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Psychiatric genetics in silico: databases and tools for psychiatric geneticists.

Bioinformatics can significantly impact the laboratory genetics process from the study design phase to conclusive identification of a disease gene. The present review will highlight key databases to enhance psychiatric genetic study design, based on full use of genomics data and the golden path sequence. It will address methods to ensure comprehensive genetic data mining, using the best available genomic and genetic databases such as the University of California Santa Cruz human genome browser, Ensembl, Mapview, dbSNP and GDB, and locus-specific databases such as Online Mendelian Inheritance In Man. Using the golden path sequence as a template, with the necessary quality checks, it is possible to design detailed genetic studies from sequence information alone. Drawing together this diverse information, it is possible to characterize a locus or gene in silico to a very detailed level. This in turn can have real cost and efficiency benefits by assisting in the identification of markers that are most likely to be informative, or by highlighting the best candidate genes for study.

Databases, Bibliographic↗

The next challenge for psychiatric genetics: characterizing the risk associated with identified genes.

BACKGROUND: As advances in genetics further our ability to identify genes influencing psychiatric disorders, the next challenge facing psychiatric genetics is to characterize the risk associated with specific genetic variants in order to better understand how these susceptibility genes are involved in the pathways leading to illness. METHODS: To further this goal, findings from behavior genetic analyses about how genetic influences act can be used to guide hypothesis testing about the effects associated with specific genes. RESULTS: Using the phenotype of alcohol dependence as an example, this paper provides an overview of how the integration of behavioral and statistical genetics can advance our knowledge about the genetics of psychiatric disorders. Areas currently being investigated in behavior genetics include careful delineation of phenotypes, to examine the heritability of various aspects of normal and abnormal behavior; developmental changes in the nature and magnitude of genetic and environmental effects; the extent to which different behaviors are influenced by common genes; and different forms of gene-environment correlation and interaction. CONCLUSIONS: Understanding how specific genes are involved in these processes has the potential to significantly enhance our understanding of the development of psychiatric disorders.

Alcoholism↗

Summary of the Third World Congress on Psychiatric Genetics.

A summary of the proceedings of the third world congress on psychiatric genetics is presented. The meeting was held in New Orleans on October 2-5, 1993 and brought together researchers from around the world. The International Society of Psychiatric Genetics sponsored and organized this meeting. Rapid advances of the last few years were reviewed and discussed in terms of their impact on the evolution of experimental design. The importance of definition of heritable clinical phenotypes, and the need to continue to enhance analytic methods were stressed as a priority for the field.

Animals↗

Can Psychiatric Genetics Advance Without Incorporating a Life Course Perspective?

Psychiatric disorders unfold over the life course; however, genomic studies of these conditions overwhelmingly rely on phenotypes collected at a single time point, often in adulthood. Therefore, genome-wide association studies (GWASs) of psychiatric conditions may miss genetic variants with time-varying relevance to etiology, prevention, and treatment, such as those that influence trajectories of symptoms and behaviors, age at onset, course of treatment response, and the co-evolution of comorbidities. With recent advances in longitudinal biobanks and analytic tools, we posit that incorporating a life course perspective in psychiatric genetics will enable critically relevant insights into each of these areas of investigation. We propose that the current inconsistent portability of polygenic scores across age groups can be reconciled through the design of carefully considered longitudinal GWASs in age-diverse samples. Pioneering longitudinal GWASs in psychiatry have revealed novel genomic signals associated with time-dependent phenotypes that are distinct from those influencing lifetime diagnosis, suggesting that the study of longitudinal phenotypes will complement cross-sectional approaches and empower biological and therapeutic discoveries. Advances in post-GWAS functional annotation resources and analytic approaches now enable us to contextualize the genetic contributions to psychiatric disorders as dynamic age- and exposure-dependent processes. Although longitudinal GWASs pose unique challenges with regard to data availability, selection bias, and missing data, integrating temporality into psychiatric genetics at scale is now attainable and promises to reveal novel biology and therapeutic opportunities for psychiatric conditions.

Cohort study↗

The biography of psychiatric genetics: from early achievements to historical burden, from an anxious society to critical geneticists.

