{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T21:38:17Z","timestamp":1792100297780,"version":"4.4.0"},"reference-count":45,"publisher":"American Medical Association (AMA)","issue":"7","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JAMA Psychiatry"],"published-print":{"date-parts":[[2024,7,1]]},"abstract":"<jats:sec id=\"ab-yoi240008-4\"><jats:title>Importance<\/jats:title><jats:p>Large-scale biobanks provide important opportunities for mental health research, but selection biases raise questions regarding the comparability of individuals with those in clinical research settings.<\/jats:p><\/jats:sec><jats:sec id=\"ab-yoi240008-5\"><jats:title>Objective<\/jats:title><jats:p>To compare the genetic liability to psychiatric disorders in individuals with schizophrenia in the UK Biobank with individuals in the Psychiatric Genomics Consortium (PGC) and to compare genetic liability and phenotypic features with participants recruited from clinical settings.<\/jats:p><\/jats:sec><jats:sec id=\"ab-yoi240008-6\"><jats:title>Design, Setting, and Participants<\/jats:title><jats:p>This cross-sectional study included participants from the population-based UK Biobank and schizophrenia samples recruited from clinical settings (CLOZUK, CardiffCOGS, Cardiff F-Series, and Cardiff Affected Sib-Pairs). Data were collected between January 1993 and July 2021. Data analysis was conducted between July 2021 and June 2023.<\/jats:p><\/jats:sec><jats:sec id=\"ab-yoi240008-7\"><jats:title>Main Outcomes and Measures<\/jats:title><jats:p>A genome-wide association study of UK Biobank schizophrenia case-control status was conducted, and the results were compared with those from the PGC via genetic correlations. To test for differences with the clinical samples, polygenic risk scores (PRS) were calculated for schizophrenia, bipolar disorder, depression, and intelligence using PRS-CS. PRS and phenotypic comparisons were conducted using pairwise logistic regressions. The proportions of individuals with copy number variants associated with schizophrenia were compared using Firth logistic regression.<\/jats:p><\/jats:sec><jats:sec id=\"ab-yoi240008-8\"><jats:title>Results<\/jats:title><jats:p>The sample of 517\u202f375 participants included 1438 UK Biobank participants with schizophrenia (550 [38.2%] female; mean [SD] age, 54.7 [8.3] years), 499\u202f475 UK Biobank controls (271\u202f884 [54.4%] female; mean [SD] age, 56.5 [8.1] years), and 4 schizophrenia research samples (4758 [28.9%] female; mean [SD] age, 38.2 [21.0] years). Liability to schizophrenia in UK Biobank was highly correlated with the latest genome-wide association study from the PGC (genetic correlation, 0.98; SE, 0.18) and showed the expected patterns of correlations with other psychiatric disorders. The schizophrenia PRS explained 6.8% of the variance in liability for schizophrenia case status in UK Biobank. UK Biobank participants with schizophrenia had significantly lower schizophrenia PRS than 3 of the clinically ascertained samples and significantly lower rates of schizophrenia-associated copy number variants than the CLOZUK sample. UK Biobank participants with schizophrenia had higher educational attainment and employment rates than the clinically ascertained schizophrenia samples, lower rates of smoking, and a later age of onset of psychosis.<\/jats:p><\/jats:sec><jats:sec id=\"ab-yoi240008-9\"><jats:title>Conclusions and Relevance<\/jats:title><jats:p>Individuals with schizophrenia in the UK Biobank, and likely other volunteer-based biobanks, represent those less severely affected. Their inclusion in wider studies should enhance the representation of the full spectrum of illness severity.