PMID- 33736735 OWN - NLM STAT- MEDLINE DCOM- 20211119 LR - 20211119 IS - 1778-3585 (Electronic) IS - 0924-9338 (Print) IS - 0924-9338 (Linking) VI - 64 IP - 1 DP - 2021 Mar 19 TI - Examining the association between exposome score for schizophrenia and functioning in schizophrenia, siblings, and healthy controls: Results from the EUGEI study. PG - e25 LID - 10.1192/j.eurpsy.2021.19 [doi] LID - e25 AB - BACKGROUND: A cumulative environmental exposure score for schizophrenia (exposome score for schizophrenia [ES-SCZ]) may provide potential utility for risk stratification and outcome prediction. Here, we investigated whether ES-SCZ was associated with functioning in patients with schizophrenia spectrum disorder, unaffected siblings, and healthy controls. METHODS: This cross-sectional sample consisted of 1,261 patients, 1,282 unaffected siblings, and 1,525 healthy controls. The Global Assessment of Functioning (GAF) scale was used to assess functioning. ES-SCZ was calculated based on our previously validated method. The association between ES-SCZ and the GAF dimensions (symptom and disability) was analyzed by applying regression models in each group (patients, siblings, and controls). Additional models included polygenic risk score for schizophrenia (PRS-SCZ) as a covariate. RESULTS: ES-SCZ was associated with the GAF dimensions in patients (symptom: B = -1.53, p-value = 0.001; disability: B = -1.44, p-value = 0.001), siblings (symptom: B = -3.07, p-value < 0.001; disability: B = -2.52, p-value < 0.001), and healthy controls (symptom: B = -1.50, p-value < 0.001; disability: B = -1.31, p-value < 0.001). The results remained the same after adjusting for PRS-SCZ. The degree of associations of ES-SCZ with both symptom and disability dimensions were higher in unaffected siblings than in patients and controls. By analyzing an independent dataset (the Genetic Risk and Outcome of Psychosis study), we replicated the results observed in the patient group. CONCLUSIONS: Our findings suggest that ES-SCZ shows promise for enhancing risk prediction and stratification in research practice. From a clinical perspective, ES-SCZ may aid in efforts of clinical characterization, operationalizing transdiagnostic clinical staging models, and personalizing clinical management. FAU - Erzin, Gamze AU - Erzin G AD - Department of Psychiatry, University of Health Sciences Ankara Diskapi Training and Research Hospital, Ankara, Turkey. AD - Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands. FAU - Pries, Lotta-Katrin AU - Pries LK AD - Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands. FAU - van Os, Jim AU - van Os J AUID- ORCID: 0000-0002-7245-1586 AD - Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands. AD - Department of Psychiatry, UUMC Utrecht Brain Centre, University Medical Centre Utrecht, trecht University, Utrecht, The Netherlands. AD - Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, United Kingdom. FAU - Fusar-Poli, Laura AU - Fusar-Poli L AUID- ORCID: 0000-0002-5847-6947 AD - Department of Clinical and Experimental Medicine, Psychiatry Unit, University of Catania, Catania, Italy. FAU - Delespaul, Philippe AU - Delespaul P AD - Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands. AD - FACT, Mondriaan Mental Health, Maastricht, The Netherlands. FAU - Kenis, Gunter AU - Kenis G AD - Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands. FAU - Luykx, Jurjen J AU - Luykx JJ AUID- ORCID: 0000-0002-6439-2774 AD - Department of Psychiatry, UUMC Utrecht Brain Centre, University Medical Centre Utrecht, trecht University, Utrecht, The Netherlands. AD - Department of Translational Neuroscience, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands. AD - GGNet Mental Health, Apeldoorn, The Netherlands. FAU - Lin, Bochao D AU - Lin BD AD - Department of Translational Neuroscience, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht University, Utrecht, The Netherlands. FAU - Richards, Alexander L AU - Richards AL AD - Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Cardiff, United Kingdom. FAU - Akdede, Berna AU - Akdede B AD - Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey. FAU - Binbay, Tolga AU - Binbay T AD - Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey. FAU - Altinyazar, Vesile AU - Altinyazar V AD - Department of Psychiatry, Faculty of Medicine, Adnan Menderes University, Aydin, Turkey. FAU - Yalincetin, Berna AU - Yalincetin B AD - Department of