Cited by 1,519Bipolar Disorder and TreatmentGenetic Associations and EpidemiologySchizophrenia research and treatment

Genome-wide association study identifies 30 loci associated with bipolar disorder

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eQTLGen Consortium, Stahl, Eli A., BIOS Consortium, the Bipolar Disorder Working Group of the Psychiatric Genomics Consortium, Breen, Gerome, Forstner, Andreas J., McQuillin, Andrew, Ripke, Stephan +272 more·2019·Nature Genetics

Published version of a preprint

Abstract

Bipolar disorder is a highly heritable psychiatric disorder. We performed a genome-wide association study (GWAS) including 20,352 cases and 31,358 controls of European descent, with follow-up analysis of 822 variants with P < 1 × 10−4 in an additional 9,412 cases and 137,760 controls. Eight of the 19 variants that were genome-wide significant (P < 5 × 10−8) in the discovery GWAS were not genome-wide significant in the combined analysis, consistent with small effect sizes and limited power but also with genetic heterogeneity. In the combined analysis, 30 loci were genome-wide significant, including 20 newly identified loci. The significant loci contain genes encoding ion channels, neurotransmitter transporters and synaptic components. Pathway analysis revealed nine significantly enriched gene sets, including regulation of insulin secretion and endocannabinoid signaling. Bipolar I disorder is strongly genetically correlated with schizophrenia, driven by psychosis, whereas bipolar II disorder is more strongly correlated with major depressive disorder. These findings address key clinical questions and provide potential biological mechanisms for bipolar disorder. Genome-wide analysis identifies 30 loci associated with bipolar disorder, allowing for comparisons of shared genes and pathways with other psychiatric disorders, including schizophrenia and depression.

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  • Upregulated genes in chronological aging showed overrepresentation for genes in AD or PD GWAS loci, but not for genes in SCZ or BD.

    “The upregulated genes in chronological aging showed overrepresentation for genes in AD (e.g. MS4A6A, FCER1G, and CR1) or PD (e.g. BST1, PTPN22, and TNFSF13) GWAS loci, but not for genes in schizophrenia (SCZ) or bipolar disorder (BD) (Fig. 3d).”

    From Genetic analysis of the human microglial transcriptome across brain regions, aging and disease pathologies (2022) · cites this paper as [35]

    The Results section (‘Follow-up of suggestive loci in additional samples’; page unavailable) identifies 30 bipolar-disorder GWAS loci, supporting use of this paper as a source for BD loci. It does not test whether genes upregulated in chronological aging are overrepresented in AD or PD loci but not SCZ or BD loci; that comparison is not supported by this source. (LLM, conf=0.83)

    Experimental — accuracy not yet measured
  • There is a significant genetic overlap between people with addictive disorders and people with bipolar disorder.

    “There is a significant genetic overlap between people with addictive disorders and people with BD as demonstrated both by family studies (16) and shared polymorphisms of candidate genes involved in monoamine transport or metabolism (17, 18).”

    From The detrimental effects of smoking on the course and outcome in adults with bipolar disorder—A narrative review (2023) · cites this paper as [17]

    The Results section, “Shared loci and genetic correlations with other traits” (page unavailable), reports genetic correlations between bipolar disorder and schizophrenia, depression, and several other traits, but not addictive disorders. Searches for addiction, substance dependence, family studies, and shared monoamine-gene polymorphisms found no passage establishing the claimed overlap. (LLM, conf=0.72)

    Experimental — accuracy not yet measured
  • In several GWASs of depression-related traits, TNKS was found to be associated with depression-related traits (p = 7.68 × 10−10), bipolar disorder (p = 3 × 10−6), and positive affect (p = 0.0003).

    “In several genome-wide association studies (GWASs) of depression-related traits, TNKS was found to be associated with (p = 7.68 × 10−10)38, bipolar disorder (p = 3 × 10−6)39, and positive affect (p = 0.0003)40.”

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Research works printed but not linked: 3

  1. [35]Cross-Disorder Group of the Psychiatric Genomics Consortium Genetic relationship between five psychiatric disorders estimated from genome-wide SNPs. Nat. Genet 45, 984– 994 (2013). 23933821 PMC3800159
  2. [44]Hou L Genome-wide association study of 40,000 individuals identifies two novel loci associated with bipolar disorder. Hum. Mol. Genet 25, 3383– 3394 (2016). 27329760 PMC5179929
  3. [57]Palmer C & Pe’er I Statistical Correction of the Winner9s Curse Explains Replication Variability in Quantitative Trait Genome-Wide Association Studies. bioRxiv 104786 (2017). PMC5536394 28715421