<\/jats:p><\/jats:sec>","DOI":"10.1001\/jamapsychiatry.2024.0200","type":"journal-article","created":{"date-parts":[[2024,3,27]],"date-time":"2024-03-27T15:34:19Z","timestamp":1711553659000},"page":"681","source":"Crossref","is-referenced-by-count":44,"title":["Genetic and Phenotypic Features of Schizophrenia in the UK Biobank"],"prefix":"10.1001","volume":"81","author":[{"given":"Sophie E.","family":"Legge","sequence":"first","affiliation":[{"name":"Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonio F.","family":"Pardi\u00f1as","sequence":"additional","affiliation":[{"name":"Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grace","family":"Woolway","sequence":"additional","affiliation":[{"name":"Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elliott","family":"Rees","sequence":"additional","affiliation":[{"name":"Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alastair G.","family":"Cardno","sequence":"additional","affiliation":[{"name":"Leeds Institute of Health Sciences, Division of Psychological and Social Medicine, Faculty of Medicine and Health, University of Leeds, Leeds, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valentina","family":"Escott-Price","sequence":"additional","affiliation":[{"name":"Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peter","family":"Holmans","sequence":"additional","affiliation":[{"name":"Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"George","family":"Kirov","sequence":"additional","affiliation":[{"name":"Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael J.","family":"Owen","sequence":"additional","affiliation":[{"name":"Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael C.","family":"O\u2019Donovan","sequence":"additional","affiliation":[{"name":"Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James T. R.","family":"Walters","sequence":"additional","affiliation":[{"name":"Centre for Neuropsychiatric Genetics and Genomics, Division of Psychological Medicine and Clinical Neurosciences, School of Medicine, Cardiff University, Cardiff, United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"10","reference":[{"issue":"5","key":"yoi240008r1","doi-asserted-by":"publisher","first-page":"663","DOI":"10.1038\/s41588-021-00846-7","article-title":"Genetic analyses identify widespread sex-differential participation bias.","volume":"53","author":"Pirastu","year":"2021","journal-title":"Nat Genet"},{"issue":"9","key":"yoi240008r2","doi-asserted-by":"publisher","first-page":"1026","DOI":"10.1093\/aje\/kwx246","article-title":"Comparison of sociodemographic and health-related characteristics of UK Biobank participants with those of the general population.","volume":"186","author":"Fry","year":"2017","journal-title":"Am J Epidemiol"},{"issue":"4","key":"yoi240008r3","doi-asserted-by":"publisher","first-page":"1012","DOI":"10.1093\/ije\/dys223","article-title":"Why representativeness should be avoided.","volume":"42","author":"Rothman","year":"2013","journal-title":"Int J Epidemiol"},{"issue":"5","key":"yoi240008r4","doi-asserted-by":"publisher","first-page":"407","DOI":"10.1136\/jech.2009.107185","article-title":"Sample selection and validity of exposure-disease association estimates in cohort studies.","volume":"65","author":"Pizzi","year":"2011","journal-title":"J Epidemiol Community Health"},{"issue":"7","key":"yoi240008r5","doi-asserted-by":"publisher","first-page":"1216","DOI":"10.1038\/s41562-023-01579-9","article-title":"Participation bias in the UK Biobank distorts genetic associations and downstream analyses.","volume":"7","author":"Schoeler","year":"2023","journal-title":"Nat Hum Behav"},{"issue":"1","key":"yoi240008r7","doi-asserted-by":"publisher","first-page":"113","DOI":"10.1007\/s00127-022-02338-3","article-title":"Examining selection bias in a population-based cohort study of 522 children with familial high risk of schizophrenia or bipolar disorder, and controls: the Danish High Risk and Resilience study VIA 7.","volume":"58","author":"Krantz","year":"2023","journal-title":"Soc Psychiatry Psychiatr Epidemiol"},{"issue":"3","key":"yoi240008r8","doi-asserted-by":"publisher","first-page":"210","DOI":"10.1001\/jamapsychiatry.2021.3990","article-title":"Representation and outcomes of individuals with schizophrenia seen in everyday practice who are ineligible for randomized clinical trials.","volume":"79","author":"Taipale","year":"2022","journal-title":"JAMA Psychiatry"},{"issue":"4","key":"yoi240008r9","doi-asserted-by":"publisher","first-page":"437","DOI":"10.1038\/s41588-020-0594-5","article-title":"Minimal