When the study of human inheritance became a topic of scientific interest more than 100 years ago, brain function and mental disease immediately attracted the interest of researchers. Psychiatric genetics was dominated from its early beginnings by the question of nature and nurture. Today this problem can be quantitatively approached with odds ratios and attributable risks for certain genotypes. The false doctrine of eugenics and its practical application by the Nazi regime paved the way for the development of a prevailing anxiety in society that psychiatric genetics might lead to stigmatisation or even a revitalization of eugenics. The major challenge for the field, however, stems from the attitudes of fellow geneticists who doubt that genetics can ever contribute to an understanding of brain function and mental disease. Whereas genetically complex traits are being successfully pinned down to the molecular level in other fields of medicine, psychiatric genetics still awaits a major breakthrough. Although mental disorders are harder to tackle than any other complex disease the concepts developed and the methods available today are powerful enough to predict a bright future of the field.

Eugenics↗

Psychiatric genetics and forensic psychiatry: a review.

Research in psychiatric genetics has been revolutionized by the development of new and powerful molecular genetic techniques. Family, twin, and adoption studies of antisocial personality disorder (ASPD) and criminality are reviewed, and ramifications of new research methods for the study of antisocial behavior are considered. Implications of these developments for forensic psychiatry are discussed.

Antisocial Personality Disorder↗

[Program and practice of psychiatric genetics at the German Research Institute of Psychiatry under Ernst Rüdin: on the relationship between science, politics and the concept of race before and after 1993].

The first research institution exclusively devoted to psychiatric genetics was the Department of Genealogy and Demography at the German Psychiatric Research Institute (Deutsche Forschungsanstalt für Psychiatrie) in Munich. From its foundation in 1917 until 1945 it was directed by Ernst Rüdin, one of the protagonists of the racial hygiene movement in Germany. In scientific terms, colleagues from abroad regarded the research undertaken by Rüdin and his collaborators as outstanding in 1933/34, and as remarkable even in the post-1945 period. This paper analyses programme and practice of psychiatric genetics at the Munich Institute as well as Rüdin's involvement in Nazi mental health policy including his active support of the systematic patient killings ('euthanasia'). It is argued that the idea of a healthy 'race' was a guiding principle motivating all of Rüdin's research and political activities, and that it is not possible to distinguish in his work a phase of 'good' research (in scientific terms) untainted by racial ideas from a phase of 'bad' (pseudo-) research contaminated by racial ideology.

Academies and Institutes↗

Psychiatric genetics: research challenges and pathways forward.

Lessons from past psychiatric genetic research, together with key issues in psychiatry requiring genetic investigation, are reviewed in order to consider the implications for the ways forward. It is argued that traditional quantitative genetics needs to use a combination of twin, adoptee, and family strategies, to examine continuities and discontinuities in psychopathology between childhood and adult life, to compare dimensions and categories, to employ adequate conceptualization and measurement of disorders, to use statistical techniques based on latent constructs, to use biological trait indicators where possible, to examine risk factors as well as diseases, to include good measures of postulated environmental risk variables, to study the interplay between genes and environment, and to study the key assumptions underlying genetic strategies. Molecular cytogenetics needs to consider both the general and specific psychopathological risks associated with chromosome abnormalities and to examine the mechanism involved, to examine the role of submicroscopic chromosomal deletions and of mitochondrial disorders, and to investigate the mechanisms involved in trinucleotide repeat amplifications that take place during intergenerational transmission. Molecular genetics needs to make greater use of smaller pedigrees in view of the concerns over phenotypic definition and genetic heterogeneity in very large extended dense pedigrees, to use sib-pair designs in view of the likelihood that most psychiatric disorder will prove to be multifactorial, to combine association strategies with linkage analyses, to pay careful attention to the definition of phenotypes in probands, to remain in close touch with other branches of biological psychiatry, and to make effective use of collaboration between centers. To date, transgenic models have had a rather limited application in psychiatry but, despite their difficulties, they are likely to provide an underpinning for gene therapy in disorders where that seems feasible.

Genetic Heterogeneity↗

Sixth World Congress of Psychiatric Genetics X Chromosome Workshop.

