Mental health and chronic disease: A psycheMERGE investigation into the shared biology underlying psychiatric disorders and their physical comorbidities

神经精神障碍与发病率和死亡率的显著增加有关。 慢性复杂疾病包括心血管疾病(CVD)是导致 精神障碍患者的过早死亡。虽然有证据表明 可更改的风险因素(如吸烟、体重、用药等)增加风险，他们不会 充分考虑到这一人群中的过高发病率和死亡率。日益增长的可用性 将电子健康记录(EHR)与生物样本联系起来的大规模生物库创造了一个 精神病学研究的强大机会，但仍相对未开发，旨在解决 这种过高的发病率和死亡率。2007年，国家人类基因组研究所 (NHGRI)组织了电子病历和基因组学(Emerge)网络， 将美国各地的研究人员聚集在一起，以促进基于EHR的基因组研究和 实施基因组医学。我们已经创建了一个新的、大规模的协作 一个联盟-利用 Emerge Network、精神病学基因组学联盟(PGC)以及当地的EHR和生物库 资源。此应用程序跨多个医疗保健系统使用电子病历和基因组数据 (合作伙伴包括医疗保健、范德比尔特大学医疗中心和盖辛格医疗系统) 他们是心理医生网络中的合作伙伴。我们的初步数据也 表明严重抑郁障碍(MDD)的多基因风险与 重要的心血管疾病预后生物标志物在EHR中广泛可用。以此为基础 初步数据，我们的第一个目标是发现导致MDD风险的多效性基因，CVD 风险和已知的心血管疾病生物标志物，我们假设也将指向重要的途径 参与MDD的生物学研究。在目标2中，我们采用人口流行病学方法来 研究生物心理社会变量对遗传和表型的调节作用 将MDD和CVD联系起来的危险因素。最后，在目标3中，我们描述了表型和基因组 三种常见的严重精神疾病与其他疾病之间的关系 医学现象，包括500项临床实验室测试，涉及30多万名有数据的个人 在电子病历中。公共卫生迫切需要改善精神病患者的护理和治疗 疾病及其共病。拟议的研究包括一套全面的 旨在调查遗传、临床和心理社会风险因素的综合分析 导致精神障碍的发展及其对生命的威胁 在国家环境卫生记录和相关生物库网络背景下的共生问题。 好了！

Neuropsychiatric disorders are associated with significantly increased morbidity and mortality. Chronic complex diseases including cardiovascular disease (CVD) are the primary drivers of premature death among individuals with psychiatric disorders. While there is evidence that modifiable risk factors (i.e., smoking, weight, medication use, etc.) increase risk, they do not fully account for the excess morbidity and mortality in this population. The growing availability of large-scale biobanks linking electronic health records (EHRs) to biospecimens has created a powerful, but still relatively untapped, opportunity for psychiatric research aimed at addressing this excess morbidity and mortality. In 2007, the National Human Genome Research Institute (NHGRI) organized the Electronic Medical Records and Genomics (eMERGE) network which brought together investigators around the U.S. to facilitate EHR-based genomic research and the implementation of genomic medicine. We have created a new, large-scale collaborative consortium—PsycheMERGE—that leverages the resources and existing infrastructure of the eMERGE network, the Psychiatric Genomics Consortium (PGC), and local EHR and biobank resources. This application uses EHR and genomic data across multiple health care systems (Partners Health Care, Vanderbilt University Medical Center, and Geisinger Health Systems) that are collaborative partners in the PsycheMERGE network. Our preliminary data also demonstrates that polygenic risk for Major Depressive Disorder (MDD) is associated with important prognostic biomarkers of CVD widely available within the EHR. Building on this preliminary data, our first aim is to discover pleiotropic genes contributing to MDD risk, CVD risk, and known CVD biomarkers which we hypothesize will also point to important pathways involved in the biology of MDD. In aim 2 we employ a population epidemiological approach to investigate the moderating effects of biopsychosocial variables on the genetic and phenotypic risk factors linking MDD and CVD. Finally, in aim 3 we characterize the phenotypic and genomic relationships between each of three common severe mental illnesses, and the rest of the medical phenome including >500 clinical lab tests in over 300,000 individuals with data present in the EHR. There is an urgent public health need to improve care and treatment of psychiatric disorders and their comorbidities. The proposed research includes a comprehensive set of integrative analyses aimed at investigating the genetic, clinical, and psychosocial risk factors that contribute to the development of psychiatric disorders and their life-threatening comorbidities in the context of a national network of EHRs and associated biobanks. !