Abstract

BackgroundAnxiety is a prominent feature of schizophrenia, present in the prodromal phase of the illness. There is strong evidence that the personality trait neuroticism, an underlying factor strongly associated with anxiety, is genetically correlated with schizophrenia, implying that neuroticism and schizophrenia share genetic risk factors in common. However, a genetic correlation may also suggest a possible role of neuroticism in the pathogenesis of schizophrenia. We therefore performed a Mendelian randomization (MR) analysis using publicly available data to investigate the potential casual association between neuroticism and schizophrenia.MethodsWe performed bi-directional two-sample MR between neuroticism and schizophrenia using the most recent publically available summary-level genome-wide data. Single nucleotide polymorphisms (SNPs) associated with neuroticism (p ≤ 1e-5) and schizophrenia (p ≤ 5e-8) were combined using an inverse-variance-weighted (IVW) multiplicative random effects approach. Impact of potential MR assumption violations were explored using weighted median, weighted mode and MR Egger methods. All analyses were performed using the TwoSampleMR R package.ResultsThe IVW MR method provided strong evidence of a casual effect of genetically instrumented neuroticism on risk of schizophrenia (p < 0.001). This causal association was also evident when using the median weighted approach (p = 0.004) but evidence was weaker when using the weighted mode (p = 0.719) and MR Egger approaches (p = 0.439). The MR Egger intercept provided weak evidence of presence of horizontal pleiotropy (p = 0.067), however, the I2GX statistic indicated potential violation of the no measurement error MR assumption. There was also evidence of a causal effect of schizophrenia on neuroticism (IVW p = 0.001, weighted median p = 0.017, weighted mode p = 0.018) however, again, the I2GX statistic indicated potential violation of the no measurement error MR assumption.DiscussionAssuming certain MR assumptions are met, our results provide evidence of a bi-directional causal association between neuroticism and schizophrenia suggesting a genetic overlap rather than a uni-directional casual association, however, the impact of feedback loops between exposure and outcome cannot be addressed. Although there was evidence of horizontal pleiotropy between neuroticism and schizophrenia, evidence of violation of the no measurement error indicates that the MR Egger results should be interpreted with caution.

Highlights

  • Prolonged duration of untreated psychosis (DUP) is associated with poor outcome

  • The current study aims to investigate the utility of quantile regression (QR) to analyze the impact of an early detection (ED) campaign across the DUP distribution, using data from the TIPS study

  • Assuming certain Mendelian randomization (MR) assumptions are met, our results provide evidence of a bi-directional causal association between neuroticism and schizophrenia suggesting a genetic overlap rather than a uni-directional casual association, the impact of feedback loops between exposure and outcome cannot be addressed

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Summary

Introduction

Prolonged duration of untreated psychosis (DUP) is associated with poor outcome. The Scandinavian TIPS study deployed an early detection (ED) campaign to halve DUP. Discussion: This population-based cohort study will be the largest to date investigating the association between CNS-infections and mental disorders, and whether there’s a difference in risk depending on the pathogen responsible for the CNS-infection. It will be one of the largest studies investigating the effect of CNS-infections on cognition. Discussion: Homicides of mental health workers, and of physicians generally, are rare events that emerge from a background of common aggression and violence in healthcare settings. Many of these homicides may have been preventable. The law has mainly focused on risk of bodily harm and there is no legal

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