Skip to main content Accessibility help
×
Home

The psychosis risk timeline: can we improve our preventive strategies? Part 1: early life

  • Karen Romain (a1), Alexandra Eriksson (a1), Richard Onyon (a2) and Manoj Kumar (a3)

Summary

Psychosis is a complex presentation with a wide range of factors contributing to its development, biological and environmental. Psychosis is a feature present in a variety of psychiatric disorders. It is important for clinicians to keep up to date with evidence regarding current understanding of the reasons psychosis may occur. Furthermore, it is necessary to find clinical utility from this knowledge so that effective primary, secondary and tertiary preventative strategies can be considered. This article is the first of a three-part series that examines contemporary knowledge of risk factors for psychosis and presents an overview of current explanations. The articles focus on the psychosis risk timeline, which gives a structure within which to consider key aspects of risk likely to affect people at different stages of life. In this first article, early life is discussed. It covers elements that contribute in the prenatal and early childhood period and includes genetic, nutritional and infective risk factors.

LEARNING OBJECTIVES

After reading this article you will be able to:

  • give an up-to-date overview of psychosis risk factors that can affect early life
  • describe some important genetic risk factors
  • understand more about the role of environmental factors such as nutrition and infection.

DECLARATION OF INTEREST

None.

Copyright

Corresponding author

Correspondence Dr Karen Romain, St Michael's Hospital, Warwick CV34 5QW, UK. Email: karen.romain@nhs.net

Footnotes

Hide All

Parts 2 and 3 of this series appear in this issue. For a commentary on the three articles, see this issue.

