The schizophrenia envirome
The schizophrenia envirome
复制标题
DOI：
10.1097/00001504-200503000-00006
复制
发表时间：
2005-03-01
影响因子：
6.9
通讯作者：
Delespaul, P
中科院分区：
文献类型：
--
作者：
van Os, J;Krabbendam, L;Delespaul, P
审查的目的为了显示哪些方面的环境增加精神分裂症的风险，以及它们如何相互作用与预先存在的责任精神病最近的调查结果不仅大麻生存作为一个危险因素的精神病，但证据显示具体的协同效应大麻和预先存在的责任精神病。就归因风险而言，城市环境是最重要的代理环境风险因素。有证据表明，它与遗传风险相互作用，有人假设，这一机制涉及在个人一级，也可能在更广泛的社会环境一级，如邻里，改变社会互动的累积效应。早期创伤是环境的另一个方面，最近被前瞻性地与精神病联系在一起，元分析工作最终表明，少数群体地位是一个风险因素，其中一部分可能是长期遭受歧视所介导的。产前环境影响可能包括叶酸或维生素D缺乏、病毒感染或与出生体重低或高相关的不良影响。环境可能影响风险的机制一方面是通过认知和情感途径，另一方面是通过生物途径，可能涉及多巴胺敏化。提供了具体的途径来进行研究，这是一个很好的机会，阐明至少一些精神分裂症的原因。
Purpose of review To show which aspects of the environment increase the risk for schizophrenia and how they interact with pre-existing liability for psychosis.Recent findings Not only does cannabis survive as a risk factor for psychosis, but the evidence is showing concrete I synergistic effects between cannabis and pre-existing liability to psychosis. The urban environment is, in terms of attributable risk, the most important proxy environmental risk factor. There is evidence that it interacts with genetic risk and it has been hypothesized that the mechanism involves the cumulative effects of altered social interactions at the individual level and possibly also at the level of the wider social environment, such as the neighbourhood. Early trauma is another aspect of the environment that has recently been linked prospectively to psychosis, and meta-analytic work demonstrates conclusively that minority status is a risk factor, part of which may be mediated by chronic exposure to discrimination. Prenatal environmental effects may involve folate or vitamin D deficiency, viral infections or adverse effects associated with low or high birth weight. The mechanism by which the environment is likely to impact on risk is through cognitive and emotional pathways on the one hand, and biological pathways, possibly involving dopamine sensitization, on the other.Summary Several synergistic mechanisms involving proxy measures of genes and proxy measures of the environment, such as gene-cannabis, gene-urbanicity and gene-stress interactions, offer concrete avenues to pursue research that stands a good chance of elucidating at least some of the causes of schizophrenia.