Examining the association between exposome score for schizophrenia and functioning in schizophrenia, siblings, and healthy controls: Results from the EUGEI study.


Journal

European psychiatry : the journal of the Association of European Psychiatrists
ISSN: 1778-3585
Titre abrégé: Eur Psychiatry
Pays: England
ID NLM: 9111820

Informations de publication

Date de publication:
19 03 2021
Historique:
pubmed: 20 3 2021
medline: 20 11 2021
entrez: 19 3 2021
Statut: epublish

Résumé

A cumulative environmental exposure score for schizophrenia (exposome score for schizophrenia [ES-SCZ]) may provide potential utility for risk stratification and outcome prediction. Here, we investigated whether ES-SCZ was associated with functioning in patients with schizophrenia spectrum disorder, unaffected siblings, and healthy controls. This cross-sectional sample consisted of 1,261 patients, 1,282 unaffected siblings, and 1,525 healthy controls. The Global Assessment of Functioning (GAF) scale was used to assess functioning. ES-SCZ was calculated based on our previously validated method. The association between ES-SCZ and the GAF dimensions (symptom and disability) was analyzed by applying regression models in each group (patients, siblings, and controls). Additional models included polygenic risk score for schizophrenia (PRS-SCZ) as a covariate. ES-SCZ was associated with the GAF dimensions in patients (symptom: B = -1.53, p-value = 0.001; disability: B = -1.44, p-value = 0.001), siblings (symptom: B = -3.07, p-value < 0.001; disability: B = -2.52, p-value < 0.001), and healthy controls (symptom: B = -1.50, p-value < 0.001; disability: B = -1.31, p-value < 0.001). The results remained the same after adjusting for PRS-SCZ. The degree of associations of ES-SCZ with both symptom and disability dimensions were higher in unaffected siblings than in patients and controls. By analyzing an independent dataset (the Genetic Risk and Outcome of Psychosis study), we replicated the results observed in the patient group. Our findings suggest that ES-SCZ shows promise for enhancing risk prediction and stratification in research practice. From a clinical perspective, ES-SCZ may aid in efforts of clinical characterization, operationalizing transdiagnostic clinical staging models, and personalizing clinical management.

Sections du résumé

BACKGROUND
A cumulative environmental exposure score for schizophrenia (exposome score for schizophrenia [ES-SCZ]) may provide potential utility for risk stratification and outcome prediction. Here, we investigated whether ES-SCZ was associated with functioning in patients with schizophrenia spectrum disorder, unaffected siblings, and healthy controls.
METHODS
This cross-sectional sample consisted of 1,261 patients, 1,282 unaffected siblings, and 1,525 healthy controls. The Global Assessment of Functioning (GAF) scale was used to assess functioning. ES-SCZ was calculated based on our previously validated method. The association between ES-SCZ and the GAF dimensions (symptom and disability) was analyzed by applying regression models in each group (patients, siblings, and controls). Additional models included polygenic risk score for schizophrenia (PRS-SCZ) as a covariate.
RESULTS
ES-SCZ was associated with the GAF dimensions in patients (symptom: B = -1.53, p-value = 0.001; disability: B = -1.44, p-value = 0.001), siblings (symptom: B = -3.07, p-value < 0.001; disability: B = -2.52, p-value < 0.001), and healthy controls (symptom: B = -1.50, p-value < 0.001; disability: B = -1.31, p-value < 0.001). The results remained the same after adjusting for PRS-SCZ. The degree of associations of ES-SCZ with both symptom and disability dimensions were higher in unaffected siblings than in patients and controls. By analyzing an independent dataset (the Genetic Risk and Outcome of Psychosis study), we replicated the results observed in the patient group.
CONCLUSIONS
Our findings suggest that ES-SCZ shows promise for enhancing risk prediction and stratification in research practice. From a clinical perspective, ES-SCZ may aid in efforts of clinical characterization, operationalizing transdiagnostic clinical staging models, and personalizing clinical management.

