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极其致残，并导致个人、国民保健服务和整个社会付出巨大代价。更深入地了解这些疾病的发展和持续存在的因素将有助于预防和治疗这些疾病。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，可能与基因结合在一起。因此，我建议调查那些在童年时期经历过潜在痛苦经历（被父母严重殴打或与父母分离）并有遗传风险（阳性家族史）的人是否比那些只有或没有这些因素的人更有可能在很长一段时间内经历精神病症状（如幻听）并在生命过程中需要治疗精神病。为了验证这一命题，我将分析四项不同纵向研究的数据：青春期和成年期的三个普通人群出生队列，以及对临床诊断为精神病的患者进行为期10年的随访，这些患者的家庭和童年病史以及不同时间点的精神病症状和心理健康治疗经历。

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.