Impact of comorbidity on family genetic risk profiles for psychiatric and substance use disorders: a descriptive analysis

2021 ◽  
pp. 1-10
Author(s):  
Kenneth S. Kendler ◽  
Henrik Ohlsson ◽  
Jan Sundquist ◽  
Kristina Sundquist

Abstract Background – Comorbidity between psychiatric disorders is extensive but, from a genetic perspective, still poorly understood. Modern molecular genetic approaches to this problem are limited by a reliance on case–control designs. Methods – In 5 828 760 individuals born in Sweden from 1932–1995 with a mean (s.d.) age at follow-up of 54.4 (18.1), we examined family genetic risk score (FGRS) profiles including internalizing, psychotic, substance use and developmental disorders in 10 pairs of psychiatric and substance use disorders diagnosed from population registries. We examined these profiles in three groups of patients: disorder A only, disorder B only and comorbid cases with both disorders. Results – The most common pattern of findings, seen in five pairings, was simple and quantitative. Comorbid cases had higher FGRS than both non-comorbid cases for all (or nearly all) disorders. However, the pattern was more complex in the remaining five pairings and included qualitative changes where the comorbid cases showed no increases in FGRS for certain disorders and in a few cases significant decreases. Several comparisons showed an asymmetric pattern of findings with increases, in comorbidity compared to single disorder cases, of the FGRS for only one of the two disorders. Conclusions – The examination of FGRS profiles in general population samples where all disorders are assessed in all subjects provides a fruitful line of inquiry to understand the origins of psychiatric comorbidity. Further work will be needed, with an expansion of analytic approaches, to gain deeper insights into the complex mechanisms likely involved.

2016 ◽  
Vol 10 (1) ◽  
pp. 33-46 ◽  
Author(s):  
Claire Kullack ◽  
Jonathan Laugharne

This report begins with a summary of the literature regarding the theoretical models behind the comorbid relationship between posttraumatic stress disorder and substance use disorders and the various modified addiction protocols formulated to assist in treating these disorders. This case series outlines the effect that the standard eye movement desensitization and reprocessing (EMDR) protocol had on alcohol and substance dependence for 4 patients who attended our Post Traumatic Stress Clinic in Fremantle, Western Australia, primarily for treatment for posttraumatic stress disorder. Patients were assessed for substance use disorders using the Mini International Neuropsychiatric Interview Plus prior to, immediately after, and 12 months after completing EMDR therapy. Results indicate that the standard EMDR protocol was successful in reducing alcohol and substance use. Prior to treatment, 3 patients met criteria for alcohol dependence and 1 met criteria for substance dependence. At 12-month follow-up, 3 out of 4 clients did not meet the diagnostic criteria for current alcohol dependence or current substance dependence. The implications of these findings are discussed with reference to theories of comorbid posttraumatic stress disorder and substance use disorder and the modified EMDR protocols developed for patients with substance dependence.


2008 ◽  
Vol 6 (3) ◽  
pp. 358-365 ◽  
Author(s):  
Joseph Biederman ◽  
Michael C. Monuteaux ◽  
Thomas Spencer ◽  
Timothy E. Wilens ◽  
Heather A. MacPherson ◽  
...  

2018 ◽  
Vol 35 (4) ◽  
pp. 220-225 ◽  
Author(s):  
Karen Urbanoski ◽  
Joyce Cheng ◽  
Jürgen Rehm ◽  
Paul Kurdyak

