Hostname: page-component-cd9895bd7-gbm5v Total loading time: 0 Render date: 2024-12-19T03:25:29.409Z Has data issue: false hasContentIssue false

Increased rare duplication burden genomewide in patients with treatment-resistant schizophrenia

Published online by Cambridge University Press:  09 September 2015

A. K. Martin*
Affiliation:
Queensland Brain Institute, University of Queensland, St Lucia, Brisbane 4072, Australia
B. Mowry
Affiliation:
Queensland Brain Institute, University of Queensland, St Lucia, Brisbane 4072, Australia Queensland Centre for Mental Health Research, University of Queensland, Wacol, Brisbane 4076, Australia
*
* Address for correspondence: A. Martin, Queensland Brain Institute, University of Queensland, St Lucia, Brisbane 4072, Australia. (Email: [email protected])

Abstract

Background

A significant number of patients with schizophrenia fail to respond to antipsychotic medication. Although several studies have investigated associated patient characteristics, the emerging findings from genetic studies offer further scope for study.

Method

In 612 schizophrenia patients with detailed clinical information, common genetic variants indexed by polygenic risk scores, and rare variants indexed by deletion and duplication burden genomewide, we explored potential genetic predictors alongside other established risk factors for treatment resistance. Clinical outcomes of treatment resistance were also calculated using lifetime measures of positive, negative/disorganized and mood symptoms as well as number of hospitalizations and suicide attempts.

Results

Logistic regression models identified a significant relationship between treatment resistance and total duplication burden genomewide, years of formal schooling and age at onset. Clinically, treatment-resistant patients were characterized by greater negative/disorganized and positive symptoms and greater number of hospitalizations.