Footnotes

References

Hide All
Agerbo, E, Sullivan, PF, Vilhjálmsson, BJ, et al. (2015) Polygenic risk score, parental socioeconomic status, family history of psychiatric disorders, and the risk for schizophrenia: a Danish population-based study and meta-analysis. JAMA Psychiatry, 72: 635–41.
Baker, K, Costain, G, Fung, WLA, et al. (2014) Chromosomal microarray analysis – a routine clinical genetic test for patients with schizophrenia. Lancet Psychiatry, 1: 329–31.
Bao, Y, Ibram, G, Blaner, WS, et al. (2012) Low maternal retinol as a risk factor for schizophrenia spectrum disorders in adult offspring. Schizophrenia Research, 137: 159–65.
Bipolar Disorder and Schizophrenia Working Group of the Psychiatric Genomics Consortium (2018) Genomic dissection of bipolar disorder and schizophrenia, including 28 subphenotypes. Cell, 173: 1705–15.
Byars, SG, Boomsma, JJ (2016) Opposite differential risks for autism and schizophrenia based on maternal age, paternal age, and parental age differences. Evolution, Medicine and Public Health, 1: 286–98.
Cai, L, Wan, CL, He, L, et al. (2015) Gestational influenza increases the risk of psychosis in adults. Medicinal Chemistry, 11: 676–82.
Cederlöf, M, Ohlsson Gotby, A, Larsson, H, et al. (2014) Klinefelter syndrome and risk of psychosis, autism and ADHD. Journal of Psychiatric Research, 48: 128–30.
Chu, CS, Chow, PC, Cohen-Woods, S, et al. (2017) The DAOA gene is associated with schizophrenia in the Taiwanese population. Psychiatry Research, 252: 201–7.
Firth, J, Carney, R, Stubbs, B, et al. (2018) Nutritional deficiencies and clinical correlates in first-episode psychosis: a systematic review and meta-analysis. Schizophrenia Bulletin, 44:1275–92.
Fountoulakis, KN, Gonda, X, Siamouli, M, et al. (2018) Paternal and maternal age as risk factors for schizophrenia: a case-control study. International Journal of Psychiatry in Clinical Practice, 22: 170–6.
Fusar-Poli, P, Borgwardt, S, Crescini, A, et al. (2011) Neuroanatomy of vulnerability to psychosis: a voxel-based meta-analysis. Neuroscience and Biobehavioural Reviews, 35: 1175–85.
Fusar-Poli, P, Bonoldi, I, Yung, AR, et al. (2012) Meta-analysis of transition outcomes in individuals at high clinical risk. Archives of General Psychiatry, 69: 220–29.
Fusar-Poli, P, Borgwardt, S, Bechdolf, A, et al. (2013) The psychosis high-risk state: a comprehensive state-of-the-art-review. JAMA Psychiatry, 70: 107–20.
Gandal, MJ, Haney, JR, Parikshak, NN, et al. (2018) Shared molecular neuropathology across major psychiatric disorders parallels polygenic overlap. Science, 359: 693–7.
Giannitelli, M, Consoli, A, Raffin, M, et al. (2018) An overview of medical risk factors for childhood psychosis: implications for research and treatment. Schizophrenia Research, 192: 3949.
Giaroli, G, Bass, N, Strydom, A, et al. (2014) Does rare matter? Copy number variants at 16p11.2 and the risk of psychosis: a systematic review of literature and meta-analysis. Schizophrenia Research, 159: 340–6.
Gothelf, D, Law, AJ, Frisch, A, et al. (2014) Biological effects of COMT haplotypes and psychosis risk in 22q11.2 deletion syndrome. Biological Psychiatry, 75: 406–13.
Gutiérrez-Fernández, J, del Castillo, JDL, Mañanes-González, S, et al. (2015) Different presence of Chlamydia pneumoniae, herpes simplex virus type I, human herpes virus 6, and Toxoplasma gondii in schizophrenia: meta-analysis and analytical study. Neuropsychiatric Diseases and Treatment, 11: 843–52.
Hameed, MA, Lewis, AJ (2016) Offspring of parents with schizophrenia: a systematic review of developmental features across childhood. Harvard Review of Psychiatry, 24: 104–17.
He, P, Chen, G, Guo, C, et al. (2018) Long-term effect of prenatal exposure to malnutrition on risk of schizophrenia in adulthood: evidence from the Chinese famine of 1959–1961. European Psychiatry, 51: 42–7.
Hilker, R, Helenius, D, Fagerlund, B, et al. (2018) Heritability of schizophrenia and schizophrenia spectrum based on the nationwide Danish twin register. Biological Psychiatry, 83: 492–8.
Howes, OD, McCutcheon, R, Owen, MJ, et al. (2017) The role of genes, stress and dopamine in the development of schizophrenia. Biological Psychiatry, 81: 920.
