Cross-cultural gene- environment interactions in depression, post-traumatic stress disorder, and the cortisol awakening response: FKBP5 polymorphisms and childhood trauma in South Asia

Int Rev Psychiatry. 2015;27(3):180-96. doi: 10.3109/09540261.2015.1020052. Epub 2015 Jun 23.

Abstract

Despite increased attention to global mental health, psychiatric genetic research has been dominated by studies in high-income countries, especially with populations of European descent. The objective of this study was to assess single nucleotide polymorphisms (SNPs) in the FKBP5 gene in a population living in South Asia. Among adults in Nepal, depression was assessed with the Beck Depression Inventory (BDI), post-traumatic stress disorder (PTSD) with the PTSD Checklist-Civilian Version (PCL-C), and childhood maltreatment with the Childhood Trauma Questionnaire (CTQ). FKBP5 SNPs were genotyped for 682 participants. Cortisol awakening response (CAR) was assessed in a subsample of 118 participants over 3 days. The FKBP5 tag-SNP rs9296158 showed a main effect on depressive symptoms (p = 0.03). Interaction of rs9296158 and childhood maltreatment predicted adult depressive symptoms (p = 0.02) but not PTSD. Childhood maltreatment associated with endocrine response in individuals homozygous for the A allele, demonstrated by a negative CAR and overall hypocortisolaemia in the rs9296158 AA genotype and childhood maltreatment group (p < 0.001). This study replicated findings related to FKBP5 and depression but not PTSD. Gene-environment studies should take differences in prevalence and cultural significance of phenotypes and exposures into account when interpreting cross-cultural findings.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Child
  • Child Abuse* / ethnology
  • Child Abuse* / statistics & numerical data
  • Depression* / ethnology
  • Depression* / etiology
  • Depression* / genetics
  • Depression* / metabolism
  • Female
  • Gene-Environment Interaction*
  • Humans
  • Hydrocortisone / metabolism*
  • Male
  • Middle Aged
  • Nepal / ethnology
  • Social Class*
  • Stress Disorders, Post-Traumatic* / ethnology
  • Stress Disorders, Post-Traumatic* / etiology
  • Stress Disorders, Post-Traumatic* / genetics
  • Stress Disorders, Post-Traumatic* / metabolism
  • Tacrolimus Binding Proteins / genetics*

Substances

  • Tacrolimus Binding Proteins
  • tacrolimus binding protein 5
  • Hydrocortisone