European Psychiatry (Jan 2021)
Examining the association between exposome score for schizophrenia and functioning in schizophrenia, siblings, and healthy controls: Results from the EUGEI study
- Gamze Erzin,
- Lotta-Katrin Pries,
- Jim van Os,
- Laura Fusar-Poli,
- Philippe Delespaul,
- Gunter Kenis,
- Jurjen J. Luykx,
- Bochao D. Lin,
- Alexander L. Richards,
- Berna Akdede,
- Tolga Binbay,
- Vesile Altınyazar,
- Berna Yalınçetin,
- Güvem Gümüş-Akay,
- Burçin Cihan,
- Haldun Soygür,
- Halis Ulaş,
- Eylem Şahin Cankurtaran,
- Semra Ulusoy Kaymak,
- Marina M. Mihaljevic,
- Sanja Andric-Petrovic,
- Tijana Mirjanic,
- Miguel Bernardo,
- Gisela Mezquida,
- Silvia Amoretti,
- Julio Bobes,
- Pilar A. Saiz,
- Maria Paz García-Portilla,
- Julio Sanjuan,
- Eduardo J. Aguilar,
- Jose Luis Santos,
- Estela Jiménez-López,
- Manuel Arrojo,
- Angel Carracedo,
- Gonzalo López,
- Javier González-Peñas,
- Mara Parellada,
- Nadja P. Maric,
- Cem Atbaşoğlu,
- Alp Ucok,
- Köksal Alptekin,
- Meram Can Saka,
- Celso Arango,
- Micheal C. O’Donovan,
- Bart P. F. Rutten,
- Sinan Guloksuz
Affiliations
- Gamze Erzin
- 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
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
- Jim van Os
- ORCiD
- 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
- ORCiD
- Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, Catania, Italy
- Philippe Delespaul
- 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
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
- Jurjen J. Luykx
- ORCiD
- 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
- Department of Translational Neuroscience, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands
- Alexander L. Richards
- Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Cardiff, United Kingdom
- Berna Akdede
- Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
- Tolga Binbay
- Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
- Vesile Altınyazar
- Department of Psychiatry, Faculty of Medicine, Adnan Menderes University, Aydin, Turkey
- Berna Yalınçetin
- Department of Neuroscience, Graduate School of Health Sciences, Dokuz Eylul University, Izmir, Turkey
- Güvem Gümüş-Akay
- ORCiD
- 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
- Department of Psychology, Middle East Technical University, Ankara, Turkey
- Haldun Soygür
- Turkish Federation of Schizophrenia Associations, Ankara, Turkey
- Halis Ulaş
- Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey
- Eylem Şahin Cankurtaran
- Güven Çayyolu Healthcare Campus, Ankara, Turkey
- Semra Ulusoy Kaymak
- Atatürk Research and Training Hospital Psychiatry Clinic, Ankara, Turkey
- Marina M. Mihaljevic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia Clinic for Psychiatry Clinical Centre of Serbia, Belgrade, Serbia
- Sanja Andric-Petrovic
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia Clinic for Psychiatry Clinical Centre of Serbia, Belgrade, Serbia
- Tijana Mirjanic
- Special Hospital for Psychiatric Disorders Kovin, Kovin, Serbia
- Miguel Bernardo
- ORCiD
- 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
- ORCiD
- 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
- 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
- ORCiD
- 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
- 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
- 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
- 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
- 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
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Barcelona, Spain Department of Psychiatry, Hospital Virgen de la Luz, Cuenca, Spain
- Estela Jiménez-López
- Biomedical Research Networking Centre in Mental Health (CIBERSAM), Barcelona, Spain Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Manuel Arrojo
- Department of Psychiatry, Instituto de Investigación Sanitaria, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain
- Angel Carracedo
- 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
- 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
- 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
- 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
- Faculty of Medicine, University of Belgrade, Belgrade, Serbia Institute of Mental Health, Belgrade, Serbia
- Cem Atbaşoğlu
- Department of Psychiatry, School of Medicine, Ankara University, Ankara, Turkey
- Alp Ucok
- Department of Psychiatry, Faculty of Medicine, Istanbul University, Istanbul, Turkey
- Köksal Alptekin
- 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
- Department of Psychiatry, School of Medicine, Ankara University, Ankara, Turkey
- Celso Arango
- 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
- 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
- Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands
- Sinan Guloksuz
- ORCiD
- 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
- DOI
- https://doi.org/10.1192/j.eurpsy.2021.19
- Journal volume & issue
-
Vol. 64
Abstract
AbstractBackgroundA 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.MethodsThis 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.ResultsES-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.ConclusionsOur 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.
Keywords