Abstract
Genome-wide approaches including polygenic risk scores (PRSs) are now widely used in medical research; however, few studies have been conducted in low- and middle-income countries (LMICs), especially in South America. This study was designed to test the transferability of psychiatric PRSs to individuals with different ancestral and cultural backgrounds and to provide genome-wide association study (GWAS) results for psychiatric outcomes in this sample. The PrOMIS cohort (N = 3308) was recruited from prenatal care clinics at the Instituto Nacional Materno Perinatal (INMP) in Lima, Peru. Three major psychiatric outcomes (depression, PTSD, and suicidal ideation and/or self-harm) were scored by interviewers using valid Spanish questionnaires. Illumina Multi-Ethnic Global chip was used for genotyping. Standard procedures for PRSs and GWAS were used along with extra steps to rule out confounding due to ancestry. Depression PRSs significantly predicted depression, PTSD, and suicidal ideation/self-harm and explained up to 0.6% of phenotypic variation (minimum p = 3.9 × 10−6). The associations were robust to sensitivity analyses using more homogeneous subgroups of participants and alternative choices of principal components. Successful polygenic prediction of three psychiatric phenotypes in this Peruvian cohort suggests that genetic influences on depression, PTSD, and suicidal ideation/self-harm are at least partially shared across global populations. These PRS and GWAS results from this large Peruvian cohort advance genetic research (and the potential for improved treatments) for diverse global populations.
Similar content being viewed by others
Log in or create a free account to read this content
Gain free access to this article, as well as selected content from this journal and more on nature.com
or
References
Wray NR, Lee SH, Mehta D, Vinkhuyzen AAE, Dudbridge F, Middeldorp CM. Research review: polygenic methods and their application to psychiatric traits. J Child Psychol Psychiatry. 2014;55:1068–87.
Wray NR, Kemper KE, Hayes BJ, Goddard ME, Visscher PM. Complex trait prediction from genome data: contrasting EBV in livestock to PRS in humans: genomic prediction. Genetics. 2019;211:1131–41.
Wray NR, Goddard ME, Visscher PM. Prediction of individual genetic risk to disease from genome-wide association studies. Genome Res. 2007;17:1520–8.
Purcell SM, Wray NR, Stone JL, Visscher PM, O’Donovan MC, Sullivan PF, et al. Common polygenic variation contributes to risk of schizophrenia and bipolar disorder. Nature. 2009;460:748–52.
Pardiñas AF, Holmans P, Pocklington AJ, Escott-Price V, Ripke S, Carrera N, et al. Publisher correction: common schizophrenia alleles are enriched in mutation-intolerant genes and in regions under strong background selection. Nat Genet. 2019;51:1193.
Scutari M, Mackay I, Balding D. Using genetic distance to infer the accuracy of genomic prediction. PLoS Genet. 2016;12:e1006288.
Martin AR, Kanai M, Kamatani Y, Okada Y, Neale BM, Daly MJ. Clinical use of current polygenic risk scores may exacerbate health disparities. Nat Genet. 2019;51:584–91.
Duncan L, Shen H, Gelaye B, Meijsen J, Ressler K, Feldman M, et al. Analysis of polygenic risk score usage and performance in diverse human populations. Nat Commun. 2019;10:3328.
Borba CPC, Gelaye B, Zayas L, Ulloa M, Lavelle J, Mollica RF, et al. Making strides towards better mental health care in Peru: results from a primary care mental health training. Int J Clin Psychiatry Ment Health. 2015;3:9–19.
Sanchez SE, Pineda O, Chaves DZ, Zhong Q-Y, Gelaye B, Simon GE. et al. Childhood physical and sexual abuse experiences associated with post-traumatic stress disorder among pregnant women. Ann Epidemiol. 2017;27:716–.723.e1.
Gelaye B, Zhong Q-Y, Basu A, Levey EJ, Rondon MB, Sanchez S, et al. Trauma and traumatic stress in a sample of pregnant women. Psychiatry Res. 2017;257:506–13.
Barrios YV, Sanchez SE, Nicolaidis C, Garcia PJ, Gelaye B, Zhong Q, et al. Childhood abuse and early menarche among Peruvian women. J Adolesc Health Publ Soc Adolesc Med. 2015;56:197–202.
Kroenke K, Spitzer RL, Williams JB. The PHQ-9: validity of a brief depression severity measure. J Gen Intern Med. 2001;16:606–13.
Spitzer RL, Kroenke K, Williams JB. Validation and utility of a self-report version of PRIME-MD: the PHQ primary care study. Primary Care Evaluation of Mental Disorders. Patient Health Questionnaire. JAMA. 1999;282:1737–44.
Gelaye B, Zheng Y, Medina-Mora ME, Rondon MB, Sánchez SE, Williams MA. Validity of the posttraumatic stress disorders (PTSD) checklist in pregnant women. BMC Psychiatry. 2017;17:179.
Wilkins KC, Lang AJ, Norman SB. Synthesis of the psychometric properties of the PTSD checklist (PCL) military, civilian, and specific versions. Depress Anxiety. 2011;28:596–606.
Zhong Q-Y, Bizu G, Rondon MB, Sánchez SE, Simon GE, Henderson DC, et al. Using the Patient Health Questionnaire (PHQ-9) and the Edinburgh Postnatal Depression Scale (EPDS) to assess suicidal ideation among pregnant women in Lima, Peru. Arch Women’s Ment Health. 2015;18:783–92.
