TY - JOUR
T1 - An exposure-wide and mendelian randomization approach to identifying modifiable factors for the prevention of depression
AU - 23andMe Research Team, Major Depressive Disorder Working Group of the Psychiatric Genomics Consortium
AU - Choi, Karmel W.
AU - Stein, Murray B.
AU - Nishimi, Kristen M.
AU - Ge, Tian
AU - Coleman, Jonathan R.I.
AU - Chen, Chia Yen
AU - Ratanatharathorn, Andrew
AU - Zheutlin, Amanda B.
AU - Dunn, Erin C.
AU - Breen, Gerome
AU - Koenen, Karestan C.
AU - Smoller, Jordan W.
AU - Agee, Michelle
AU - Alipanahi, Babak
AU - Auton, Adam
AU - Bell, Robert K.
AU - Bryc, Katarzyna
AU - Elson, Sarah L.
AU - Fontanillas, Pierre
AU - Furlotte, Nicholas A.
AU - Hicks, Barry
AU - Hinds, David A.
AU - Huber, Karen E.
AU - Jewett, Ethan M.
AU - Jiang, Yunxuan
AU - Kleinman, Aaron
AU - Lin, Keng Han
AU - Litterman, Nadia K.
AU - McCreight, Jennifer C.
AU - McIntyre, Matthew H.
AU - McManus, Kimberly F.
AU - Mountain, Joanna L.
AU - Noblin, Elizabeth S.
AU - Northover, Carrie A.M.
AU - Pitts, Steven J.
AU - David Poznik, G.
AU - Fah Sathirapongsasuti, J.
AU - Shelton, Janie F.
AU - Shringarpure, Suyash
AU - Tian, Chao
AU - Tung, Joyce Y.
AU - Vacic, Vladimir
AU - Wang, Xin
AU - Wilson, Catherine H.
PY - 2020/10
Y1 - 2020/10
N2 - Objective: Efforts to prevent depression, the leading cause of disability worldwide, have focused on a limited number of candidate factors. Using phenotypic and genomic data from over 100,000 UK Biobank participants, the authors sought to systematically screen and validate a wide range of potential modifiable factors for depression. Methods: Baseline data were extracted for 106 modifiable factors, including lifestyle (e.g., exercise, sleep, media, diet), social (e.g., support, engagement), and environmental (e.g., green space, pollution) variables. Incident depression was defined as minimal depressive symptoms at baseline and clinically significant depression at follow-up. At-risk individuals for incident depression were identified by polygenic risk scores or by reported traumatic life events. An exposure-wide association scan was conducted to identify factors associated with incident depression in the full sample and among at-risk individuals. Two-sample Mendelian randomization was then used to validate potentially causal relationships between identified factors and depression. Results: Numerous factors across social, sleep, media, dietary, and exercise-related domains were prospectively associated with depression, even among at-risk individuals. However, only a subset of factors was supported by Mendelian randomization evidence, including confiding in others (odds ratio=0.76, 95% CI=0.67, 0.86), television watching time (odds ratio=1.09, 95% CI=1.05, 1.13), and daytime napping (odds ratio=1.34, 95% CI=1.17, 1.53). Conclusions: Using a two-stage approach, this study validates several actionable targets for preventing depression. It also demonstrates that not all factors associated with depression in observational research may translate into robust targets for prevention. A large-scale exposure-wide approach combined with genetically informed methods for causal inference may help prioritize strategies for multimodal prevention in psychiatry.
AB - Objective: Efforts to prevent depression, the leading cause of disability worldwide, have focused on a limited number of candidate factors. Using phenotypic and genomic data from over 100,000 UK Biobank participants, the authors sought to systematically screen and validate a wide range of potential modifiable factors for depression. Methods: Baseline data were extracted for 106 modifiable factors, including lifestyle (e.g., exercise, sleep, media, diet), social (e.g., support, engagement), and environmental (e.g., green space, pollution) variables. Incident depression was defined as minimal depressive symptoms at baseline and clinically significant depression at follow-up. At-risk individuals for incident depression were identified by polygenic risk scores or by reported traumatic life events. An exposure-wide association scan was conducted to identify factors associated with incident depression in the full sample and among at-risk individuals. Two-sample Mendelian randomization was then used to validate potentially causal relationships between identified factors and depression. Results: Numerous factors across social, sleep, media, dietary, and exercise-related domains were prospectively associated with depression, even among at-risk individuals. However, only a subset of factors was supported by Mendelian randomization evidence, including confiding in others (odds ratio=0.76, 95% CI=0.67, 0.86), television watching time (odds ratio=1.09, 95% CI=1.05, 1.13), and daytime napping (odds ratio=1.34, 95% CI=1.17, 1.53). Conclusions: Using a two-stage approach, this study validates several actionable targets for preventing depression. It also demonstrates that not all factors associated with depression in observational research may translate into robust targets for prevention. A large-scale exposure-wide approach combined with genetically informed methods for causal inference may help prioritize strategies for multimodal prevention in psychiatry.
UR - http://www.scopus.com/inward/record.url?scp=85092281665&partnerID=8YFLogxK
U2 - 10.1176/appi.ajp.2020.19111158
DO - 10.1176/appi.ajp.2020.19111158
M3 - Article
C2 - 32791893
AN - SCOPUS:85092281665
SN - 0002-953X
VL - 177
SP - 944
EP - 954
JO - American Journal of Psychiatry
JF - American Journal of Psychiatry
IS - 10
ER -