phenotyping yields genome-wide association signals of low specificity for major depression.","volume":"52","author":"Cai","year":"2020","journal-title":"Nat Genet"},{"issue":"3","key":"yoi240008r10","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001779","article-title":"UK biobank: an open access resource for identifying the causes of a wide range of complex diseases of middle and old age.","volume":"12","author":"Sudlow","year":"2015","journal-title":"PLoS Med"},{"issue":"3","key":"yoi240008r11","doi-asserted-by":"publisher","first-page":"381","DOI":"10.1038\/s41588-018-0059-2","article-title":"Common schizophrenia alleles are enriched in mutation-intolerant genes and in regions under strong background selection.","volume":"50","author":"Pardi\u00f1as","year":"2018","journal-title":"Nat Genet"},{"issue":"10","key":"yoi240008r12","doi-asserted-by":"publisher","first-page":"1143","DOI":"10.1001\/jamapsychiatry.2021.1961","article-title":"Associations between schizophrenia polygenic liability, symptom dimensions, and cognitive ability in schizophrenia.","volume":"78","author":"Legge","year":"2021","journal-title":"JAMA Psychiatry"},{"issue":"12","key":"yoi240008r14","doi-asserted-by":"publisher","first-page":"1256","DOI":"10.1001\/jamapsychiatry.2019.2508","article-title":"Association of genetic liability to psychotic experiences with neuropsychotic disorders and traits.","volume":"76","author":"Legge","year":"2019","journal-title":"JAMA Psychiatry"},{"issue":"1","key":"yoi240008r15","doi-asserted-by":"publisher","first-page":"4506","DOI":"10.1038\/s41467-021-24082-z","article-title":"Identifying individuals with high risk of Alzheimer\u2019s disease using polygenic risk scores.","volume":"12","author":"Leonenko","year":"2021","journal-title":"Nat Commun"},{"key":"yoi240008r16","doi-asserted-by":"publisher","first-page":"7","DOI":"10.1186\/s13742-015-0047-8","article-title":"Second-generation PLINK: rising to the challenge of larger and richer datasets.","volume":"4","author":"Chang","year":"2015","journal-title":"Gigascience"},{"issue":"7906","key":"yoi240008r17","doi-asserted-by":"publisher","first-page":"502","DOI":"10.1038\/s41586-022-04434-5","article-title":"Mapping genomic loci implicates genes and synaptic biology in schizophrenia.","volume":"604","author":"Trubetskoy","year":"2022","journal-title":"Nature"},{"issue":"9","key":"yoi240008r18","doi-asserted-by":"publisher","first-page":"1335","DOI":"10.1038\/s41588-018-0184-y","article-title":"Efficiently controlling for case-control imbalance and sample relatedness in large-scale genetic association studies.","volume":"50","author":"Zhou","year":"2018","journal-title":"Nat Genet"},{"issue":"1","key":"yoi240008r19","doi-asserted-by":"publisher","first-page":"1826","DOI":"10.1038\/s41467-017-01261-5","article-title":"Functional mapping and annotation of genetic associations with FUMA.","volume":"8","author":"Watanabe","year":"2017","journal-title":"Nat Commun"},{"issue":"3","key":"yoi240008r20","doi-asserted-by":"publisher","first-page":"291","DOI":"10.1038\/ng.3211","article-title":"LD score regression distinguishes confounding from polygenicity in genome-wide association studies.","volume":"47","author":"Bulik-Sullivan","year":"2015","journal-title":"Nat Genet"},{"issue":"11","key":"yoi240008r21","doi-asserted-by":"publisher","first-page":"1236","DOI":"10.1038\/ng.3406","article-title":"An atlas of genetic correlations across human diseases and traits.","volume":"47","author":"Bulik-Sullivan","year":"2015","journal-title":"Nat Genet"},{"issue":"6","key":"yoi240008r22","doi-asserted-by":"publisher","first-page":"817","DOI":"10.1038\/s41588-021-00857-4","article-title":"Genome-wide association study of more than 40,000 bipolar disorder cases provides new insights into the underlying biology.","volume":"53","author":"Mullins","year":"2021","journal-title":"Nat Genet"},{"issue":"3","key":"yoi240008r23","doi-asserted-by":"publisher","first-page":"343","DOI":"10.1038\/s41593-018-0326-7","article-title":"Genome-wide meta-analysis of depression identifies 102 