Publications by authors named "Kelli Lehto"

Antidepressants exhibit a considerable variation in efficacy, and increasing evidence suggests that individual genetics contribute to antidepressant treatment response. Here, we combined data on antidepressant non-response measured using rating scales for depressive symptoms, questionnaires of treatment effect, and data from electronic health records, to increase statistical power to detect genomic loci associated with non-response to antidepressants in a total sample of 135,471 individuals prescribed antidepressants (25,255 non-responders and 110,216 responders). We performed genome-wide association meta-analyses, genetic correlation analyses, leave-one-out polygenic prediction, and bioinformatics analyses for genetically informed drug prioritization.

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  • * Both male and female schizophrenia patients faced higher risks of all-cause mortality, suicide, and natural causes, but no significant differences were found between the sexes in these risks.
  • * Young females (<40) showed a notably higher mortality risk compared to older females, while males faced a much greater risk of dying from neurological disorders than females, indicating a need for better healthcare interventions.
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  • Low drug adherence significantly hampers the effectiveness of prescribed medications, making it crucial to understand the factors that lead to poor adherence and discontinuation of treatments.
  • Analysis of data from over 1.8 million individuals reveals that socio-demographic factors, such as needing social assistance and immigration status, negatively impact medication adherence and persistence, while demographic and health factors show less consistent effects.
  • Genetic factors show limited association with adherence, with some pharmacogenes linked to persistence; the study suggests that interventions targeting socio-economically disadvantaged populations could enhance medication uptake and overall health outcomes.
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  • - Individuals with mental illness are at a higher risk for severe COVID-19 outcomes, but studies on their vaccination uptake have shown mixed results.
  • - This research analyzed data from multiple cohort studies and Swedish registers to explore the relationship between mental illness and COVID-19 vaccination rates.
  • - Findings revealed that while overall vaccine uptake was high in both groups, there was a slight decrease in vaccination rates among unmedicated individuals with mental illness, indicating a need for further investigation into this subgroup.
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  • - The study aimed to explore the genetic basis of major depressive disorder by analyzing symptoms across various clinical and community cohorts, acknowledging challenges like sample size differences and missing data patterns.
  • - Researchers performed genome-wide association studies using data from both diagnosed and undiagnosed participants, fitting models to understand the relationships between different depressive symptoms.
  • - Findings emphasized the relevance of symptom directionality (e.g., hypersomnia vs. insomnia) and the necessity of considering study design when analyzing genetic data related to depression.
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Introduction: People with severe mental illness have poor cardiometabolic health. Commonly used antidepressants and antipsychotics frequently lead to weight gain, which may further contribute to adverse cardiovascular outcomes.

Areas Covered: We searched MEDLINE up to April 2023 for umbrella reviews, (network-)meta-analyses, trials and cohort studies on risk factors, prevention and treatment strategies of weight gain associated with antidepressants/antipsychotics.

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The aim is to investigate the evidence for shared genetic architecture between each of asthma, allergic rhinitis and eczema with gastro-esophageal reflux disease (GERD). Structural equation models (SEM) and polygenic risk score (PRS) analyses are applied to three Swedish twin cohorts (n = 46,582) and reveal a modest genetic correlation between GERD and asthma of 0.18 and bidirectional PRS and phenotypic associations ranging between OR 1.

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To further explore the role of different antipsychotic treatments for cardio-cerebrovascular mortality, we performed several subgroup, sensitivity and meta-regression analyses based on a large previous meta-analysis focusing on cohort studies assessing mortality relative risk (RR) for cardio-cerebrovascular disorders in people with schizophrenia, comparing antipsychotic treatment versus no antipsychotic. Quality assessment through the Newcastle-Ottawa Scale (NOS) and publication bias was measured. We meta-analyzed 53 different studies (schizophrenia patients: n = 2,513,359; controls: n = 360,504,484) to highlight the differential effects of antipsychotic treatment regimens on cardio-cerebrovascular-related mortality in incident and prevalent samples of patients with schizophrenia.

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  • Childhood maltreatment (CM) impacts health across one's life, and this study investigates its role in severe COVID-19 outcomes among 151,427 participants in the UK Biobank.
  • * The study found that individuals with a history of CM had a significantly higher risk of hospitalization or death from COVID-19, with physical neglect being the most impactful type.
  • * Results indicated that socio-economic status, lifestyle, and pre-existing health conditions explained over half of the link between CM and severe COVID-19 outcomes, while CM was less strongly tied to COVID-19 diagnosis and vaccine uptake.
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  • * A genome-wide association meta-analysis of nearly 122,000 ANX cases revealed 58 significant genetic variants and 66 related genes, with many of these findings replicated in a larger independent sample.
  • * The findings indicate a substantial genetic overlap between ANX and other conditions like depression, emphasizing GABAergic signaling as a key mechanism, thereby enhancing our understanding of the genetic basis of ANX for future research.
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  • PTSD genetics have been difficult to study compared to other psychiatric disorders, limiting our biological understanding of the condition.
  • A large-scale meta-analysis involving over 1.2 million individuals identified 95 genome-wide significant loci, with 80 being new discoveries related to PTSD.
  • Researchers identified 43 potential causal genes linked to neurotransmitter activity, developmental processes, synaptic function, and immune regulation, enhancing our knowledge of the neurobiological systems involved in PTSD.
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Background: Attention-deficit hyperactivity disorder (ADHD) is often comorbid with other medical conditions in adult patients. However, ADHD is extremely underdiagnosed in adults and little is known about the medical comorbidities in undiagnosed adult individuals with high ADHD liability. In this study we investigated associations between ADHD genetic liability and electronic health record (EHR)-based ICD-10 diagnoses across all diagnostic categories, in individuals without ADHD diagnosis history.

