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利用精神遗传学的进步来促进人群心理健康。

Harnessing Progress in Psychiatric Genetics to Advance Population Mental Health.

机构信息

Kathleen Ries Merikangas is with the Genetic Epidemiology Research Branch, Division of Intramural Research Program, National Institute of Mental Health, Bethesda, MD. Alison K. Merikangas is with the Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, PA.

出版信息

Am J Public Health. 2019 Jun;109(S3):S171-S175. doi: 10.2105/AJPH.2019.304948.

Abstract

Advances in genomics and neuroscience have ushered in unprecedented opportunities to increase our understanding of the biological underpinnings of mental disorders, yet there has been limited progress in translating knowledge on genetic risk factors to reduce the burden of these conditions in the population. We describe the challenges and opportunities afforded by the growth of large-scale population health databases, progress in genomics, and collaborative efforts in epidemiology and neuroscience to develop informed population-wide interventions for mental disorders. Future progress is likely to benefit from the following efforts: expansion of large collaborative studies of mental disorders to include more systematically ascertained multiethnic samples from biobanks and registries, harmonization of phenotypic characterization in registry and population samples to extend clinical diagnosis to transdiagnostic concepts, systematic investigation of the influences of both specific and nonspecific environmental factors that may combine with genetic susceptibility to confer increased risk of specific mental disorders, and implementation of study designs that can inform gene-environment interactions. Such data can ultimately be combined to develop comprehensive models of risks of, interventions for, and outcomes of mental disorders. With its focus on phenotypic characterization, sampling, study designs, and analytic methods, epidemiology will be central to progress in translating genomics to public health.

摘要

基因组学和神经科学的进步为增进我们对精神障碍生物学基础的理解带来了前所未有的机遇,但将遗传风险因素方面的知识转化为减轻人群中这些疾病负担的方面进展有限。我们描述了大规模人群健康数据库的增长、基因组学的进展以及流行病学和神经科学方面的合作努力为精神障碍提供明智的人群干预措施所带来的挑战和机遇。未来的进展可能受益于以下努力:扩大精神障碍的大型合作研究,包括从生物库和登记处更系统地确定多民族样本,协调登记处和人群样本中的表型特征,将临床诊断扩展到跨诊断概念,系统研究特定和非特定环境因素的影响,这些因素可能与遗传易感性结合,增加特定精神障碍的风险,以及实施可以为基因-环境相互作用提供信息的研究设计。这些数据最终可以结合起来,为精神障碍的风险、干预措施和结果开发综合模型。流行病学将以表型特征描述、抽样、研究设计和分析方法为重点,成为将基因组学转化为公共卫生的核心。

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