Cooperative Studies Program (CSP) #572: A Study of Serious Mental Illness in Veterans As a Pathway to Personalized Medicine in Schizophrenia and Bipolar Illness

Overview

Journal Pers Med Psychiatry

Specialty Psychiatry

Date 2021 Jul 5

PMID 34222732

Authors

Philip D Harvey

Tim B Bigdeli

Ayman H Fanous

Yuli Li

Nallakkandi Rajeevan

Frederick Sayward

Krishnan Radhakrishnan

Grant Huang

Mihaela Aslan

Affiliations

Soon will be listed here.

Abstract

Background: Personalization of psychiatric treatment includes treatment of symptoms, cognition and functional deficits, suicide, and medical co-morbidities. VA Collaborative Study 572 examined a large sample of male and female veterans with schizophrenia (n=3,942) and with bipolar disorder (n=5,414) with phenotyping and genomic analyses. We present the results to date and future directions.

Methods: All veterans received a structured diagnostic interview and assessments of suicidal ideation and behavior, PTSD, and health. Veterans with schizophrenia were assessed for negative symptoms and lifetime depression. All were assessed with a cognitive and functional capacity assessment. Data for genome wide association studies were collected. Controls came from the VA Million Veteran Program.

Results: Suicidal ideation or behavior was present in 66%. Cognitive and functional deficits were consistent with previous studies. 40% of the veterans with schizophrenia had a lifetime major depressive episode and PTSD was present in over 30%. Polygenic risk score (PRS) analyses indicated that cognitive and functional deficits overlapped with PRS for cognition, education, and intelligence in the general population and PRS for suicidal ideation and behavior correlated with previous PRS for depression and suicidal ideation and behavior, as did the PRS for PTSD.

Discussion: Results to date provide directions for personalization of treatment in SMI, veterans with SMI, and veterans in general. The results of the genomic analyses suggest that cognitive deficits in SMI may be associated with general population features. Upcoming genomic analyses will reexamine the issues above, as well as genomic factors associated with smoking, substance abuse, negative symptoms, and treatment response.

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