independent variants and highlights the importance of the prefrontal brain regions.","volume":"22","author":"Howard","year":"2019","journal-title":"Nat Neurosci"},{"issue":"1","key":"yoi240008r24","doi-asserted-by":"publisher","first-page":"63","DOI":"10.1038\/s41588-018-0269-7","article-title":"Discovery of the first genome-wide significant risk loci for attention deficit\/hyperactivity disorder.","volume":"51","author":"Demontis","year":"2019","journal-title":"Nat Genet"},{"issue":"3","key":"yoi240008r25","doi-asserted-by":"publisher","first-page":"431","DOI":"10.1038\/s41588-019-0344-8","article-title":"Identification of common genetic risk variants for autism spectrum disorder.","volume":"51","author":"Grove","year":"2019","journal-title":"Nat Genet"},{"issue":"8","key":"yoi240008r26","doi-asserted-by":"publisher","first-page":"1207","DOI":"10.1038\/s41588-019-0439-2","article-title":"Genome-wide association study identifies eight risk loci and implicates metabo-psychiatric origins for anorexia nervosa.","volume":"51","author":"Watson","year":"2019","journal-title":"Nat Genet"},{"issue":"12","key":"yoi240008r27","doi-asserted-by":"publisher","first-page":"1032","DOI":"10.1016\/S2215-0366(20)30339-4","article-title":"A large-scale genome-wide association study meta-analysis of cannabis use disorder.","volume":"7","author":"Johnson","year":"2020","journal-title":"Lancet Psychiatry"},{"issue":"12","key":"yoi240008r28","doi-asserted-by":"publisher","first-page":"1656","DOI":"10.1038\/s41593-018-0275-1","article-title":"Transancestral GWAS of alcohol dependence reveals common genetic underpinnings with psychiatric disorders.","volume":"21","author":"Walters","year":"2018","journal-title":"Nat Neurosci"},{"issue":"7","key":"yoi240008r29","doi-asserted-by":"publisher","first-page":"912","DOI":"10.1038\/s41588-018-0152-6","article-title":"Genome-wide association meta-analysis in 269,867 individuals identifies new genetic and functional links to intelligence.","volume":"50","author":"Savage","year":"2018","journal-title":"Nat Genet"},{"issue":"9","key":"yoi240008r30","doi-asserted-by":"publisher","first-page":"1466","DOI":"10.1093\/bioinformatics\/btu848","article-title":"PRSice: polygenic risk score software.","volume":"31","author":"Euesden","year":"2015","journal-title":"Bioinformatics"},{"issue":"2","key":"yoi240008r31","doi-asserted-by":"publisher","DOI":"10.1192\/bjo.2022.636","article-title":"DRAGON-Data: a platform and protocol for integrating genomic and phenotypic data across large psychiatric cohorts.","volume":"9","author":"Lynham","year":"2023","journal-title":"BJPsych Open"},{"issue":"4","key":"yoi240008r32","doi-asserted-by":"publisher","first-page":"276","DOI":"10.1002\/gepi.2015.39.issue-4","article-title":"Robust inference of population structure for ancestry prediction and correction of stratification in the presence of relatedness.","volume":"39","author":"Conomos","year":"2015","journal-title":"Genet Epidemiol"},{"issue":"5","key":"yoi240008r33","doi-asserted-by":"publisher","first-page":"668","DOI":"10.1038\/s41588-018-0090-3","article-title":"Genome-wide association analyses identify 44 risk variants and refine the genetic architecture of major depression.","volume":"50","author":"Wray","year":"2018","journal-title":"Nat Genet"},{"issue":"1","key":"yoi240008r35","doi-asserted-by":"publisher","first-page":"1776","DOI":"10.1038\/s41467-019-09718-5","article-title":"Polygenic prediction via bayesian regression and continuous shrinkage priors.","volume":"10","author":"Ge","year":"2019","journal-title":"Nat Commun"},{"issue":"7","key":"yoi240008r36","doi-asserted-by":"publisher","first-page":"1412","DOI":"10.1038\/s41591-022-01869-1","article-title":"Genome-wide polygenic score to predict chronic kidney disease across ancestries.","volume":"28","author":"Khan","year":"2022","journal-title":"Nat Med"},{"issue":"5","key":"yoi240008r37","doi-asserted-by":"publisher","first-page":"1256","DOI":"10.1002\/cpt.2019.105.issue-5","article-title":"Standardized biogeographic grouping system for annotating populations in pharmacogenetic