetic variation influencing disease risk. We report here the results of experiments to explore the effects of these susceptibility variants on DNA methylation and mRNA expression in human cerebellum samples. Among the top susceptibility variants, we identified an enrichment of cis regulatory loci on mRNA expression (eQTLs), and a significant excess of quantitative trait loci for DNA CpG methylation, hereafter referred to as methylation quantitative trait loci (mQTLs). Bipolar disorder susceptibility variants that cis regulate both cerebellar expression and methylation of the same gene are a very small proportion of bipolar disorder susceptibility variants. This finding suggests that mQTLs and eQTLs provide orthogonal ways of functionally annotating genetic variation within the context of studies of pathophysiology in brain. No lymphocyte mQTL enrichment was found, suggesting that mQTL enrichment was specific to the cerebellum, in contrast to eQTLs. Separately, we found that using mQTL information to restrict the number of single-nucleotide polymorphisms studied enhances our ability to detect a significant association. With this restriction a priori informed by the observed functional enrichment, we identified a significant association (rs12618769, P(bonferroni)<0.05) from two other GWA studies (TGen+GAIN; 2191 cases and 1434 controls) of bipolar disorder, which we replicated in an independent GWA study (WTCCC). Collectively, our findings highlight the importance of integrating functional annotation of genetic variants for gene expression and DNA methylation to advance the biological understanding of bipolar disorder.
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Affiliation(s)
- ER Gamazon
- Department of Medicine, University of Chicago, Chicago, IL, USA
| | - JA Badner
- Department of Psychiatry, University of Chicago, Chicago, IL, USA
| | - L Cheng
- Department of Psychiatry, Institute of Human Genetics, University of Illinois at Chicago, Chicago, IL, USA
| | - C Zhang
- Department of Psychiatry, Institute of Human Genetics, University of Illinois at Chicago, Chicago, IL, USA
| | - D Zhang
- School of Medicine, University of Zhejiang, Hanzhou, Zhejiang, China
| | - NJ Cox
- Department of Medicine, University of Chicago, Chicago, IL, USA
| | - ES Gershon
- Department of Psychiatry, University of Chicago, Chicago, IL, USA
| | - JR Kelsoe
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - TA Greenwood
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - CM Nievergelt
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - C Chen
- Department of Psychiatry, Institute of Human Genetics, University of Illinois at Chicago, Chicago, IL, USA
| | - R McKinney
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - PD Shilling
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
| | - NJ Schork
- Scripps Genomic Medicine and Scripps Translational Science Institute, La Jolla, CA, USA
| | - EN Smith
- Scripps Genomic Medicine and Scripps Translational Science Institute, La Jolla, CA, USA
| | - CS Bloss
- Scripps Genomic Medicine and Scripps Translational Science Institute, La Jolla, CA, USA
| | - JI Nurnberger
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - HJ Edenberg
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - T Foroud
- Department of Medical and Molecular Genetics, Indiana University School of Medicine, Indianapolis, IN, USA
| | - DL Koller
- Department of Psychiatry, Indiana University School of Medicine, Indianapolis, IN, USA
| | - WA Scheftner
- Department of Psychiatry, Rush University, Chicago, IL, USA
| | - W Coryell
- Department of Psychiatry, University of Iowa, Iowa City, IA, USA
| | - J Rice
- Division of Biostatistics, Washington University, St Louis, MO, USA
| | - WB Lawson
- Department of Psychiatry, Howard University, Washington, DC, USA
| | - EA Nwulia
- Department of Psychiatry, Howard University, Washington, DC, USA
| | - M Hipolito
- Department of Psychiatry, Howard University, Washington, DC, USA
| | - W Byerley
- Department of Psychiatry, University of California, San Francisco, CA, USA
| | - FJ McMahon
- Genetic Basis of Mood and Anxiety Disorders Unit, National Institute of Mental Health Intramural Research Program, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD, USA
| | - TG Schulze
- Genetic Basis of Mood and Anxiety Disorders Unit, National Institute of Mental Health Intramural Research Program, National Institutes of Health, US Department of Health and Human Services, Bethesda, MD, USA,Department of Genetic Epidemiology in Psychiatry, Central Institute of Mental Health, Mannheim, Germany
| | - WH Berrettini
- Department of Psychiatry, University of Pennsylvania, Philadelphia, PA, USA
| | - JB Potash
- Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - PP Zandi
- Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - PB Mahon
- Department of Psychiatry, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - MG McInnis
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - S Zöllner
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - P Zhang
- Department of Psychiatry, University of Michigan, Ann Arbor, MI, USA
| | - DW Craig
- Neurogenomics Division, The Translational Genomics Research Institute, Phoenix, AZ, USA
| | - S Szelinger
- Neurogenomics Division, The Translational Genomics Research Institute, Phoenix, AZ, USA
| | - TB Barrett
- Department of Psychiatry, Portland VA Medical Center, Portland, OR, USA
| | - C Liu
- Department of Psychiatry, Institute of Human Genetics, University of Illinois at Chicago, Chicago, IL, USA
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7
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Nissen S, Liang S, Shehktman T, Kelsoe JR, Greenwood TA, Nievergelt CM, McKinney R, Shilling PD, Smith EN, Schork NJ, Bloss CS, Nurnberger JI, Edenberg HJ, Foroud T, Koller DL, Gershon ES, Liu C, Badner JA, Scheftner WA, Lawson WB, Nwulia EA, Hipolito M, Coryell W, Rice J, Byerley W, McMahon FJ, Berrettini WH, Potash JB, Zandi PP, Mahon PB, McInnis MG, Zöllner S, Zhang P, Craig DW, Szelinger S, Barrett TB, Schulze TG. Evidence for association of bipolar disorder to haplotypes in the 22q12.3 region near the genes stargazin, IFT27 and parvalbumin. Am J Med Genet B Neuropsychiatr Genet 2012; 159B:941-50. [PMID: 23038240 PMCID: PMC3665332 DOI: 10.1002/ajmg.b.32099] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2012] [Accepted: 08/22/2012] [Indexed: 12/13/2022]
Abstract
We have previously reported genome-wide significant linkage of bipolar disorder to a region on 22q12.3 near the marker D22S278. Towards identifying the susceptibility gene, we have conducted a fine-mapping association study of the region in two independent family samples, an independent case-control sample and a genome-wide association dataset. Two hundred SNPs were first examined in a 5 Mb region surrounding the D22S278 marker in a sample of 169 families and analyzed using PLINK. The peak of association was a haplotype near the genes stargazin (CACNG2), intraflagellar transport protein homolog 27 (IFT27) and parvalbumin (PVALB; P = 4.69 × 10(-4)). This peak overlapped a significant haplotype in a family based association study of a second independent sample of 294 families (P = 1.42 × 10(-5)). Analysis of the combined family sample yielded statistically significant evidence of association to a rare three SNP haplotype in the gene IFT27 (P = 8.89 × 10(-6)). Twelve SNPs comprising these haplotypes were genotyped in an independent sample of 574 bipolar I cases and 550 controls. Statistically significant association was found for a haplotype window that overlapped the region from the first two family samples (P = 3.43 × 10(-4)). However, analyses of the two family samples using the program LAMP, found no evidence for association in this region, but did yield significant evidence for association to a haplotype 3' of CACNG2 (P = 1.76 × 10(-6)). Furthermore, no evidence for association was found in a large genome-wide association dataset. The replication of association to overlapping haplotypes in three independent datasets suggests the presence of a bipolar disorder susceptibility gene in this region.
