Fig. 1: Schematic overview of methods and the derivation of discovery and validation samples.

PRS polygenic risk score, PMPS poly-methylomic profile score, HR high-risk individuals, CON control, BD bipolar disorder, HRunwell high-risk individuals who developed sub-threshold or threshold BD at baseline or follow-up, HRwell high-risk individuals who remained well after follow-up, EA European ancestry based on components from multidimensional scaling analysis of SNP genotype data.