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Annotation

Sullivan PF, Magnusson C, Reichenberg A, Boman M, Dalman C, Davidson M, Fruchter E, Hultman CM, Lundberg M, Långström N, Weiser M, Svensson AC, Lichtenstein P. Family History of Schizophrenia and Bipolar Disorder as Risk Factors for AutismFamily History of Psychosis as Risk Factor for ASD. Arch Gen Psychiatry . 2012 Jul 2 ; :1-5. PubMed Abstract

Comments on Paper and Primary News
Primary News: Family Roots for Autism, Schizophrenia, Bipolar Disorder

Comment by:  Bernard Crespi
Submitted 30 July 2012 Posted 30 July 2012

In a new paper in Archives of General Psychiatry that has received considerable media attention, Sullivan et al. (Sullivan et al., 2012) use register data from Sweden and Israel to show higher rates of ASDs among individuals with family histories of schizophrenia and bipolar disorder. The authors interpret these results as indicating that ASD, schizophrenia, and bipolar disorder share etiology. This is a very interesting hypothesis that, if supported, would have important implications for our understanding of the genetic underpinnings of schizophrenia in relation to other conditions. However, two alternative hypotheses not involving shared causation may, at least in part, help to explain their results.

First, a recent set of studies demonstrates that drug treatments for schizophrenia and bipolar disorder increase the incidence of ASDs, or their biologically based phenotypic correlates, in offspring. Croen et al. (Croen et al., 2011) reported that prenatal exposure to...  Read more


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Primary News: Family Roots for Autism, Schizophrenia, Bipolar Disorder

Comment by:  William Carpenter, SRF Advisor (Disclosure)
Submitted 30 July 2012 Posted 30 July 2012

Shared risk for ASDs in bipolar and schizophrenia families is important, and the apparent gradient in risk with schizophrenia being greater than bipolar may be informative. From the view that schizophrenia and bipolar disorder are heterogeneous syndromes, the following is surmised:

  • The association with ASDs probably is related to specific aspects of shared features, perhaps impaired social affiliation or neurodevelopmental pathology.
  • These features are more common in schizophrenia than in bipolar disorder, so the gradient may be determined by the difference in proportion of relevant probands with the key features.
  • If the same data could be reduced to family definition based on probands who have impaired social affiliation and/or neurodevelopmental psychopathology, then the odds ratios might be substantially higher and the ORs for schizophrenia and bipolar disorder might be more similar.


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Primary News: Family Roots for Autism, Schizophrenia, Bipolar Disorder

Comment by:  John McGrath, SRF Advisor
Submitted 30 July 2012 Posted 30 July 2012
  I recommend this paper

This impressive study adds to the growing body of evidence demonstrating that heritable factors are shared among autism, schizophrenia, and bipolar disorder. The authors suggest that genetic factors could underlie the findings, but also remind the reader that environmental factors could play a role. They note that twin-based studies of heritability in schizophrenia and autism have demonstrated appreciable contributions for environmental factors that were shared between the affected individuals—usually referred to as common environmental effects. It should be noted that in this context, the word “common” does not equate with “prevalent.” With respect to shared genetic factors, the growing body of evidence regarding structural variation such as copy number variants is impressive. With respect to non-genetic factors, more work is needed—prenatal infection (which could trigger maternal immune activation) and nutrition (e.g., low vitamin D) might be candidate domains. If there are shared environmental risk factors contributing to schizophrenia, bipolar disorder, and...  Read more


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