Genomic dissection of bipolar disorder and schizophrenia including 28 subphenotypes

AbstractSchizophrenia (SCZ) and bipolar disorder (BD) are highly heritable disorders that share a significant proportion of common risk variation. Understanding the genetic factors underlying the specific symptoms of these disorders will be crucial for improving diagnosis, intervention and treatment. In case-control data consisting of 53,555 cases (20,129 BD, 33,426 SCZ) and 54,065 controls, we identified 114 genome-wide significant loci (GWS) when comparing all cases to controls, of which 41 represented novel findings. Two genome-wide significant loci were identified when comparing SCZ to BD and a third was found when directly incorporating functional information. Regional joint association identified a genomic region of overlapping association in BD and SCZ with disease-independent causal variants indicating a fourth region contributing to differences between these disorders. Regional SNP-heritability analyses demonstrated that the estimated heritability of BD based on the SCZ GWS regions was significantly higher than that based on the average genomic region (91 regions, p = 1.2×10−6) while the inverse was not significant (19 regions, p=0.89). Using our BD and SCZ GWAS we calculated polygenic risk scores and identified several significant correlations with: 1) SCZ subphenotypes: negative symptoms (SCZ, p=3.6×10−6) and manic symptoms (BD, p=2×10−5), 2) BD subphenotypes: psychotic features (SCZ p=1.2×10−10, BD p=5.3×10−5) and age of onset (SCZ p=7.9×10−4). Finally, we show that psychotic features in BD has significant SNP-heritability (h2snp=0.15, SE=0.06), and a significant genetic correlation with SCZ (rg=0.34) in addition there is a significant sign test result between SCZ GWAS and a GWAS of BD cases contrasting those with and without psychotic features (p=0.0038, one-side binomial test). For the first time, we have identified specific loci pointing to a potential role of 4 genes (DARS2, ARFGEF2, DCAKD and GATAD2A) that distinguish between BD and SCZ, providing an opportunity to understand the biology contributing to clinical differences of these disorders. Our results provide the best evidence so far of genomic components distinguishing between BD and SCZ that contribute directly to specific symptom dimensions.

Download Full-text

Kleine-Levin syndrome is associated with birth difficulties and genetic variants in the TRANK1 gene loci

Proceedings of the National Academy of Sciences ◽

10.1073/pnas.2005753118 ◽

2021 ◽

Vol 118 (12) ◽

pp. e2005753118

Author(s):

Aditya Ambati ◽

Ryan Hillary ◽

Smaranda Leu-Semenescu ◽

Hanna M. Ollila ◽

Ling Lin ◽

...

Keyword(s):

Bipolar Disorder ◽

Genome Wide Association Study ◽

Perinatal Outcomes ◽

Case Control ◽

Risk Scores ◽

Circadian Regulation ◽

Genetic Associations ◽

Imaging Studies ◽

Genome Wide

Kleine-Levin syndrome (KLS) is a rare disorder characterized by severe episodic hypersomnia, with cognitive impairment accompanied by apathy or disinhibition. Pathophysiology is unknown, although imaging studies indicate decreased activity in hypothalamic/thalamic areas during episodes. Familial occurrence is increased, and risk is associated with reports of a difficult birth. We conducted a worldwide case−control genome-wide association study in 673 KLS cases collected over 14 y, and ethnically matched 15,341 control individuals. We found a strong genome-wide significant association (rs71947865, Odds Ratio [OR] = 1.48, P = 8.6 × 10−9) within the 3′region of TRANK1 gene locus, previously associated with bipolar disorder and schizophrenia. Strikingly, KLS cases with rs71947865 variant had significantly increased reports of a difficult birth. As perinatal outcomes have dramatically improved over the last 40 y, we further stratified our sample by birth years and found that recent cases had a significantly reduced rs71947865 association. While the rs71947865 association did not replicate in the entire follow-up sample of 171 KLS cases, rs71947865 was significantly associated with KLS in the subset follow-up sample of 59 KLS cases who reported birth difficulties (OR = 1.54, P = 0.01). Genetic liability of KLS as explained by polygenic risk scores was increased (pseudo R2 = 0.15; P < 2.0 × 10−22 at P = 0.5 threshold) in the follow-up sample. Pathway analysis of genetic associations identified enrichment of circadian regulation pathway genes in KLS cases. Our results suggest links between KLS, circadian regulation, and bipolar disorder, and indicate that the TRANK1 polymorphisms in conjunction with reported birth difficulties may predispose to KLS.