Ingason, A, Rujescu, D, Cichon, S, et al. (2011) Copy number variants of chromosome 16p13.1 region associated with schizophrenia. Molecular Psychiatry, 16(1): 1725.
Janecka, M, Mill, J, Basson, MA, et al. (2017) Advanced paternal age effects in neurodevelopmental disorders – review of potential underlying mechanisms. Translational Psychiatry, 7: e1019.
Keshavan, MS, Mehta, UM, Padmanabhan, JL, et al. (2015) Dysplasticity, metaplasticity, and schizophrenia: implications for risk, illness, and novel interventions. Development and Psychopathology, 27: 615–35.
Khandaker, GM, Zimbron, J, Dalman, C, et al. (2012) Childhood infection and adult schizophrenia: a meta-analysis of population-based studies. Schiophrenia Research, 139: 161–8.
Kimoto, S, Glausier, JR, Fish, KN, et al. (2016) Reciprocal alterations in regulator of G protein signalling 4 and microRNA16 in schizophrenia. Schizophrenia Bulletin, 42: 396405.
Kinoshita, M, Numata, S, Tajima, A, et al. (2016) Cumulative effect of the plasma total homocysteine-related genetic variants on schizophrenia risk. Psychiatry Research, 246: 833–7.
Kocˇovskà, E, Gaughran, F, Krivoy, A, et al. (2017) Vitamin D deficiency as a potential environmental risk factor in multiple sclerosis, schizophrenia and autism. Frontiers in Psychiatry, 8: 47.
Kotlar, AV, Mercer, KB, Zwick, ME, et al. (2015) New discoveries in schizophrenia genetics reveal neurobiological pathways: a review of recent findings. European Journal of Medical Genetics, 58: 704–14.
Laurens, KR, Luo, L, Matheson, SL, et al. (2015) Common or distinct pathways to psychosis? A systematic review of evidence from prospective studies for developmental risk factors and antecedents of the schizophrenia spectrum disorders and affective psychoses. BMC Psychiatry, 15: 205.
Linszen, MM, Brouwer, RM, Heringa, SM, et al. (2016) Increased risk of psychosis in patients with hearing impairment: review and meta-analyses. Neuroscience and Behavioural Reviews, 62: 120.
Miller, B, Messias, E, Miettunen, J, et al. (2010) Meta-analysis of paternal age and schizophrenia risk in male versus female offspring. Schizophrenia Bulletin, 37: 1039–47.
Moreno-De-Luca, D, Mulle, JG, Kaminsky, EB, et al. (2010) Deletion 17q12 is a recurrent copy number variant that confers a high risk of autism and schizophrenia. American Journal of Human Genetics, 87: 618–30.
Mulle, JG (2012) Schizophrenia genetics: progress, at last. Current Opinion in Genetics & Development, 22: 238–44.
Nimgaonkar, VL, Prasad, KM, Chowdari, KV, et al. (2017) The complement system: a gateway to gene–environment interactions in schizophrenia pathogenesis. Molecular Psychiatry, 22: 1554–61.
Owen, MJ, O'Donovan, MC (2017) Schizophrenia and the neurodevelopmental continuum: evidence from genomics. World Psychiatry, 16: 227–35.
Pawelczyk, T, Trafalska, E, Kotlicka-Antczak, M, et al. (2016) The association between polyunsaturated fatty acid consumption and the transition to psychosis in ultra-high risk individuals. Prostaglandins, Leukotrienes, and Essential Fatty Acids, 108: 30–7.
Perry, BI, Upthegrove, R, Thompson, A, et al. (2018) Dysglycaemia, inflammation and psychosis: findings from the UK ALSPAC Birth Cohort. Schizophrenia Bulletin, Apr 9: doi 10.1093/schbul/sby040 [Epub ahead of print].
Prats, C, Arias, B, Moya-Higueras, J, et al. (2017) Evidence of an epistatic effect between Dysbindin-1 and Neuritin-1 genes on the risk for schizophrenia spectrum disorders. European Psychiatry, 40: 60–4.
Rice, SM, Schäfer, MR, Klier, C, et al. (2015) Erythrocyte polyunsaturated fatty acid levels in young people at ultra-high risk for psychotic disorder and healthy adolescent controls. Psychiatry Research, 228: 174–6.
Riglin, L, Collishaw, S, Richards, A, et al. (2017) Schizophrenia risk alleles and neurodevelopmental outcomes in childhood: a population-based cohort study. Lancet Psychiatry, 4: 5762.
Romain, K, Eriksson, A, Onyon, R, et al. (2019a) The psychosis risk timeline: can we improve our preventive strategies? Part 2: adolescence and adulthood. BJPsych Advances, 25.
Romain, K, Eriksson, A, Onyon, R, et al. (2019b) The psychosis risk timeline: can we improve our preventive strategies? Part 3: primary common pathways and preventive strategies. BJPsych Advances, 25.
