8/23/2017 feature story
William Axinn, Dirgha Ghimire, and Colter Mitchell examine social, environmental, and genetic precedents to the onset of psychiatric disorders in Nepal.
Psychiatric disorders are the leading source of disability worldwide, affecting 53% of the U.S. population and having substantial consequences in terms of individual suffering and family and health outcomes. Dissecting the relationship among community, family, and psychiatric factors is complex because of the high potential for reciprocal causation, creating a formidable challenge to identifying the role of psychiatric disorders in a range of adverse outcomes. The first step toward disentangling this relationship is to identify the role of causal factors that precede the onset of psychiatric disorders. Successful documentation of causal pathways requires longitudinal data on large cohorts with repeated measures of environmental exposures, assessment of social and family variables, genetic data, and mental health outcomes. Our research uses data from one of the few such cohorts available worldwide, the 20-year Chitwan Valley Family Study (CVFS). The CVFS panel study collects detailed data on social environment factors, migration histories and demographics, and biospecimens from a cohort residing in a setting of unusually high exposures to risk factors (South Asia). Our demographic analyses identify key predictors of psychiatric disorders - focusing on major depression, PTSD, and alcohol use disorders - while our genome-wide genotyping examines the role of polygenic risk scores and genetic modifiers of environmental risk and resilience factors. The project identifies the role of community and gene-environment interactions in producing common psychiatric disorders and creates a resource for helping to identify the role of psychiatric disorders in shaping later life outcomes.
William G. Axinn, Dirgha J. Ghimire, Colter Mitchell
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