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Affiliation(s)
- Stephanie Nissen
- Departmentof Psychiatry, University of California San Diego, La Jolla, California
| | - Sherri Liang
- Departmentof Psychiatry, University of California San Diego, La Jolla, California
| | - Tatyana Shehktman
- Departmentof Psychiatry, University of California San Diego, La Jolla, California,Department of Psychiatry, VA San Diego Healthcare System, La Jolla, California
| | - John R. Kelsoe
- Departmentof Psychiatry, University of California San Diego, La Jolla, California,Department of Psychiatry, VA San Diego Healthcare System, La Jolla, California,Institute for Genomic Medicine, University of California San Diego, La Jolla, California
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8
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Shyn SI, Shi J, Kraft JB, Potash JB, Knowles JA, Weissman MM, Garriock HA, Yokoyama JS, McGrath PJ, Peters EJ, Scheftner WA, Coryell W, Lawson WB, Jancic D, Gejman PV, Sanders AR, Holmans P, Slager SL, Levinson DF, Hamilton SP. Novel loci for major depression identified by genome-wide association study of Sequenced Treatment Alternatives to Relieve Depression and meta-analysis of three studies. Mol Psychiatry 2011; 16:202-15. [PMID: 20038947 PMCID: PMC2888856 DOI: 10.1038/mp.2009.125] [Citation(s) in RCA: 207] [Impact Index Per Article: 15.9] [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: 03/23/2009] [Revised: 08/20/2009] [Accepted: 08/27/2009] [Indexed: 01/11/2023]
Abstract
We report a genome-wide association study (GWAS) of major depressive disorder (MDD) in 1221 cases from the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) study and 1636 screened controls. No genome-wide evidence for association was detected. We also carried out a meta-analysis of three European-ancestry MDD GWAS data sets: STAR*D, Genetics of Recurrent Early-onset Depression and the publicly available Genetic Association Information Network-MDD data set. These data sets, totaling 3957 cases and 3428 controls, were genotyped using four different platforms (Affymetrix 6.0, 5.0 and 500 K, and Perlegen). For each of 2.4 million HapMap II single-nucleotide polymorphisms (SNPs), using genotyped data where available and imputed data otherwise, single-SNP association tests were carried out in each sample with correction for ancestry-informative principal components. The strongest evidence for association in the meta-analysis was observed for intronic SNPs in ATP6V1B2 (P=6.78 x 10⁻⁷), SP4 (P=7.68 x 10⁻⁷) and GRM7 (P=1.11 x 10⁻⁶). Additional exploratory analyses were carried out for a narrower phenotype (recurrent MDD with onset before age 31, N=2191 cases), and separately for males and females. Several of the best findings were supported primarily by evidence from narrow cases or from either males or females. On the basis of previous biological evidence, we consider GRM7 a strong MDD candidate gene. Larger samples will be required to determine whether any common SNPs are significantly associated with MDD.
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Affiliation(s)
- SI Shyn
- Department of Psychiatry and Institute for Human Genetics, University of California, San Francisco, CA, USA
| | - J Shi
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, USA
| | - JB Kraft
- Department of Psychiatry and Institute for Human Genetics, University of California, San Francisco, CA, USA
| | - JB Potash
- Department of Psychiatry, Johns Hopkins University, Baltimore, MD, USA
| | - JA Knowles
- Department of Psychiatry, University of Southern California, Los Angeles, CA, USA
| | - MM Weissman
- Department of Psychiatry, Columbia University College of Physicians and Surgeons and New York State Psychiatric Institute, New York, NY, USA
| | - HA Garriock
- Department of Psychiatry and Institute for Human Genetics, University of California, San Francisco, CA, USA
| | - JS Yokoyama
- Department of Psychiatry and Institute for Human Genetics, University of California, San Francisco, CA, USA
| | - PJ McGrath
- Department of Psychiatry, Columbia University College of Physicians and Surgeons and New York State Psychiatric Institute, New York, NY, USA
| | - EJ Peters
- Department of Psychiatry and Institute for Human Genetics, University of California, San Francisco, CA, USA
| | - WA Scheftner
- Department of Psychiatry, Rush University Hospital, Chicago, IL, USA
| | - W Coryell
- Department of Psychiatry, University of Iowa, Iowa City, IW, USA
| | - WB Lawson
- Department of Psychiatry, Howard University, Washington, DC, USA
| | - D Jancic
- Department of Psychiatry, Johns Hopkins University, Baltimore, MD, USA
| | - PV Gejman
- NorthShore University HealthCare Research Institute and Department of Psychiatry, Northwestern University, Evanston, IL, USA
| | - AR Sanders
- NorthShore University HealthCare Research Institute and Department of Psychiatry, Northwestern University, Evanston, IL, USA
| | - P Holmans
- Department of Psychological Medicine, Cardiff University, Cardiff, UK
| | - SL Slager
- Department of Health Sciences Research, Mayo Clinic College of Medicine
| | - DF Levinson
- Department of Psychiatry and Behavioral Sciences, Stanford University, Palo Alto, CA, USA
| | - SP Hamilton
- Department of Psychiatry and Institute for Human Genetics, University of California, San Francisco, CA, USA
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9
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Mahon PB, Payne JL, MacKinnon DF, Mondimore FM, Goes FS, Schweizer B, Jancic D, Coryell WH, Holmans PA, Shi J, Knowles JA, Scheftner WA, Weissman MM, Levinson DF, DePaulo JR, Zandi PP, Potash JB, Zandi PP, Potash JB. Genome-wide linkage and follow-up association study of postpartum mood symptoms. Am J Psychiatry 2009; 166:1229-37. [PMID: 19755578 PMCID: PMC3665341 DOI: 10.1176/appi.ajp.2009.09030417] [Citation(s) in RCA: 74] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
OBJECTIVE Family studies have suggested that postpartum mood symptoms might have a partly genetic etiology. The authors used a genome-wide linkage analysis to search for chromosomal regions that harbor genetic variants conferring susceptibility for such symptoms. The authors then fine-mapped their best linkage regions, assessing single nucleotide polymorphisms (SNPs) for genetic association with postpartum symptoms. METHOD Subjects were ascertained from two studies: the NIMH Genetics Initiative Bipolar Disorder project and the Genetics of Recurrent Early-Onset Depression. Subjects included women with a history of pregnancy, any mood disorder, and information about postpartum symptoms. In the linkage study, 1,210 women met criteria (23% with postpartum symptoms), and 417 microsatellite markers were analyzed in multipoint allele sharing analyses. For the association study, 759 women met criteria (25% with postpartum symptoms), and 16,916 SNPs in the regions of the best linkage peaks were assessed for association with postpartum symptoms. RESULTS The maximum linkage peak for postpartum symptoms occurred on chromosome 1q21.3-q32.1, with a chromosome-wide significant likelihood ratio Z score (Z(LR)) of 2.93 (permutation p=0.02). This was a significant increase over the baseline Z(LR) of 0.32 observed at this locus among all women with a mood disorder (permutation p=0.004). Suggestive linkage was also found on 9p24.3-p22.3 (Z(LR)=2.91). In the fine-mapping study, the strongest implicated gene was HMCN1 (nominal p=0.00017), containing four estrogen receptor binding sites, although this was not region-wide significant. CONCLUSIONS This is the first study to examine the genetic etiology of postpartum mood symptoms using genome-wide data. The results suggest that genetic variations on chromosomes 1q21.3-q32.1 and 9p24.3-p22.3 may increase susceptibility to postpartum mood symptoms.