Conclusions

Taken together, these findings suggest genetic information, specifically the genomewide burden of rare copy number variants, may increase our understanding and clinical management of patients with treatment-resistant schizophrenia.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2015 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Psychiatric Association (1994). Diagnostic and Statistical Manual of Mental Disorders, 4th edn. APA: Washington, DC.Google Scholar
Buizer-Voskamp, JE, Muntjewerff, JW, Strengman, E, Sabatti, C, Stefansson, H, Vorstman, JA, Ophoff, RA (2011). Genome-wide analysis shows increased frequency of copy number variation deletions in Dutch schizophrenia patients. Biological Psychiatry 70, 655662.Google Scholar
Cardno, AG, Gottesman, II (2000). Twin studies of schizophrenia: from bow-and-arrow concordances to Star Wars Mx and functional genomics. American Journal of Medical Genetics 97, 1217.3.0.CO;2-U>CrossRefGoogle ScholarPubMed
Chakos, M, Lieberman, J, Hoffman, E, Bradford, D, Sheitman, B (2001). Effectiveness of second-generation antipsychotics in patients with treatment-resistant schizophrenia: a review and meta-analysis of randomized trials. American Journal of Psychiatry 158, 518526.Google Scholar
Crespo-Facorro, B, de la Foz, VO, Ayesa-Arriola, R, Perez-Iglesias, R, Mata, I, Suarez-Pinilla, P, Tabares-Seisdedos, R, Vazquez-Barquero, JL (2013). Prediction of acute clinical response following a first episode of non affective psychosis: results of a cohort of 375 patients from the Spanish PAFIP study. Progress in Neuro-Psychopharmacology and Biological Psychiatry 44, 162167.Google Scholar
Dolzan, V, Serretti, A, Mandelli, L, Koprivsek, J, Kastelic, M, Plesnicar, BK (2008). Acute antipsychotic efficacy and side effects in schizophrenia: association with serotonin transporter promoter genotypes. Progress in Neuro-Psychopharmacology and Biological Psychiatry 32, 15621566.Google Scholar
Fanous, AH, Zhou, B, Aggen, SH, Bergen, SE, Amdur, RL, Duan, J, Sanders, AR, Shi, J, Mowry, BJ, Olincy, A, Amin, F, Cloninger, CR, Silverman, JM, Buccola, NG, Byerley, WF, Black, DW, Freedman, R, Dudbridge, F, Holmans, PA, Ripke, S, Gejman, PV, Kendler, KS, Levinson, DF (2012). Genome-wide association study of clinical dimensions of schizophrenia: polygenic effect on disorganized symptoms. American Journal of Psychiatry 169, 13091317.Google Scholar
Frank, J, Lang, M, Witt, SH, Strohmaier, J, Rujescu, D, Cichon, S, Degenhardt, F, Nothen, MM, Collier, DA, Ripke, S, Naber, D, Rietschel, M (2015). Identification of increased genetic risk scores for schizophrenia in treatment-resistant patients. Molecular Psychiatry 20, 150151.Google Scholar
Gupta, S, Hendricks, S, Kenkel, AM, Bhatia, SC, Haffke, EA (1996). Relapse in schizophrenia: is there a relationship to substance abuse? Schizophrenia Research 20, 153156.Google Scholar
Hassan, AN, De Luca, V (2015). The effect of lifetime adversities on resistance to antipsychotic treatment in schizophrenia patients. Schizophrenia Research 161, 496500.CrossRefGoogle ScholarPubMed
Hollis, C (2000). Adult outcomes of child- and adolescent-onset schizophrenia: diagnostic stability and predictive validity. American Journal of Psychiatry 157, 16521659.Google Scholar
Ikeda, M, Yamanouchi, Y, Kinoshita, Y, Kitajima, T, Yoshimura, R, Hashimoto, S, O'Donovan, MC, Nakamura, J, Ozaki, N, Iwata, N (2008). Variants of dopamine and serotonin candidate genes as predictors of response to risperidone treatment in first-episode schizophrenia. Pharmacogenomics 9, 14371443.Google Scholar
International Schizophrenia Consortium (2014). Biological insights from 108 schizophrenia-associated genetic loci. Nature 511, 421427.Google Scholar
Kane, J, Honigfeld, G, Singer, J, Meltzer, H (1988). Clozapine for the treatment-resistant schizophrenic. A double-blind comparison with chlorpromazine. Archives of General Psychiatry 45, 789796.Google Scholar
