■许多但不是所有的双相情感障碍患者由于严重的情绪发作需要住院治疗。同样,一些但并非所有患者都经历了超出急性情绪发作的长期职业功能障碍。尚不清楚双相情感障碍的这些不同结果是否由不同的多基因谱驱动。这里,我们评估了主要精神疾病的多基因评分(PGSs)和受教育程度与双相情感障碍患者的职业功能和精神科住院率的关联.
■对4,782名双相情感障碍患者和2,963名对照受试者进行了基因分型,并与瑞典国家登记册相关联。使用至少10年登记数据的纵向测量得出不就业年份的百分比,长期病假的百分比,和平均每年精神病住院人数。序数回归用于测试结果与双相情感障碍的PGS之间的关联。精神分裂症,重度抑郁症,注意缺陷多动障碍(ADHD),和教育程度。使用来自双相情感障碍研究网络队列(N=4,219)的数据对住院患者进行复制分析。
■双相情感障碍的长期病假和失业与精神分裂症的PGS显著相关,多动症,重度抑郁症,和教育程度,但不能用PGS治疗双相情感障碍.相比之下,每年住院人数与双相情感障碍和精神分裂症的较高PGS相关,但不是与其他发电系统。
■双相情感障碍的严重程度(以住院人数为指标)与长期职业功能障碍不同的多基因特征相关。这些发现具有临床意义,这表明减轻职业功能障碍需要采取干预措施,而不是预防情绪发作的干预措施。
UNASSIGNED: Many but not all persons with bipolar disorder require hospital care because of severe mood episodes. Likewise, some but not all patients experience long-term occupational dysfunction that extends beyond acute mood episodes. It is not known whether these dissimilar outcomes of bipolar disorder are driven by different polygenic profiles. Here, polygenic scores (PGSs) for major psychiatric disorders and educational attainment were assessed for associations with occupational functioning and psychiatric hospital admissions in bipolar disorder.
UNASSIGNED: A total of 4,782 patients with bipolar disorder and 2,963 control subjects were genotyped and linked to Swedish national registers. Longitudinal measures from at least 10 years of registry data were used to derive percentage of years without employment, percentage of years with long-term sick leave, and mean number of psychiatric hospital admissions per year. Ordinal regression was used to test associations between outcomes and PGSs for bipolar disorder, schizophrenia, major depressive disorder, attention deficit hyperactivity disorder (ADHD), and educational attainment. Replication analyses of hospital admissions were conducted with data from the Bipolar Disorder Research Network cohort (N=4,219).
UNASSIGNED: Long-term sick leave and unemployment in bipolar disorder were significantly associated with PGSs for schizophrenia, ADHD, major depressive disorder, and educational attainment, but not with the PGS for bipolar disorder. By contrast, the number of hospital admissions per year was associated with higher PGSs for bipolar disorder and schizophrenia, but not with the other PGSs.
UNASSIGNED: Bipolar disorder severity (indexed by hospital admissions) was associated with a different polygenic profile than long-term occupational dysfunction. These findings have clinical implications, suggesting that mitigating occupational dysfunction requires interventions other than those deployed to prevent mood episodes.