Explore the vast range of titles available.

BackgroundPsychotic disorders, including schizophrenia (SZ), schizoaffective disorder (SZA), bipolar disorder (BD), psychotic depression (PD), and other nonaffective psychoses (ONAP), are associated with increased risk of suicidal acts. Few studies have compared suicidal act prevalence across psychotic disorders using both self-report and register data. The impact of hospitalization duration on subsequent suicidal acts is unclear.MethodsWe used data from the SUPER-Finland study, involving 7067 participants with register-based ICD-10 diagnoses of psychotic disorders (SZ, SZA, BD, PD, ONAP). Lifetime suicidal acts were identified through self-report and register-based records of intentional self-harm events requiring medical treatment. Associations between diagnostic categories and suicidal acts were assessed using logistic regression, adjusted for sex, duration of illness, socioeconomic status, childhood abuse, and substance use. Survival analysis was used to examine the impact of hospital stay length on postdischarge self-harm.ResultsLifetime suicide attempts (39.1%) and register self-harm (19.3%) were prevalent. of those with self-reported suicide attempts, 40.5% also had register-based self-harm. Self-harm and suicide attempts were significantly more prevalent in SZA, BD, and PD compared to schizophrenia, with large differences between groups (24.1–46.4% for suicide attempts, 11.1–23.9% for self-harm). Adjusted odds of self-harm were higher for disorders with a mood component. Shorter hospitalizations were associated with an elevated hazard ratio for subsequent self-harm.ConclusionsPrevalence of register-based self-harm and self-reported suicide attempts differ markedly. Suicidal acts are common in psychotic disorders, particularly in those with a mood component. Very short inpatient stays may not be adequate in these disorders.

Schizophrenia (SZ), schizoaffective disorder (SZA), bipolar disorder (BD), and psychotic depression (PD) are associated with premature death due to preventable general medical comorbidities (GMCs). The interaction between psychosis, risk factors, and GMCs is complex and should be elucidated. More research particularly among those with SZA or PD is warranted. We evaluated the association between registry-based psychotic disorders and GMC diagnoses in a large national sample of participants with different psychotic disorders. In addition, we examined whether body mass index (BMI) and smoking as risk factors for GMCs explain differences between diagnostic groups. This was a cross-sectional study of a clinical population of participants (n = 10,417) in the Finnish SUPER study. Registry-based diagnoses of psychotic disorders and hypertension, diabetes, chronic obstructive pulmonary disease (COPD), cancers, ischemic heart disease, and liver disorders were obtained. Participants’ BMI and self-reported smoking were recorded. Total effect of diagnostic category adjusted for age and sex as well as direct effect including known risk factors was calculated using logistic regression. Regardless of diagnostic category, participants had high BMI (average 30.3 kg/m2), and current smoking was common (42.4%). Diabetes and COPD were more common in SZ than in other diagnostic categories. The differences between psychotic disorders were not explained by obesity or smoking status only. Obesity and smoking were prevalent in all diagnostic categories of psychotic disorders, and continued efforts at prevention are warranted. Additional differences in GMC prevalence exist between psychotic disorders that are not explained by obesity and smoking.

Compelling evidence suggests that human cognitive function is strongly influenced by genetics. Here, we conduct a large-scale exome study to examine whether rare protein-coding variants impact cognitive function in the adult population ( n  = 485,930). We identify eight genes ( ADGRB2 , KDM5B , GIGYF1 , ANKRD12 , SLC8A1 , RC3H2 , CACNA1A and BCAS3 ) that are associated with adult cognitive function through rare coding variants with large effects. Rare genetic architecture for cognitive function partially overlaps with that of neurodevelopmental disorders. In the case of KDM5B we show how the genetic dosage of one of these genes may determine the variability of cognitive, behavioral and molecular traits in mice and humans. We further provide evidence that rare and common variants overlap in association signals and contribute additively to cognitive function. Our study introduces the relevance of rare coding variants for cognitive function and unveils high-impact monogenic contributions to how cognitive function is distributed in the normal adult population. Analysis of rare coding variants in the UK Biobank identifies eight genes associated with adult cognitive function, including KDM5B . Rare and common variant signals overlap and contribute additively to the phenotype.

Sleep problems are common in psychotic disorders and are associated with worse quality of life and disease prognosis. Genome-wide association studies (GWAS) have revealed genetic influences for schizophrenia and sleep, but polygenic scores (PGSs) for sleep traits have not been evaluated systematically in patients with psychotic disorders. This study investigated the associations between PGSs for sleep traits (insomnia, PGS ; sleep duration, PGS ; short sleep duration, PGS ; long sleep duration; PGS ), diurnal preference (eveningness, PGS ), and schizophrenia (PGS ) with clinical features of psychotic disorders in the Finnish SUPER study comprising 8,232 patients with psychotic disorders. The measures included self-reported sleep and well-being, cognitive assessments, clozapine use, and functional outcomes. Using FinnGen data of 356,077 individuals, we analyzed the distributions of PGSs in psychotic and bipolar disorders and the general population. PGS associated with more sleep problems and worse well-being (e.g. worse health-related quality of life [β = -0.07, CI = -0.09, -0.05,  < .001]). High PGS is associated with better sleep quality, worse clinical outcomes, and performance in cognitive tests (e.g. more errors in paired-associated learning [β = 0.07, CI = 0.04, 0.09,  < .001]). PGS was higher in affective psychotic and bipolar disorders, while PGS and PGS were higher in schizophrenia as compared with individuals with no psychiatric disorders. Genetic risks for sleep and diurnal preference vary between non-affective psychosis, affective psychosis, and the general population. The findings in this study emphasize the heterogeneity in genetic etiology of the objective features of disease severity and the more subjective measures related to well-being and self-reported measures of sleep.