Korn, JM, Kuruvilla, FG, McCarroll, SA, Wysoker, A, Nemesh, J, Cawley, S, Hubbell, E, Veitch, J, Collins, PJ, Darvishi, K, Lee, C, Nizzari, MM, Gabriel, SB, Purcell, S, Daly, MJ, Altshuler, D (2008). Integrated genotype calling and association analysis of SNPs, common copy number polymorphisms and rare CNVs. Nature Genetics 40, 12531260.Google Scholar
Lai, TL, Xing, H, Zhang, N (2008). Stochastic segmentation models for array-based comparative genomic hybridization data analysis. Biostatistics 9, 290307.Google Scholar
Lee, SH, Decandia, TR, Ripke, S, Yang, J, Sullivan, PF, Goddard, ME, Keller, MC, Visscher, PM, Wray, NR (2012). Estimating the proportion of variation in susceptibility to schizophrenia captured by common SNPs. Nature Genetics 44, 247250.Google Scholar
Lencz, T, Robinson, DG, Xu, K, Ekholm, J, Sevy, S, Gunduz-Bruce, H, Woerner, MG, Kane, JM, Goldman, D, Malhotra, AK (2006). DRD2 promoter region variation as a predictor of sustained response to antipsychotic medication in first-episode schizophrenia patients. American Journal of Psychiatry 163, 529531.CrossRefGoogle ScholarPubMed
Leucht, S, Cipriani, A, Spineli, L, Mavridis, D, Orey, D, Richter, F, Samara, M, Barbui, C, Engel, RR, Geddes, JR, Kissling, W, Stapf, MP, Lassig, B, Salanti, G, Davis, JM (2013). Comparative efficacy and tolerability of 15 antipsychotic drugs in schizophrenia: a multiple-treatments meta-analysis. Lancet 382, 951962.Google Scholar
Levinson, DF, Duan, J, Oh, S, Wang, K, Sanders, AR, Shi, J, Zhang, N, Mowry, BJ, Olincy, A, Amin, F, Cloninger, CR, Silverman, JM, Buccola, NG, Byerley, WF, Black, DW, Kendler, KS, Freedman, R, Dudbridge, F, Pe'er, I, Hakonarson, H, Bergen, SE, Fanous, AH, Holmans, PA, Gejman, PV (2011). Copy number variants in schizophrenia: confirmation of five previous findings and new evidence for 3q29 microdeletions and VIPR2 duplications. American Journal of Psychiatry 168, 302316.Google Scholar
Lieberman, J, Jody, D, Geisler, S, Alvir, J, Loebel, A, Szymanski, S, Woerner, M, Borenstein, M (1993). Time course and biologic correlates of treatment response in first-episode schizophrenia. Archives of General Psychiatry 50, 369376.Google Scholar
Malaspina, D, Goetz, RR, Yale, S, Berman, A, Friedman, JH, Tremeau, F, Printz, D, Amador, X, Johnson, J, Brown, A, Gorman, JM (2000). Relation of familial schizophrenia to negative symptoms but not to the deficit syndrome. American Journal of Psychiatry 157, 9941003.Google Scholar
Martin, AK, Robinson, G, Reutens, D, Mowry, B (2014 a). Cannabis abuse and age at onset in schizophrenia patients with large, rare copy number variants. Schizophrenia Research 155, 2125.Google Scholar
Martin, AK, Robinson, G, Reutens, D, Mowry, B (2014 b). Cognitive and structural neuroimaging characteristics of schizophrenia patients with large, rare copy number deletions. Psychiatry Research 224, 311318.Google Scholar
Martin, AK, Robinson, G, Reutens, D, Mowry, B (2014 c). Copy number deletion burden is associated with cognitive, structural, and resting-state network differences in patients with schizophrenia. Behavioural Brain Research 272C, 324334.Google Scholar
Martin, AK, Robinson, G, Reutens, D, Mowry, B (2015 a). Clinical and parental age characteristics associated with rare copy number variants in patients with schizophrenia. American Journal of Medical Genetics Part B: Neuropsychiatric Genetics 168B, 374382.Google Scholar
Martin, AK, Robinson, G, Reutens, D, Mowry, B (2015 b). Common genetic risk variants are associated with positive symptoms and decision-making ability in patients with schizophrenia. Psychiatry Research 229, 606608.Google Scholar
Maxwell, ME (1992). Family Interview for Genetic Studies (FIGS): A Manual for FIGS. Clinical Neurogenetics Branch, Intramural Research Program, NIMH: Bethesda, MD.Google Scholar
McGlashan, TH (1988). A selective review of recent North American long-term followup studies of schizophrenia. Schizophrenia Bulletin 14, 515542.CrossRefGoogle ScholarPubMed
Meltzer, H, Kostacoglu, A (2001). Treatment-Resistant Schizophrenia. Martin Dunitz: London.Google Scholar