Download Full-text

Genome-Wide Association Studies of Schizophrenia and Bipolar Disorder in a Diverse Cohort of US Veterans

Schizophrenia Bulletin ◽

10.1093/schbul/sbaa133 ◽

2020 ◽

Author(s):

Tim B Bigdeli ◽

Ayman H Fanous ◽

Yuli Li ◽

Nallakkandi Rajeevan ◽

Frederick Sayward ◽

...

Keyword(s):

Bipolar Disorder ◽

Association Studies ◽

Genome Wide Association ◽

Risk Scores ◽

Genome Wide Association Studies ◽

Summary Statistics ◽

Susceptibility Loci ◽

New Associations ◽

Genome Wide ◽

Us Veterans

Abstract Background Schizophrenia (SCZ) and bipolar disorder (BIP) are debilitating neuropsychiatric disorders, collectively affecting 2% of the world’s population. Recognizing the major impact of these psychiatric disorders on the psychosocial function of more than 200 000 US Veterans, the Department of Veterans Affairs (VA) recently completed genotyping of more than 8000 veterans with SCZ and BIP in the Cooperative Studies Program (CSP) #572. Methods We performed genome-wide association studies (GWAS) in CSP #572 and benchmarked the predictive value of polygenic risk scores (PRS) constructed from published findings. We combined our results with available summary statistics from several recent GWAS, realizing the largest and most diverse studies of these disorders to date. Results Our primary GWAS uncovered new associations between CHD7 variants and SCZ, and novel BIP associations with variants in Sortilin Related VPS10 Domain Containing Receptor 3 (SORCS3) and downstream of PCDH11X. Combining our results with published summary statistics for SCZ yielded 39 novel susceptibility loci including CRHR1, and we identified 10 additional findings for BIP (28 326 cases and 90 570 controls). PRS trained on published GWAS were significantly associated with case-control status among European American (P < 10–30) and African American (P < .0005) participants in CSP #572. Conclusions We have demonstrated that published findings for SCZ and BIP are robustly generalizable to a diverse cohort of US veterans. Leveraging available summary statistics from GWAS of global populations, we report 52 new susceptibility loci and improved fine-mapping resolution for dozens of previously reported associations.

Download Full-text

The Maudsley bipolar disorder project Clinical characteristics of bipolar disorder I in a Catchment area treatment sample

European Psychiatry ◽

10.1016/s0924-9338(02)00009-3 ◽

2003 ◽

Vol 18 (1) ◽

pp. 13-17 ◽

Cited By ~ 29

Author(s):

Vanessa Raymont ◽

David Bettany ◽

Sophia Frangou

Keyword(s):

Bipolar Disorder ◽

Substance Abuse ◽

Catchment Area ◽

Clinical Characteristics ◽

Age Of Onset ◽

Psychiatric Service ◽

Male Gender ◽

Younger Age ◽

Male Patients ◽

Psychotic Features

AbstractThe clinical characteristics of bipolar I disorder (BD1) have prognostic and therapeutic importance. The aim of this study was to examine the effect of demographic and clinical variables on the course of BD1. We reviewed the case notes of all BD1 patients (n = 63) receiving treatment in a London psychiatric service during a 1-month period. Depressive and manic onsets were equally likely without any gender difference. The earlier the age of onset, the more likely it was for patients to experience psychotic features. Only depressive onsets predicted a higher number of episodes of the same polarity. Male gender and substance abuse were associated with younger age at first presentation, while women with co-morbid substance abuse had more manic episodes. Male patients were more likely than females to be unemployed or single.

