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. 2020 Aug 24;10(1):298.
doi: 10.1038/s41398-020-00981-5.

Polygenic risk for anxiety influences anxiety comorbidity and suicidal behavior in bipolar disorder

Collaborators, Affiliations

Polygenic risk for anxiety influences anxiety comorbidity and suicidal behavior in bipolar disorder

Fabiana L Lopes et al. Transl Psychiatry. .

Abstract

Bipolar disorder is often comorbid with anxiety, which is itself associated with poorer clinical outcomes, including suicide. A better etiologic understanding of this comorbidity could inform diagnosis and treatment. The present study aims to test whether comorbid anxiety in bipolar disorder reflects shared genetic risk factors. We also sought to assess the contribution of genetic risk for anxiety to suicide attempts in bipolar disorder. Polygenic risk scores (PRS) were calculated from published genome-wide association studies of samples of controls and cases with anxiety (n = 83,566) or bipolar disorder (n = 51,710), then scored in independent target samples (total n = 3369) of individuals with bipolar disorder who reported or denied lifetime anxiety disorders or suicidal attempts in research interviews. Participants were recruited from clinical and nonclinical settings and genotyped for common genetic variants. The results show that polygenic risk for anxiety was associated with comorbid anxiety disorders and suicide attempts in bipolar disorder, while polygenic risk for bipolar disorder was not associated with any of these variables. Our findings point out that comorbid anxiety disorders in bipolar disorder reflect a dual burden of bipolar and anxiety-related genes; the latter may also contribute to suicide attempts. Clinical care that recognizes and addresses this dual burden may help improve outcomes in people living with comorbid bipolar and anxiety disorders.

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Conflict of interest statement

M.L. reports grants from the Swedish Medical Research Council, grants from the Broad Institute, during the conduct of the study; personal fees from Lundbeck pharmaceuticals, outside the submitted work. J.N. reports a grant from Janssen, outside the submitted work. All other authors declare no competing interests.

Figures

Fig. 1
Fig. 1. Association of anxiety or bipolar disorder polygenic scores with anxiety comorbidity and suicide attempts.
a The association between anxiety polygenic score (PRS) and anxiety comorbidity in patients with bipolar disorder. Anxiety comorbidity was evaluated as a categorical phenotype (“Any Anxiety”). b The association between anxiety PRS and suicide attempts in patients with bipolar disorder. c The association between bipolar PRS and anxiety comorbidity in patients with bipolar disorer. d The association between bipolar PRS and suicide attempts in patients with bipolar disorder. Logistic regression results are reported as odds ratios (OR). 95% confidence intervals (CI) are also shown. The PRS data are distributed in quintile.

References

    1. Olfson M, et al. Reexamining associations between mania, depression, anxiety and substance use disorders: results from a prospective national cohort. Mol. Psychiatry. 2017;22:235–241. doi: 10.1038/mp.2016.64. - DOI - PubMed
    1. Pavlova B, Perlis RH, Alda M, Uher R. Lifetime prevalence of anxiety disorders in people with bipolar disorder: a systematic review and meta-analysis. Lancet Psychiatry. 2015;2:710–717. doi: 10.1016/S2215-0366(15)00112-1. - DOI - PubMed
    1. MacKinnon DF, McMahon FJ, Simpson SG, McInnis MG, DePaulo JR. Panic disorder with familial bipolar disorder. Biol. Psychiatry. 1997;42:90–95. doi: 10.1016/S0006-3223(96)00299-5. - DOI - PubMed
    1. Wozniak J, Biederman J, Monuteaux MC, Richards J, Faraone SV. Parsing the comorbidity between bipolar disorder and anxiety disorders: a familial risk analysis. J. Child Adolesc. Psychopharmacol. 2002;12:101–111. doi: 10.1089/104454602760219144. - DOI - PubMed
    1. Frank E, et al. Clinical significance of lifetime panic spectrum symptoms in the treatment of patients with bipolar I disorder. Arch. Gen. Psychiatry. 2002;59:905–911. doi: 10.1001/archpsyc.59.10.905. - DOI - PubMed

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