research.","volume":"105","author":"Huddart","year":"2019","journal-title":"Clin Pharmacol Ther"},{"issue":"9","key":"yoi240008r38","doi-asserted-by":"publisher","first-page":"963","DOI":"10.1001\/jamapsychiatry.2016.1831","article-title":"Analysis of intellectual disability copy number variants for association with schizophrenia.","volume":"73","author":"Rees","year":"2016","journal-title":"JAMA Psychiatry"},{"issue":"2","key":"yoi240008r39","doi-asserted-by":"publisher","first-page":"108","DOI":"10.1192\/bjp.bp.113.131052","article-title":"Analysis of copy number variations at 15 schizophrenia-associated loci.","volume":"204","author":"Rees","year":"2014","journal-title":"Br J Psychiatry"},{"issue":"5","key":"yoi240008r40","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1192\/bjp.2018.301","article-title":"Cognitive performance and functional outcomes of carriers of pathogenic copy number variants: analysis of the UK Biobank.","volume":"214","author":"Kendall","year":"2019","journal-title":"Br J Psychiatry"},{"issue":"10","key":"yoi240008r41","doi-asserted-by":"publisher","first-page":"846","DOI":"10.1176\/appi.ajp.2019.18091085","article-title":"Penetrance and pleiotropy of polygenic risk scores for schizophrenia in 106,160 patients across four health care systems.","volume":"176","author":"Zheutlin","year":"2019","journal-title":"Am J Psychiatry"},{"issue":"11","key":"yoi240008r42","doi-asserted-by":"publisher","first-page":"1092","DOI":"10.1001\/jamapsychiatry.2022.2742","article-title":"Penetrance and pleiotropy of polygenic risk scores for schizophrenia, bipolar disorder, and depression among adults in the US Veterans Affairs Health Care System.","volume":"79","author":"Bigdeli","year":"2022","journal-title":"JAMA Psychiatry"},{"issue":"6","key":"yoi240008r44","doi-asserted-by":"publisher","DOI":"10.1192\/bjo.2020.42","article-title":"Impact of schizophrenia genetic liability on the association between schizophrenia and physical illness: data-linkage study.","volume":"6","author":"Kendall","year":"2020","journal-title":"BJPsych Open"},{"issue":"1","key":"yoi240008r45","doi-asserted-by":"publisher","first-page":"5","DOI":"10.1016\/j.biopsych.2020.01.017","article-title":"Large-scale genomics: a paradigm shift in psychiatry?","volume":"89","author":"Owen","year":"2021","journal-title":"Biol Psychiatry"},{"key":"yoi240008r13","volume-title":"Schedules for Clinical Assessment in Neuropsychiatry: Version 2: Manual","author":"World Health Organization","year":"1994"},{"key":"yoi240008r6","doi-asserted-by":"crossref","unstructured":"van Alten? S, Domingue? BW, Galama? T, Marees? AT. Reweighting the UK Biobank to reflect its underlying sampling population substantially reduces pervasive selection bias due to volunteering.? medRxiv. Preprint posted online May 16, 2022. doi:10.1101\/2022.05.16.22275048","DOI":"10.1101\/2022.05.16.22275048"},{"key":"yoi240008r34","unstructured":"Hubbard? L, Anney? R. summaRygwasqc. Accessed January 26, 2022. https:\/\/github.com\/CardiffMRCPathfinder\/summaRygwasqc"},{"key":"yoi240008r43","doi-asserted-by":"crossref","unstructured":"Grace? EW, Sophie? EL, Amy? L, . Assessing the validity of a self-reported clinical diagnosis of schizophrenia.? medRxiv. Preprint posted online December 8, 2023. doi:10.1101\/2023.12.06.23299622","DOI":"10.1101\/2023.12.06.23299622"}],"container-title":["JAMA Psychiatry"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/jamanetwork.com\/journals\/jamapsychiatry\/articlepdf\/2816804\/jamapsychiatry_legge_2024_oi_240008_1719970600.40189.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,7,3]],"date-time":"2024-07-03T15:12:30Z","timestamp":1720019550000},"score":1,"resource":{"primary":{"URL":"https:\/\/jamanetwork.com\/journals\/jamapsychiatry\/fullarticle\/2816804"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,1]]},"references-count":45,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2024,7,1]]}},"URL":"https:\/\/doi.org\/10.1001\/jamapsychiatry.2024.0200","relation":{},"ISSN":["2168-622X"],"issn-type":[{"value":"2168-622X","type":"print"}],"subject":[],"published":{"date-parts":[[2024,7,1]]}}}