Download Full-text

Autism Rating Scale: A New Tool for Characterizing the Schizophrenia Phenotype

Frontiers in Psychiatry ◽

10.3389/fpsyt.2021.622359 ◽

2021 ◽

Vol 12 ◽

Author(s):

Davide Palumbo ◽

Giovanni Stanghellini ◽

Armida Mucci ◽

Massimo Ballerini ◽

Giulia Maria Giordano ◽

...

Keyword(s):

Bipolar Disorder ◽

Internal Consistency ◽

Negative Symptoms ◽

Rating Scale ◽

Autistic Traits ◽

Structured Interview ◽

Autism Spectrum ◽

Divergent Validity ◽

Convergent And Divergent Validity ◽

Psychotic Features

Social dysfunctions (SD) are frequently observed in subjects with schizophrenia. Some of these dysfunctions are also observed in other neuropsychiatric disorders such as autism spectrum disorders (ASD), major depression, bipolar disorder, or Alzheimer disease. Recently, a characterization of a specific type of SD in schizophrenia has been proposed, with the concept of dis-sociality, which form the core aspect of “Schizophrenic Autism” (SA). The present study aimed to explore the presence in people with schizophrenia of SA, independent of other autistic traits, which can be often found in schizophrenia and other neurodevelopmental disorders. We used a structured interview—the Autism Rating Scale (ARS), an instrument devised to detect and measure SA. Fifty-one outpatients affected by schizophrenia (26 remitted, SCZ-r) and 28 affected by bipolar disorder type 1, with psychotic features, in the euthymic phase (BD-e) were recruited. Before assessing the specificity for schizophrenia of SA, we tested the internal consistency, the convergent and divergent validity of the ARS in the schizophrenia sample. Specificity was assessed by examining potential differences in ARS scores between SCZ-r and BD-e subjects. ARS showed good internal consistency, as well as convergent and divergent validity. ARS items were more frequently of moderate severity in SCZ-r than in BD-e subjects. This scale can contribute to establish more precise phenomenal boundaries between schizophrenia and bipolar disorder, and opens up the possibility of identifying a different type of SD in schizophrenia, independent of autistic traits and negative symptoms, which might benefit from different treatments.

Download Full-text

Genome-wide analysis of adolescent psychotic experiences shows genetic overlap with psychiatric disorders

10.1101/265512 ◽

2018 ◽

Author(s):

Oliver Pain ◽

Frank Dudbridge ◽

Alastair G. Cardno ◽

Daniel Freeman ◽

Yi Lu ◽

...

Keyword(s):

Bipolar Disorder ◽

Major Depression ◽

Psychiatric Disorders ◽

Negative Symptoms ◽

Genome Wide Association Study ◽

Genetic Influences ◽

Psychotic Experiences ◽

Psychotic Experience ◽

Genome Wide ◽

Genetic Overlap

AbstractThis study aimed to test for overlap in genetic influences between psychotic experience traits shown by adolescents in the community, and clinically-recognized psychiatric disorders in adulthood, specifically schizophrenia, bipolar disorder, and major depression. The full spectra of psychotic experience domains, both in terms of their severity and type (positive, cognitive, and negative), were assessed using self- and parent-ratings in three European community samples aged 15-19 years (Final N incl. siblings = 6,297-10,098). A mega-genome-wide association study (mega-GWAS) for each psychotic experience domain was performed. SNP-heritability of each psychotic experience domain was estimated using genomic-relatedness-based restricted maximum-likelihood (GREML) and linkage disequilibrium-(LD-) score regression. Genetic overlap between specific psychotic experience domains and schizophrenia, bipolar disorder, and major depression was assessed using polygenic risk scoring (PRS) and LD-score regression. GREML returned SNP-heritability estimates of 3-9% for psychotic experience trait domains, with higher estimates for less skewed traits (Anhedonia, Cognitive Disorganization) than for more skewed traits (Paranoia and Hallucinations, Parent-rated Negative Symptoms). Mega-GWAS analysis identified one genome-wide significant association for Anhedonia within IDO2 but which did not replicate in an independent sample. PRS analysis revealed that the schizophrenia PRS significantly predicted all adolescent psychotic experience trait domains (Paranoia and Hallucinations only in non-zero scorers). The major depression PRS significantly predicted Anhedonia and Parent-rated Negative Symptoms in adolescence. Psychotic experiences during adolescence in the community show additive genetic effects and partly share genetic influences with clinically-recognized psychiatric disorders, specifically schizophrenia and major depression.