Miller, A, McEvoy, J, Jeste, D, Marder, SR (2006). Treatment of Chronic Schizophrenia. American Psychiatric Publishing: Washington, DC.Google Scholar
Mowry, BJ, Gratten, J (2013). The emerging spectrum of allelic variation in schizophrenia: current evidence and strategies for the identification and functional characterization of common and rare variants. Molecular Psychiatry 18, 3852.Google Scholar
Murray, RM, Van Os, J (1998). Predictors of outcome in schizophrenia. Journal of Clinical Psychopharmacology 18, 2S4S.Google Scholar
Nielsen, J, Nielsen, RE, Correll, CU (2012). Predictors of clozapine response in patients with treatment-refractory schizophrenia: results from a Danish Register Study. Journal of Clinical Psychopharmacology 32, 678683.Google Scholar
Nurnberger, JI Jr, Blehar, MC, Kaufmann, CA, York-Cooler, C, Simpson, SG, Harkavy-Friedman, J, Severe, JB, Malaspina, D, Reich, T (1994). Diagnostic Interview for Genetic Studies. Rationale, unique features, and training. NIMH Genetics Initiative. Archives of General Psychiatry 51, 849859; discussion 863–864.Google Scholar
Purcell, S, Neale, B, Todd-Brown, K, Thomas, L, Ferreira, MA, Bender, D, Maller, J, Sklar, P, de Bakker, PI, Daly, MJ, Sham, PC (2007). PLINK: a tool set for whole-genome association and population-based linkage analyses. American Journal of Human Genetics 81, 559575.Google Scholar
Rasmussen, H, Ebdrup, BH, Erritzoe, D, Aggernaes, B, Oranje, B, Kalbitzer, J, Pinborg, LH, Baare, WF, Svarer, C, Lublin, H, Knudsen, GM, Glenthoj, B (2011). Serotonin2A receptor blockade and clinical effect in first-episode schizophrenia patients treated with quetiapine. Psychopharmacology 213, 583592.Google Scholar
Reichert, A, Kreiker, S, Mehler-Wex, C, Warnke, A (2008). The psychopathological and psychosocial outcome of early-onset schizophrenia: preliminary data of a 13-year follow-up. Child and Adolescent Psychiatry and Mental Health 2, 6.Google Scholar
Revicki, DA, Luce, BR, Weschler, JM, Brown, RE, Adler, MA (1990). Cost-effectiveness of clozapine for treatment-resistant schizophrenic patients. Hospital and Community Psychiatry 41, 850854.Google Scholar
Schennach, R, Riedel, M, Musil, R, Moller, HJ (2012). Treatment response in first-episode schizophrenia. Clinical Psychopharmacology and Neuroscience 10, 7887.Google Scholar
Schizophrenia Working Group of the Psychiatric Genomics Consortium (2014). Biological insights from 108 schizophrenia-associated genetic loci. Nature 511, 421427.Google Scholar
Sullivan, PF, Posthuma, D (2015). Biological pathways and networks implicated in psychiatric disorders. Current Opinion in Behavioral Sciences 2, 5868.Google Scholar
Wang, K, Li, M, Hadley, D, Liu, R, Glessner, J, Grant, SF, Hakonarson, H, Bucan, M (2007). PennCNV: an integrated hidden Markov model designed for high-resolution copy number variation detection in whole-genome SNP genotyping data. Genome Research 17, 16651674.Google Scholar
Wray, NR, Lee, SH, Mehta, D, Vinkhuyzen, AA, Dudbridge, F, Middeldorp, CM (2014). Research review: polygenic methods and their application to psychiatric traits. Journal of Child Psychology and Psychiatry and Allied Disciplines 55, 10681087.Google Scholar
Yeo, RA, Gangestad, SW, Liu, J, Ehrlich, S, Thoma, RJ, Pommy, J, Mayer, AR, Schulz, SC, Wassink, TH, Morrow, EM, Bustillo, JR, Sponheim, SR, Ho, BC, Calhoun, VD (2013). The impact of copy number deletions on general cognitive ability and ventricle size in patients with schizophrenia and healthy control subjects. Biological Psychiatry 73, 540545.Google Scholar
Yeo, RA, Gangestad, SW, Walton, E, Ehrlich, S, Pommy, J, Turner, JA, Liu, J, Mayer, AR, Schulz, SC, Ho, BC, Bustillo, JR, Wassink, TH, Sponheim, SR, Morrow, EM, Calhoun, VD (2014). Genetic influences on cognitive endophenotypes in schizophrenia. Schizophrenia Research 156, 7175.Google Scholar
Zhang, JP, Malhotra, AK (2011). Pharmacogenetics and antipsychotics: therapeutic efficacy and side effects prediction. Expert Opinion on Drug Metabolism and Toxicology 7, 937.Google Scholar