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Abstract
Anxiety/stress-related disorders have been associated with multiple diseases, whereas a comprehensive assessment of the structure and interplay of subsequent associated diseases and their genetic underpinnings is lacking. Here, we first identify 136, out of 454 tested, medical conditions associated with incident anxiety/stress-related disorders attended in specialized care using a population-based cohort from the nationwide Swedish Patient Register, comprising 70,026 patients with anxiety/stress-related disorders and 1:10 birth year- and sex-matched unaffected individuals. By combining findings from the comorbidity network and disease trajectory analyses, we identify five robust disease clusters to be associated with a prior diagnosis of anxiety/stress-related disorders, featured by predominance of psychiatric disorders, eye diseases, ear diseases, cardiovascular diseases, and skin and genitourinary diseases. These five clusters and their featured diseases are largely validated in the UK Biobank. GWAS analyses based on the UK Biobank identify 3, 33, 40, 4, and 16 significantly independent single nucleotide polymorphisms for the link to the five disease clusters, respectively, which are mapped to several distinct risk genes and biological pathways. These findings motivate further mechanistic explorations and aid early risk assessment for cluster-based disease prevention among patients with newly diagnosed anxiety/stress-related disorders in specialized care.
In this study, the authors found five disease clusters associated with a prior diagnosis of anxiety/stress-related disorders, and identified several underlying genetic components. These findings may aid mechanistic exploration and risk management for health decline among those patients.
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1 Sichuan University, Mental Health Center, West China Hospital, Chengdu, China (GRID:grid.13291.38) (ISNI:0000 0001 0807 1581); West China Hospital, Sichuan University, West China Biomedical Big Data Center, Chengdu, China (GRID:grid.412901.f) (ISNI:0000 0004 1770 1022); Sichuan University, Med-X Center for Informatics, Chengdu, China (GRID:grid.13291.38) (ISNI:0000 0001 0807 1581)
2 Tongji University School of Medicine, Clinical Research Center for Mental Disorders, Shanghai Pudong New Area Mental Health Center, Shanghai, China (GRID:grid.24516.34) (ISNI:0000 0001 2370 4535); Tongji University, Institute for Advanced Study, Shanghai, China (GRID:grid.24516.34) (ISNI:0000 0001 2370 4535); Karolinska Institutet, Institute of Environmental Medicine, Stockholm, Sweden (GRID:grid.4714.6) (ISNI:0000 0004 1937 0626)
3 West China Hospital, Sichuan University, West China Biomedical Big Data Center, Chengdu, China (GRID:grid.412901.f) (ISNI:0000 0004 1770 1022); Sichuan University, Med-X Center for Informatics, Chengdu, China (GRID:grid.13291.38) (ISNI:0000 0001 0807 1581)
4 Fudan University, Department of Epidemiology & Ministry of Education Key Laboratory of Public Health Safety, School of Public Health, Shanghai, China (GRID:grid.8547.e) (ISNI:0000 0001 0125 2443); Fudan University, Taizhou Institute of Health Sciences, Taizhou, China (GRID:grid.8547.e) (ISNI:0000 0001 0125 2443)
5 Karolinska Institutet, Department of Medical Epidemiology and Biostatistics, Stockholm, Sweden (GRID:grid.4714.6) (ISNI:0000 0004 1937 0626)
6 Karolinska Institutet, Institute of Environmental Medicine, Stockholm, Sweden (GRID:grid.4714.6) (ISNI:0000 0004 1937 0626)
7 Karolinska Institutet, Institute of Environmental Medicine, Stockholm, Sweden (GRID:grid.4714.6) (ISNI:0000 0004 1937 0626); University of Iceland, Center of Public Health Sciences, Faculty of Medicine, Reykjavík, Iceland (GRID:grid.14013.37) (ISNI:0000 0004 0640 0021); Harvard T H Chan School of Public Health, Department of Epidemiology, Boston, USA (GRID:grid.38142.3c) (ISNI:000000041936754X)
8 West China Hospital, Sichuan University, West China Biomedical Big Data Center, Chengdu, China (GRID:grid.412901.f) (ISNI:0000 0004 1770 1022); Sichuan University, Med-X Center for Informatics, Chengdu, China (GRID:grid.13291.38) (ISNI:0000 0001 0807 1581); University of Iceland, Center of Public Health Sciences, Faculty of Medicine, Reykjavík, Iceland (GRID:grid.14013.37) (ISNI:0000 0004 0640 0021)