Collip Dina, Myin-Germeys Inez, Van Os Jim
Department of Psychiatry and Neuropsychology, South Limburg Mental Health Research and Teaching Network, EURON, Maastricht University, PO Box 616, 6200 MD Maastricht, The Netherlands.
Schizophr Bull. 2008 Mar;34(2):220-5. doi: 10.1093/schbul/sbm163. Epub 2008 Jan 18.
Previous evidence reviewed in Schizophrenia Bulletin suggests the importance of a range of different environmental factors in the development of psychotic illness. It is unlikely, however, that the diversity of environmental influences associated with schizophrenia can be linked to as many different underlying mechanisms. There is evidence that environmental exposures may induce, in interaction with (epi)genetic factors, psychological or physiological alterations that can be traced to a final common pathway of cognitive biases and/or altered dopamine neurotransmission, broadly referred to as "sensitization," facilitating the onset and persistence of psychotic symptoms. At the population level, the behavioral phenotype for sensitization may be examined by quantifying, in populations exposed to environmental risk factors associated with stress or dopamine-agonist drugs, (1) the increased rate of persistence (indicating lasting sensitization) of normally transient developmental expressions of subclinical psychotic experiences and (2) the subsequent increased rate of transition to clinical psychotic disorder.
《精神分裂症通报》中回顾的先前证据表明,一系列不同的环境因素在精神病性疾病的发展中具有重要意义。然而,与精神分裂症相关的环境影响的多样性不太可能与同样多的不同潜在机制相关联。有证据表明,环境暴露可能与(表观)遗传因素相互作用,诱发心理或生理改变,这些改变可追溯到认知偏差和/或多巴胺神经传递改变的最终共同途径,广义上称为“致敏作用”,从而促进精神病性症状的发作和持续。在人群层面,可以通过在暴露于与压力或多巴胺激动剂药物相关的环境危险因素的人群中量化以下两点来检验致敏作用的行为表型:(1)亚临床精神病性体验的正常短暂发育表现的持续率增加(表明持续致敏),以及(2)随后向临床精神病性障碍转变的发生率增加。