Download Full-text

Genome-wide analysis of 944,133 individuals provides insights into the etiology of hemorrhoidal disease

10.1101/2020.12.03.20242776 ◽

2020 ◽

Author(s):

Tenghao Zheng ◽

David Ellinghaus ◽

Simonas Juzenas ◽

François Cossais ◽

Greta Burmeister ◽

...

Keyword(s):

Age Of Onset ◽

Meta Analysis ◽

Large Fraction ◽

Smooth Muscles ◽

Hemorrhoidal Disease ◽

European Ancestry ◽

Risk Scores ◽

Genome Wide ◽

Affected Tissue ◽

Endothelial Development

AbstractHemorrhoidal disease (HEM) affects a large fraction of the population but its etiology including suspected genetic predisposition is poorly understood. We conducted a GWAS meta-analysis of 218,920 HEM patients and 725,213 controls of European ancestry, demonstrating modest heritability and genetic correlation with several other diseases from the gastrointestinal, neuroaffective and cardiovascular domains. HEM polygenic risk scores validated in 180,435 individuals from independent datasets allowed the identification of those at risk and correlated with younger age of onset and recurrent surgery. We identified 102 independent HEM risk loci harboring genes whose expression is enriched in blood vessels and gastrointestinal tissues, and in pathways associated with smooth muscles, epithelial and endothelial development and morphogenesis. Network transcriptomic analyses of affected tissue from HEM patients highlighted HEM gene co-expression modules that are relevant to the development and integrity of the musculoskeletal and epidermal systems, and the organization of the extracellular matrix. We conclude HEM has a genetic component that predisposes to smooth muscle, epithelial and connective tissue dysfunction.

Download Full-text

Genome-wide analysis of 944 133 individuals provides insights into the etiology of haemorrhoidal disease

Gut ◽

10.1136/gutjnl-2020-323868 ◽

2021 ◽

pp. gutjnl-2020-323868

Author(s):

Tenghao Zheng ◽

David Ellinghaus ◽

Simonas Juzenas ◽

François Cossais ◽

Greta Burmeister ◽

...

Keyword(s):

Genetic Correlation ◽

Genome Wide Association Study ◽

Age Of Onset ◽

Meta Analysis ◽

Smooth Muscles ◽

European Ancestry ◽

Risk Scores ◽

Haemorrhoidal Disease ◽

Genome Wide ◽

Endothelial Development

ObjectiveHaemorrhoidal disease (HEM) affects a large and silently suffering fraction of the population but its aetiology, including suspected genetic predisposition, is poorly understood. We report the first genome-wide association study (GWAS) meta-analysis to identify genetic risk factors for HEM to date.DesignWe conducted a GWAS meta-analysis of 218 920 patients with HEM and 725 213 controls of European ancestry. Using GWAS summary statistics, we performed multiple genetic correlation analyses between HEM and other traits as well as calculated HEM polygenic risk scores (PRS) and evaluated their translational potential in independent datasets. Using functional annotation of GWAS results, we identified HEM candidate genes, which differential expression and coexpression in HEM tissues were evaluated employing RNA-seq analyses. The localisation of expressed proteins at selected loci was investigated by immunohistochemistry.ResultsWe demonstrate modest heritability and genetic correlation of HEM with several other diseases from the GI, neuroaffective and cardiovascular domains. HEM PRS validated in 180 435 individuals from independent datasets allowed the identification of those at risk and correlated with younger age of onset and recurrent surgery. We identified 102 independent HEM risk loci harbouring genes whose expression is enriched in blood vessels and GI tissues, and in pathways associated with smooth muscles, epithelial and endothelial development and morphogenesis. Network transcriptomic analyses highlighted HEM gene coexpression modules that are relevant to the development and integrity of the musculoskeletal and epidermal systems, and the organisation of the extracellular matrix.ConclusionHEM has a genetic component that predisposes to smooth muscle, epithelial and connective tissue dysfunction.

