Department of Psychiatry, College of Physicians and Surgeons of Columbia University, New York State Psychiatric Institute, NewYork, NY 10032, USA.
Schizophr Bull. 2011 Mar;37(2):284-90. doi: 10.1093/schbul/sbq146. Epub 2010 Dec 6.
Accumulating evidence suggests that maternal infection is a risk factor for schizophrenia. Prospective epidemiological studies indicate that maternal influenza, toxoplasmosis, and genital/reproductive infection are associated with this disorder in offspring. Preclinical models of maternal immune activation have supported the neurobiological plausibility of these microbes in schizophrenia. Previous studies suggest that treatment or prophylactic efforts targeting these and other infections could have significant effects on reducing the incidence of schizophrenia, given that they are common in the population and the effect sizes derived from epidemiological studies of these and other microbial pathogens and schizophrenia, to date, are not small. Fortunately, the occurrence of many of these infections can be reduced with relatively practical and inexpensive interventions that are scalable to large populations given adequate resources. Hence, in the present article, we focus on the potential for prevention of schizophrenia by control of infection, using these 3 categories of infection as examples. Lessons learned from previous successful public health efforts targeting these infections, including the relative advantages and disadvantages of these measures, are reviewed.
越来越多的证据表明，母体感染是精神分裂症的一个风险因素。前瞻性的流行病学研究表明，母体流感、弓形虫病和生殖/感染与后代的这种疾病有关。母体免疫激活的临床前模型支持这些微生物在精神分裂症中的神经生物学可能性。先前的研究表明，针对这些和其他感染的治疗或预防措施可能会对降低精神分裂症的发病率产生重大影响，因为它们在人群中很常见，而且从这些微生物病原体和精神分裂症的流行病学研究中得出的效应大小迄今为止并不小。幸运的是，由于有足够的资源，许多这些感染的发生可以通过相对实用和廉价的干预措施来减少，这些干预措施具有大规模应用于大量人群的潜力。因此，在本文中，我们以这三种感染为例，重点讨论通过控制感染预防精神分裂症的可能性。回顾了以前针对这些感染的成功公共卫生措施的经验教训，包括这些措施的相对优缺点。
