title: Symptom profiles and illness course among Anabaptist and Non-Anabaptist adults with major mood disorders.
abstract: BACKGROUND
  Anabaptists comprise large and growing Amish and Mennonite populations with a unique genetic heritage and cultural background. Little is known about the symptoms and course of major mood disorders in Anabaptists. Even less is known about the impact of potential moderators on symptom severity and course.
  
  
  METHODS
  A sample of Amish and Mennonite participants with bipolar, recurrent unipolar, or schizoaffective bipolar disorder (n = 155) were systematically evaluated with a well-validated instrument. Cases were compared with non-Anabaptist participants (n = 155) matched for age, sex, and psychiatric diagnosis and evaluated by the same methods.
  
  
  RESULTS
  Despite substantial cultural differences, the profile of manic and depressive symptoms during illness episodes did not significantly differ between the two groups. Alcohol use disorder (AUD) was significantly less frequent among Anabaptists, and was associated with more major depressive episodes and more hospitalizations for major depression in Anabaptist, but not non-Anabaptist participants. Lifetime history of head injury showed a trend toward association with more episodes of major depression in both Anabaptist and non-Anabaptist groups that did not withstand multiple test correction.
  
  
  CONCLUSIONS
  The presentation of a highly heritable psychiatric illness such as bipolar disorder does not differ in cases drawn from genetically unique Anabaptist populations. However, alcohol comorbidity, head injury, and their effects on illness course suggest some differences that deserve further investigation.
authors.affiliation: Human Genetics Branch, Section on Genetic Basis of Mood and Anxiety Disorders, National Institute of Mental Health Intramural Research Program, National Institutes of Health, New York City, USA. kegill13@gmail.com.|Department of Psychology, The Catholic University of America, 620 Michigan Ave NE, Washington, D.C., 20064, USA. kegill13@gmail.com.
authors.forename: Kelly E
authors.initials: KE
authors.lastname: Gill
authors.affiliation: Human Genetics Branch, Section on Genetic Basis of Mood and Anxiety Disorders, National Institute of Mental Health Intramural Research Program, National Institutes of Health, New York City, USA.
authors.forename: Stephanie A
authors.initials: SA
authors.lastname: Cardenas
authors.affiliation: Human Genetics Branch, Section on Genetic Basis of Mood and Anxiety Disorders, National Institute of Mental Health Intramural Research Program, National Institutes of Health, New York City, USA.
authors.forename: Layla
authors.initials: L
authors.lastname: Kassem
authors.affiliation: Human Genetics Branch, Section on Genetic Basis of Mood and Anxiety Disorders, National Institute of Mental Health Intramural Research Program, National Institutes of Health, New York City, USA.|Institute of Psychiatric Phenomics and Genomics (IPPG), Medical Center of the University of Munich, Munich, Germany.
authors.forename: Thomas G
authors.initials: TG
authors.lastname: Schulze
authors.affiliation: Human Genetics Branch, Section on Genetic Basis of Mood and Anxiety Disorders, National Institute of Mental Health Intramural Research Program, National Institutes of Health, New York City, USA.
authors.forename: Francis J
authors.initials: FJ
authors.lastname: McMahon
keywords: Alcohol; Amish; Bipolar disorder; Concussion; Depression; Head injury; Mania; Mennonite