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10
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Verma R, Cutler DJ, Holmans P, Knowles JA, Crowe RR, Scheftner WA, Weissman MM, DePaulo JR, Levinson DF, Potash JB. Investigating the role of p11 (S100A10) sequence variation in susceptibility to major depression. Am J Med Genet B Neuropsychiatr Genet 2007; 144B:1079-82. [PMID: 17510952 DOI: 10.1002/ajmg.b.30514] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
Recent evidence suggests a potential role for the p11 gene in conferring risk to depressive disorders. p11 has been shown to influence serotonergic transmission, and its expression was found to be reduced in a mouse model of depression, as well as in post-mortem brain tissue from major depressive disorder (MDD) cases. In the present study, we tested for rare variants in p11 by resequencing promoter, exonic and flanking intronic regions in 176 MDD cases and 176 matched controls. We also assessed common variation by genotyping eight single nucleotide polymorphisms (SNPs), seven tag SNPs and one found through resequencing, in 641 cases and 650 controls. Resequencing revealed nine novel rare variants, including a missense mutation (Asp60Glu) observed in one case and one control, and four variants that occurred only in cases and not controls. The number of rare variants in cases did not exceed that expected by chance for the length of sequence analyzed, and also was not significantly greater than that observed in controls. Resequencing also identified two known SNPs, one (rs4845720) of which was significantly more frequent in cases than controls in the resequenced sample (3.1% vs. 0.9%, P = 0.03), though not in the larger sample (3% vs. 2%, P = 0.15). None of the tag SNPs showed any evidence of association. Our results do not support a major role for either common or rare p11 SNPs with MDD. Several limitations of the study are discussed.
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Affiliation(s)
- Ranjana Verma
- Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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11
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Mondimore FM, Zandi PP, MacKinnon DF, McInnis MG, Miller EB, Schweizer B, Crowe RP, Scheftner WA, Weissman MM, Levinson DF, DePaulo JR, Potash JB. A comparison of the familiality of chronic depression in recurrent early-onset depression pedigrees using different definitions of chronicity. J Affect Disord 2007; 100:171-7. [PMID: 17126912 PMCID: PMC1950152 DOI: 10.1016/j.jad.2006.10.011] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.1] [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: 08/29/2006] [Revised: 10/05/2006] [Accepted: 10/13/2006] [Indexed: 10/23/2022]
Abstract
BACKGROUND The study of chronicity in the course of major depression has been complicated by varying definitions of this illness feature. Because familial clustering is one component of diagnostic validity we compared family clustering of chronicity as defined in the DSM-IV to that of chronicity determined by an assessment of lifetime course of depressive illness. METHODS In 1750 affected subjects from 652 families recruited for a genetic study of recurrent, early-onset depression, we applied several definitions of chronicity. Odds ratios were determined for the likelihood of chronicity in a proband predicting chronicity in an affected relative. RESULTS There was greater family clustering of chronicity as determined by assessment of lifetime course (OR=2.54) than by DSM-IV defined chronic major depressive episode (MDE) (OR=1.93) or dysthymic disorder (OR=1.76). In families with probands who had preadolescent onset of MDD, familiality was increased by all definitions, with a much larger increase observed for chronicity by lifetime course (ORs were 6.14 for lifetime chronicity, 2.43 for chronic MDE, and 3.42 for comorbid dysthymic disorder). Agreement between these definitions of chronicity was only fair. LIMITATIONS The data used to determine chronicity were collected retrospectively and not blindly to relatives' status, and assessment of lifetime course was based on global clinical impressions gathered during a semi-structured diagnostic interview. Also, it can be difficult to determine whether individuals with recurrent major depressive episodes who frequently experience long periods of low grade depressive symptoms meet the strict timing requirements of DSM-IV dysthymic disorder. CONCLUSIONS An assessment of lifetime symptom course identifies a more familial, and thus possibly a more valid, type of chronic depression than the current DSM-IV categories which are defined in terms of particular cross-sectional features of illness.
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Affiliation(s)
- Francis M Mondimore
- Department of Psychiatry and Behavioral Sciences, School of Medicine, Johns Hopkins University, Baltimore, MD 21287, USA.
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Holmans P, Weissman MM, Zubenko GS, Scheftner WA, Crowe RR, Depaulo JR, Knowles JA, Zubenko WN, Murphy-Eberenz K, Marta DH, Boutelle S, McInnis MG, Adams P, Gladis M, Steele J, Miller EB, Potash JB, Mackinnon DF, Levinson DF. Genetics of recurrent early-onset major depression (GenRED): final genome scan report. Am J Psychiatry 2007; 164:248-58. [PMID: 17267787 DOI: 10.1176/ajp.2007.164.2.248] [Citation(s) in RCA: 69] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The authors carried out a genomewide linkage scan to identify chromosomal regions likely to contain genes that contribute to susceptibility to recurrent early-onset major depressive disorder, the form of the disorder with the greatest reported risk to relatives of index cases. METHOD Microsatellite DNA markers were studied in 656 families with two or more such cases (onset before age 31 in probands and age 41 in other relatives), including 1,494 informative "all possible" affected relative pairs (there were 894 independent affected sibling pairs). Analyses included a primary multipoint allele-sharing analysis (with ALLEGRO) and a secondary logistic regression analysis taking the sex of each relative pair into account (male-male, male-female, female-female). RESULTS Genomewide suggestive evidence for linkage was observed on chromosome 15q25-q26 (at 105.4 centimorgans [cM]). The authors previously reported genomewide significant linkage in this region in the first 297 families. In the secondary analysis, after empirical genomewide correction for multiple testing, suggestive linkage results were observed on chromosome 17p12 (28.0 cM, excess sharing in male-male and male-female pairs) and on chromosome 8p22-p21.3 (25.1 cM, excess sharing in male-male pairs). CONCLUSIONS These regions of chromosomes 15q, 17p, and 8p might contain genes that contribute to susceptibility to major depression and related disorders. Evidence for linkage has been reported independently in the same regions of chromosome 15q for major depression and of chromosome 8p for related personality traits.
