Supplementary Information

Supplementary Table 1.OPCRIT items.

The 48 clinical OPCRIT items included in principal component analysis.

Item number / Item
17 / Bizarre behavior
18 / Catatonia
19 / Excessive activity
20 / Reckless activity
21 / Distractibility
22
23
24
25
26
27
28
29
30
31
32
33
34
35
36
37
39
41
42
43
53
54
55
56
57
58
59
60
61
62
63
66
67
68
69
70
71
72
73
74
75
76
77 / Reduced need for sleep
Agitated activity
Slowed activity
Loss of energy/tiredness
Speech difficult to understand
Incoherent
Positive formal thought disorder
Negative formal thought disorder
Pressured speech
Thoughts racing
Restricted affect
Blunted affect
Inappropriate affect
Elevated mood
Irritable mood
Dysphoria
Loss of pleasure
Poor concentration
Excessive self reproach
Suicidal ideation
Increased sociability
Persecutory delusions
Well organized delusions
Increased self esteem
Grandiose delusions
Delusion of influence
Bizarre delusions
Widespread delusions
Delusion of passivity
Primary delusional perception
Other primary delusional perception
Thought insertion
Thought withdrawal
Thought broadcast
Delusions of guilt
Delusions of poverty
Nihilistic delusions
Thought echo
Third person auditory hallucinations
Running commentary voices
Abusive/accusatory/persecutory voices
Other (non affective) auditory voices
Non-affective hallucination in any modality

Supplementary Table 2. Factor solution.

Twelve-factor solution. Item loadings after varimax rotation.