Download Full-text

Associations between polygenic liability for schizophrenia and level of psychosis and mood-incongruence in bipolar disorder

10.1101/160119 ◽

2017 ◽

Author(s):

Judith Allardyce ◽

Ganna Leonenko ◽

Marian Hamshere ◽

Antonio F. Pardiñas ◽

Liz Forty ◽

...

Keyword(s):

Bipolar Disorder ◽

Logistic Regression ◽

Multinomial Logistic Regression ◽

Bipolar Affective Disorder ◽

Research Network ◽

Risk Scores ◽

Psychotic Symptoms ◽

P Value ◽

Polygenic Risk ◽

Psychotic Features

AbstractImportanceBipolar disorder (BD) overlaps schizophrenia in its clinical presentation and genetic liability. Alternative approaches to patient stratification beyond current diagnostic categories are needed to understand the underlying disease processes/mechanisms.ObjectivesTo investigate the relationship between common-variant liability for schizophrenia, indexed by polygenic risk scores (PRS) and psychotic presentations of BD, using clinical descriptions which consider both occurrence and level of mood-incongruent psychotic features.DesignCase-control design: using multinomial logistic regression, to estimate differential associations of PRS across categories of cases and controls.Settings & Participants4399 BDcases, mean [sd] age-at-interview 46[12] years, of which 2966 were woman (67%) from the BD Research Network (BDRN) were included in the final analyses, with data for 4976 schizophrenia cases and 9012 controls from the Type-1 diabetes genetics consortium and Generation Scotland included for comparison.ExposureStandardised PRS, calculated using alleles with an association p-value threshold < 0.05 in the second Psychiatric Genomics Consortium genome-wide association study of schizophrenia, adjusted for the first 10 population principal components and genotyping-platform.Main outcome measureMultinomial logit models estimated PRS associations with BD stratified by (1) Research Diagnostic Criteria (RDC) BD subtypes (2) Lifetime occurrence of psychosis.(3) Lifetime mood-incongruent psychotic features and (4) ordinal logistic regression examined PRS associations across levels of mood-incongruence. Ratings were derived from the Schedule for Clinical Assessment in Neuropsychiatry interview (SCAN) and the Bipolar Affective Disorder Dimension Scale (BADDS).ResultsAcross clinical phenotypes, there was an exposure-response gradient with the strongest PRS association for schizophrenia (RR=1.94, (95% C.1.1.86, 2.01)), then schizoaffective BD (RR=1.37, (95% C.I. 1.22, 1.54)), BD I (RR= 1.30, (95% C.I. 1.24, 1.36)) and BD II (RR=1.04, (95% C.1. 0.97, 1.11)). Within BD cases, there was an effect gradient, indexed by the nature of psychosis, with prominent mood-incongruent psychotic features having the strongest association (RR=1.46, (95% C.1.1.36, 1.57)), followed by mood-congruent psychosis (RR= 1.24, (95% C.1. 1.17, 1.33)) and lastly, BD cases with no history of psychosis (RR= 1.09, (95% C.1. 1.04, 1.15)).ConclusionWe show for the first time a polygenic-risk gradient, across schizophrenia and bipolar disorder, indexed by the occurrence and level of mood-incongruent psychotic symptoms.

Download Full-text

A Comparative Study of Affective Bipolar Disorder with Schizoaffective Disorder from a Longitudinal Perspective

Acta Medica Marisiensis ◽

10.2478/amma-2013-0051 ◽

2013 ◽

Vol 59 (4) ◽

pp. 219-222

Author(s):

Milin Miruna ◽

Lăzărescu M ◽

Racolţa Anca ◽

Silvoșeanu C ◽

Bredicean Cristina

Keyword(s):

