Journal
ANNUAL REVIEW OF CLINICAL PSYCHOLOGY, VOL 17, 2021
Volume 17, Issue -, Pages 285-311Publisher
ANNUAL REVIEWS
DOI: 10.1146/annurev-clinpsy-081219-103805
Keywords
schizophrenia; prenatal stress; hypoxia; maternal immune activation; brain development; ecohealth
Categories
Funding
- Canadian Institutes of Health Research
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This review discusses the impact of prenatal environmental factors on schizophrenia spectrum disorders, proposes potential mechanisms and future research directions, and emphasizes the importance of gene-environment interactions, developmental timing, and individual ecosystem in the development of psychiatric disorders.
Why does prenatal exposure to wars, natural disasters, urbanicity, or winter increase the risk for schizophrenia? Research from the last two decades has provided rich insight about the underlying chains of causation at play during environmental upheaval, from conception to early infancy. In this review, we appraise the evidence linking schizophrenia spectrum disorder to prenatal maternal stress, obstetric complications, early infections, and maternal nutrition and other lifestyle factors. We discuss putative mechanisms, including the maternal stress system, perinatal hypoxia, and maternal-offspring immune activation. We propose that gene-environment interactions, timing during development, and sex differentiate the neuropsychiatric outcomes. Future research should pursue the translation of animal studies to humans and the longitudinal associations between early exposures, intermediate phenotypes, and psychiatric disorders. Finally, to paint a comprehensive model of risk and to harness targets for prevention, we argue that risk factors should be situated within the individual's personal ecosystem.
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