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eQTLGen Consortium, Stahl, E. A., BIOS Consortium, the Bipolar Disorder Working Group of the Psychiatric Genomics Consortium, Breen, G., Forstner, A. J., McQuillin, A., Ripke, S., Trubetskoy, V., Mattheisen, M., Wang, Y., Coleman, J. R. I., Gaspar, H. A., de Leeuw, C. A., Steinberg, S., Pavlides, J. M. W., Trzaskowski, M., Byrne, E. M., Pers, T. H., Holmans, P. A., Richards, A. L., Abbott, L., Agerbo, E., Akil, H., Albani, D., Alliey-Rodriguez, N., Als, T. D., Anjorin, A., Antilla, V., Awasthi, S., Badner, J. A., Bækvad-Hansen, M., Barchas, J. D., Bass, N., Bauer, M., Belliveau, R., Bergen, S. E., Pedersen, C. B., Bøen, E., Boks, M. P., Boocock, J., Budde, M., Bunney, W., Burmeister, M., Bybjerg-Grauholm, J., Byerley, W., Casas, M., Cerrato, F., Cervantes, P., Chambert, K., Charney, A. W., Chen, D., Churchhouse, C., Clarke, T.-K., Coryell, W., Craig, D. W., Cruceanu, C., Curtis, D., Czerski, P. M., Dale, A. M., de Jong, S., Degenhardt, F., Del-Favero, J., DePaulo, J. R., Djurovic, S., Dobbyn, A. L., Dumont, A., Elvsåshagen, T., Escott-Price, V., Fan, C. C., Fischer, S. B., Flickinger, M., Foroud, T. M., Forty, L., Frank, J., Fraser, C., Freimer, N. B., Frisén, L., Gade, K., Gage, D., Garnham, J., Giambartolomei, C., Pedersen, M. G., Goldstein, J., Gordon, S. D., Gordon-Smith, K., Green, E. K., Green, M. J., Greenwood, T. A., Grove, J., Guan, W., Guzman-Parra, J., Hamshere, M. L., Hautzinger, M., Heilbronner, U., Herms, S., Hipolito, M., Hoffmann, P., Holland, D., Huckins, L., Jamain, S., Johnson, J. S., Juréus, A., Kandaswamy, R., Karlsson, R., Kennedy, J. L., Kittel-Schneider, S., Knowles, J. A., Kogevinas, M., Koller, A. C., Kupka, R., Lavebratt, C., Lawrence, J., Lawson, W. B., Leber, M., Lee, P. H., Levy, S. E., Li, J. Z., Liu, C., Lucae, S., Maaser, A., MacIntyre, D. J., Mahon, P. B., Maier, W., Martinsson, L., McCarroll, S., McGuffin, P., McInnis, M. G., McKay, J. D., Medeiros, H., Medland, S. E., Meng, F., Milani, L., Montgomery, G. W., Morris, D. W., Mühleisen, T. W., Mullins, N., Nguyen, H., Nievergelt, C. M., Adolfsson, A. N., Nwulia, E. A., O’Donovan, C., Loohuis, L. M. O., Ori, A. P. S., Oruc, L., Ösby, U., Perlis, R. H., Perry, A., Pfennig, A., Potash, J. B., Purcell, S. M., Regeer, E. J., Reif, A., Reinbold, C. S., Rice, J. P., Rivas, F., Rivera, M., Roussos, P., Ruderfer, D. M., Ryu, E., Sánchez-Mora, C., Schatzberg, A. F., Scheftner, W. A., Schork, N. J., Shannon Weickert, C., Shehktman, T., Shilling, P. D., Sigurdsson, E., Slaney, C., Smeland, O. B., Sobell, J. L., Søholm Hansen, C., Spijker, A. T., St Clair, D., Steffens, M., Strauss, J. S., Streit, F., Strohmaier, J., Szelinger, S., Thompson, R. C., Thorgeirsson, T. E., Treutlein, J., Vedder, H., Wang, W., Watson, S. J., Weickert, T. W., Witt, S. H., Xi, S., Xu, W., Young, A. H., Zandi, P., Zhang, P., Zöllner, S., Adolfsson, R., Agartz, I., Alda, M., Backlund, L., Baune, B. T., Bellivier, F., Berrettini, W. H., Biernacka, J. M., Blackwood, D. H. R., Boehnke, M., Børglum, A. D., Corvin, A., Craddock, N., Daly, M. J., Dannlowski, U., Esko, T., Etain, B., Frye, M., Fullerton, J. M., Gershon, E. S., Gill, M., Goes, F., Grigoroiu-Serbanescu, M., Hauser, J., Hougaard, D. M., Hultman, C. M., Jones, I., Jones, L. A., Kahn, R. S., Kirov, G., Landén, M., Leboyer, M., Lewis, C. M., Li, Q. S., Lissowska, J., Martin, N. G., Mayoral, F., McElroy, S. L., McIntosh, A. M., McMahon, F. J., Melle, I., Metspalu, A., Mitchell, P. B., Morken, G., Mors, O., Mortensen, P. B., Müller-Myhsok, B., Myers, R. M., Neale, B. M., Nimgaonkar, V., Nordentoft, M., Nöthen, M. M., O’Donovan, M. C., Oedegaard, K. J., Owen, M. J., Paciga, S. A., Pato, C., Pato, M. T., Posthuma, D., Ramos-Quiroga, J. A., Ribasés, M., Rietschel, M., Rouleau, G. A., Schalling, M., Schofield, P. R., Schulze, T. G., Serretti, A., Smoller, J. W., Stefansson, H., Stefansson, K., Stordal, E., Sullivan, P. F., Turecki, G., Vaaler, A. E., Vieta, E., Vincent, J. B., Werge, T., Nurnberger, J. I., Wray, N. R., Di Florio, A., Edenberg, H. J., Cichon, S., Ophoff, R. A., Scott, L. J., Andreassen, O. A., Kelsoe, J., & Sklar, P.