Bipolar Disorder ◽

Schizoaffective Disorder ◽

Age Of Onset ◽

Long Term Evolution ◽

Psychotic Symptoms ◽

First Episode ◽

Term Evolution ◽

Bipolar Patients ◽

Psychotic Features

Abstract Introduction: In the last years there is a great interest for the theory of the “psychotic continuum”, which accepts that there is a transition between schizophrenia and affective pathology, including bipolar disorder with psychotic interferences and the recently introduced diagnosis of schizoaffective disorder. There are few studies that analyze bipolar disorder with mood-incongruent psychosis. The purpose of this study was to observe the way in which the interference of mood-incongruent psychotic symptoms can influence the long term evolution of patients diagnosed with bipolar disorder and the similarities that exists between this type of pathology and schizoaffective disorder. Material and methods: Sixty subjects were selected, who are now diagnosed with schizoaffective disorder and bipolar disorder, with and without psychotic features. All cases have at least 15 years of evolution since the first episode of psychosis and were analyzed in term of their age of onset and longitudinal evolution. Results: The results showed that bipolar patients who had mood incongruent psychotic symptoms had an earlier age of onset and a higher rate of hospitalizations in their long term evolution compared to bipolar patients without psychotic features, which brings them closer to patients with schizoaffective disorder in term of their pattern of evolution. Conclusions: This study has demonstrated that the interference of mood-incongruent psychosis with bipolar disorder determines a worse prognosis of this disease, very similar with the evolution of patients with schizoaffective disorder

Download Full-text

0026 Strong Gene-Environment Interactions of Trank1 Gene Polymorphisms with Birth Difficulties in Kleine Levin Syndrome

SLEEP ◽

10.1093/sleep/zsaa056.025 ◽

2020 ◽

Vol 43 (Supplement_1) ◽

pp. A10-A11 ◽

Cited By ~ 1

Author(s):

A Ambati ◽

R Hillary ◽

S L Semenescu ◽

L Lin ◽

H Ollila ◽

...

Keyword(s):

Bipolar Disorder ◽

Perinatal Outcomes ◽

Risk Scores ◽

Nucleotide Polymorphisms ◽

Behavioral Disturbances ◽

Gene Environment ◽

Genome Wide ◽

Relapsing Remitting ◽

Independent Replication ◽

Sexual Disinhibition

Abstract Introduction Kleine-Levin Syndrome (KLS) is a rare disorder affecting adolescents and characterized by relapsing-remitting episodes of severe hypersomnia, cognitive impairment, and behavioral disturbances such as hyperphagia and sexual disinhibition. Pathophysiology is unknown, although imaging studies indicate decreased activity in hypothalamic/thalamic areas and in cortical areas during episodes. Familial occurrence is increased, and risk is associated with reports of complicated birth. Methods A worldwide Genome wide association (GWA) study was conducted in 673 KLS patients and ethnically matched 15,341 control individuals. Results We found a strong genome-wide significant association (OR=1.48 at rs150168018, p=8.6x10-9) with 24 single nucleotide polymorphisms (SNPs) encompassing a 35kb region located in the 5’ region of TRANK1 gene previously associated with bipolar disorder and schizophrenia. Strikingly, KLS cases with TRANK1 had statistically increased reports of difficult birth. As perinatal outcomes have dramatically improved over the last 40 years, we further stratified our sample by birth years, and found that recent cases had a significantly reduced TRANK1 association. These findings were confirmed in an independent replication cohort of 171 new patients where polygenic risk scores constructed on the discovery cohort replicated (r2=0.15; p<2.7x10-22 at p=0.1 threshold) and the TRANK1 association was found to be dependent on reports of birth difficulties (OR=1.54, p=0.01 versus OR=1.12, p=0.4). Pathway analysis of the overall GWAS association revealed significant association (p=0.02) with 19 genes in a pathway modulating rhythmic behaviors. Conclusion Our results demonstrate links between hypersomnia, behavioral rhythmicity and bipolar disorder and indicate that a polymorphism in the TRANK1 region affect brain development in the presence of a perinatal injury, with pathophysiological consequences such as KLS, bipolar disorder and schizophrenia. Support NIH NIMH 1R01MH080957 to EM PHRC 070138 to IA

Download Full-text