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@ARTICLE{GuzmanParra:893926,
      author       = {Guzman-Parra, Jose and Streit, Fabian and Forstner, Andreas
                      J. and Strohmaier, Jana and González, Maria José and Gil
                      Flores, Susana and Cabaleiro Fabeiro, Francisco J. and del
                      Río Noriega, Francisco and Perez Perez, Fermin and Haro
                      González, Jesus and Orozco Diaz, Guillermo and de
                      Diego-Otero, Yolanda and Moreno-Kustner, Berta and Auburger,
                      Georg and Degenhardt, Franziska and Heilmann-Heimbach,
                      Stefanie and Herms, Stefan and Hoffmann, Per and Frank,
                      Josef and Foo, Jerome C. and Sirignano, Lea and Witt,
                      Stephanie H. and Cichon, Sven and Rivas, Fabio and Mayoral,
                      Fermín and Nöthen, Markus M. and Andlauer, Till F. M. and
                      Rietschel, Marcella},
      title        = {{C}linical and genetic differences between bipolar disorder
                      type 1 and 2 in multiplex families},
      journal      = {Translational Psychiatry},
      volume       = {11},
      number       = {1},
      issn         = {2158-3188},
      address      = {London},
      publisher    = {Nature Publishing Group},
      reportid     = {FZJ-2021-02936},
      pages        = {31},
      year         = {2021},
      abstract     = {The two major subtypes of bipolar disorder (BD), BD-I and
                      BD-II, are distinguished based on the presence of manic or
                      hypomanic episodes. Historically, BD-II was perceived as a
                      less severe form of BD-I. Recent research has challenged
                      this concept of a severity continuum. Studies in large
                      samples of unrelated patients have described clinical and
                      genetic differences between the subtypes. Besides an
                      increased schizophrenia polygenic risk load in BD-I, these
                      studies also observed an increased depression risk load in
                      BD-II patients. The present study assessed whether such
                      clinical and genetic differences are also found in BD
                      patients from multiplex families, which exhibit reduced
                      genetic and environmental heterogeneity. Comparing 252 BD-I
                      and 75 BD-II patients from the Andalusian Bipolar Family
                      (ABiF) study, the clinical course, symptoms during
                      depressive and manic episodes, and psychiatric comorbidities
                      were analyzed. Furthermore, polygenic risk scores (PRS) for
                      BD, schizophrenia, and depression were assessed. BD-I
                      patients not only suffered from more severe symptoms during
                      manic episodes but also more frequently showed incapacity
                      during depressive episodes. A higher BD PRS was
                      significantly associated with suicidal ideation. Moreover,
                      BD-I cases exhibited lower depression PRS. In line with a
                      severity continuum from BD-II to BD-I, our results link BD-I
                      to a more pronounced clinical presentation in both mania and
                      depression and indicate that the polygenic risk load of BD
                      predisposes to more severe disorder characteristics.
                      Nevertheless, our results suggest that the genetic risk
                      burden for depression also shapes disorder presentation and
                      increases the likelihood of BD-II subtype development.},
      cin          = {INM-1},
      ddc          = {610},
      cid          = {I:(DE-Juel1)INM-1-20090406},
      pnm          = {5251 - Multilevel Brain Organization and Variability
                      (POF4-525)},
      pid          = {G:(DE-HGF)POF4-5251},
      typ          = {PUB:(DE-HGF)16},
      pubmed       = {33431802},
      UT           = {WOS:000609884900005},
      doi          = {10.1038/s41398-020-01146-0},
      url          = {https://juser.fz-juelich.de/record/893926},
}