Exposotypes in psychotic disorders.

Journal: Scientific reports
Published Date:

Abstract

Psychiatry lags in adopting etiological approaches to diagnosis, prognosis, and outcome prediction compared to the rest of medicine. Etiological factors such as childhood trauma (CHT), substance use (SU), and socioeconomic status (SES) significantly affect psychotic disorder symptoms. This study applied an agnostic clustering approach to identify exposome clusters "Exposotypes (ETs)" and examine their relationship with clinical, cognitive, and functional outcomes. Using data from individuals with psychotic disorders (n = 1,350), and controls (n = 623), we assessed the relationship between the exposotypes and outcomes. Four exposotypes were identified: ET1 characterized by high CHT and SU; ET2, high CHT; ET3, high SU; ET4, low exposure. Compared to ET4, ET1 demonstrated higher positive and general symptoms, anxiety, depression, impulsivity, and mania; ET2 had higher anxiety, depression, and impulsivity; ET3 had better cognitive and functional outcomes with lower negative symptoms. Intracranial volume was largest in ET3, and smallest in ET2. No group differences in schizophrenia polygenic risk scores were found. The age of onset was 5 years earlier in ET1 than in ET4. These findings provide insight into the complex etiological interplay between trauma, and SU, as well as their unique effects on clinical symptoms, cognition, neurobiology, genetic risk, and functioning.

Authors

  • Walid Yassin
    Beth Israel Deaconess Medical Center, Boston, MA, U.S.. walid.yassin00@gmail.com.
  • Bryan Kromenacker
    College of Medicine, University of Arizona, Tucson, Arizona, USA.
  • James B Green
    Beth Israel Deaconess Medical Center, Boston, MA, U.S.
  • Carol A Tamminga
    Department of Psychiatry, University of Texas Southwestern Medical Center, Dallas, TX, USA.
  • Elisabetta C Del Re
    Beth Israel Deaconess Medical Center, Boston, MA, U.S.
  • Pegah Seif
    Beth Israel Deaconess Medical Center, Boston, MA, U.S.
  • Cuihua Xia
    Departments of Psychiatry and Human Genetics, University of Chicago, Chicago, IL, U.S.
  • Ney Alliey-Rodriguez
    Departments of Psychiatry and Human Genetics, University of Chicago, Chicago, IL, U.S.
  • Elliot S Gershon
    Department of Psychiatry, University of Chicago, Chicago, IL, USA.
  • Brett A Clementz
    Department of Psychology, University of Georgia, Athens, Georgia.
  • Godfrey D Pearlson
    Olin Neuropsychiatry Research Center, Hartford Hospital (IOL Campus), Hartford, CT, USA; Department of Psychiatry and Neurobiology, Yale University School of Medicine, New Haven, CT, USA.
  • Sarah K Keedy
    Departments of Psychiatry and Human Genetics, University of Chicago, Chicago, IL, U.S.
  • Elena I Ivleva
    Department of Psychiatry, UT Southwestern Medical Center, Dallas, TX, U.S.
  • Scott Kristian Hill
    Departments of Psychiatry and Human Genetics, University of Chicago, Chicago, IL, U.S.
  • Jennifer E McDowell
    Department of Psychology, University of Georgia, Athens, Georgia.
  • Matcheri S Keshavan
    BethIsrael Deaconess Medical Center, United States; Harvard Medical School, United States. Electronic address: mkeshava@bidmc.harvard.edu.