Developmental trajectories of psychosis in population-based samples: interplay between early adversity and familial risk

精神疾病(如精神分裂症)等精神健康问题可能会造成极大的残疾，并导致个人、NHS服务和整个社会付出巨大代价。更好地了解这类疾病的发展和持久性涉及哪些因素，将有助于预防和治疗它们的努力。人们认为导致精神病的主要因素之一是个体的基因构成，但环境因素也被认为发挥了作用，可能是与基因结合在一起的。因此，我建议调查那些在童年经历过潜在痛苦经历(被父母严重殴打或与父母分离)并具有遗传风险(阳性家族史)的人，是否比只有一个或没有这些因素的人更有可能在很长一段时间内出现精神病症状(如听力障碍)并需要治疗精神病。为了验证这一命题，我将分析来自四个不同纵向研究的数据：三个青春期和成年期的普通人群出生队列，以及临床诊断为精神病患者的10年随访，这些患者可以获得关于他们的家庭和儿童史以及不同时间点的精神病症状和精神健康治疗经验的信息。

Mental health problems such as psychosis (e.g., schizophrenia) can be extremely disabling and result in massive costs for the individual, NHS services and society in general. Greater understanding of what factors are involved in development and persistence of such disorders would assist attempts to prevent and treat them. One of the major factors thought to cause psychosis is an individual‘s genetic make-up but environmental factors are also thought to play a role, possibly in combination with genes. Therefore, I propose to investigate whether individuals who have been exposed to potentially distressing experiences in childhood (severely beaten by or separated from their parents) and have a genetic risk (positive family history) are more likely to experience psychotic symptoms (such as hearing voices) over a long period of time and require treatment for psychosis during the life-course than individuals with only one or neither of these factors. To test this proposition I will analyse data from four different longitudinal studies: three general population birth cohorts in adolescence and adulthood and a 10-year follow-up of clinically diagnosed psychosis patients on whom information is available about their family and childhood history and experience of psychotic symptoms and mental health treatment at different time points.