
Courtesy NBC News
By Maggie Fox, Senior
Writer, NBC News
The biggest study yet into genetics and
mental health has come up with a stunning result: The five most common mental
illnesses -- autism, attention deficit disorder, bipolar disease, schizophrenia
and major depression -- all have a common genetic root.
The finding, published in the journal
Lancet on Wednesday, may eventually lead to a complete rewrite of the medical
understanding of the causes of mental illness.
"We have been able to discover specific
genetic variants that seem to overlap among disorders that we think of as very
clinically different," Dr. Jordan Smoller of Massachusetts General Hospital in
Boston, who led the study, said in a telephone interview.
The study does not explain every case of
psychiatric disease, the researchers stress.
"We think this is one tiny fraction of the
genetic component of these disorders. They involve hundreds and possibly
thousands of genes," Smoller said.
And it didn't show every case was related.
But it demonstrated on a genetic level that the five diseases are more like a
continuum of dysfunction than five separate and discrete conditions.
Smoller's international team included
dozens of researchers who looked at the genetics of more than 33,000 psychiatric
patients and compared them to nearly 28,000 people without mental illness. They
did what is called a genome-wide association study -- a scan of all the DNA.
"We aimed to identify specific variants
underlying genetic effects shared between the five disorders in the Psychiatric
Genomics Consortium: autism spectrum disorder, attention deficit-hyperactivity
disorder, bipolar disorder, major depressive disorder, and schizophrenia," they
wrote in their report.
They linked a considerable number to four
places in the genome: a big stretch of chromosome 3; another part of chromsome
10, and two very specific genetic areas known to be involved in controlling cell
function called calcium channels.
It wasn't a complete surprise, Smoller
says. Doctors have noted some overlap of symptoms and knew that in families
prone to one psychiatric disease, another could also occur. "Autism was once
known as childhood schizophrenia and the two disorders were not clearly
differentiated until the 1970s," the team wrote.
This finding could suggest that a genetic
weakness upstream in the development of the brain could lead to a variety of
psychiatric symptoms, perhaps influenced by other genes, or by the environment
as well.
"We didn't know going in that we would be
able to find commonality with such a broad array of disorders," Smoller said.
"The fact that a particular pathway emerged as being relevant was also
surprising. We didn't know about that one before."
Dr. Ken Duckworth, medical director of the
National Alliance on Mental Illness, hopes the findings may help dispel some of
the stigma that still surrounds psychiatric diseases.
"Ultimately this kind of research will
give us a return in terms of social attitudes toward brain-based illness,"
Duckworth said in a telephone interview. "If you can understand an illness
process, it doesn't seem so mysterious and terrifying."
Duckworth said every psychiatrist knows of
patients whose symptoms don't clearly meet the definition of any one disease,
and he noted that Sigmund Freud defined schizophrenia as a group of diseases.
"This is a corner piece of the jigsaw puzzle," he said.
And it might lead to better treatments,
said Dr. Bruce Cuthbert, who is director of the National Institute of Mental
Health's division of Adult Translational Research. "We are finally starting to
make inroads where we have actual physiological mechanisms that we can target,"
he said. "We can really start to understand the biology instead of having to
guess at it."