Dr Crow is concerned that the publication of our recent study on BDNF endangers the field of psychiatric genetics. We would suggest that this concern may be overstated for the following reasons.
First, Dr Crow claims that the two meta-analyses and two cohort studies invalidate our results. We find this conclusion to be puzzling, given that none of these studies assessed the phenotype of schizoaffective disorder. Notably, the cohort studies relied on a single self-report item as the primary assessment of psychopathology. We addressed limitations of the meta-analyses in our original paper. We suggest that careful and comprehensive examination of the diverse phenotypes associated with neuropsychiatric illness may be a more fruitful approach.
Second, Dr Crow cites his own review of the linkage literature to suggest that most of the candidate genes reported by our group, and many others, are not supported by linkage studies and thus should be discounted. This reasoning is based on a flawed understanding of the role of linkage in complex disorders and is inconsistent with a large body of recent empirical evidence in complex genetics. In other complex disorders, a majority of susceptibility loci that have been unambiguously replicated in association studies fall outside of previously identified areas of even suggestive linkage (e.g. Barrett et al 1 ). Therefore, an argument utilising non-significant linkage data to invalidate a subsequent candidate gene association is erroneous.
Third, Dr Crow notes the productivity of our lab over the past several years as a source of concern for him. In so doing he mischaracterises our papers. First, he is simply incorrect in stating that only one paper reports strictly negative results (see Fubke et al 2 and Hodgkinson et al 3 ). Moreover, many of our papers report complex relationships that are not so simplistically reduced to ‘positive’ v. ‘negative’. More importantly, Dr Crow fails to mention that most of our papers are not simply analyses of association to schizophrenia diagnosis, but instead examine alternative phenotypes. For example, our study of DRD2 assessed the relationship between a functional promoter region polymorphism and clinical response to olanzapine and risperidone in the context of a randomised controlled clinical trial in first-episode schizophrenia. 4 Therefore, it is not surprising that our DRD2 results were not ‘replicated’ in either linkage studies or the association study of Sanders et al, 5 as these papers were restricted to mere association to diagnosis.
Although Dr Crow is entitled to his opinions, the field of psychiatric genetics may be better served by more constructive discussion leading towards a better understanding of the complexities of these devastating disorders.