Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Original Article
  • Published:

Strong genetic evidence for a selective influence of GABAA receptors on a component of the bipolar disorder phenotype

A Corrigendum to this article was published on 14 September 2010

Abstract

Despite compelling evidence for a major genetic contribution to risk of bipolar mood disorder, conclusive evidence implicating specific genes or pathophysiological systems has proved elusive. In part this is likely to be related to the unknown validity of current phenotype definitions and consequent aetiological heterogeneity of samples. In the recent Wellcome Trust Case Control Consortium genome-wide association analysis of bipolar disorder (1868 cases, 2938 controls) one of the most strongly associated polymorphisms lay within the gene encoding the GABAA receptor β1 subunit, GABRB1. Aiming to increase biological homogeneity, we sought the diagnostic subset that showed the strongest signal at this polymorphism and used this to test for independent evidence of association with other members of the GABAA receptor gene family. The index signal was significantly enriched in the 279 cases meeting Research Diagnostic Criteria for schizoaffective disorder, bipolar type (P=3.8 × 10−6). Independently, these cases showed strong evidence that variation in GABAA receptor genes influences risk for this phenotype (independent system-wide P=6.6 × 10−5) with association signals also at GABRA4, GABRB3, GABRA5 and GABRR1. Our findings have the potential to inform understanding of presentation, pathogenesis and nosology of bipolar disorders. Our method of phenotype refinement may be useful in studies of other complex psychiatric and non-psychiatric disorders.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Similar content being viewed by others

References

  1. Müller-Oerlinghausen B, Berghöfer A, Bauer M . Bipolar disorder. Lancet 2002; 359: 241–247.

    Article  PubMed  Google Scholar 

  2. Craddock N, Jones I . Genetics of bipolar disorder. J Med Genet 1999; 36: 585–594.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  3. McGuffin P, Rijsdijk F, Andrew M, Sham P, Katz R, Cardno A . The heritability of bipolar affective disorder and the genetic relationship to unipolar depression. Arch Gen Psychiatry 2003; 60: 497–502.

    Article  PubMed  Google Scholar 

  4. Gershon ES, Liu C, Badner JA . Genome-wide association in bipolar. Mol Psychiatry 2008; 13: 1–2.

    Article  CAS  PubMed  Google Scholar 

  5. Hayden EP, Nurnberger Jr JI . Molecular genetics of bipolar disorder. Genes Brain Behav 2006; 5: 85–95.

    Article  CAS  PubMed  Google Scholar 

  6. Potash JB . Carving chaos: genetics and the classification of mood and psychotic syndromes. Harv Rev Psychiatry 2006; 14: 47–63.

    Article  PubMed  Google Scholar 

  7. Maier W, Höfgen B, Zobel A, Rietschel M . Models of schizophrenia and bipolar disorder: overlapping inheritance or discrete genotypes? Eur Arch Psychiatry Clin Neurosci 2005; 255: 159–166.

    Article  PubMed  Google Scholar 

  8. Berrettini W . Bipolar disorder and schizophrenia: not so distant relatives? World Psychiatry 2003; 2: 68–72.

    PubMed  PubMed Central  Google Scholar 

  9. Craddock N, O’Donovan MC, Owen MJ . The genetics of schizophrenia and bipolar disorder: dissecting psychosis. J Med Genet 2005; 42: 193–204.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  10. Potash JB, Zandi PP, Willour VL, Lan TH, Huo Y, Avramopoulos D et al. Suggestive linkage to chromosomal regions 13q31 and 22q12 in families with psychotic bipolar disorder. Am J Psychiatry 2003; 160: 680–686.

    Article  PubMed  Google Scholar 

  11. Park N, Juo SH, Cheng R, Liu J, Loth JE, Lilliston B et al. Linkage analysis of psychosis in bipolar pedigrees suggests novel putative loci for bipolar disorder and shared susceptibility with schizophrenia. Mol Psychiatry 2004; 9: 1091–1099.