Identifiants

pubmed: 33736735
doi: 10.1192/j.eurpsy.2021.19
pii: S0924933821000195
pmc: PMC8080213
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e25

Subventions

Organisme : Medical Research Council
ID : G08005009
Pays : United Kingdom
Organisme : Medical Research Council
ID : MR/L010305/1
Pays : United Kingdom

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Auteurs

Gamze Erzin (G)

Department of Psychiatry, University of Health Sciences Ankara Diskapi Training and Research Hospital, Ankara, Turkey.
Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands.

Lotta-Katrin Pries (LK)

Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands.

Jim van Os (J)

Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands.
Department of Psychiatry, UUMC Utrecht Brain Centre, University Medical Centre Utrecht, trecht University, Utrecht, The Netherlands.
Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom.

Laura Fusar-Poli (L)

Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, Catania, Italy.

Philippe Delespaul (P)

Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands.
FACT, Mondriaan Mental Health, Maastricht, The Netherlands.

Gunter Kenis (G)

Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands.

Jurjen J Luykx (JJ)

Department of Psychiatry, UUMC Utrecht Brain Centre, University Medical Centre Utrecht, trecht University, Utrecht, The Netherlands.
Department of Translational Neuroscience, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.
GGNet Mental Health, Apeldoorn, The Netherlands.

Bochao D Lin (BD)

Department of Translational Neuroscience, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands.

Alexander L Richards (AL)

Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Cardiff, United Kingdom.

Berna Akdede (B)

Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.

Tolga Binbay (T)

Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.

Vesile Altınyazar (V)

Department of Psychiatry, Faculty of Medicine, Adnan Menderes University, Aydin, Turkey.

Berna Yalınçetin (B)

Department of Neuroscience, Graduate School of Health Sciences, Dokuz Eylul University, Izmir, Turkey.

Güvem Gümüş-Akay (G)

Department of Physiology, School of Medicine, Ankara University, Ankara, Turkey.
Brain Research Center, Ankara University, Ankara, Turkey.
Neuroscience and Neurotechnology Center of Excellence (NÖROM), Ankara, Turkey.

Burçin Cihan (B)

Department of Psychology, Middle East Technical University, Ankara, Turkey.

Haldun Soygür (H)

Turkish Federation of Schizophrenia Associations, Ankara, Turkey.

Halis Ulaş (H)

Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.

Eylem Şahin Cankurtaran (EŞ)

Güven Çayyolu Healthcare Campus, Ankara, Turkey.

Semra Ulusoy Kaymak (SU)

Atatürk Research and Training Hospital Psychiatry Clinic, Ankara, Turkey.

Marina M Mihaljevic (MM)

Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
Clinic for Psychiatry Clinical Centre of Serbia, Belgrade, Serbia.

Sanja Andric-Petrovic (S)

Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
Clinic for Psychiatry Clinical Centre of Serbia, Belgrade, Serbia.

Tijana Mirjanic (T)

Special Hospital for Psychiatric Disorders Kovin, Kovin, Serbia.

Miguel Bernardo (M)

Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain.
Institut d'Investigacions Biomèdiques August Pi I Sunyer, Barcelona, Spain.
Biomedical Research Networking Centre in Mental Health (CIBERSAM), Barcelona, Spain.

Gisela Mezquida (G)

Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain.
Institut d'Investigacions Biomèdiques August Pi I Sunyer, Barcelona, Spain.
Biomedical Research Networking Centre in Mental Health (CIBERSAM), Barcelona, Spain.

Silvia Amoretti (S)

Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain.
Institut d'Investigacions Biomèdiques August Pi I Sunyer, Barcelona, Spain.
Biomedical Research Networking Centre in Mental Health (CIBERSAM), Barcelona, Spain.

Julio Bobes (J)

Biomedical Research Networking Centre in Mental Health (CIBERSAM), Barcelona, Spain.
Department of Psychiatry, School of Medicine, University of Oviedo, Oviedo, Spain.
Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain.
Mental Health Services of Principado de Asturias, Oviedo, Spain.

