Recognition and Intervention in Individuals in at-Risk Mental States, Department of Psychiatry, Universidade Federal de São Paulo, São Paulo, Brazil.
Braz J Psychiatry. 2012 Dec;34(4):480-8. doi: 10.1016/j.rbp.2012.04.009.
Advances in our knowledge of mental disorder (MD) genetics have contributed to a better understanding of their pathophysiology. Nonetheless, several questions and doubts persist. Recent studies have focused on environmental influences in the development of MDs, and the advent of neuroscientific methodologies has provided new perspectives. Early life events, such as childhood stress, may affect neurodevelopment through mechanisms such as gene-environment interactions and epigenetic regulation, thus leading to diseases in adulthood. The aim of this paper is to review the evidence regarding the role of the environment, particularly childhood stress, in the pathophysiology of MD.
We reviewed articles that evaluated environmental influences, with a particular focus on childhood trauma, brain morphology, cognitive functions, and the development of psychopathology and MD.
MRI studies have shown that exposure to trauma at an early age can result in several neurostructural changes, such as the reduction of the hippocampus and corpus callosum. Cognitive performance and functioning are also altered in this population. Finally, childhood stress is related to an increased risk of developing MD such as depression, bipolar disorder, schizophrenia and substance abuse. We conclude that there is robust evidence of the role of the environment, specifically adverse childhood experiences, in various aspects of MD.
我们对精神障碍（MD）遗传学的认识的进步有助于更好地了解其病理生理学。尽管如此，仍有一些问题和疑虑存在。最近的研究集中在环境对 MD 发展的影响上，神经科学方法的出现提供了新的视角。早期生活事件，如儿童期压力，可能通过基因-环境相互作用和表观遗传调控等机制影响神经发育，从而导致成年后患病。本文旨在综述环境（特别是儿童期压力）在 MD 病理生理学中的作用的证据。
我们回顾了评估环境影响的文章，特别关注儿童创伤、大脑形态、认知功能以及精神病理学和 MD 的发展。
MRI 研究表明，早期接触创伤会导致多种神经结构变化，如海马体和胼胝体的减少。该人群的认知表现和功能也发生改变。最后，儿童期压力与抑郁、双相情感障碍、精神分裂症和物质滥用等 MD 的发病风险增加有关。我们得出结论，有强有力的证据表明环境（特别是不良的儿童经历）在 MD 的各个方面都发挥了作用。