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People with schizophrenia die prematurely, yet regional differences are unclear. PRISMA 2020-compliant systematic review/random-effects meta-analysis of cohort studies assessing mortality relative risk (RR) versus any control group, and moderators, in people with ICD/DSM-defined schizophrenia, comparing countries and continents. We conducted subgroup, meta-regression analyses, and quality assessment.

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Background: Although the persistence of physical symptoms after SARS-CoV-2 infection is a major public health concern, evidence from large observational studies beyond one year post diagnosis remain scarce. We aimed to assess the prevalence of physical symptoms in relation to acute illness severity up to more than 2-years after diagnosis of COVID-19.

Methods: This multinational study included 64,880 adult participants from Iceland, Sweden, Denmark, and Norway with self-reported data on COVID-19 and physical symptoms from April 2020 to August 2022.

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Higher blood pressure levels in patients with depression may be associated with lower adherence to antihypertensive medications (AHMs). Here, we use electronic health record (EHR) data from the Estonian Biobank (EstBB) to investigate the role of lifetime depression in AHM adherence and persistence. We also explore the relationship between antidepressant initiation and intraindividual change in AHM adherence among hypertension (HTN) patients with newly diagnosed depression.

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  • PTSD genetics are harder to study compared to other mental health disorders, resulting in limited biological insights from past research.
  • A large-scale analysis involving over 1.2 million individuals found 95 significant genetic loci related to PTSD, with 80 being new discoveries.
  • The study identified 43 potential causal genes linked to neurotransmitters, synaptic function, and immune responses, enhancing understanding of PTSD's biological mechanisms and suggesting new research directions.
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  • Major depressive disorder shows varied symptoms, and genetic analysis can help identify specific subtypes and clinical profiles.
  • Challenges in integrating symptom data arise from differences in sample sizes and patterns of missing data in clinical vs. community groups.
  • The study used genome-wide association studies to find that a model including unique symptom factors and accounting for missing data best represented the symptoms of depression, highlighting the need to consider symptom directionality and study design when analyzing genetic data.
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Objectives: The Estonian National Mental Health Study (EMHS) was conducted in 2021-2022 to provide population-wide data on mental health in the context of COVID-19 pandemic. The main objective of this paper is to describe the rationale, design, and methods of the EMHS and to evaluate the survey response.

Methods: Regionally representative stratified random sample of 20,000 persons aged 15 years and older was drawn from the Estonian Population Register for the study.

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Despite advances in identifying the genetic basis of psychiatric and neurological disorders, fundamental questions about their evolutionary origins remain elusive. Here, introgressed variants from archaic humans such as Neandertals can serve as an intriguing research paradigm. We compared the number of associations for Neandertal variants to the number of associations of frequency-matched non-archaic variants with regard to human CNS disorders (neurological and psychiatric), nervous system drug prescriptions (as a proxy for disease), and related, non-disease phenotypes in the UK biobank (UKBB).

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Growing evidence suggests that ADHD, an early onset neurodevelopmental disorder, is associated with poor somatic health in adulthood. However, the mechanisms underlying these associations are poorly understood. Here, we tested whether ADHD polygenic risk scores (PRS) are associated with mid-to-late life somatic health in a general population sample.

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  • Long COVID has significant long-term mental and physical health impacts, particularly in non-hospitalized patients, but little is known about the mental health consequences based on the severity of the initial infection.
  • A study across six European countries included over 247,000 individuals, comparing mental health symptoms like depression and sleep quality in those diagnosed with COVID-19 against those without.
  • Findings showed that COVID-19 patients experienced higher rates of depression and poor sleep, but anxiety levels didn't differ significantly; the negative effects on mental health diminished over time, especially for those with mild cases.
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Introduction: Gastro-oesophageal reflux disease (GERD) is the most common non-allergic comorbidity in adults with asthma; however, comorbidity with other atopic diseases such as eczema and hay fever is unclear. The objective was to assess the comorbidity of GERD with asthma and atopic diseases and to investigate possible mechanisms, including genetic and/or affective factors.

Methods: A co-twin control study harnessing 46 583 adult twins.

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