At the X chromosome workshop of the Sixth World Congress on Psychiatric Genetics, new data regarding psychiatric phenotypes and the X chromosome were presented. In the last year a number of groups have published linkage results for the X chromosome in schizophrenia, which provide no significant evidence for linkage. Presentations by groups from Cardiff, Oxford, State University of New York (SUNY), and Finland provide weak nonsignificant evidence for linkage of markers on the Xp11.4-p11.3, Xq21, and Xq26 with schizophrenia. However, the presence of a male-specific transmission ratio distorter (DMS1) that maps to Xp11.4-21.2 [Naumova et al., 1998: Am. J. Hum. Genet. 62:1493-1499] makes the interpretation of linkage findings in brother-brother pairs difficult in this region. Regarding bipolar affective disorder, little new data were reported, but previous reports provide evidence for linkage to Xq25-q26. Summary tables of linkage results for schizophrenia and bipolar disorder can be obtained from http://www.camh.net/ research/x-chromosome/. No linkage or transmission disequilibrium of polymorphisms of MAOA and MAOB in attention deficit hyperactivity disorder was seen. Negative results for transmission disequilibrium of polymorphisms of HTR2C and MAOA with autism were provided from German and Austrian families.

Alcoholism↗

Psychiatric genetics: search for phenotypes.

Failure to obtain convincing results in psychiatric genetics can partly be attributed to the fact that progress in molecular biology and genetic epidemiology has not been followed by an equivalent development in phenotypic description. Instead of relying entirely on classical nosological approaches, we argue that identifying more homogeneous forms of diseases through a'candidate symptom approach' among affected subjects and an endophenotype approach that identifies sub-clinical traits among non-affected relatives might yield better results. Examples where these strategies have already been fruitful when applied to complex diseases are presented in this review. Focusing on vulnerability traits might stimulate the redefinition of traditional psychiatric syndromes and help to bridge the gap between clinical and experimental approaches.

Animals↗

Seymour S. Kety MD: the man and his accomplishments. Summary of a symposium in his honor at the VIIIth World Congress of Psychiatric Genetics, Versailles, France, 30 August 2000.

Seymour S. Kety was a physician and neuroscientist of great distinction. His impact on both the dynamics and imaging of cerebral blood flow and metabolism, as well as the nature-nurture controversy about the etiology of schizophrenia, led to his receiving the Lasker Award in 1999. He died at the age of 84 in the year 2000, leaving medical research, and psychiatric genetics in particular, a bountiful legacy of rich science, thoughtful critiques and prophesies about hypotheses from the past and well into the future. Reviewed in this paper is a tribute to his work as presented during the VIIIth World Congress of Psychiatric Genetics in Versailles, France, August 2000.

Cerebrovascular Circulation↗

Benefits and pitfalls encountered in psychiatric genetic association studies.

The genetic association strategy is currently being applied to a number of psychiatric phenotypes including disease vulnerability, personality variation and clinical response to psychotropic drugs. Association studies offer the prospect of identification of the specific alleles that confer significant effects on clinical phenotype. However, it should be noted that this strategy has additional advantages as well as unique drawbacks. In this paper, we review the basic methodology utilized in each step of a typical psychiatric genetic association study and discuss their potential benefits and pitfalls with particular emphasis on the selection of clinical phenotype, the identification of a candidate gene, the selection of a candidate variant, clinical data set design, and the statistical analysis of association data. With appropriate design and execution, it is hoped that the association strategy will prove to be as successful in psychiatry as it has proven to be in other branches of medicine.

Alleles↗

Ethical issues in psychiatric genetics.

As knowledge grows regarding the genetic bases of psychiatric disorders, a variety of ethical issues will need to be confronted. Current evidence suggests that the etiology of most psychiatric disorders rests on a combination of multiple genes and environmental factors. As tests for the genes involved become more easily available, pressures will arise to use them for prenatal testing, screening of children and adults, selection of potential adoptees, and pre-marital screening. Common problems that will need to be addressed include popular misunderstanding of the consequences of possessing an affected allele, impact of knowledge of one's genetic make-up on one's sense of self, and the discriminatory use of genetic information to deny persons access to insurance and employment. Although most states have some legislation aimed at preventing discrimination, the laws' coverage is spotty and federal rules are lacking. Physicians may find that newly available genetic information creates new duties for them, including warning third parties who may share the patient's genetic endowment. And genetics research itself has raised questions about when to disclose information to subjects and their family members about the genes that are being studied, and how to define the subjects of the research when information is collected about family members other than the proband. Knowledge of these dilemmas is a first step to resolving them, something that the medical profession will need to attend to in the near-term. Neglect will lead others to set the rules that will control medical practice, including the practice of psychiatry, in the new world of genetic medicine.