Pilar A Saiz (PA)

Biomedical Research Networking Centre in Mental Health (CIBERSAM), Barcelona, Spain.
Department of Psychiatry, School of Medicine, University of Oviedo, Oviedo, Spain.
Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain.
Mental Health Services of Principado de Asturias, Oviedo, Spain.

Maria Paz García-Portilla (MP)

Biomedical Research Networking Centre in Mental Health (CIBERSAM), Barcelona, Spain.
Department of Psychiatry, School of Medicine, University of Oviedo, Oviedo, Spain.
Instituto de Investigación Sanitaria del Principado de Asturias, Oviedo, Spain.
Mental Health Services of Principado de Asturias, Oviedo, Spain.

Julio Sanjuan (J)

Biomedical Research Networking Centre in Mental Health (CIBERSAM), Barcelona, Spain.
Department of Psychiatry, Hospital Clínico Universitario de Valencia, INCLIVA, School of Medicine, Universidad de Valencia, Valencia, Spain.

Eduardo J Aguilar (EJ)

Biomedical Research Networking Centre in Mental Health (CIBERSAM), Barcelona, Spain.
Department of Psychiatry, Hospital Clínico Universitario de Valencia, INCLIVA, School of Medicine, Universidad de Valencia, Valencia, Spain.

Jose Luis Santos (JL)

Biomedical Research Networking Centre in Mental Health (CIBERSAM), Barcelona, Spain.
Department of Psychiatry, Hospital Virgen de la Luz, Cuenca, Spain.

Estela Jiménez-López (E)

Biomedical Research Networking Centre in Mental Health (CIBERSAM), Barcelona, Spain.
Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain.

Manuel Arrojo (M)

Department of Psychiatry, Instituto de Investigación Sanitaria, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain.

Angel Carracedo (A)

Grupo de Medicina Genómica, Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Universidad de Santiago de Compostela, Santiago de Compostela, Spain.
Fundación Pública Galega de Medicina Xenómica (SERGAS), Instituto de Investigación Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, Spain.

Gonzalo López (G)

Biomedical Research Networking Centre in Mental Health (CIBERSAM), Barcelona, Spain.
Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón (IiSGM), School of Medicine, Universidad Complutense, Madrid, Spain.

Javier González-Peñas (J)

Biomedical Research Networking Centre in Mental Health (CIBERSAM), Barcelona, Spain.
Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón (IiSGM), School of Medicine, Universidad Complutense, Madrid, Spain.

Mara Parellada (M)

Biomedical Research Networking Centre in Mental Health (CIBERSAM), Barcelona, Spain.
Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón (IiSGM), School of Medicine, Universidad Complutense, Madrid, Spain.

Nadja P Maric (NP)

Faculty of Medicine, University of Belgrade, Belgrade, Serbia.
Institute of Mental Health, Belgrade, Serbia.

Cem Atbaşoğlu (C)

Department of Psychiatry, School of Medicine, Ankara University, Ankara, Turkey.

Alp Ucok (A)

Department of Psychiatry, Faculty of Medicine, Istanbul University, Istanbul, Turkey.

Köksal Alptekin (K)

Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey.
Department of Neuroscience, Graduate School of Health Sciences, Dokuz Eylul University, Izmir, Turkey.

Meram Can Saka (MC)

Department of Psychiatry, School of Medicine, Ankara University, Ankara, Turkey.

Celso Arango (C)

Biomedical Research Networking Centre in Mental Health (CIBERSAM), Barcelona, Spain.
Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón (IiSGM), School of Medicine, Universidad Complutense, Madrid, Spain.

Micheal C O'Donovan (MC)

Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Cardiff, United Kingdom.

Bart P F Rutten (BPF)

Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands.

Sinan Guloksuz (S)

Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands.
Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA.

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