    Article  CAS  PubMed  Google Scholar 

  12. Maziade M, Roy MA, Chagnon YC, Cliche D, Fournier JP, Montgrain N et al. Shared and specific susceptibility loci for schizophrenia and bipolar disorder: a dense genome scan in Eastern Quebec families. Mol Psychiatry 2005; 10: 486–499.

    Article  CAS  PubMed  Google Scholar 

  13. Craddock N, Owen MJ . Rethinking psychosis: the disadvantages of a dichotomous classification now outweigh the advantages. World Psychiatry 2007; 6: 20–27.

    Google Scholar 

  14. Wellcome Trust Case Control Consortium. Genome-wide association study of 14 000 cases of seven common diseases and 3000 shared controls. Nature 2007; 447: 661–678.

    Article  Google Scholar 

  15. Brambilla P, Perez J, Barale F, Schettini G, Soares JC . GABAergic dysfunction in mood disorders. Mol Psychiatry 2003; 8: 721–737, 715.

    Article  CAS  PubMed  Google Scholar 

  16. Coyle JT . The GABA-glutamate connection in schizophrenia: which is the proximate cause? Biochem Pharmacol 2004; 68: 1507–1514.

    Article  CAS  PubMed  Google Scholar 

  17. Kalueff AV, Nutt DJ . Role of GABA in anxiety and depression. Depress Anxiety 2007; 24: 495–517.

    Article  CAS  PubMed  Google Scholar 

  18. Krystal JH, Staley J, Mason G, Petrakis IL, Kaufman J, Harris RA et al. Gamma-aminobutyric acid type A receptors and alcoholism: intoxication, dependence, vulnerability, and treatment. Arch Gen Psychiatry 2006; 63: 957–968.

    Article  CAS  PubMed  Google Scholar 

  19. Moss SJ, Smart TG . Constructing inhibitory synapses. Nat Rev Neurosci 2001; 2: 240–250.

    Article  CAS  PubMed  Google Scholar 

  20. Möhler H . GABA(A) receptor diversity and pharmacology. Cell Tissue Res 2006; 326: 505–516.

    Article  PubMed  Google Scholar 

  21. Rudolph U, Crestani F, Möhler H . GABA(A) receptor subtypes: dissecting their pharmacological functions. Trends Pharmacol Sci 2001; 22: 188–194.

    Article  CAS  PubMed  Google Scholar 

  22. Simon J, Wakimoto H, Fujita N, Lalande M, Barnard EA . Analysis of the set of GABA(A) receptor genes in the human genome. J Biol Chem 2004; 279: 41422–41435.

    Article  CAS  PubMed  Google Scholar 

  23. Spitzer RL, Endicott J, Robins E . Research diagnostic criteria: rationale and reliability. Arch Gen Psychiatry 1978; 35: 773–782.

    Article  CAS  PubMed  Google Scholar 

  24. Wing JK, Babor T, Brugha T, Burke J, Cooper JE, Giel R et al. SCAN: Schedules for Clinical Assessment in Neuropsychiatry. Arch Gen Psychiatry 1990; 47: 589–593.

    Article  CAS  PubMed  Google Scholar 

  25. McGuffin P, Farmer A, Harvey I . A polydiagnostic application of operational criteria in studies of psychotic illness. Development and reliability of the OPCRIT system. Arch Gen Psychiatry 1991; 48: 764–770.

    Article  CAS  PubMed  Google Scholar 

  26. Green EK, Raybould R, Macgregor S, Hyde S, Young AH, O’Donovan MC et al. Genetic variation of brain-derived neurotrophic factor (BDNF) in bipolar disorder: case-control study of over 3000 individuals from the UK. Br J Psychiatry 2006; 188: 21–25.

    Article  PubMed  Google Scholar 

  27. Green EK, Raybould R, Macgregor S, Gordon-Smith K, Heron J, Hyde S et al. Operation of the schizophrenia susceptibility gene, neuregulin 1, across traditional diagnostic boundaries to increase risk for bipolar disorder. Arch Gen Psychiatry 2005; 62: 642–648.

