Epiphenomena in psychosis: how perinatal stressful events shape long-term outcomes.

Exposure to perinatal stress has been linked to the later emergence of mental health problems including neurodevelopmental disorders such as psychosis. Recent research highlights not only an increased risk of psychotic illness in offspring following perinatal maternal life events but also the future manifestation of diverse epiphenomena. These epiphenomena include metabolic disturbances, structural brain abnormalities, and cognitive impairment in addition to distinct psychopathological profiles involving motor and physical anomalies. Our aim here lies in discussing the different clinical features of psychosis as they emerge at onset and during the evolution of the disease-from a translational perspective-in terms of perinatal stressful experiences. A hypothetical model of metabolic manifestations that are present in adulthood stemming from perinatal events will be elaborated to provide a partial explanation of the increased morbidity and early mortality observed in patients who develop psychosis. This model will encompass aspects related to brain structural abnormalities, clinical psychopathological characteristics and the cognitive impairment typically observed in individuals with psychotic disorders. We also put forward a framework that encapsulates the 'scars' of perinatal stressful experiences associated with psychosis in terms of a public health agenda.