ObjectivesWe described the population of people who frequently use ED for mental disorders, delineating differences by the number of visits for substance use disorders (SUDs), and predicted the receipt of follow-up services and 2-year mortality by the level of ED use for SUD.MethodsThis retrospective observational study included all Ontario residents 15 years and older who had five or more ED visits during any 12-month period from 2010 to 2012 (n=263 346). The study involved a secondary analysis of administrative health databases capturing emergency, hospital and ambulatory care. Frequent ED users for mental disorders (n=5416) were grouped into nested categories based on the number of ED visits for SUD. Logistic regression was used to examine group differences in the receipt of follow-up services and mortality, controlling for sociodemographics, comorbidities and past service use.ResultsThe majority of frequent ED users for mental disorders had at least one ED visit for SUD, most commonly involving alcohol. Relative to people with no visits for SUD, those with ED visits for SUD were older and more likely to be men (Ps <0.001). As the number of ED visits for SUD increased, the likelihood of receiving follow-up care, particularly specialist mental healthcare, declined while 2-year mortality steadily increased (Ps <0.001). These associations remained after controlling for comorbidities and past service use.ConclusionsFindings highlight disparities in the receipt of specialist care based on use of ED services for SUD, coupled with a greater mortality risk. There is a need for policies and procedures to help address unmet needs for care and to connect members of this vulnerable subgroup with services that are better able to support recovery and improve survival.


2019 ◽  
Vol 110 (3) ◽  
pp. 759-768 ◽  
Author(s):  
Tiange Wang ◽  
Yoriko Heianza ◽  
Dianjianyi Sun ◽  
Yan Zheng ◽  
Tao Huang ◽  
...  

ABSTRACT Background Whether changes in fruit and vegetable intake can modify the effect of genetic susceptibility to obesity on long-term changes in BMI and body weight are uncertain. Objective We analyzed the interactions of changes in total and specific fruit and vegetable intake with genetic susceptibility to obesity in relation to changes in BMI and body weight. Methods We calculated a genetic risk score on the basis of 77 BMI-associated loci to determine the genetic susceptibility to obesity, and examined the interactions of changes in total and specific fruit and vegetable intake with the genetic risk score on changes in BMI and body weight within five 4-y intervals over 20 y of follow-up in 8943 women from the Nurses’ Health Study (NHS) and 5308 men from the Health Professionals Follow-Up Study (HPFS). Results In the combined cohorts, repeated 4-y BMI change per 10-risk allele increment was 0.09 kg/m2 among participants with the greatest decrease in total fruit and vegetable intake and −0.02 among those with the greatest increase in intake (P-interaction <0.001; corresponding weight change: 0.20 kg compared with −0.06 kg). The magnitude of decrease in BMI associated with increasing fruit and vegetable intake was more prominent among participants with high genetic risk than those with low risk. Reproducible interactions were observed for fruits and vegetables separately (both P-interaction <0.001). Based on similar nutritional content, the interaction effect was greatest for berries, citrus fruits, and green leafy vegetables, and the interaction pattern persisted regardless of the different fiber content or glycemic load of fruits and vegetables. Conclusions Genetically associated increased BMI and body weight could be mitigated by increasing fruit and vegetable intake, and the beneficial effect of improving fruit and vegetable intake on weight management was more pronounced in individuals with greater genetic susceptibility to obesity.


Author(s):  
Stephanie Yarnell ◽  
Ellen Edens

Chapter 20—The Prevalence and Severity of Psychiatric Comorbidities provides a summary of a landmark study in epidemiology, the The National Comorbidity Survey Replication (NCS-R). This chapter study sought to answer some fundamental questions. How common are comorbid psychiatric conditions? What are the prevalence and severity rates for comorbid anxiety, mood, impulse control, and substance use disorders? Starting with these questions, this chapter describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case.


Author(s):  
Stephanie Yarnell ◽  
Ellen Edens

This chapter provides a summary of a landmark study in epidemiology. The Global Burden of Disease Study was a ground breaking venture in answering the question regarding the prevalence of various diseases. By analyzing this database, the current study was sought to determine the burden of disease attributable to mental and substance use disorders. With this in mind, it describes the basics of the study, including funding, study location, who was studied, how many patients, study design, study intervention, follow-up, endpoints, results, and criticism and limitations. The chapter briefly reviews other relevant studies and information, discusses implications, and concludes with a relevant clinical case.


2007 ◽  
Vol 88 (2-3) ◽  
pp. 244-250 ◽  
Author(s):  
Stephen V. Faraone ◽  
Joel J. Adamson ◽  
Timothy E. Wilens ◽  
Michael C. Monuteaux ◽  
Joseph Biederman

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