Non-Genetic Factors in Schizophrenia

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Abstract

Purpose of Review

We review recent developments on risk factors in schizophrenia.

Recent Findings

The way we think about schizophrenia today is profoundly different from the way this illness was seen in the twentieth century. We now know that the etiology of schizophrenia is multifactorial and reflects an interaction between genetic vulnerability and environmental contributors. Environmental risk factors such as pregnancy and birth complications, childhood trauma, migration, social isolation, urbanicity, and substance abuse, alone and in combination, acting at a number of levels over time, influence the individual’s likelihood to develop the disorder.

Summary

Environmental risk factors together with the identification of a polygenic risk score for schizophrenia, research on gene–environment interaction and environment–environment interaction have hugely increased our knowledge of the disorder.

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Most cited references 124

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The stressed synapse: the impact of stress and glucocorticoids on glutamate transmission.

Maurizio Popoli, Zhen Yan, Bruce McEwen … (2011)

Mounting evidence suggests that acute and chronic stress, especially the stress-induced release of glucocorticoids, induces changes in glutamate neurotransmission in the prefrontal cortex and the hippocampus, thereby influencing some aspects of cognitive processing. In addition, dysfunction of glutamatergic neurotransmission is increasingly considered to be a core feature of stress-related mental illnesses. Recent studies have shed light on the mechanisms by which stress and glucocorticoids affect glutamate transmission, including effects on glutamate release, glutamate receptors and glutamate clearance and metabolism. This new understanding provides insights into normal brain functioning, as well as the pathophysiology and potential new treatments of stress-related neuropsychiatric disorders.

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Childhood trauma, psychosis and schizophrenia: a literature review with theoretical and clinical implications.

J. Read, J. VAN OS, A Morrison … (2005)

To review the research addressing the relationship of childhood trauma to psychosis and schizophrenia, and to discuss the theoretical and clinical implications. Relevant studies and previous review papers were identified via computer literature searches. Symptoms considered indicative of psychosis and schizophrenia, particularly hallucinations, are at least as strongly related to childhood abuse and neglect as many other mental health problems. Recent large-scale general population studies indicate the relationship is a causal one, with a dose-effect. Several psychological and biological mechanisms by which childhood trauma increases risk for psychosis merit attention. Integration of these different levels of analysis may stimulate a more genuinely integrated bio-psycho-social model of psychosis than currently prevails. Clinical implications include the need for staff training in asking about abuse and the need to offer appropriate psychosocial treatments to patients who have been abused or neglected as children. Prevention issues are also identified.

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Glutamate and schizophrenia: beyond the dopamine hypothesis.

Joseph T. Coyle (2006)

: 1. After 50 years of antipsychotic drug development focused on the dopamine D2 receptor, schizophrenia remains a chronic, disabling disorder for most affected individuals. 2. Studies over the last decade demonstrate that administration of low doses of NMDA receptor antagonists can cause in normal subjects the negative symptoms, cognitive impairments and physiologic disturbances observed in schizophrenia. 3. Furthermore, a number of recently identified risk genes for schizophrenia affect NMDA receptor function or glutamatergic neurotransmission. 4. Placebo-controlled trials with agents that directly or indirectly activate the glycine modulatory site on the NMDA receptor have shown reduction in negative symptoms, improvement in cognition and in some cases reduction in positive symptoms in schizophrenic patients receiving concurrent antipsychotic medications. 5. Thus, hypofunction of the NMDA receptor, possibly on critical GABAergic inter-neurons, may contribute to the pathophysiology of schizophrenia.

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Author and article information

Contributors

Simona A. Stilo: simona.stilo@kcl.ac.uk

Journal

Journal ID (nlm-ta): Curr Psychiatry Rep

Journal ID (iso-abbrev): Curr Psychiatry Rep

Title: Current Psychiatry Reports

Publisher: Springer US (New York )

ISSN (Print): 1523-3812

ISSN (Electronic): 1535-1645

Publication date (Electronic): 14 September 2019

Publication date PMC-release: 14 September 2019

Publication date (Print): 2019

Volume: 21

Issue: 10

Electronic Location Identifier: 100

Affiliations

[1 ]ISNI 0000 0001 2322 6764, GRID grid.13097.3c, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, , King’s College London, ; De Crespigny Park, London, SE5 8AF UK

[2 ]ISNI 0000 0001 2116 3923, GRID grid.451056.3, National Institute for Health Research (NIHR) Mental Health Biomedical Research Centre at South London and Maudsley NHS Foundation Trust and King’s College London, ; London, UK

Article

Publisher ID: 1091

DOI: 10.1007/s11920-019-1091-3

PMC ID: 6745031

PubMed ID: 31522306

SO-VID: 1eb166dd-cd30-4621-bd91-4c4f2f54a2e6

License:

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License ( http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

History

Funding

Funded by: King's College London

Custom metadata

ScienceOpen disciplines: Clinical Psychology & Psychiatry

Keywords: schizophrenia,psychosis,risk factors,environment,gene–environment interaction,childhood trauma,cannabis

Data availability:

ScienceOpen disciplines: Clinical Psychology & Psychiatry

Keywords: schizophrenia, psychosis, risk factors, environment, gene–environment interaction, childhood trauma, cannabis

Non-Genetic Factors in Schizophrenia

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Abstract

Purpose of Review

Recent Findings

Summary

Related collections

New Psychiatry Preprints

Most cited references 124

The stressed synapse: the impact of stress and glucocorticoids on glutamate transmission.

Childhood trauma, psychosis and schizophrenia: a literature review with theoretical and clinical implications.

Glutamate and schizophrenia: beyond the dopamine hypothesis.

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Contributors

Journal

Affiliations

Article

History

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