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Control Selection

Because cases were ascertained from a variety inpatient, outpatient, and community settings, we used the same venues for control recruitment. Thus, where possible, controls were selected from the same medical settings as the cases and from neighborhoods where cases had been recruited. The control sample was age 18 and older and had no lifetime symptoms indicative of psychosis or mania personally or in first-degree relatives

Controls completed the screening questionnaire to assess demographic characteristics and medical history, as well as personal and family psychiatric history. Specifically, drawing on validated instruments, the screening questionnaire included questions on mania, psychosis, depression, substance use, anxiety, PTSD, OCD, and other psychiatric conditions.

GPC Sample Characteristics and Limitations

Table 16.1 summarizes the GPC sample characteristics.21 As a model of a “mega-study” of the genetics of psychiatric disorder, it is important to acknowledge the limitations of the GPC because these limitations will apply to other similarly designed undertakings. First, cases ascertained from clinical settings are subject to Berkson’s bias; that is, they have an increased likelihood of having multiple disorders compared to untreated populations.22 It is also likely that, to the extent that participating sites focused on clinical cases, there is an overrepresentation of chronically ill cases.23 We underscore that no affordable ascertainment strategy would be without limitations and that the most important aspect of our design is to be aware of the effects of these limitations on the generalizability of the findings.

Table 16.1 Genomic Psychiatry Cohort sample characteristics

Bipolar

without

Psychosis

Bipolar

with

Psychosis

Schizoaffective

Bipolar

Subtype

Schizoaffective

Depressed

Subtype

Schizophrenia

Controls

N

663

1,507

1,486

552

5,586

10,311

Latino

17%

18%

19%

14%

15%

34%

African

14%

18%

24%

30%

35%

17%

Ancestry

Asian

2%

2%

2%

1%

2%

7%

European

60%

55%

46%

49%

39%

37%

Caucasian

Mixed-race

4%

4%

4%

2%

3%

2%

Sex:

Female

61%

51%

2%

45%

30%

56%

Male

39%

49%

58%

55%

70%

44%

Age

Average

42

43

44

44

44

38

Reprinted with permission.21

 
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