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Psychosis risk and development: What do we know from population-based studies?
Biological Psychiatry ( IF 10.6 ) Pub Date : 2020-08-01 , DOI: 10.1016/j.biopsych.2019.12.014
Eva Mennigen 1 , Carrie E Bearden 2
Affiliation  

Recent years have seen an advent in population-based studies in children, adolescents, and adults that examine the prevalence, etiology, and developmental trajectories of diverse subclinical psychopathological symptoms that pose a risk for the later development of severe mental illnesses. It is increasingly recognized that most categorically defined psychiatric disorders occur on a spectrum or continuum, show high heterogeneity and symptom overlap, and share genetic and environmental risk factors. We discuss neurodevelopmental underpinnings of psychosis spectrum symptoms and review brain morphometric and functional alterations as well as genetic liability for psychosis in individuals experiencing psychotic symptoms (PSs) in the general population. With regard to brain structure and function, findings of qualitatively similar alterations in individuals experiencing subthreshold PSs and individuals with overt psychotic disorders support the notion of a psychosis continuum. However, genetic and epidemiological studies have emphasized the overlap of PSs and other psychiatric illnesses. In particular, PSs during adolescence appear to be a nonspecific precursor of different psychopathological outcomes. Given the evidence presented in this review, we argue that findings from population-based studies are appropriate to guide policy-making to further emphasize public health efforts. Broadly accessible mental health programs are promising to make a difference in the field of adolescent mental health. However, the specific efficacy of these programs warrants further study, and caution is advised to not overpathologize potentially transient occurrence of mental health problems.

中文翻译:

精神病风险和发展:我们从基于人群的研究中了解到什么?

近年来,以人群为基础的儿童、青少年和成人研究出现了,这些研究检查了各种亚临床精神病理学症状的患病率、病因和发展轨迹,这些症状对以后发展为严重精神疾病构成风险。人们越来越认识到,大多数分类定义的精神疾病发生在一个谱系或连续体上,表现出高度的异质性和症状重叠,并具有共同的遗传和环境风险因素。我们讨论了精神病谱系症状的神经发育基础,并回顾了普通人群中出现精神病症状 (PSs) 的个体的脑形态和功能改变以及精神病的遗传责任。关于大脑的结构和功能,在经历亚阈值 PS 的个体和患有明显精神病的个体中质量相似的改变的发现支持了精神病连续体的概念。然而,遗传和流行病学研究强调了 PS 与其他精神疾病的重叠。特别是,青春期的 PS 似乎是不同精神病理学结果的非特异性前兆。鉴于本次审查中提供的证据,我们认为基于人群的研究结果适合指导政策制定,以进一步强调公共卫生工作。广泛使用的心理健康计划有望在青少年心理健康领域产生影响。然而,这些计划的具体功效值得进一步研究,
更新日期:2020-08-01
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