Dimensions of personality have been linked with the liability to have psychiatric illness.¹ Perhaps the strongest link between personality and psychiatric illness is the association of neuroticism with major depressive disorder (MDD).^2-5 Neuroticism is also associated with other psychiatric disorders that entail emotional dysregulation, including personality, substance use, and anxiety disorders.^2,6-8 Furthermore, neuroticism is associated with neurological diseases such as migraine and Alzheimer disease.^9,10 Hence, neuroticism is a psychological risk factor of profound public health significance.¹¹

Extraversion is a relatively stable and heritable personality trait associated with numerous psychosocial, lifestyle and health outcomes. Despite its substantial heritability, no genetic variants have been detected in previous genome-wide association (GWA) studies, which may be due to relatively small sample sizes of those studies. Here, we report on a large meta-analysis of GWA studies for extraversion in 63,030 subjects in 29 cohorts. Extraversion item data from multiple personality inventories were harmonized across inventories and cohorts. No genome-wide significant associations were found at the single nucleotide polymorphism (SNP) level but there was one significant hit at the gene level for a long non-coding RNA site (LOC101928162). Genome-wide complex trait analysis in two large cohorts showed that the additive variance explained by common SNPs was not significantly different from zero, but polygenic risk scores, weighted using linkage information, significantly predicted extraversion scores in an independent cohort. These results show that extraversion is a highly polygenic personality trait, with an architecture possibly different from other complex human traits, including other personality traits. Future studies are required to further determine which genetic variants, by what modes of gene action, constitute the heritable nature of extraversion.

It is known that the orbitofrontal cortex (OFC) is crucially involved in emotion regulation. However, the specific role of the OFC in controlling the behavior evoked by these emotions, such as approach–avoidance (AA) responses, remains largely unexplored. We measured behavioral and neural responses (using fMRI) during the performance of a social task, a reaction time (RT) task where subjects approached or avoided visually presented emotional faces by pulling or pushing a joystick, respectively. RTs were longer for affect-incongruent responses (approach angry faces and avoid happy faces) as compared to affect-congruent responses (approach–happy; avoid–angry). Moreover, affect-incongruent responses recruited increased activity in the left lateral OFC. These behavioral and neural effects emerged only when the subjects responded explicitly to the emotional value of the faces (AA-task) and largely disappeared when subjects responded to an affectively irrelevant feature of the faces during a control (gender evaluation: GE) task. Most crucially, the size of the OFC-effect correlated positively with the size of the behavioral costs of approaching angry faces. These findings qualify the role of the lateral OFC in the voluntary control of social–motivational behavior, emphasizing the relevance of this region for selecting rule-driven stimulus–response associations, while overriding automatic (affect-congruent) stimulus–response mappings.

Major depressive disorder (MDD) presents different clinical features in women and men, with women being more affected and responding differently to antidepressant treatment. Specific molecular mechanisms underlying these differences are not well studied and this narrative review aims at providing an overview of the neurobiological features underlying sex-differences in biological systems involved in MDD pathophysiology and response to antidepressant treatment, focusing on human studies. The majority of the reviewed studies were performed through candidate gene approaches, focusing on biological systems involved in MDD pathophysiology, including the stress response, inflammatory and immune, monoaminergic, neurotrophic, gamma-aminobutyric acid and glutamatergic, and oxytocin systems. The influence of the endocrine system and sex-specific hormone effects are also discussed. Genome, epigenome and transcriptome-wide approaches are less frequently performed and most of these studies do not focus on sex-specific alterations, revealing a paucity of omics studies directed to unravel sex-based differences in MDD. Few studies about sex-related differences in antidepressant treatment response have been conducted, mostly involving the inflammatory system, with less evidence on the monoaminergic system and sparse evidence in omics approaches. Our review covers the importance of accounting for sex-differences in research, optimizing patient stratification for a more precise diagnostic and individualized treatment for women and men.

Genome-wide screenings for copy number variations (CNVs) in patients with schizophrenia have demonstrated the presence of several CNVs that increase the risk of developing the disease and a growing number of large rare CNVs; the contribution of these rare CNVs to schizophrenia remains unknown. Using Affymetrix 6.0 arrays, we undertook a systematic search for CNVs in 172 patients with schizophrenia and 160 healthy controls, all of Italian origin, with the aim of confirming previously identified loci and identifying novel schizophrenia susceptibility genes. We found five patients with a CNV occurring in one of the regions most convincingly implicated as risk factors for schizophrenia: NRXN1 and the 16p13.1 regions were found to be deleted in single patients and 15q11.2 in 2 patients, whereas the 15q13.3 region was duplicated in one patient. Furthermore, we found three distinct patients with CNVs in 2q12.2, 3q29 and 17p12 loci, respectively. These loci were previously reported to be deleted or duplicated in patients with schizophrenia but were never formally associated with the disease. We found 5 large CNVs (>900 kb) in 4q32, 5q14.3, 8q23.3, 11q25 and 17q12 in five different patients that could include some new candidate schizophrenia susceptibility genes. In conclusion, the identification of previously reported CNVs and of new, rare, large CNVs further supports a model of schizophrenia that includes the effect of multiple, rare, highly penetrant variants.