Multivariate GWAS of psychiatric disorders and their cardinal symptoms reveal two dimensions of cross-cutting genetic liabilities

Abstract

Understanding which biological pathways are specific versus general across diagnostic categories and levels of symptom severity is critical to improving nosology and treatment of psychopathology. Here, we combine transdiagnostic and dimensional approaches to genetic discovery for the first time, conducting a novel multivariate genome-wide association study (GWAS) of eight psychiatric symptoms and disorders broadly related to mood disturbance and psychosis. We identify two transdiagnostic genetic liabilities that distinguish between common forms of mood disturbance (major depressive disorder, bipolar II, and self-reported symptoms of depression, mania, and psychosis) versus rarer forms of serious mental illness (bipolar I, schizoaffective disorder, and schizophrenia). Biological annotation revealed divergent genetic architectures that differentially implicated prenatal neurodevelopment and neuronal function and regulation. These findings inform psychiatric nosology and biological models of psychopathology, as they suggest the severity of mood and psychotic symptoms present in serious mental illness may reflect a difference in kind, rather than merely in degree.