Adoption↗

Chromosome 4 Workshop Summary: Sixth World Congress on Psychiatric Genetics, Bonn, Germany, October 6-10, 1998.

This report summarizes the findings presented at the Chromosome 4 Workshop of the Sixth World Congress on Psychiatric Genetics (October 1998, Bonn, Germany). Chromosome 4 linkage and association results for several psychiatric phenotypes including bipolar affective disorder, schizophrenia, alcoholism, and mental retardation are reviewed. In bipolar affective disorder, positive linkage results for markers on 4q35 were reported by three independent groups. In addition, findings in bipolar disorder were reported for markers spanning 4p14-16, and of particular interest are the results that coincide with the original Blackwood et al. [1996: Nat Genet 12:427-430] region at 4p16. For schizophrenia, modest positive results were reported for 4q31, as well as for marker D4S2917 at a region of 4q close to the centromere. Chromosome 4 continues to demonstrate interesting results in alcoholism, particularly in the region of the alcohol dehydrogenase gene cluster; however, it is not clear how to interpret the contrast in the susceptibility versus protective loci that are being reported in this region.

Alcoholism↗

Psychiatric genetics: recent advances and clinical implications.

OBJECTIVE: To present an overview on current progress and future directions in psychiatric genetics. METHODS: The review of studies that have demonstrated a genetic contribution to a wide range of psychopathology using family, twin, adoption studies and exploration of the methods and limitations of molecular genetic studies. RESULTS: Single gene disorders has been the area that is most straightforward with striking advances in disorders such as Huntington Disease and early onset familial Alzheimer disease. Complex phenotypes such as schizophrenia and affective disorder have presented greater difficulties but late onset Alzheimer disease and dyslexia are examples where replicated molecular genetic findings suggest that gene identification is feasible even for multifactorial disorders. CONCLUSION: The combination of increasingly complete information on the genome together with accessibility to this on the internet provide the essential tools for the search for susceptibility genes. Another essential requirement in trying to identify genes of small effect is well characterized large scale collections of cases and this demands the interaction of epidemiological and clinical researchers. Advances in genomics will also allow tailoring of pharmaceuticals pointing at treatment response and side effects. Hopefully all this perspectives together, will improve our understanding of the neurobiological pathogenesis of diseases such as Schizophrenia, Depression and Bipolar disorder 'legitimizing' them in the public view.

Biological Psychiatry↗

An agenda for psychiatric genetics.

Although it has long been known that people inherit vulnerabilities to particular forms of mental illness, ongoing advances in psychiatric genetics and DNA technology are only now making it possible to actually find the specific genes and gene variants that play critical roles in complex disorders, such as schizophrenia and bipolar disorder. For this reason, the National Institute of Mental Health convened a work group "to facilitate the search for the genes that influence mental disorders"--genes whose identification will affect diagnosis, prevention, and treatment. This article briefly summarizes the problems addressed by the work group and its main recommendations.

Biological Psychiatry↗

Psychiatric genetic research at the National Institute of Mental Health.

For some time it has been known through the results of family, twin, and adoption studies that heredity appears to play a significant causal role in many mental disorders, including schizophrenia, bipolar disorder, and other mood disorders, Alzheimer's Disease, panic disorder, obsessive compulsive disorder, autism, dyslexia, and Tourette's Syndrome. The precise patterns of inheritance of these complex disorders have not been determined, nor have the relevant genes been localized or cloned. Because the genetics are complex and because there is also clearly an environmental contribution to behavior, we expect the analysis of the genetics of mental illness to be arduous, and not quickly resolved. There are several compelling reasons to continue to focus our attention on uncovering the genetic factors for severe mental illness. Prominent among these are the implications for better treatment of mental disorders. The National Institute of Mental Health supports a wide range of studies on psychiatric genetic research.

Brain Diseases↗