Department of Psychiatry and Psychotherapy, Central Institute of Mental Health, Medical Faculty Mannheim, University of Heidelberg, Square J5, 68159, Mannheim, Germany.
Soc Psychiatry Psychiatr Epidemiol. 2014 Apr;49(4):507-17. doi: 10.1007/s00127-014-0858-4. Epub 2014 Mar 18.
Schizophrenia is a severe and complex brain disorder that usually manifests in early adulthood and disturbs a wide range of human functions. More than 100 years after its initial description, the pathophysiology of the disorder is still incompletely understood. Many epidemiological studies strongly suggest a complex interaction between genetic and environmental risk factors for the development of the disorder. While there is considerable evidence for a social environmental component of this risk, the links between adverse social factors and altered brain function have just come into focus.
In the present review, we first summarize epidemiological evidence for the significance of social environmental risk factors, outline the role of altered social stress processing in mental illness, and review the latest experimental evidence for the neural correlates of social environmental risk for schizophrenia.
The studies we have discussed in this review provide a selection of the current work in the field. We suggest that many of the social environmental risk factors may impact on perceived social stress and engage neural circuits in the brain whose functional and structural architecture undergoes detrimental change in response to prolonged exposure. We conclude that multidisciplinary approaches involving various fields and thoroughly constructed longitudinal designs are necessary to capture complex structure of social environmental risks.
精神分裂症是一种严重且复杂的脑部疾病,通常在成年早期发作,并扰乱多种人体功能。在最初描述 100 多年后,该疾病的病理生理学仍未完全被理解。许多流行病学研究强烈表明,遗传和环境风险因素的复杂相互作用导致了该疾病的发生。虽然有大量证据表明社会环境因素是这种风险的一个组成部分,但不良社会因素与改变大脑功能之间的联系才刚刚引起关注。
在本综述中,我们首先总结了社会环境风险因素的重要性的流行病学证据,概述了改变的社会压力处理在精神疾病中的作用,并回顾了精神分裂症社会环境风险的神经相关性的最新实验证据。
我们在这篇综述中讨论的研究提供了该领域当前工作的一个选择。我们认为,许多社会环境风险因素可能会影响到感知到的社会压力,并使大脑中的神经回路参与其中,这些回路的功能和结构架构在长时间暴露后会发生有害的变化。我们得出的结论是,需要采用多学科方法,涉及多个领域,并进行精心构建的纵向设计,以捕捉社会环境风险的复杂结构。