Symptom profiles and illness course among Anabaptist and Non-Anabaptist adults with major mood disorders

Abstract

BackgroundAnabaptists comprise large and growing Amish and Mennonite populations with a unique genetic heritage and cultural background. Little is known about the symptoms and course of major mood disorders in Anabaptists. Even less is known about the impact of potential moderators on symptom severity and course.MethodsA sample of Amish and Mennonite participants with bipolar, recurrent unipolar, or schizoaffective bipolar disorder (n = 155) were systematically evaluated with a well-validated instrument. Cases were compared with non-Anabaptist participants (n = 155) matched for age, sex, and psychiatric diagnosis and evaluated by the same methods.ResultsDespite substantial cultural differences, the profile of manic and depressive symptoms during illness episodes did not significantly differ between the two groups. Alcohol use disorder (AUD) was significantly less frequent among Anabaptists, and was associated with more major depressive episodes and more hospitalizations for major depression in Anabaptist, but not non-Anabaptist participants. Lifetime history of head injury showed a trend toward association with more episodes of major depression in both Anabaptist and non-Anabaptist groups that did not withstand multiple test correction.ConclusionsThe presentation of a highly heritable psychiatric illness such as bipolar disorder does not differ in cases drawn from genetically unique Anabaptist populations. However, alcohol comorbidity, head injury, and their effects on illness course suggest some differences that deserve further investigation.

Strong Genetic Overlaps Between Dimensional and Categorical Models of Bipolar Disorders in a Family Sample

“…We have also previously shown that the symptom profiles of manic and depressive episodes are similar between Anabaptist and non-Anabaptist individuals diagnosed with BD (Gill et al, 2016). In the present study, we used the MDQ to investigate the genetic relationship between categorical BD diagnoses and manic symptoms assessed by the MDQ.…”

“…Utilizing the Amish Mennonite Bipolar Genetics Study (AMBiGen) (Gill et al, 2016), we have previously demonstrated that the MDQ is a sensitive and specific screening tool for BD in Anabaptist families ascertained through probands with BD (Dumont et al 2020). Anabaptists include well-known communities such as the Amish and Mennonites, both of which originated in Western Europe.…”

“…Anabaptists include well-known communities such as the Amish and Mennonites, both of which originated in Western Europe. Anabaptist communities typically comprise large families, well-documented genealogy, rural lifestyles, and a low prevalence of substance abuse (Gill et al, 2016). These characteristics offer advantages in the study of the genetic underpinnings of common disorders like BD.…”

“…The MDQ has a good capacity to detect individuals with probable BD at the widely agreed MDQS of seven or more, with sensitivity around 0.60 and specificity around 0.85 known communities such as the Amish and Mennonites, both of which originated in Western Europe, as well as other lesser-known communities of various ancestries 14 . Anabaptists are religious groups with substantial genetic isolation, large families, well-documented pedigree structures, rural lifestyles, and a low prevalence of substance abuse 14 . These characteristics offer a unique opportunity to study the genetic underpinnings of common diseases like BD.…”

Clinical and genetic validity of quantitative bipolarity

“…One of the limitations of this study is that the QBS findings were not evaluated in the general population. However, although OOA/M are culturally and environmentally separated from other Caucasians of European descent in North America, there is evidence that the clinical presentation of mood disorders is similar 36 . The original version of the BSDS has been applied to several populations leading to a range of values for sensitivity (0.70–0.90) and specificity (0.51–0.93) of bipolar vs non-bipolar patients depending on the cutoff score used 7–11 .…”