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MESH Headings
- Adult
- Age of Onset
- Chromosome Mapping/statistics & numerical data
- Chromosomes, Human, Pair 15/genetics
- Chromosomes, Human, Pair 17/genetics
- Chromosomes, Human, Pair 8/genetics
- Comorbidity
- DNA, Satellite/genetics
- Depressive Disorder, Major/diagnosis
- Depressive Disorder, Major/epidemiology
- Depressive Disorder, Major/genetics
- Family Health
- Female
- Genetic Markers
- Genetic Predisposition to Disease/epidemiology
- Genetic Predisposition to Disease/genetics
- Humans
- Male
- Middle Aged
- Pedigree
- Personality/genetics
- Recurrence
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Affiliation(s)
- Peter Holmans
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 701A Welch Rd., Suite 3325, Palo Alto, CA 94304-5797, USA
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13
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Levinson DF, Evgrafov OV, Knowles JA, Potash JB, Weissman MM, Scheftner WA, Depaulo JR, Crowe RR, Murphy-Eberenz K, Marta DH, McInnis MG, Adams P, Gladis M, Miller EB, Thomas J, Holmans P. Genetics of recurrent early-onset major depression (GenRED): significant linkage on chromosome 15q25-q26 after fine mapping with single nucleotide polymorphism markers. Am J Psychiatry 2007; 164:259-64. [PMID: 17267788 DOI: 10.1176/ajp.2007.164.2.259] [Citation(s) in RCA: 39] [Impact Index Per Article: 2.3] [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] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The authors studied a dense map of single nucleotide polymorphism (SNP) DNA markers on chromosome 15q25-q26 to maximize the informativeness of genetic linkage analyses in a region where they previously reported suggestive evidence for linkage of recurrent early-onset major depressive disorder. METHOD In 631 European-ancestry families with multiple cases of recurrent early-onset major depressive disorder, 88 SNPs were genotyped, and multipoint allele-sharing linkage analyses were carried out. Marker-marker linkage disequilibrium was minimized, and a simulation study with founder haplotypes from these families suggested that linkage scores were not inflated by linkage disequilibrium. RESULTS The dense SNP map increased the information content of the analysis from around 0.7 to over 0.9. The maximum evidence for linkage was the Z likelihood ratio score statistic of Kong and Cox (Z(LR))=4.69 at 109.8 cM. The exact p value was below the genomewide significance threshold. By contrast, in the genome scan with microsatellite markers at 9 cM spacing, the maximum Z(LR) for European-ancestry families was 3.43 (106.53 cM). It was estimated that the linked locus or loci in this region might account for a 20% or less populationwide increase in risk to siblings of cases. CONCLUSIONS This region has produced modestly positive evidence for linkage to depression and related traits in other studies. These results suggest that DNA sequence variations in one or more genes in the 15q25-q26 region can increase susceptibility to major depression and that efforts are warranted to identify these genes.
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Affiliation(s)
- Douglas F Levinson
- Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, 701A Welch Rd., Suite 3325, Palo Alto, CA 94304-5797, USA.
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Mondimore FM, Zandi PP, Mackinnon DF, McInnis MG, Miller EB, Crowe RP, Scheftner WA, Marta DH, Weissman MM, Levinson DF, Murphy-Ebenez KP, Depaulo JR, Potash JB. Familial aggregation of illness chronicity in recurrent, early-onset major depression pedigrees. Am J Psychiatry 2006; 163:1554-60. [PMID: 16946180 DOI: 10.1176/ajp.2006.163.9.1554] [Citation(s) in RCA: 42] [Impact Index Per Article: 2.3] [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] [Indexed: 11/30/2022]
Abstract
OBJECTIVE The authors used a large sample collected for genetic studies to determine whether a chronic course of illness defines a familial clinical subtype in major depressive disorder. METHOD A measure of lifetime chronicity of depressive symptoms (substantial mood symptoms most or all of the time) was tested for familial aggregation in 638 pedigrees from the Genetics of Recurrent Early-Onset Depression (GenRED) project. RESULTS In subjects with chronic depression, the mean age at illness onset was lower and rates of attempted suicide, panic disorder, and substance abuse were higher than among those with nonchronic depression. Chronicity was assessed in 37.8% of affected first-degree relatives of probands with chronic depression and in 20.2% of relatives of probands with nonchronic depression. Analysis using the generalized estimating equation model yielded an odds ratio of 2.52 (SE=0.39, z=6.02, p<0.0001) for the likelihood of chronicity in a proband predicting chronicity in an affected relative. With stratification by proband age at illness onset, the odds ratio for chronicity in relatives by proband chronicity status was 6.17 (SE=2.09, z=5.35, p<0.0001) in families of probands whose illness onset was before age 13 and 1.92 (SE=0.34, z=3.72, p<0.0001) in families of probands whose illness started at age 13 or later. CONCLUSIONS These findings suggest that chronicity of depressive symptoms is familial, especially in preadolescent-onset illness. Chronicity is also associated with other indicators of illness severity in recurrent, early-onset major depression. Further study using chronicity as a subtype in the genetic analysis of depressive illness is warranted. Refinement of the definition of chronicity in depressive illness may increase the power of such studies.
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Affiliation(s)
- Francis M Mondimore
- Johns Hopkins Hospital, Meyer 3-181, 600 North Wolfe St., Baltimore, MD 21287, USA.
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15
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Murphy-Eberenz K, Zandi PP, March D, Crowe RR, Scheftner WA, Alexander M, McInnis MG, Coryell W, Adams P, DePaulo JR, Miller EB, Marta DH, Potash JB, Payne J, Levinson DF. Is perinatal depression familial? J Affect Disord 2006; 90:49-55. [PMID: 16337009 DOI: 10.1016/j.jad.2005.10.006] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.8] [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: 03/14/2005] [Accepted: 10/17/2005] [Indexed: 12/26/2022]
Abstract
BACKGROUND While major depressive disorder (MDD) is familial, it is not clear whether distinct familial-genetic factors influence vulnerability to depression during or after pregnancy. Here we examine familial aggregation of perinatal major depression (PND, any episode during pregnancy or the month after childbirth) and the subset of post-partum depression (PPD) in families with multiple cases of recurrent, early-onset MDD from the Genetics of Recurrent Early-Onset Depression dataset. METHODS The dataset included 691 childbearing women who could be classified as PND (27.6%) or non-PND (NPND), of whom 328 were members of 148 sibships with two or more PND or NPND women. PND and NPND subjects were compared for differences in putative predictors. Prediction of sibling PND or PPD by the proband's history was examined using logistic regression and general estimating equation methods. RESULTS PND was associated with fewer episodes and younger current age. Odds ratios for prediction of sibling status were significant for PND (2.28) and PPD (3.96), particularly when current age was under 46 (2.87 and 4.39, respectively). ORs for PPD were not significantly different from those for PND. The OR for PPD (3.52), but not for PND, remained significant after current age was introduced as a covariate, but not when both current age and number of episodes were included in the model. LIMITATIONS Because detailed data were not collected for all pregnancies, we cannot determine whether current age and number of episodes mediated the observed effects due to recall bias or other factors (cohort effect, number of episodes). CONCLUSIONS A familial component to PND, and particularly PPD, is suggested by the results. However more systematic study is needed to confirm this result. A greater understanding of both genetic and non-genetic familial factors could lead to improved prevention and clinical management.
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Affiliation(s)
- Kathleen Murphy-Eberenz
- Department of Psychiatry, University of Pennsylvania School of Medicine, Philadelphia, PA 19104-3309, USA
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16
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Holmans P, Zubenko GS, Crowe RR, DePaulo Jr. JR, Scheftner WA, Weissman MM, Zubenko WN, Boutelle S, Murphy-Eberenz K, MacKinnon D, McInnis MG, Marta DH, Adams P, Knowles JA, Gladis M, Thomas J, Chellis J, Miller E, Levinson DF. Genomewide significant linkage to recurrent, early-onset major depressive disorder on chromosome 15q. Am J Hum Genet 2004; 74:1154-67. [PMID: 15108123 PMCID: PMC1182079 DOI: 10.1086/421333] [Citation(s) in RCA: 93] [Impact Index Per Article: 4.7] [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: 02/02/2004] [Accepted: 03/12/2004] [Indexed: 02/04/2023] Open
Abstract
A genome scan was performed on the first phase sample of the Genetics of Recurrent Early-Onset Depression (GenRED) project. The sample consisted of 297 informative families containing 415 independent affected sibling pairs (ASPs), or, counting all possible pairs, 685 informative affected relative pairs (555 ASPs and 130 other pair types). Affected cases had recurrent major depressive disorder (MDD) with onset before age 31 years for probands or age 41 years for other affected relatives; the mean age at onset was 18.5 years, and the mean number of depressive episodes was 7.3. The Center for Inherited Disease Research genotyped 389 microsatellite markers (mean spacing of 9.3 cM). The primary linkage analysis considered allele sharing in all possible affected relative pairs with the use of the Z(lr) statistic computed by the ALLEGRO program. A secondary logistic regression analysis considered the effect of the sex of the pair as a covariate. Genomewide significant linkage was observed on chromosome 15q25.3-26.2 (Zlr=4.14, equivalent LOD = 3.73, empirical genomewide P=.023). The linkage was not sex specific. No other suggestive or significant results were observed in the primary analysis. The secondary analysis produced three regions of suggestive linkage, but these results should be interpreted cautiously because they depended primarily on the small subsample of 42 male-male pairs. Chromosome 15q25.3-26.2 deserves further study as a candidate region for susceptibility to MDD.