    Article  CAS  PubMed  Google Scholar 

  28. American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, 4th edn. American Psychiatric Press: Washington, DC, 1994.

  29. Craddock N, Jones I, Kirov G, Jones L . The Bipolar Affective Disorder Dimension Scale (BADDS)—a dimensional scale for rating lifetime psychopathology in bipolar spectrum disorders. BMC Psychiatry 2004; 5: 4:19.

    Google Scholar 

  30. Hoh J, Wille A, Ott J . Trimming, weighting, and grouping SNPs in human case-control association studies. Genome Res 2001; 11: 2115–2119.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  31. Barrett JC, Fry B, Maller J, Daly MJ . Haploview: analysis and visualization of LD and haplotype maps. Bioinformatics 2005; 21: 263–265.

    Article  CAS  PubMed  Google Scholar 

  32. Purcell S, Neale B, Todd-Brown K, Thomas L, Ferreira MA, Bender D et al. PLINK: a tool set for whole-genome association and population-based linkage analyses. Am J Hum Genet 2007; 81: 559–575.

    Article  CAS  PubMed  PubMed Central  Google Scholar 

  33. Khoury MJ, Beaty TH, Cohen BH (eds). Fundamentals of Genetic Epidemiology 1993; Oxford University Press: Oxford, 381p.

    Google Scholar 

  34. Lattin JM, Carroll JD, Green PE . Analyzing Multivariate Data. Thomson Brooks/Cole: Pacific Grove, CA, 2003.

    Google Scholar 

  35. Hattori E, Liu C, Zhu H, Gershon ES . Genetic tests of biologic systems in affective disorders. Mol Psychiatry 2005; 10: 719–740.

    Article  CAS  PubMed  Google Scholar 

  36. Hamshere ML, Bennett P, Williams N, Segurado R, Cardno A, Norton N et al. Genomewide linkage scan in schizoaffective disorder: significant evidence for linkage at 1q42 close to DISC1, and suggestive evidence at 22q11 and 19p13. Arch Gen Psychiatry 2005; 62: 1081–1088.

    Article  CAS  PubMed  Google Scholar 

  37. Craddock N, Owen MJ . The beginning of the end for the Kraepelinian dichotomy. Br J Psychiatry 2005; 186: 364–366.

    Article  PubMed  Google Scholar 

  38. Merikangas KR, Ames M, Cui L, Stang PE, Ustun TB, Von Korff M et al. The impact of comorbidity of mental and physical conditions on role disability in the US adult household population. Arch Gen Psychiatry 2007; 64: 1180–1188.

    Article  PubMed  PubMed Central  Google Scholar 

  39. Craddock N, Owen MJ, O’Donovan MC . The catechol-O-methyl transferase (COMT) gene as a candidate for psychiatric phenotypes: evidence and lessons. Mol Psychiatry 2006; 11: 446–458.

    Article  CAS  PubMed  Google Scholar 

Download references

Acknowledgements

We are indebted to all individuals who have participated in our research. Funding for recruitment and phenotype assessment has been provided by the Wellcome Trust and the Medical Research Council. We are grateful to Dr Shaun Purcell for advice and support in the use of the PLINK analysis software. The genotype analyses were funded by the Wellcome Trust and undertaken within the context of the Wellcome Trust Case Control Consortium (WTCCC). The members of the WTCCC are listed in online supplementary information.

Author information

Authors and Affiliations

Authors

Consortia

Corresponding author

Correspondence to N Craddock.

Additional information

Supplementary Information accompanies the paper on the Molecular Psychiatry website (http://www.nature.com/mp)

Supplementary information

Rights and permissions

Reprints and permissions

About this article

Cite this article

Craddock, N., Jones, L., Jones, I. et al. Strong genetic evidence for a selective influence of GABAA receptors on a component of the bipolar disorder phenotype. Mol Psychiatry 15, 146–153 (2010). https://doi.org/10.1038/mp.2008.66

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/mp.2008.66

Keywords

This article is cited by

Search

Quick links