Childhood maltreatment and polygenic risk in bipolar disorders
Childhood maltreatment and polygenic risk in bipolar disorders
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DOI：
10.1111/bdi.12851
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发表时间：
2019-11-13
影响因子：
5.4
通讯作者：
Etain, Bruno
中科院分区：
文献类型：
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作者：
Aas, Monica;Bellivier, Frank;Etain, Bruno
众所周知，儿童虐待是发展为更严重和更复杂形式的双相情感障碍（BD）的危险因素。然而，关于儿童虐待和潜在遗传易感性之间的相互作用对双相障碍临床表达的了解很少。方法我们分配了一个由精神病学基因组学联盟计算的BD-多基因风险评分（BD- prs）。以402例双相障碍患者为样本，通过结构化访谈和患者完成童年创伤问卷（CTQ）来评估童年虐待的严重程度，来描述双相障碍的终生临床表现。结果儿童时期受虐待程度较重的患者BD-PRS较低（rho = -0.12, P = 0.01），特别是考虑到精神虐待的患者（rho = -0.16, P = .001）。在快速循环的风险方面，观察到BD-PRS与儿童虐待之间的相互作用（P = 0.01）。在其他临床特征（发病年龄、自杀企图、情绪发作次数、混合特征、物质使用障碍和精神病症状）方面，未观察到BD-PRS与儿童虐待之间的进一步相互作用。结论：我们的研究首次表明，当儿童遭受虐待时，可能需要较少的遗传风险来发展成更不稳定的双相障碍。我们的研究支持童年创伤是双相障碍的独立危险因素。
Background Childhood maltreatment is a well-known risk factor for developing a more severe and complex form of bipolar disorders (BD). However, knowledge is scarce about the interactions between childhood maltreatment and underlying genetic vulnerability on the clinical expression of BD. Method We assigned a BD-polygenic risk score (BD-PRS), calculated from the Psychiatric Genomics Consortium, to each individual in a sample of 402 cases with BD. The lifetime clinical expression of BD was characterized using structured interviews and patients completed the Childhood Trauma Questionnaire (CTQ) to assess the severity of childhood maltreatment. Results Cases who reported more severe childhood maltreatment had a lower BD-PRS (rho = -0.12, P = .01), especially when considering emotional abuse (rho = -0.16, P = .001). An interaction between BD-PRS and childhood maltreatment was observed for the risk of rapid cycling (P = .01). No further interactions between BD-PRS and childhood maltreatment were observed for other clinical characteristics (age at onset, suicide attempts, number of mood episodes, mixed features, substance use disorders and psychotic symptoms). Conclusion Our study is the first to show that less genetic risk may be needed to develop a more unstable form of BD when exposed to childhood maltreatment. Our study supports childhood trauma as an independent risk factor for BD.