Evidence, and replication thereof, that molecular-genetic and environmental risks for psychosis impact through an affective pathway

J. van Os*, L.K. Pries, M. ten Have, R. de Graaf, S. van Dorsselaer, P. Delespaul, M. Bak, G. Kenis, B.D. Lin, J.J. Luykx, A.L. Richards, B. Akdede, T. Binbay, V. Altinyazar, B. Yalincetin, G. Gumus-Akay, B. Cihan, H. Soygur, H. Ulas, E.S. CankurtaranS.U. Kaymak, M.M. Mihaljevic, S.A. Petrovic, T. Mirjanic, M. Bernardo, G. Mezquida, S. Amoretti, J. Bobes, P.A. Saiz, M.P. Garcia-Portilla, J. Sanjuan, E.J. Aguilar, J.L. Santos, E. Jimenez-Lopez, M. Arrojo, A. Carracedo, G. Lopez, J. Gonzalez-Penas, M. Parellada, N.P. Maric, C. Atbasoglu, A. Ucok, K. Alptekin, M.C. Saka, C. Arango, M. O'Donovan, B.P.F. Rutten, S. Guloksuz

*Corresponding author for this work

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Abstract

Background There is evidence that environmental and genetic risk factors for schizophrenia spectrum disorders are transdiagnostic and mediated in part through a generic pathway of affective dysregulation. Methods We analysed to what degree the impact of schizophrenia polygenic risk (PRS-SZ) and childhood adversity (CA) on psychosis outcomes was contingent on co-presence of affective dysregulation, defined as significant depressive symptoms, in (i) NEMESIS-2 (n = 6646), a representative general population sample, interviewed four times over nine years and (ii) EUGEI (n = 4068) a sample of patients with schizophrenia spectrum disorder, the siblings of these patients and controls. Results The impact of PRS-SZ on psychosis showed significant dependence on co-presence of affective dysregulation in NEMESIS-2 [relative excess risk due to interaction (RERI): 1.01, p = 0.037] and in EUGEI (RERI = 3.39, p = 0.048). This was particularly evident for delusional ideation (NEMESIS-2: RERI = 1.74, p = 0.003; EUGEI: RERI = 4.16, p = 0.019) and not for hallucinatory experiences (NEMESIS-2: RERI = 0.65, p = 0.284; EUGEI: -0.37, p = 0.547). A similar and stronger pattern of results was evident for CA (RERI delusions and hallucinations: NEMESIS-2: 3.02, p < 0.001; EUGEI: 6.44, p < 0.001; RERI delusional ideation: NEMESIS-2: 3.79, p < 0.001; EUGEI: 5.43, p = 0.001; RERI hallucinatory experiences: NEMESIS-2: 2.46, p < 0.001; EUGEI: 0.54, p = 0.465). Conclusions The results, and internal replication, suggest that the effects of known genetic and non-genetic risk factors for psychosis are mediated in part through an affective pathway, from which early states of delusional meaning may arise.
Original languageEnglish
Article number0033291720003748
Pages (from-to)1910-1922
Number of pages13
JournalPsychological Medicine
Volume52
Issue number10
DOIs
Publication statusPublished - 1 Jul 2022

Keywords

  • Affective pathway
  • childhood adversity
  • environment
  • genetics
  • psychosis
  • MENTAL-HEALTH SURVEY
  • SCHIZOPHRENIA SPECTRUM DISORDERS
  • 1ST EPISODE PSYCHOSIS
  • CHILDHOOD TRAUMA
  • PSYCHIATRIC-DISORDERS
  • CLINICAL PSYCHOSIS
  • GENERAL-POPULATION
  • NEGATIVE SYMPTOMS
  • NETWORK APPROACH
  • SHORT-FORM

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