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Affiliation(s)
- Peter Holmans
- Biostatistics and Bioinformatics Unit, University of Wales College of Medicine, Cardiff, United Kingdom; MRC Biostatistics Unit, Cambridge, United Kingdom; Department of Psychiatry, University of Pittsburgh, Pittsburgh; Department of Psychiatry and Mental Health CRC, University of Iowa, Iowa City; Department of Psychiatry, Johns Hopkins University, Baltimore; Department of Psychiatry, Rush University Medical Center, Chicago; Department of Psychiatry, College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York; and Department of Psychiatry and Center for Neurobiology and Behavior, University of Pennsylvania, Philadelphia
| | - George S. Zubenko
- Biostatistics and Bioinformatics Unit, University of Wales College of Medicine, Cardiff, United Kingdom; MRC Biostatistics Unit, Cambridge, United Kingdom; Department of Psychiatry, University of Pittsburgh, Pittsburgh; Department of Psychiatry and Mental Health CRC, University of Iowa, Iowa City; Department of Psychiatry, Johns Hopkins University, Baltimore; Department of Psychiatry, Rush University Medical Center, Chicago; Department of Psychiatry, College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York; and Department of Psychiatry and Center for Neurobiology and Behavior, University of Pennsylvania, Philadelphia
| | - Raymond R. Crowe
- Biostatistics and Bioinformatics Unit, University of Wales College of Medicine, Cardiff, United Kingdom; MRC Biostatistics Unit, Cambridge, United Kingdom; Department of Psychiatry, University of Pittsburgh, Pittsburgh; Department of Psychiatry and Mental Health CRC, University of Iowa, Iowa City; Department of Psychiatry, Johns Hopkins University, Baltimore; Department of Psychiatry, Rush University Medical Center, Chicago; Department of Psychiatry, College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York; and Department of Psychiatry and Center for Neurobiology and Behavior, University of Pennsylvania, Philadelphia
| | - J. Raymond DePaulo Jr.
- Biostatistics and Bioinformatics Unit, University of Wales College of Medicine, Cardiff, United Kingdom; MRC Biostatistics Unit, Cambridge, United Kingdom; Department of Psychiatry, University of Pittsburgh, Pittsburgh; Department of Psychiatry and Mental Health CRC, University of Iowa, Iowa City; Department of Psychiatry, Johns Hopkins University, Baltimore; Department of Psychiatry, Rush University Medical Center, Chicago; Department of Psychiatry, College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York; and Department of Psychiatry and Center for Neurobiology and Behavior, University of Pennsylvania, Philadelphia
| | - William A. Scheftner
- Biostatistics and Bioinformatics Unit, University of Wales College of Medicine, Cardiff, United Kingdom; MRC Biostatistics Unit, Cambridge, United Kingdom; Department of Psychiatry, University of Pittsburgh, Pittsburgh; Department of Psychiatry and Mental Health CRC, University of Iowa, Iowa City; Department of Psychiatry, Johns Hopkins University, Baltimore; Department of Psychiatry, Rush University Medical Center, Chicago; Department of Psychiatry, College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York; and Department of Psychiatry and Center for Neurobiology and Behavior, University of Pennsylvania, Philadelphia
| | - Myrna M. Weissman
- Biostatistics and Bioinformatics Unit, University of Wales College of Medicine, Cardiff, United Kingdom; MRC Biostatistics Unit, Cambridge, United Kingdom; Department of Psychiatry, University of Pittsburgh, Pittsburgh; Department of Psychiatry and Mental Health CRC, University of Iowa, Iowa City; Department of Psychiatry, Johns Hopkins University, Baltimore; Department of Psychiatry, Rush University Medical Center, Chicago; Department of Psychiatry, College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York; and Department of Psychiatry and Center for Neurobiology and Behavior, University of Pennsylvania, Philadelphia
| | - Wendy N. Zubenko
- Biostatistics and Bioinformatics Unit, University of Wales College of Medicine, Cardiff, United Kingdom; MRC Biostatistics Unit, Cambridge, United Kingdom; Department of Psychiatry, University of Pittsburgh, Pittsburgh; Department of Psychiatry and Mental Health CRC, University of Iowa, Iowa City; Department of Psychiatry, Johns Hopkins University, Baltimore; Department of Psychiatry, Rush University Medical Center, Chicago; Department of Psychiatry, College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York; and Department of Psychiatry and Center for Neurobiology and Behavior, University of Pennsylvania, Philadelphia
| | - Sandra Boutelle
- Biostatistics and Bioinformatics Unit, University of Wales College of Medicine, Cardiff, United Kingdom; MRC Biostatistics Unit, Cambridge, United Kingdom; Department of Psychiatry, University of Pittsburgh, Pittsburgh; Department of Psychiatry and Mental Health CRC, University of Iowa, Iowa City; Department of Psychiatry, Johns Hopkins University, Baltimore; Department of Psychiatry, Rush University Medical Center, Chicago; Department of Psychiatry, College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York; and Department of Psychiatry and Center for Neurobiology and Behavior, University of Pennsylvania, Philadelphia
| | - Kathleen Murphy-Eberenz
- Biostatistics and Bioinformatics Unit, University of Wales College of Medicine, Cardiff, United Kingdom; MRC Biostatistics Unit, Cambridge, United Kingdom; Department of Psychiatry, University of Pittsburgh, Pittsburgh; Department of Psychiatry and Mental Health CRC, University of Iowa, Iowa City; Department of Psychiatry, Johns Hopkins University, Baltimore; Department of Psychiatry, Rush University Medical Center, Chicago; Department of Psychiatry, College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York; and Department of Psychiatry and Center for Neurobiology and Behavior, University of Pennsylvania, Philadelphia
| | - Dean MacKinnon
- Biostatistics and Bioinformatics Unit, University of Wales College of Medicine, Cardiff, United Kingdom; MRC Biostatistics Unit, Cambridge, United Kingdom; Department of Psychiatry, University of Pittsburgh, Pittsburgh; Department of Psychiatry and Mental Health CRC, University of Iowa, Iowa City; Department of Psychiatry, Johns Hopkins University, Baltimore; Department of Psychiatry, Rush University Medical Center, Chicago; Department of Psychiatry, College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York; and Department of Psychiatry and Center for Neurobiology and Behavior, University of Pennsylvania, Philadelphia
| | - Melvin G. McInnis
- Biostatistics and Bioinformatics Unit, University of Wales College of Medicine, Cardiff, United Kingdom; MRC Biostatistics Unit, Cambridge, United Kingdom; Department of Psychiatry, University of Pittsburgh, Pittsburgh; Department of Psychiatry and Mental Health CRC, University of Iowa, Iowa City; Department of Psychiatry, Johns Hopkins University, Baltimore; Department of Psychiatry, Rush University Medical Center, Chicago; Department of Psychiatry, College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York; and Department of Psychiatry and Center for Neurobiology and Behavior, University of Pennsylvania, Philadelphia
| | - Diana H. Marta
