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Study protocol of DIVERGE, the first genetic epidemiological study of major depressive disorder in Pakistan

Valkovskaya, Maria; Hassan, Arsalan; Zartaloudi, Eirini; Hussain, Fahad; Umar, Muhammad; Khizar, Bakht; Khattak, Inzemam; ... Kuchenbaecker, Karoline; + view all (2022) Study protocol of DIVERGE, the first genetic epidemiological study of major depressive disorder in Pakistan. Psychiatric Genetics 10.1097/YPG.0000000000000333. (In press). Green open access

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Abstract

INTRODUCTION: Globally, 80% of the burdenof major depressive disorder (MDD) pertains to low- and middle-income countries. Research into genetic and environmental risk factors has the potential to uncover disease mechanisms that may contribute to better diagnosis and treatment of mental illness, yet has so far been largely limited to participants with European ancestry from high-income countries. The DIVERGE study was established to help overcome this gap and investigate genetic and environmental risk factors for MDD in Pakistan. METHODS: DIVERGE aims to enrol 9000 cases and 4000 controls in hospitals across the country. Here, we provide the rationale for DIVERGE, describe the study protocol and characterise the sample using data from the first 500cases. Exploratory data analysis is performed to describe demographics, socioeconomic status, environmental risk factors, family history of mental illness and psychopathology. RESULTS AND DISCUSSION: Many participants had severe depression with 74% of patients who experienced multiple depressive episodes. It was a common practice to seek help for mental health struggles from faith healers and religious leaders. Socioeconomic variables reflected the local context with a large proportion of women not having access to any education and the majority of participants reporting no savings. CONCLUSION: DIVERGE is a carefully designed case-control study of MDD in Pakistan that captures diverse risk factors. As the largest genetic study in Pakistan, DIVERGE helps address the severe underrepresentation of people from South Asian countries in genetic as well as psychiatric research.

Type: Article
Title: Study protocol of DIVERGE, the first genetic epidemiological study of major depressive disorder in Pakistan
Location: England
Open access status: An open access version is available from UCL Discovery
DOI: 10.1097/YPG.0000000000000333
Publisher version: https://doi.org/10.1097/YPG.0000000000000333
Language: English
Additional information: This is an Open Access article published under a Creative Commons Attribution 4.0 International (CC BY 4.0) Licence (https://creativecommons.org/licenses/by/4.0/).
Keywords: depression, genome-wide association study, major depressive disorder, Pakistan, protocol, risk factor
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Division of Psychiatry
URI: https://discovery.ucl.ac.uk/id/eprint/10162621
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