Nievergelt CM, Maihofer AX, Klengel T, Atkinson EG, Chen C-Y, Choi KW, et al. International meta-analysis of PTSD genome-wide association studies identifies sex- and ancestry-specific genetic risk loci. Nat Commun. 2019;10:4558.
1000 Genomes Project Consortium Auton A, Brooks LD, Durbin RM, Garrison EP, Kang HM, et al. A global reference for human genetic variation. Nature. 2015;526:68–74.
Delaneau O, Zagury J-F, Marchini J. Improved whole-chromosome phasing for disease and population genetic studies. Nat Methods. 2013;10:5–6.
Conomos MP, Reiner AP, Weir BS, Thornton TA. Model-free estimation of recent genetic relatedness. Am J Hum Genet. 2016;98:127–48.
Abecasis GR, Altshuler D, Auton A, Brooks LD, Durbin RM, Gibbs RA, et al. A map of human genome variation from population-scale sequencing. Nature. 2010;467:1061–73.
Howard DM, Adams MJ, Clarke T-K, Hafferty JD, Gibson J, Shirali M, et al. Genome-wide meta-analysis of depression identifies 102 independent variants and highlights the importance of the prefrontal brain regions. Nat Neurosci. 2019;22:343–52.
Development Core Team. R: a language and environment for statistical computing. Vienna, Austria: R Foundation for Statistical Computing. ISBN 3-900051-07-0. 2005. 2005.
Hoffmann TJ, Ehret GB, Nandakumar P, Ranatunga D, Schaefer C, Kwok P-Y, et al. Genome-wide association analyses using electronic health records identify new loci influencing blood pressure variation. Nat Genet. 2017;49:54–64.
Levey DF, Polimanti R, Cheng Z, Zhou H, Nuñez YZ, Jain S, et al. Genetic associations with suicide attempt severity and genetic overlap with major depression. Transl Psychiatry. 2019;9:22.
Homburger JR, Moreno-Estrada A, Gignoux CR, Nelson D, Sanchez E, Ortiz-Tello P, et al. Genomic insights into the ancestry and demographic history of South America. PLoS Genet. 2015;11:e1005602.
Luo Y, Suliman S, Asgari S, Amariuta T, Baglaenko Y, Martínez-Bonet M, et al. Early progression to active tuberculosis is a highly heritable trait driven by 3q23 in Peruvians. Nat Commun. 2019;10:1–10.
Poldrack RA, Huckins G, Varoquaux G. Establishment of best practices for evidence for prediction: a review. JAMA Psychiatry. 2019. https://doi.org/10.1001/jamapsychiatry.2019.3671.
Duncan LE, Ratanatharathorn A, Aiello AE, Almli LM, Amstadter AB, Ashley-Koch AE, et al. Largest GWAS of PTSD (N=20 070) yields genetic overlap with schizophrenia and sex differences in heritability. Mol Psychiatry. 2018;23:666–73.
Duncan LE, Cooper BN, Shen H. Robust findings from 25 years of PTSD genetics research. Curr Psychiatry Rep. 2018;20:115.
Acknowledgements
The authors are indebted to the participants of the PrOMIS study for their cooperation. They are also grateful to the dedicated staff members of Asociacion Civil Proyectos en Salud (PROESA), Peru and Instituto Especializado Maternao Perinatal, Peru, for their expert technical assistance with this research. Some of the computing for this project was performed on the Sherlock cluster. We would like to thank Stanford University and the Stanford Research Computing Center for providing computational resources and support that contributed to these research results.
Author information
Authors and Affiliations
Contributions
LED, BG, HS conceived of the investigation and developed the analysis plan. MBR, SS, BG recruited and communicated with participants, and collected and cleaned the clinical data. HS conducted the analyses. HS and LED did the literature review for the paper. HS, LED, BG, and HH drafted the manuscript, and all authors contributed and edited the final manuscript.
Corresponding authors
Additional information
Publisher’s note Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Rights and permissions
About this article
Cite this article
Shen, H., Gelaye, B., Huang, H. et al. Polygenic prediction and GWAS of depression, PTSD, and suicidal ideation/self-harm in a Peruvian cohort. Neuropsychopharmacol. 45, 1595–1602 (2020). https://doi.org/10.1038/s41386-020-0603-5
Received:
Revised:
Accepted:
Published:
Version of record:
Issue date:
DOI: https://doi.org/10.1038/s41386-020-0603-5
This article is cited by
-
A phenome-wide association and Mendelian randomization study for suicide attempt within UK Biobank
Molecular Psychiatry (2026)
-
Polygenic scores for psychiatric traits mediate the impact of multigenerational history for depression on offspring psychopathology
Molecular Psychiatry (2026)
-
Polygenic architecture of brain structure and function, behaviors, and psychopathologies in children
Nature Communications (2025)
-
Genetic Variants Associated with the Development of Stress Disorders: A Systematic Review of GWAS
Neuroscience and Behavioral Physiology (2025)
-
Multi-ancestry genome-wide association study of major depression aids locus discovery, fine mapping, gene prioritization and causal inference
Nature Genetics (2024)