- Biostatistics and Bioinformatics Unit, University of Wales College of Medicine, Cardiff, United Kingdom; MRC Biostatistics Unit, Cambridge, United Kingdom; Department of Psychiatry, University of Pittsburgh, Pittsburgh; Department of Psychiatry and Mental Health CRC, University of Iowa, Iowa City; Department of Psychiatry, Johns Hopkins University, Baltimore; Department of Psychiatry, Rush University Medical Center, Chicago; Department of Psychiatry, College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York; and Department of Psychiatry and Center for Neurobiology and Behavior, University of Pennsylvania, Philadelphia
| | - Philip Adams
- Biostatistics and Bioinformatics Unit, University of Wales College of Medicine, Cardiff, United Kingdom; MRC Biostatistics Unit, Cambridge, United Kingdom; Department of Psychiatry, University of Pittsburgh, Pittsburgh; Department of Psychiatry and Mental Health CRC, University of Iowa, Iowa City; Department of Psychiatry, Johns Hopkins University, Baltimore; Department of Psychiatry, Rush University Medical Center, Chicago; Department of Psychiatry, College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York; and Department of Psychiatry and Center for Neurobiology and Behavior, University of Pennsylvania, Philadelphia
| | - James A. Knowles
- Biostatistics and Bioinformatics Unit, University of Wales College of Medicine, Cardiff, United Kingdom; MRC Biostatistics Unit, Cambridge, United Kingdom; Department of Psychiatry, University of Pittsburgh, Pittsburgh; Department of Psychiatry and Mental Health CRC, University of Iowa, Iowa City; Department of Psychiatry, Johns Hopkins University, Baltimore; Department of Psychiatry, Rush University Medical Center, Chicago; Department of Psychiatry, College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York; and Department of Psychiatry and Center for Neurobiology and Behavior, University of Pennsylvania, Philadelphia
| | - Madeleine Gladis
- Biostatistics and Bioinformatics Unit, University of Wales College of Medicine, Cardiff, United Kingdom; MRC Biostatistics Unit, Cambridge, United Kingdom; Department of Psychiatry, University of Pittsburgh, Pittsburgh; Department of Psychiatry and Mental Health CRC, University of Iowa, Iowa City; Department of Psychiatry, Johns Hopkins University, Baltimore; Department of Psychiatry, Rush University Medical Center, Chicago; Department of Psychiatry, College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York; and Department of Psychiatry and Center for Neurobiology and Behavior, University of Pennsylvania, Philadelphia
| | - Jo Thomas
- Biostatistics and Bioinformatics Unit, University of Wales College of Medicine, Cardiff, United Kingdom; MRC Biostatistics Unit, Cambridge, United Kingdom; Department of Psychiatry, University of Pittsburgh, Pittsburgh; Department of Psychiatry and Mental Health CRC, University of Iowa, Iowa City; Department of Psychiatry, Johns Hopkins University, Baltimore; Department of Psychiatry, Rush University Medical Center, Chicago; Department of Psychiatry, College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York; and Department of Psychiatry and Center for Neurobiology and Behavior, University of Pennsylvania, Philadelphia
| | - Jennifer Chellis
- Biostatistics and Bioinformatics Unit, University of Wales College of Medicine, Cardiff, United Kingdom; MRC Biostatistics Unit, Cambridge, United Kingdom; Department of Psychiatry, University of Pittsburgh, Pittsburgh; Department of Psychiatry and Mental Health CRC, University of Iowa, Iowa City; Department of Psychiatry, Johns Hopkins University, Baltimore; Department of Psychiatry, Rush University Medical Center, Chicago; Department of Psychiatry, College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York; and Department of Psychiatry and Center for Neurobiology and Behavior, University of Pennsylvania, Philadelphia
| | - Erin Miller
- Biostatistics and Bioinformatics Unit, University of Wales College of Medicine, Cardiff, United Kingdom; MRC Biostatistics Unit, Cambridge, United Kingdom; Department of Psychiatry, University of Pittsburgh, Pittsburgh; Department of Psychiatry and Mental Health CRC, University of Iowa, Iowa City; Department of Psychiatry, Johns Hopkins University, Baltimore; Department of Psychiatry, Rush University Medical Center, Chicago; Department of Psychiatry, College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York; and Department of Psychiatry and Center for Neurobiology and Behavior, University of Pennsylvania, Philadelphia
| | - Douglas F. Levinson
- Biostatistics and Bioinformatics Unit, University of Wales College of Medicine, Cardiff, United Kingdom; MRC Biostatistics Unit, Cambridge, United Kingdom; Department of Psychiatry, University of Pittsburgh, Pittsburgh; Department of Psychiatry and Mental Health CRC, University of Iowa, Iowa City; Department of Psychiatry, Johns Hopkins University, Baltimore; Department of Psychiatry, Rush University Medical Center, Chicago; Department of Psychiatry, College of Physicians and Surgeons, Columbia University, and New York State Psychiatric Institute, New York; and Department of Psychiatry and Center for Neurobiology and Behavior, University of Pennsylvania, Philadelphia
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Scheftner WA, Shulman RB. Treatment Choice in Neuroleptic Malignant Syndrome. Convuls Ther 2002; 8:267-279. [PMID: 11941178] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
Abstract
A literature review of patients with symptomatic neuroleptic malignant syndrome (NMS) treated with electroconvulsive therapy (ECT) yielded 26 cases, to which we add five cases. ECT was associated with a positive outcome in 26 of 31 cases with one unclear outcome and a poor outcome in four cases, including two deaths. ECT appeared to be effective in eight of nine patients previously treated with dantrolene and/or bromocriptine; no difference in time to apparent response was seen between those treated with medication first and those undergoing ECT first. The mean time to clinical response after the first ECT was 1.46 +/- 2.38 days, with 19 of 20 having a clinical response by 72 h. The possible relationship of ECT to the two deaths is discussed. Given this experience, the suggested treatment sequence is medication (dantrolene or bromocriptine) for 48 h; if no clinical response is seen, ECT should be initiated. ECT may be used earlier in response to specific clinical situations.
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Affiliation(s)
- William A. Scheftner
- Department of Psychiatry, Rush-Presbyterian St. Luke's Medical Center, Chicago, Illinois, USA
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Abstract
OBJECTIVE Several reports have raised concern that the discontinuation of lithium may result in treatment resistance following recurrence of affective disorder. This report explores this possibility. METHOD The data derive from a large, naturalistic follow-up of patients with major depressive disorder or mania. Twenty-eight of the patients in the study were free of lithium and experiencing an episode of mania or schizoaffective mania diagnosed according to Research Diagnostic Criteria when they entered the study, recovered while taking lithium, later experienced a recurrence while not taking lithium, and then resumed lithium treatment. Survival analyses of time to recovery and, subsequently, time to recurrence, used continued lithium treatment as an additional censoring variable. RESULTS Patients given lithium recovered no more quickly from their index episode than they did from their first prospectively observed episode. Moreover, lithium prophylaxis appeared no less effective after the first prospectively observed episode than after the index episode. CONCLUSIONS These findings provide no evidence that lithium discontinuation results in treatment resistance when lithium is resumed.
