Exploring the influences of education,intelligence and income on mental disorders

Background Previous studies have shown that educational attainment(EA),intelligence and income are key factors associated with mental disorders.However,the direct effects of each factor on major mental disorders are unclear.Aims We aimed to evaluate the overall and independent causal effects of the three psychosocial factors on common mental disorders.Methods Using genome-wide association study summary datasets,we performed Mendelian randomisation(MR)and multivariable MR(MVMR)analyses to assess potential associations between the 3 factors(EA,N=766345;household income,N=392422;intelligence,N=146808)and 13 common mental disorders,with sample sizes ranging from 9907 to 807553.Inverse-variance weighting was employed as the main method in the MR analysis.Results Our MR analysis showed that(1)higher EA was a protective factor for eight mental disorders but contributed to anorexia nervosa,obsessive-compulsive disorder(OCD),bipolar disorder(BD)and autism spectrum disorder(ASD);(2)higher intelligence was a protective factor for five mental disorders but a risk factor for OCD and ASD;(3)higher household income protected against 10 mental disorders but confers risk for anorexia nervosa.Our MVMR analysis showed that(1)higher EA was a direct protective factor for attention-deficit/hyperactivity disorder(ADHD)and insomnia but a direct risk factor for schizophrenia,BD and ASD;(2)higher intelligence was a direct protective factor for schizophrenia but a direct risk factor for major depressive disorder(MDD)and ASD;(3)higher income was a direct protective factor for seven mental disorders,including schizophrenia,BD,MDD,ASD,post-traumatic stress disorder,ADHD and anxiety disorder.Conclusions Our study reveals that education,intelligence and income intertwine with each other.For each factor,its independent effects on mental disorders present a more complex picture than its overall effects.

Causal associations between major depressive disorder and COVID-19

Background We aimed to evaluate whether major depressive disorder(MDD)could aggravate the outcomes of coronavirus disease 2019(COVID-19)or whether the genetic liability to COVID-19 could trigger MDD.Aims We aimed to assess bidirectional causal associations between MDD and COVID-19.Methods We performed genetic correlation and Mendelian randomisation(MR)analyses to assess potential associations between MDD and three COVID-19 outcomes.Literature-based network analysis was conducted to construct molecular pathways connecting MDD and COVID-19.Results We found that MDD has positive genetic correlations with COVID-19 outcomes(rg:0.10–0.15).Our MR analysis indicated that genetic liability to MDD is associated with increased risks of COVID-19 infection(odds ratio(OR)=1.05,95%confidence interval(CI):1.00 to 1.10,p=0.039).However,genetic liability to the three COVID-19 outcomes did not confer any causal effects on MDD.Pathway analysis identified a panel of immunity-related genes that may mediate the links between MDD and COVID-19.Conclusions Our study suggests that MDD may increase the susceptibility to COVID-19.Our findings emphasise the need to increase social support and improve mental health intervention networks for people with mood disorders during the pandemic.

男性偏执型精神分裂症患者半球间与半球内整合异常:一项图形理论分析（英文）

背景:人类大脑是由白质(WM)束结构性互相连结的复杂网络。精神分裂症(schizophrenia,SZ)可以被概念化为以WM路径广泛断开为特征的中断综合征。目的:评估解剖性断开是否与SZ患者的大脑半球内与大脑半球间的拓扑性质破坏有关。方法:我们采集了24例处于发病急性期的偏执型精神分裂症男性患者和24例与之年龄匹配的健康男性对照组的弥散张量成像(diffusion tensor imaging)数据。本研究构建了大脑的部分各向异性加权的(fractional anisotropy-weighted,FA-weighted)结构网络,并且通过估计平均特征路径长度(characteristic path lengths,CPLs)评估大脑内半球间与半球内的整合。结果:SZ患者组的全部18个所评估的半球间与半球内的CPL值均值均长于对照组,但这些差异中只有一些具有显著性,包括:整体半球间、左半球内部和右半球内部网络的CPL;额叶、颞叶和皮质下结构的半球间子网络的CPL;以及右半球内额叶子网络的CPL。在24例患者中,双侧额叶子网络间的CPL与阴性症状严重程度正相关,但这是72个相关性分析中唯一显著的结果,所以它可能只有统计学上的显著意义。结论:我们的研究结果表明,男性偏执型SZ患者的脑半球内和半球间白质束的完整性被破坏,这支持了精神分裂症的大脑网络中断模型(即"连通性假说")。我们需要对更特异的精神分裂症患者样本进行更大规模的研究来证实这些结果。

Clinical features and treatment outcomes of major depressive disorder with genital symptoms

To the Editor:Major depressive disorder(MDD)is a mood disorder characterized by complex patterns of emotional,cognitive,and behavioral symptomology and deficits in daily functioning.Genital symptoms,including a reduction in libido and menstrual disturbances,have been considered to be a classic symptom of MDD for many decades.Previous evidence has reached a broad consensus that the incidence of genital symptoms is higher in patients with MDD than in the general population.A systematic review and meta-analysis found a bidirectional association between MDD and genital symptoms,with patients with MDD showing a 50–70%increased risk of developing genital symptoms,while individuals with genital symptoms had a 130–210%increased risk of developing MDD.^([1])As previously reported,50–70%of people with MDD experience sexual dysfunction.^([2])To date,few studies have focused on the comparison of clinical features between patients with MDD with and without genital symptoms,and the longitudinal prognosis.