Neuroscience, Graduate School of Health Sciences, Dokuz Eylul University, Izmir, Turkey. FAU - Gumus-Akay, Guvem AU - Gumus-Akay G AUID- ORCID: 0000-0002-6564-3133 AD - Department of Physiology, School of Medicine, Ankara University, Ankara, Turkey. AD - Brain Research Center, Ankara University, Ankara, Turkey. AD - Neuroscience and Neurotechnology Center of Excellence (NOROM), Ankara, Turkey. FAU - Cihan, Burcin AU - Cihan B AD - Department of Psychology, Middle East Technical University, Ankara, Turkey. FAU - Soygur, Haldun AU - Soygur H AD - Turkish Federation of Schizophrenia Associations, Ankara, Turkey. FAU - Ulas, Halis AU - Ulas H AD - Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey. FAU - Cankurtaran, Eylem Sahin AU - Cankurtaran ES AD - Guven Cayyolu Healthcare Campus, Ankara, Turkey. FAU - Kaymak, Semra Ulusoy AU - Kaymak SU AD - Ataturk Research and Training Hospital Psychiatry Clinic, Ankara, Turkey. FAU - Mihaljevic, Marina M AU - Mihaljevic MM AD - Faculty of Medicine, University of Belgrade, Belgrade, Serbia. AD - Clinic for Psychiatry Clinical Centre of Serbia, Belgrade, Serbia. FAU - Andric-Petrovic, Sanja AU - Andric-Petrovic S AD - Faculty of Medicine, University of Belgrade, Belgrade, Serbia. AD - Clinic for Psychiatry Clinical Centre of Serbia, Belgrade, Serbia. FAU - Mirjanic, Tijana AU - Mirjanic T AD - Special Hospital for Psychiatric Disorders Kovin, Kovin, Serbia. FAU - Bernardo, Miguel AU - Bernardo M AUID- ORCID: 0000-0001-8748-6717 AD - Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain. AD - Institut d'Investigacions Biomediques August Pi I Sunyer, Barcelona, Spain. AD - Biomedical Research Networking Centre in Mental Health (CIBERSAM), Barcelona, Spain. FAU - Mezquida, Gisela AU - Mezquida G AUID- ORCID: 0000-0002-6080-2203 AD - Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain. AD - Institut d'Investigacions Biomediques August Pi I Sunyer, Barcelona, Spain. AD - Biomedical Research Networking Centre in Mental Health (CIBERSAM), Barcelona, Spain. FAU - Amoretti, Silvia AU - Amoretti S AD - Barcelona Clinic Schizophrenia Unit, Neuroscience Institute, Hospital Clinic of Barcelona, University of Barcelona, Barcelona, Spain. AD - Institut d'Investigacions Biomediques August Pi I Sunyer, Barcelona, Spain. AD - Biomedical Research Networking Centre in Mental Health (CIBERSAM), Barcelona, Spain. FAU - Bobes, Julio AU - Bobes J AUID- ORCID: 0000-0003-2187-4033 AD - Biomedical Research Networking Centre in Mental Health (CIBERSAM), Barcelona, Spain. AD - Department of Psychiatry, School of Medicine, University of Oviedo, Oviedo, Spain. AD - Instituto de Investigacion Sanitaria del Principado de Asturias, Oviedo, Spain. AD - Mental Health Services of Principado de Asturias, Oviedo, Spain. FAU - Saiz, Pilar A AU - Saiz PA AD - Biomedical Research Networking Centre in Mental Health (CIBERSAM), Barcelona, Spain. AD - Department of Psychiatry, School of Medicine, University of Oviedo, Oviedo, Spain. AD - Instituto de Investigacion Sanitaria del Principado de Asturias, Oviedo, Spain. AD - Mental Health Services of Principado de Asturias, Oviedo, Spain. FAU - Garcia-Portilla, Maria Paz AU - Garcia-Portilla MP AD - Biomedical Research Networking Centre in Mental Health (CIBERSAM), Barcelona, Spain. AD - Department of Psychiatry, School of Medicine, University of Oviedo, Oviedo, Spain. AD - Instituto de Investigacion Sanitaria del Principado de Asturias, Oviedo, Spain. AD - Mental Health Services of Principado de Asturias, Oviedo, Spain. FAU - Sanjuan, Julio AU - Sanjuan J AD - Biomedical Research Networking Centre in Mental Health (CIBERSAM), Barcelona, Spain. AD - Department of Psychiatry, Hospital Clinico Universitario de Valencia, INCLIVA, School of Medicine, Universidad de Valencia, Valencia, Spain. FAU - Aguilar, Eduardo J AU - Aguilar EJ AD - Biomedical Research Networking Centre in Mental Health (CIBERSAM), Barcelona, Spain. AD - Department of Psychiatry, Hospital Clinico Universitario de Valencia, INCLIVA, School of Medicine, Universidad de Valencia, Valencia, Spain. FAU - Santos, Jose Luis AU - Santos JL AD - Biomedical Research Networking Centre in Mental Health (CIBERSAM), Barcelona, Spain. AD - Department of Psychiatry, Hospital Virgen de la Luz, Cuenca, Spain. FAU - Jimenez-Lopez, Estela AU - Jimenez-Lopez E AD - Biomedical Research Networking Centre in Mental Health (CIBERSAM), Barcelona, Spain. AD - Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain. FAU - Arrojo, Manuel AU - Arrojo M AD - Department of Psychiatry, Instituto de Investigacion Sanitaria, Complejo Hospitalario Universitario de Santiago de Compostela, Santiago de Compostela, Spain. FAU - Carracedo, Angel AU - Carracedo A AD - Grupo de Medicina Genomica, Centro de Investigacion Biomedica en Red de Enfermedades Raras (CIBERER), Universidad de Santiago de Compostela, Santiago de Compostela, Spain. AD - Fundacion Publica Galega de Medicina Xenomica (SERGAS), Instituto de Investigacion Sanitaria de Santiago de Compostela (IDIS), Santiago de Compostela, Spain. FAU - Lopez, Gonzalo AU - Lopez G AD - Biomedical Research Networking Centre in Mental Health (CIBERSAM), Barcelona, Spain. AD - Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Maranon (IiSGM), School of Medicine, Universidad Complutense, Madrid, Spain. FAU - Gonzalez-Penas, Javier AU - Gonzalez-Penas J AD - Biomedical Research Networking Centre in Mental Health (CIBERSAM), Barcelona, Spain. AD - Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Maranon (IiSGM), School of Medicine, Universidad Complutense, Madrid, Spain. FAU - Parellada, Mara AU - Parellada M AD - Biomedical Research Networking Centre in Mental Health (CIBERSAM), Barcelona, Spain. AD - Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Maranon (IiSGM), School of Medicine, Universidad Complutense, Madrid, Spain. FAU - Maric, Nadja P AU - Maric NP AD - Faculty of Medicine, University of Belgrade, Belgrade, Serbia. AD - Institute of Mental Health, Belgrade, Serbia. FAU - Atbasoglu, Cem AU - Atbasoglu C AD - Department of Psychiatry, School of Medicine, Ankara University, Ankara, Turkey. FAU - Ucok, Alp AU - Ucok A AD - Department of Psychiatry, Faculty of Medicine, Istanbul University, Istanbul, Turkey. FAU - Alptekin, Koksal AU - Alptekin K AD - Department of Psychiatry, Faculty of Medicine, Dokuz Eylul University, Izmir, Turkey. AD - Department of Neuroscience, Graduate School of Health Sciences, Dokuz Eylul University, Izmir, Turkey. FAU - Saka, Meram Can AU - Saka MC AD - Department of Psychiatry, School of Medicine, Ankara University, Ankara, Turkey. CN - Genetic Risk and Outcome of Psychosis (GROUP) investigators FAU - Arango, Celso AU - Arango C AD - Biomedical Research Networking Centre in Mental Health (CIBERSAM), Barcelona, Spain. AD - Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Maranon (IiSGM), School of Medicine, Universidad Complutense, Madrid, Spain. FAU - O'Donovan, Micheal C AU - O'Donovan MC AD - Division of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Cardiff, United Kingdom. FAU - Rutten, Bart P F AU - Rutten BPF AD - Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands. FAU - Guloksuz, Sinan AU - Guloksuz S AUID- ORCID: 0000-0002-6626-1874 AD - Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, The Netherlands. AD - Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut, USA. LA - eng GR - G08005009/MRC_/Medical Research Council/United Kingdom GR - MR/L010305/1/MRC_/Medical Research Council/United Kingdom PT - Journal Article PT - Research Support, Non-U.S. Gov't DEP - 20210319 PL - England TA - Eur Psychiatry JT - European psychiatry : the journal of the Association of European Psychiatrists JID - 9111820 SB - IM MH - Cross-Sectional Studies MH - *Exposome MH - Humans MH - *Psychotic Disorders MH - *Schizophrenia/genetics MH - Siblings PMC - PMC8080213 OTO - NOTNLM OT - cannabis OT - childhood trauma OT - environment OT - functioning OT - psychosis COIS- Celso Arango has been a consultant to or has received honoraria or grants from Acadia, Angelini, Gedeon Richter, Janssen-Cilag, Lundbeck, Minerva, Otsuka, Roche, Sage, Servier, Shire, Schering-Plough, Sumitomo Dainippon Pharma, Sunovion, and Takeda. Michael O'Donovan is supported by a collaborative research grant from Takeda Pharmaceuticals. Maria Paz Garcia-Portilla has been a consultant to and/or has received honoraria/grants from Angelini, Alianza Otsuka-Lundbeck, Instituto de Salud Carlos III, Janssen-Cilag, Lundbeck, Otsuka, Pfizer, and Sage Therapeutics. EDAT- 2021/03/20 06:00 MHDA- 2021/11/20 06:00 PMCR- 2021/03/19 CRDT- 2021/03/19 05:54 PHST- 2021/03/20 06:00 [pubmed] PHST- 2021/11/20 06:00 [medline] PHST- 2021/03/19 05:54 [entrez] PHST- 2021/03/19 00:00 [pmc-release] AID - S0924933821000195 [pii] AID - 10.1192/j.eurpsy.2021.19 [doi] PST - epublish SO - Eur Psychiatry. 2021 Mar 19;64(1):e25. doi: 10.1192/j.eurpsy.2021.19.