Item / Depression / Mania / Delusions / Depersonalization / Grandiose Delusions / Voices / Agitation / Disorganization / Other Hallucinations / Negative Mood Delusions / Catatonia / Negative Symptoms
Bizarre behavior / -.060 / .106 / .504 / .098 / .079 / .097 / .176 / .227 / .105 / -.006 / .422 / .053
Catatonia / .080 / -.027 / .041 / .053 / -.020 / .109 / -.027 / .102 / .098 / .065 / .701 / .015
Excessive activity / .065 / .726 / .036 / .033 / .048 / .042 / .114 / .042 / -.023 / -.011 / .006 / -.028
Reckless activity / -.052 / .566 / -.022 / .080 / .102 / .045 / -.113 / .026 / -.244 / .010 / .074 / -.061
Distractibility / .033 / .416 / -.005 / -.059 / .201 / -.036 / .217 / .044 / .174 / .024 / .024 / .167
Reduced need for sleep / .035 / .603 / .045 / -.019 / .107 / -.041 / .074 / -.099 / .098 / .082 / .092 / -.034
Agitated activity / .167 / .219 / .069 / .044 / -.142 / .051 / .554 / -.058 / -.031 / .040 / .131 / .114
Slowed activity / .658 / -.025 / -.060 / .037 / .041 / .010 / .110 / .143 / -.007 / .014 / .040 / .025
Loss of energy/tiredness / .854 / -.002 / -.049 / -.005 / .016 / -.017 / -.016 / .047 / -.054 / -.029 / .002 / .025
Speech difficult to understand / -.087 / .130 / .207 / .003 / .034 / -.025 / .195 / .589 / .151 / .036 / .241 / .010
Incoherent / .004 / .082 / .193 / .030 / -.018 / -.051 / .687 / .262 / .210 / .030 / .001 / .002
Positive formal thought disorder / -.041 / .169 / .259 / .062 / .111 / .035 / .175 / .677 / -.028 / -.007 / .125 / -.070
Negative formal thought disorder / .159 / -.032 / .032 / -.002 / .038 / .119 / -.041 / .676 / -.015 / .088 / -.026 / .193
Pressured speech / .113 / .678 / .030 / .033 / .096 / -.002 / .098 / .105 / .095 / -.095 / -.133 / -.117
Thought racing / -.051 / .615 / .056 / .005 / .171 / -.037 / .123 / .119 / .111 / -.082 / -.066 / .086
Restricted affect / .242 / -.039 / .046 / -.023 / .082 / .065 / .251 / .110 / -.028 / -.013 / -.076 / .671
Blunted affect / .039 / -.032 / -.006 / .083 / -.077 / -.027 / -.085 / .045 / .042 / .104 / .105 / .702
Inappropriate affect / -.075 / .018 / .056 / .054 / .259 / -.006 / .308 / .065 / -.042 / .090 / .510 / .050
Elevated mood / .100 / .668 / .083 / .044 / -.107 / .015 / .014 / .022 / -.003 / .005 / .015 / -.007
Irritable mood / -.045 / .202 / -.034 / -.063 / .384 / .001 / .402 / .109 / -.001 / .015 / .024 / .162
Dysphoria / .803 / .036 / -.023 / -.034 / .085 / .014 / -.037 / -.018 / -.071 / -.076 / .019 / .044
Loss of pleasure / .863 / .012 / -.014 / -.011 / .001 / -.004 / -.035 / .018 / -.044 / -.045 / -.044 / .017
Poor concentration / .604 / .132 / .069 / .014 / -.042 / -.052 / .046 / -.002 / .129 / .029 / -.067 / .084
Excessive self reproach / .542 / .103 / .071 / .003 / -.053 / -.039 / -.060 / -.232 / .138 / .155 / .137 / .038
Suicidal ideation / .445 / .025 / .060 / .037 / -.134 / .058 / .162 / .001 / -.119 / .164 / -.028 / .001
Increased sociability / .049 / .309 / .057 / .024 / .306 / .073 / .496 / .061 / -.070 / -.109 / .167 / -.130
Persecutory delusions / -.025 / .057 / .340 / .212 / .477 / .132 / .042 / .102 / .190 / .084 / .021 / .031
Well organized delusions / .010 / .053 / .734 / .089 / .108 / .006 / .044 / .043 / .060 / .013 / -.017 / .040
Increased self esteem / -.001 / .389 / .055 / .043 / .604 / .023 / .120 / -.060 / -.030 / .005 / -.042 / .044
Grandiose delusions / -.035 / .150 / .206 / .061 / .685 / .034 / -.030 / .022 / .064 / .034 / .096 / -.058
Delusion of influence / -.004 / .029 / .256 / .324 / .520 / .101 / -.165 / .166 / .176 / .046 / .162 / -.058
Bizarre delusions / -.015 / .072 / .714 / .100 / .091 / .041 / .107 / .002 / .076 / -.084 / .201 / .077
Widespread delusions / .022 / .040 / .743 / .071 / .127 / .113 / -.009 / .199 / -.001 / .065 / -.066 / -.051
Delusion of passivity / .065 / .017 / .265 / .511 / .241 / .031 / .382 / .029 / .173 / .065 / -.165 / -.082
Primary delusional perception / .091 / .027 / .444 / .165 / .303 / .097 / .347 / .114 / .167 / .070 / -.079 / -.258
Other primary delusional perception / .083 / .023 / .354 / .111 / .361 / .025 / .267 / .221 / .137 / .154 / -.044 / -.254
Thought insertion / -.048 / .066 / .119 / .775 / .066 / .074 / .015 / .053 / -.008 / .038 / .009 / .052
Thought withdrawal / .027 / .012 / .125 / .729 / .041 / .077 / .052 / -.098 / -.105 / .015 / .094 / .098
Thought broadcast / .052 / .029 / .043 / .639 / .119 / -.018 / -.084 / .054 / .324 / .021 / .048 / -.036
Delusions of guilt / .109 / -.039 / .142 / .173 / .077 / .084 / .010 / -.006 / -.026 / .636 / .095 / .099
Delusions of poverty / .049 / .048 / -.118 / .042 / .027 / .057 / .042 / .021 / -.033 / .672 / -.109 / .077
Nihilistic delusions / -.054 / -.072 / .035 / -.126 / .012 / -.002 / -.011 / .081 / .027 / .712 / .163 / -.076
Thought echo / -.024 / .034 / -.046 / .330 / -.074 / .354 / .078 / .144 / .115 / -.056 / .073 / -.186
Third person auditory hallucinations / .007 / -.002 / .066 / .085 / .066 / .713 / -.078 / .004 / .026 / .000 / .196 / .011
Running commentary voices / -.012 / -.012 / .068 / .042 / .090 / .808 / .080 / .019 / .215 / .012 / -.066 / .022
Abusive/accusatory/persecutory voices / -.014 / .005 / .095 / .010 / .021 / .803 / .023 / .061 / .049 / .160 / -.013 / .033
Other (non affective) auditory voices / -.030 / .078 / .111 / .119 / .092 / .154 / -.034 / .072 / .754 / -.010 / .008 / .033
Non-affective hallucination in any modality / -.039 / .048 / .136 / .070 / .112 / .230 / .209 / -.025 / .679 / -.044 / .139 / -.033

Bold type indicates the item loadings that contribute to each factor

Supplementary Table 3.Distribution of the OPCRIT items for the factor dimension “Negative Mood Delusions” in the German sample.

