Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK.
Institute of Health Informatics, University College London, UK.
J Affect Disord. 2023 Nov 15;341:137-146. doi: 10.1016/j.jad.2023.08.116. Epub 2023 Aug 27.
It remains unclear how adverse childhood experiences (ACE) and increased genetic risk for bipolar disorder (BD) interact to influence BD symptom outcomes. Here we calculated multiple psychiatric polygenic risk scores (PRS) and used the measures of ACE to understand these gene-environment interactions.
885 BD subjects were included for analyses. BD, ADHD, MDD and SCZ PRSs were calculated using the PRS-CS-auto method. ACEs were evaluated using the Children Life Event Questionnaire (CLEQ). Participants were divided into groups based on the presence of ACE and the total number of ACEs. The associations between total ACE number, PRSs and their interactions were evaluated using multiple linear and logistic regressions. Secondary analyses were performed to evaluate the influence of ACE and PRS on sub-phenotypes of BD.
The number of ACEs increased with the ADHD PRS. BD participants who had ACEs showed an earlier age of BD onset and higher odds of having rapid cycling. Increased BD PRS was associated with increased odds of developing psychotic symptoms. Higher ADHD PRS was associated with increased odds of having rapid cycling. No prediction effect was observed from MDD and SCZ PRS. And, we found no significant interaction between ACE numbers and any of the PRSs in predicting any selected BD sub-phenotypes.
The study was limited by sample size, ACE definition, and cross-sectional data collection method.
The findings consolidate the importance of considering multiple psychiatric PRSs in predicting symptom outcomes among BD patients.
目前尚不清楚不良童年经历 (ACE) 和双相情感障碍 (BD) 遗传风险增加如何相互作用影响 BD 症状结果。在这里,我们计算了多个精神疾病多基因风险评分 (PRS),并使用 ACE 来理解这些基因-环境相互作用。
纳入 885 名 BD 患者进行分析。使用 PRS-CS-auto 方法计算 BD、ADHD、MDD 和 SCZ PRS。使用儿童生活事件问卷 (CLEQ) 评估 ACE。根据 ACE 的存在和 ACE 的总数将参与者分为不同的组。使用多元线性和逻辑回归评估 ACE 总数、PRS 及其相互作用之间的关联。进行了二次分析以评估 ACE 和 PRS 对 BD 亚表型的影响。
ACE 数量随着 ADHD PRS 的增加而增加。有 ACE 的 BD 患者表现出 BD 发病年龄较早和快速循环的几率较高。BD PRS 增加与出现精神病症状的几率增加有关。较高的 ADHD PRS 与快速循环的几率增加有关。MDD 和 SCZ PRS 没有预测作用。而且,我们没有发现 ACE 数量与任何 PRS 在预测任何选定的 BD 亚表型之间的交互作用有显著差异。
该研究受到样本量、ACE 定义和横断面数据收集方法的限制。
这些发现强调了在预测 BD 患者症状结果时考虑多个精神 PRS 的重要性。