Link between cognitive polygenic risk scores and clinical progression after a first-psychotic episode

Segura, Alex G. ; Mezquida, Gisela ; Martínez-Pinteño, Albert ; Gassó, Patricia ; Rodriguez, Natalia ; Moreno-Izco, Lucía ; Amoretti, Silvia ; Bioque, Miquel ; Lobo, Antonio (Universidad de Zaragoza) ; González-Pinto, Ana ; García-Alcon, Alicia ; Roldán-Bejarano, Alexandra ; Vieta, Eduard ; de la Serna, Elena ; Toll, Alba ; Cuesta, Manuel J. ; Mas, Sergi ; Bernardo, Miquel

Resumen: Background
Clinical intervention in early stages of psychotic disorders is crucial for the prevention of severe symptomatology trajectories and poor outcomes. Genetic variability is studied as a promising modulator of prognosis, thus novel approaches considering the polygenic nature of these complex phenotypes are required to unravel the mechanisms underlying the early progression of the disorder.

Methods
The sample comprised of 233 first-episode psychosis (FEP) subjects with clinical and cognitive data assessed periodically for a 2-year period and 150 matched controls. Polygenic risk scores (PRSs) for schizophrenia, bipolar disorder, depression, education attainment and cognitive performance were used to assess the genetic risk of FEP and to characterize their association with premorbid, baseline and progression of clinical and cognitive status.

Results
Schizophrenia, bipolar disorder and cognitive performance PRSs were associated with an increased risk of FEP [false discovery rate (FDR) ⩽ 0.027]. In FEP patients, increased cognitive PRSs were found for FEP patients with more cognitive reserve (FDR ⩽ 0.037). PRSs reflecting a genetic liability for improved cognition were associated with a better course of symptoms, functionality and working memory (FDR ⩽ 0.039). Moreover, the PRS of depression was associated with a worse trajectory of the executive function and the general cognitive status (FDR ⩽ 0.001).

Conclusions
Our study provides novel evidence of the polygenic bases of psychosis and its clinical manifestation in its first stage. The consistent effect of cognitive PRSs on the early clinical progression suggests that the mechanisms underlying the psychotic episode and its severity could be partially independent.

Idioma: Inglés

DOI: 10.1017/S0033291722001544

Año: 2022

Publicado en: Psychological Medicine 53, 10 (2022), 4634-4647
ISSN: 0033-2917

Factor impacto JCR: 6.9 (2022)

Categ. JCR: PSYCHIATRY rank: 27 / 154 = 0.175 (2022) - Q1 - T1
Categ. JCR: PSYCHOLOGY, CLINICAL rank: 10 / 131 = 0.076 (2022) - Q1 - T1
Categ. JCR: PSYCHIATRY rank: 21 / 143 = 0.147 (2022) - Q1 - T1
Categ. JCR: PSYCHOLOGY rank: 9 / 81 = 0.111 (2022) - Q1 - T1

Factor impacto CITESCORE: 13.6 - Medicine (Q1) - Psychology (Q1)

Factor impacto SCIMAGO: 2.465 - Psychiatry and Mental Health (Q1) - Applied Psychology (Q1)

Financiación: info:eu-repo/grantAgreement/ES/ISCIII/PI08-0208
Financiación: info:eu-repo/grantAgreement/ES/MICIU-ISCIII-FEDER/PI11-00325
Financiación: info:eu-repo/grantAgreement/ES/MICIU-ISCIII-FEDER/PI14-00612
Financiación: info:eu-repo/grantAgreement/ES/MICIU-ISCIII-FEDER/PI18-01055

Tipo y forma: Artículo (Versión definitiva)

Área (Departamento): Area Psiquiatría (Dpto. Medicina, Psiqu. y Derm.)