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Affiliation(s)
- W Coryell
- University of Iowa College of Medicine, Iowa City 52242-1000, USA.
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21
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Abstract
The authors examined interactions among risk factors for suicide, a strategy not typically followed in suicide research. Their results suggest an explanation for gender differences in suicide rates and qualifications in the relationship between hopelessness and suicide based on history of drug and alcohol abuse.
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Affiliation(s)
- M A Young
- Department of Psychiatry, Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL 60612
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22
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Abstract
The association between major depressive disorder (MDD) and self-reported histories of specific physical illnesses was investigated in 320 controls and 1968 first-degree relatives and 254 spouses of probands in the NIMH Collaborative Depression study. The Schedule for Affective Disorders and Schizophrenia-Lifetime Version was used to assign Research Diagnostic Criteria (RDC) diagnoses and a structured self-report instrument was used to assess lifetime medical history. Lifetime MDD was diagnosed in 914 subjects, 402 of whom had been hospitalized or received somatic treatment ('treated' MDD). Strong associations were observed between MDD (either treated or untreated) and both frequent/severe headaches and migraine headaches. There was a marked gender effect such that the relative odds for a woman with treated MDD to report migraine were over 5:1. Other associations were found between MDD and skin infections, respiratory illness, ulcer, hypotension, and diabetes. This is the largest non-patient sample using standardized assessment of mental disorders by direct interview in which associations between specific physical illnesses and MDD have been demonstrated. Implications for clinical practice and neurobiological research in depression are discussed.
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Affiliation(s)
- S O Moldin
- Department of Psychiatry, Washington University School of Medicine, St Louis 63110
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Abstract
The presence or absence of 12 depressive symptoms was examined in 93 bipolar and 108 unipolar patients who had two discrete episodes of major depression over a 5-year period. For each symptom the concordance of its presence or absence across episodes was low. The agreement observed was largely that to be expected by chance. A substantial amount of concordance was obtained if differences in episode intensity (propensity to have symptoms) were taken into account. This suggests that although there may be factors related to depression which remain stable across episodes, symptom presentation is moderated by other factors, such as intensity, which vary from episode to episode.
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Affiliation(s)
- M A Young
- Department of Psychiatry, Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL 60612
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25
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Abstract
The authors studied 954 psychiatric patients with major affective disorders and found that nine clinical features were associated with suicide. Six of these--panic attacks, severe psychic anxiety, diminished concentration, global insomnia, moderate alcohol abuse, and severe loss of interest or pleasure (anhedonia)--were associated with suicide within 1 year, and three others--severe hopelessness, suicidal ideation, and history of previous suicide attempts--were associated with suicide occurring after 1 year. These findings draw attention to the importance of 1) standardized prospective data for studies of suicide, 2) assessment of short-term suicide risk factors, and 3) anxiety symptoms as modifiable suicide risk factors within a clinically relevant period.
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Affiliation(s)
- J Fawcett
- Department of Psychiatry, Rush-Presbyterian-St. Luke's Medical Center, Chicago, IL 60612
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26
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Young MA, Fogg LF, Scheftner WA, Keller MB, Fawcett JA. Sex differences in the lifetime prevalence of depression: does varying the diagnostic criteria reduce the female/male ratio? J Affect Disord 1990; 18:187-92. [PMID: 2139063 DOI: 10.1016/0165-0327(90)90035-7] [Citation(s) in RCA: 68] [Impact Index Per Article: 2.0] [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] [Indexed: 12/30/2022]
Abstract
Most studies report the lifetime prevalence of major depressive disorder to be higher among women than men. One possible explanation is that this finding is the result of the diagnostic criteria used, in particular the inclusion of criterion symptoms associated with depressed mood. The number of criterion symptoms required for a diagnosis were varied and applied to 2163 first-degree relatives of affectively disordered probands of the NIMH Collaborative Study of the Psychobiology of Depression. Results indicated that differences between men and women in number of symptoms reported could not account for the difference in rates of depression. Women had a greater number of associated symptoms only at higher symptom levels, suggesting an excess of women only above a diagnostic threshold. Thus, findings supported a true difference in rates of major depressive disorder rather than a general trend for women to remember or report more criterion symptoms.
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Affiliation(s)
- M A Young
- Department of Psychiatry, Rush-Presbyterian-St. Lukes Medical Center, Chicago, IL 60012
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27
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Abstract
Gender differences in the presence or absence and the severity of forty-seven clinician-rated features of depression were examined, controlling for the sex of the rater. Subjects consisted of 498 moderately to severely depressed patients coming for treatment and diagnosed as suffering from nonpsychotic, unipolar major depressive disorder. Significant differences were found only for increased appetite and weight. No differences were observed in endogenous symptoms, global severity of depression, or impairment in functioning. The results indicate that, although the rate of major depressive disorder is greater in women, its symptomatology is relatively homogeneous with regard to gender.
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Affiliation(s)
- M A Young
- Rush-Presbyterian-St. Luke's Medical Center, Chicago, Illinois 60612
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28
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Winokur G, Coryell W, Keller M, Scheftner WA. Relationship of electroconvulsive therapy to course in affective illness: a collaborative study. Eur Arch Psychiatry Clin Neurosci 1990; 240:54-9. [PMID: 2147905 DOI: 10.1007/bf02190094] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.3] [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] [Indexed: 12/30/2022]
Abstract
Bipolars treated with electroconvulsive therapy (ECT) during the index episode were matched on the variables of age, sex, previous admissions and previous hospitalizations with 23 bipolars who did not receive ECT. A similar match was made for 42 unipolars who were under the age of 40 at time of admission. All patients were followed for 5 years. Those patients treated with ECT, both bipolars and unipolars, had the same numbers of episodes in follow-up as their matched groups. However, in both bipolar and unipolar ECT-treated patients, there were more follow-up rehospitalizations. The reason for this is not known but three possibilities exist. Successful treatment with ECT may make the family and patient more prone to consider rehospitalization. Secondly, the originally treated ECT patients may have had more aggressive doctors who were more likely to rehospitalize. Finally, ECT may change the course of an individual's illness in such a way that more severe episodes occur and rehospitalizations are necessary. The findings suggest the need for long-term studies following ECT on clinical and biological variables.
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Affiliation(s)
- G Winokur
- Department of Psychiatry, University of Iowa College of Medicine, Psychiatric Hospital, Iowa City 52242
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29
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Clark DC, Gibbons RD, Fawcett J, Scheftner WA. What is the mechanism by which suicide attempts predispose to later suicide attempts? A mathematical model. Journal of Abnormal Psychology 1989; 98:42-9. [PMID: 2708639 DOI: 10.1037/0021-843x.98.1.42] [Citation(s) in RCA: 27] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
A state dependence model of serial behavior suggests that each occurrence increases the subsequent likelihood of that behavior being repeated. A heterogeneity model, by contrast, suggests that the likelihood of a behavior occurring is predetermined, and uninfluenced by intervening occurrences. We have applied the random-effects probit model of Gibbons and Bock (1987) to examine the fit of the state dependence and heterogeneity models to longitudinal data on suicide attempts by 928 patients with affective disorder. Heterogeneity but not state dependence was required to model these data. The findings suggest that when considering patients with moderate to severe major affective disorder, the clinician should not interpret the absence of any recent suicide attempts to mean that the patient is at relatively low risk for attempting suicide in the future. An implication of the heterogeneity model is that suicide attempts made many years ago may have equal value to recent attempts when estimating an individual's "predisposition" to nonlethal attempts in the future.
