Chapter 1 General introductionChapter 2 Running in the family? Structural brain abnormalities and IQ in offspring, siblings, parents, and co-twins of patients with schizophrenia Chapter 3The association between familial risk and brain abnormalities is disease specific: an ENIGMA-Relatives study of schizophrenia and bipolar disorder Press release Biological Psychiatry Chapter 4 Intelligence, educational attainment and brain structure in those at familial high-risk for schizophrenia or bipolar disorder Chapter 5 The genetic relationship between schizophrenia, bipolar disorder and intracranial volume through polygenic scoring Chapter 6 Summary and general discussion Chapter 7 References Appendices Nederlandse samenvatting 170 Dankwoord 175 List of publications 178 Curriculum Vitae 181 8Almost everyone, either directly or indirectly, will be confronted with mental illness at some point in their lives. According to the World Health Organization, around 23 million people worldwide have a diagnosis of schizophrenia, bipolar disorder affects around 60 million people, and an estimated 300 million people are diagnosed with severe depression (World Health Organization, 2018). This means that roughly 1 in every 20 individuals is affected by a severe mental illness and the impact on the lives of these individuals, but also on their family, friends, and society as a whole, can be tremendous. Yet we still know little about the etiology (i.e. what causes disease or leads to becoming ill) of these disorders, how to effectively treat patients, and, even more importantly, how to prevent people from becoming ill.
SCHIZOPHRENIA vs. BIPOLAR DISORDERPsychiatric diseases are characterized by affective, behavioral, and cognitive abnormalities. The Diagnostic and Statistical Manual of Mental Disorders (DSM), published by the American Psychiatric Association (5th edition, 2013), lists 18 distinct disorders, including neurodevelopmental disorders, schizophrenia spectrum and psychotic disorders, bipolar and related disorders, depressive disorders and anxiety disorders.Schizophrenia and bipolar disorder are two severe psychiatric disorders listed in the DSM. Schizophrenia is characterized by delusions, hallucinations, disorganized speech and behavior, while bipolar disorder is primarily known for the (alternating) manic and depressive episodes. This distinction between these two illnesses dates back to the early 20 th century, when Kraepelin divided them into two categories: dementia praecox and manic depressive insanity (Kraepelin, 1910). Although the clinical presentation is often different, schizophrenia and bipolar disorder also share symptoms, which can make it difficult to distinguish between the two illnesses. For instance, approximately two-thirds of patients diagnosed with bipolar disorder have a life-time history of at least one psychotic episode (Goodwin & Jamison, 2007). Similarly, it is estimated that comorbid depression occurs in 50% of the patients diagnosed with schizophrenia (Buckley et al., 2009). The overlapping elements l...