Clinical symptomatology and the psychosis risk gene ZNF804A
Dear Editors,The single nucleotide polymorphism (SNP) rs1344706, mapping to the gene ZNF804A, has been implicated in schizophrenia susceptibility (O'Donovan et al. 2008; International Schizophrenia Consortium, 2009;Stefansson et al. 2009;Steinberg et al. 2010). The original study reported stronger association when the phenotype was broadened to include bipolar disorder (p = 9.96 × 10 − 9 ) (O'Donovan et al. 2008), but the variant is likely to have a modest effect on disease risk (OR = 1.12). Understanding the function of psychosis risk genes is a key step towards understanding disease biology. Little is currently known about the encoding protein, zinc finger protein 804A, except that it is brainexpressed and predicted to be involved in regulation of gene expression. Two recent studies suggest that the ZNF804A risk allele is likely to influence brain function, both with respect to connectivity within and between the dorsolateral prefrontal cortex and hippocampus (Esslinger et al. 2009) and on episodic and working memory (Walters et al. in press).An unanswered question is whether this gene has an effect at the level of clinical symptomatology within patient populations. Specifically, does this risk variant delineate a specific form of illness on the mood-psychosis spectrum (Craddock et al. 2006). For this study we investigated clinical symptom factors in a large sample (n = 820) of Irish psychotic patients. The study included 820 patients with a DSM-IV diagnosis of schizophrenia (N = 568), schizoaffective disorder (N = 127) or bipolar affective disorder (N = 125). Because clinical symptoms can vary over time we analyzed two measures of clinical symptomatology based on lifetime severity (BADDS) and presence of specific symptoms (Operational Criteria Checklist for Psychotic Illness, OPCRIT) (McGuffin et al. 1991).SNP rs1344706 was genotyped using a Taqman ® SNP Genotyping Assay on a 7900HT Sequence Detection System (Applied Biosystems) (n = 529) and the Sequenom iPLEX Gold system (n = 291) (detailed in Walters et al. in press). The call rate for both genotyping platforms was N95%. Both case/control samples were in Hardy-Weinberg Equilibrium (HWE; p N 0.05). A number of HapMap CEU DNA samples (n = 90: www.hapmap.org) and duplicates (n = 60) were genotyped across platforms for quality control purposes.All genotypes were found to be concordant with either the available online HapMap data or each other for this SNP.An exploratory factor analysis using the 60 items relating to clinical signs and symptoms from the Operational Criteria Checklist for Psychotic Illness yielded 44 items with loadings of 0.4 or more. A five factor solution gave an interpretable pattern of factors, namely manic, depressive, positive, disorganized and negative factors ( Supplementary Fig. 1, Supplementary Table 1). Factor score coefficients were then calculated in SPSS 16.0 using the regression method. There were no significant differences observed between the ZNF804A genotype groups w...