Affiliations
  • Broad Institute (US)
  • King's College London (GB)
  • University of Bonn (DE)
  • University College London (GB)
  • Charité – Universitätsmedizin Berlin (DE)
  • Aarhus University (DK)
  • University of Oslo (NO)
  • deCODE Genetics (Iceland) (IS)
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  • Weill Cornell Medicine (US)
  • University Hospital Carl Gustav Carus (DE)
  • Karolinska Institutet (SE)
  • Diakonhjemmet Hospital (NO)
  • University Medical Center Utrecht (NL)
  • University of California, Los Angeles (US)
  • Institut für Psychiatrische Phänomik und Genomik (DE)
  • University of California, Irvine (US)
  • University of California, San Francisco (US)
  • McGill University Health Centre (CA)
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Corresponding author
  • Stahl, Eli A.
  • Kelsoe, John
ORCID
Venue
Nature Genetics
Published
2019-05
Volume
51
Issue
5
Pages
793-803
ISSN
  • 1061-4036 (ISSN-L)
  • 1546-1718
OpenAlex
W2950375827
Cited by
1,519
References
82
Citations by year
2026: 77 · 2025: 130 · 2024: 177 · 2023: 185 · 2022: 246 · 2021: 303 · 2020: 235 · 2019: 121 · 2018: 36 · 2017: 4 · 2016: 1
FWCI
38.58
Type
journal article
Language
en
Open access
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  • Deutsche Forschungsgemeinschaft (Dan3/012/17, FOR 2107/ DA1151/5-1, TRR‐58, DA1151/5-1, FOR 2107, DA1151, 01ZX1314A/01ZX1614A, 667302, SFB TRR 58)
  • Agence Nationale de la Recherche (12,13)
  • Schweizerischer Nationalfonds zur Förderung der Wissenschaftlichen Forschung
  • Bundesministerium für Bildung und Forschung (FOR2107 DA1151/5-1, 01ZX1314A/01ZX1614A, 01ZX1614A, 01ZX1314A)
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  • Norges Forskningsråd ((#217776, 223273, #249711, FOR2107, 248778, 2017-004, SFB-TRR58, DA1151/5-1)
  • Universitat de Barcelona
  • Università di Bologna
  • Centro de Investigación Biomédica en Red de Salud Mental
  • Rheinische Friedrich-Wilhelms-Universität Bonn
  • NSW Ministry of Health
  • H. Lundbeck A/S
  • Victoria General Hospital Foundation
  • National Institutes of Health (223273, DA1151/5-1, SFB-TRR58, 2017-004, FOR2107)
  • Stanley Center for Psychiatric Research, Broad Institute
  • Center for Individualized Medicine, Mayo Clinic
  • NIHR Maudsley Biomedical Research Centre
  • Canadian Institutes of Health Research
  • Medical Research Council (MR/L023784/2, G0801418, G1000708, MR/L010305/1, G0800509)
  • National Health and Medical Research Council (568807, 630471, 1081603)
  • European Regional Development Fund
  • Departament de Salut, Generalitat de Catalunya
  • National Institute of Mental Health (U01MH109514, MH094421, U01MH109528, U01MH085520, R00MH101367, SFB-TRR58, R01MH119243, U01MH109536, R01MH085542, DA 1151/5-1, U01MH094421, MH109528, MH085520, FOR2107, R01MH085548, R01MH104964, U01MH105578, R01MH123451)
Topics
  • Health Sciences › Medicine › Psychiatry and Mental health › Bipolar Disorder and Treatment
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetic Associations and Epidemiology
  • Health Sciences › Medicine › Psychiatry and Mental health › Schizophrenia research and treatment
Keywords
bipolar disorder, bipolar I disorder, bipolar II disorder, genetic loci, genetic heterogeneity, ion channels, neurotransmitter transporters, synaptic genes, insulin secretion, endocannabinoid signaling, genetic correlation, schizophrenia, major depressive disorder, psychosis, psychiatric genetics
MeSH terms
Bipolar Disorder, Depressive Disorder, Major, Major Depressive Disorder, Female, Humans, Male, Psychotic Disorders, Schizophrenia, Case-Control Studies, Genetic Predisposition to Disease, Polymorphism, Single Nucleotide, Systems Biology, Genome-Wide Association Study, Genetic Loci

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