Factor Dimension / Rotation Sums of Squared Loadings
Total / % of Variance / Cumulative %
Depression / 3,634 / 7,571 / 7,571
Mania / 3,165 / 6,594 / 14,165
Delusions / 2,791 / 5,815 / 19,980
Depersonalization / 2,256 / 4,700 / 24,680
Grandiose Delusions / 2,224 / 4,633 / 29,312
Voices / 2,154 / 4,487 / 33,799
Agitation / 2,074 / 4,321 / 38,120
Disorganization / 1,747 / 3,640 / 41,761
Other Hallucinations / 1,649 / 3,435 / 45,196
Negative Mood Delusions / 1,582 / 3,295 / 48,490
Catatonia / 1,376 / 2,866 / 51,357
Negative Symptoms / 1,345 / 2,801 / 54,158

Supplementary Table 4.Correlation matrix for the derived factor dimensions.

Depression / Mania / Delusions / Grandiose Delusions / Depersonalization / Voices / Agitation / Disorganization / Other Hallucinations / Negative Mood Delusions / Catatonia / Negative Symptoms
Depression / 1 / -.033 / -.009 / .025 / -.002 / -.001 / -.018 / .057 / 0.076 / .031 / .022 / -.006
Mania / 1 / -.006 / -0.114 / -.036 / -.034 / -0.087 / .005 / .017 / .027 / -.052 / .001
Delusions / 1 / .029 / 0.144 / 0.071 / 0.151 / 0.176 / 0.102 / 0.089 / 0.1 / .018
Grandiose Delusions / 1 / 0.074 / .050 / .010 / .021 / .044 / .019 / 0.064 / -.052
Depersonalization / 1 / 0.111 / .038 / 0.11 / 0.179 / .049 / .047 / 0.067
Voices / 1 / .051 / .038 / 0.184 / 0.123 / 0.171 / .024
Agitation / 1 / 0.107 / 0.114 / .058 / 0.108 / -0.064
Disorganization / 1 / .038 / 0.082 / 0.083 / 0.069
Other Hallucinations / 1 / .012 / .036 / .026
Negative Mood Delusions / 1 / 0.123 / 0.078
Catatonia / 1 / .061
Negative Symptoms / 1

Bold type indicates significant correlations.

Supplementary Table 5.Distribution of the OPCRIT items for the factor dimension “Negative Mood Delusions” in the German sample.

Delusions of guilt / Delusions of poverty / Nihilistic delusions
Delusions of guilt / N=55 / N=15 / N=13
Delusions of poverty / N=15 / N=17 / N= 7
Nihilistic delusions / N=13 / N= 7 / N=12

OPCRIT, Operational Criteria Checklist for Psychotic Illness.

Supplementary Table 6. Association between rs9875793 and the OPCRIT items of the factor dimension “Negative Mood Delusions” in the German GWAS sample.

SNP data / Association data
German sample
allelic χ2model / MAF
Marker / Chromosome / Alleles / OPCRIT item / PG / OR / trait present / trait absent
rs9875793 / 3 / G/A / Delusions of guilt / 0.0008 / 1.87 / 0.26 / 0.16
rs9875793 / 3 / G/A / Delusions of poverty / n.s. / 1.60 / 0.23 / 0.16
rs9875793 / 3 / G/A / Nihilistic delusions / 0.023 / 2.03 / 0.28 / 0.16

Alleles.minor/major allele. Minor allele refers to dbSNP build129. and was determined in each analysis in patients with- and without the trait; SNP, single nucleotide polymorphism; MAF, minor allele frequency; OR, odds ratio; referring to the minor allele;OPCRIT,Operational Criteria Checklist for Psychotic Illness; n.s., non significant.

Supplementary Table 7. Association between rs9875793 and a categorical diagnosis of BD and “Negative Mood Delusions” in the German GWAS sample and in the European American follow-up sample.

SNP data / Association data
German sample
allelic χ2 model / MAF
Marker / Chromosome / Alleles / samples / PG / OR / cases / controls
Ncases
3 / G+ / 0.0001 / 1.93 / 0.27 / 0.16
rs9875793 / G/A / 89
rs9875793 / 3 / G/A / G- / 838 / 0.0001 / 0.72 / 0.12 / 0.16
rs9875793 / 3 / G/A / G / 927 / 0.013 / 0.82 / 0.14 / 0.16
rs9875793 / 3 / G/A / EA+ / 286 / 0.028 / 1.27 / 0.17 / 0.14
rs9875793 / 3 / G/A / EA- / 988 / n.s. / 1.21 / 0.16 / 0.14
rs9875793 / 3 / G/A / EA / 1274 / n.s. / 1.15 / 0.16 / 0.14

G, German; EA, European American; + with "Negative Mood Delusions"; - without "Negative Mood Delusions"; SNP, single nucleotide polymorphism; MAF, minor allele frequency; OR, odds ratio; referring to the minor allele;n.s., non significant.