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30
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Abstract
Family history was examined to determine whether suicide in index patients is associated with suicidal behaviour or mental disorder in their first-degree relatives. Twenty-seven suicides occurred within 5 1/2 years among 955 affectively disordered probands. Among 5042 proband relatives aged 18 years and older, 44 had committed suicide prior to proband entry to the study; however, only one was the relative of a proband suicide. Only two of the relatives who committed suicide were themselves related. As to attempted suicide of relatives, neither the number of attempts nor the severity of attempt was predictive of suicide in probands. Comparison of diagnosis between groups of relatives showed more drug abuse among relatives of proband suicides; this appears to be related to drug abuse among the proband suicides themselves. In contrast to the clustering of suicides within biological families found in other research, these data do not support the use of family history as a clinically useful indicator of suicidal potential in affectively disordered probands.
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31
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Maxwell S, Scheftner WA, Kessler HA, Busch K. Manic syndrome associated with zidovudine treatment. JAMA 1988; 259:3406-7. [PMID: 3163740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
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32
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Coryell W, Endicott J, Andreasen NC, Keller MB, Clayton PJ, Hirschfeld RM, Scheftner WA, Winokur G. Depression and panic attacks: the significance of overlap as reflected in follow-up and family study data. Am J Psychiatry 1988; 145:293-300. [PMID: 3344844 DOI: 10.1176/ajp.145.3.293] [Citation(s) in RCA: 130] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
Ninety-one patients with panic attacks limited historically to depressive episodes had more severe depressive symptoms and were less likely to recover during a 2-year follow-up than 417 depressed patients who did not have panic attacks. Family study data clearly distinguished another 15 patients with panic disorder and secondary depression; interviewed relatives of panic disorder patients were significantly less likely to have primary depression and significantly more likely to have various anxiety disorders. These data support the hierarchical system by which many of the contemporary diagnostic systems separate panic disorder and major depression.
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Affiliation(s)
- W Coryell
- Department of Psychiatry, University of Iowa, Iowa City 52242
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33
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Abstract
The authors undertook a field test of Motto and colleagues' Risk Estimator for Suicide by selecting a subset (N = 593) of psychiatric patients with major or chronic affective disorder that corresponded to Motto's sample. They rated each subject on Motto's scale, using standardized data collected at hospital admission. Fourteen patients (2.4%) in their sample and 136 (4.9%) in Motto's sample died by suicide within 2 years. The authors tested the null hypothesis of a uniform suicide risk across all 10 deciles of risk scores by comparing observed and expected frequencies of suicide using the variance test for homogeneity of the binomial distribution. Their findings raise questions about Motto's risk scale but do not definitively invalidate it.
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34
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Young MA, Keller MB, Lavori PW, Scheftner WA, Fawcett JA, Endicott J, Hirschfeld RM. Lack of stability of the RDC endogenous subtype in consecutive episodes of major depression. J Affect Disord 1987; 12:139-43. [PMID: 2955005 DOI: 10.1016/0165-0327(87)90006-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
The stability of the endogenous subtype of major depressive disorder was examined within individuals across consecutive episodes. The subjects were 119 probands from the NIMH Collaborative Depression Study who experienced at least two episodes of unipolar major depressive disorder within a two-year period of biannual evaluations. Structured data collection methods and Research Diagnostic Criteria were employed. The inter-episode stability of subtype diagnosis was low, never producing a kappa of greater than 0.25. This result was not attributable to threshold for diagnosis, time between episodes, differences in severity, or changes in raters.
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35
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Young MA, Scheftner WA, Klerman GL, Andreasen NC, Hirschfeld RM. The endogenous sub-type of depression: a study of its internal construct validity. Br J Psychiatry 1986; 148:257-67. [PMID: 3459565 DOI: 10.1192/bjp.148.3.257] [Citation(s) in RCA: 46] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023]
Abstract
The internal construct validity of the endogenous sub-type of major depression was investigated by statistically modelling the RDC endogenous and DSM-III melancholia diagnostic criteria. Data consisted of symptom ratings on 788 patients with major depression from NIMH Collaborative Depression Study. Results indicated that the symptoms in the criteria do not specify a dichotomous classification, melancholic-non-melancholic or endogenous-nonendogenous. Results did support the existence of two sub-typings, one related to anhedonia, and one related to vegetative symptoms. The vegetative sub-type rarely occurred in non-anhedonic patients. Previous studies may have found support for a simple endogenous sub-type because of this hierarchical relationship and as a result of methodological differences.
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36
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Clark DC, Clayton PJ, Andreasen NC, Lewis C, Fawcett J, Scheftner WA. Intellectual functioning and abstraction ability in major affective disorders. Compr Psychiatry 1985; 26:313-25. [PMID: 4017560 DOI: 10.1016/0010-440x(85)90086-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
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37
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Abstract
In this study of 101 patients who met DSM-III criteria for major depression, those with extreme anhedonia (N = 23) were younger, more depressed, and less neurotic than the patients with a normal-range capacity for pleasurable experiences (N = 78). The anhedonic depressed patients recovered more rapidly; at discharge they consequently had levels of symptom severity equal to those of the hedonic patients, yet they remained significantly more anhedonic. The anhedonic patients exhibited loss of pleasure in appetite, sex, social contacts, and work, which suggests a global dulling of the capacity for pleasure.
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38
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Abstract
In two studies of depressed, manic, schizophrenic, and normal subjects, a scale for measuring the intensity of subjects' pleasureable responses to normally emjoyable situations (the Pleasure Scale) evidenced good internal reliability and moderate agreement with the Chapman Anhedonia Scale and Indexes of depressive symptom severity. Only the depressed patients showed extremely anhedonic responses. Although more than half the depressed patients evidenced pleasure scores in the normal range, about 185 of them seemed more anhedonic than any norma subject. A mixture analysis resolved depressed patient scores into two distinct distributions: a normal-range distribution (88% of depressives) and an extremely anhedonic distribution (12%). The findings provide some support for the existence of a qualitatively distinct subtype of major depression that has been variously defined an "endogenomorphic" or "melancholic."
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39
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Keller MB, Lavori PW, McDonald-Scott P, Scheftner WA, Andreasen NC, Shapiro RW, Croughan J. Reliability of lifetime diagnoses and symptoms in patients with a current psychiatric disorder. J Psychiatr Res 1981; 16:229-40. [PMID: 7348278 DOI: 10.1016/0022-3956(81)90017-0] [Citation(s) in RCA: 38] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
In this study we assess the reliability of rating past psychiatric symptoms and lifetime diagnoses in a currently ill population using the SADS and RDC. Five raters from different centers interviewed 25 subjects in a short-interval test-retest design. Subjects had a wide diversity of affective and non-affective diagnoses and high levels of manifest psychopathology. Our results demonstrate that it is possible for raters from different research centers to reliably rate lifetime diagnoses and previous symptoms. Two important exceptions to the high reliability are the lifetime diagnoses of hypomania and the recurrent unipolar subtype of major depressive disorder, and we alert clinicians and researchers to be cautious when diagnosing these conditions. We conclude that the next step in measuring reliability should be a long-interval test-retest design with separate interviews conducted at the later assessment, one by the original rater and the other by a blind rater.
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