Roseboom, TJ, Painter, RC, van Abeelen, AF, et al. (2011) Hungry in the womb: what are the consequences? Lessons from the Dutch famine. Maturitas, 70: 141–5.
Russak, OD, Ives, L, Mittal, VA, et al. (2016) Fluctuating dermatoglyphic asymmetries in youth at ultrahigh-risk for psychotic disorders. Schizophrenia Research, 170: 301–3.
Schizophrenia Commission (2012) The Abandoned Illness: A Report by the Schizophrenia Commission. Schizophrenia Commission (available from: https://www.rethink.org/about-us/the-schizophrenia-commission). Accessed 1 July 2018.
Schizophrenia Working Group of the Psychiatric Genomics Consortium (2014) Biological insights from 108 schizophrenia – associated genetic loci. Nature, 511: 421–7.
Schneider, M, Debbané, M, Bassett, AS, et al. (2014) Psychiatric disorders from childhood to adulthood in 22q11.2 deletion syndrome: results from the International Consortium on Brain and Behaviour in 22q11.2 Deletion Syndrome. American Journal of Psychiatry, 171: 627–39.
Sebat, J, Levy, DL, McCarthy, SE (2009) Rare structural variants in schizophrenia: one disorder, multiple mutations; one mutation, multiple disorders. Trends in Genetics, 25: 528–35.
Singh, T, Kurki, MI, Curtis, D, et al. (2016) Rare loss-of-function variants in SETD1A are associated with schizophrenia and developmental disorders. Nature Neuroscience, 19: 571–7.
Stefansson, H, Rujescu, D (2008) Large recurrent microdeletions associated with schizophrenia. Nature, 455: 232–6.
Sun, GY, Simonyi, A, Fritsche, KL, et al. (2018) Docosahexaenoic acid (DHA): an essential nutrient and a nutraceutical for brain health and diseases. Prostaglandins, Leukotrienes and Essential Fatty Acids, 136: 313.
Tam, GW, Redon, R, Carter, NP, et al. (2009) The role of DNA copy number variation in schizophrenia. Biological Psychiatry, 66: 1005–12.
Thompson, CA, Karelis, J, Middleton, FA, et al. (2017) Associations between neurodevelopmental genes, neuroanatomy, and ultra high risk symptoms of psychosis in 22q11.2 deletion syndrome. Americal Journal of Medical Genetics Part B, 174: 295314.
Vacic, V, McCarthy, S, Malhotra, D, et al. (2011) Duplications of the neuropeptide receptor gene VIPR2 confer significant risk for schizophrenia. Nature, 471: 499503.
van der Werf, M, Hanssen, M, Köhler, S, et al. (2012) Systemic review and collaborative recalculation of 133 693 incident cases of schizophrenia. Psychological Medicine, 44: 916.
Vassos, E, Di Forti, M, Coleman, J, et al. (2017) An examination of polygenic score risk prediction in individuals with first episode psychosis. Biological Psychiatry, 81: 470–77.
Viertiö, S, Laitinen, A, Perälä, J, et al. (2007) Visual impairment in persons with psychotic disorder. Social Psychiatry and Psychiatric Epidemiology, 42: 902–8.
Weinstein, Y, Levav, I, Gelkopf, M, et al. (2018) Association of maternal exposure to terror attacks during pregnancy and the risk of schizophrenia in the offspring: a population-based study. Schizophrenia Research, 199: 163–7.
World Health Organization (2018) Schizophrenia (WHO Factsheets). WHO (http://www.who.int/en/news-room/fact-sheets/detail/schizophrenia). Accessed 17 November 2018.
Zhang, S, Zheng, F, You, Y, et al. (2016) Growth arrest specific gene 7 is associated with schizophrenia and regulates neuronal migration and morphogenesis. Molecular Brain, 9: 54.

Keywords

Type Description Title
WORD
Supplementary materials

Romain et al. supplementary material
Appendix 1

 Word (19 KB)
19 KB

Metrics

Altmetric attention score

Full text views

Total number of HTML views: 0
Total number of PDF views: 0 *
Loading metrics...

Abstract views

Total abstract views: 0 *
Loading metrics...

* Views captured on Cambridge Core between <date>. This data will be updated every 24 hours.

Usage data cannot currently be displayed

The psychosis risk timeline: can we improve our preventive strategies? Part 1: early life

  • Karen Romain (a1), Alexandra Eriksson (a1), Richard Onyon (a2) and Manoj Kumar (a3)
Submit a response

eLetters

No eLetters have been published for this article.

×

Reply to: Submit a response


Your details


Conflicting interests

Do you have any conflicting interests? *