Estimating Aggregate Environmental Risk Score in Psychiatry: The Exposome Score for Schizophrenia

Frontiers in Psychiatry

Bart P. F. Rutten²  Lotta-Katrin Pries²  Gamze Erzin³  Sinan Guloksuz⁴  Jim van Os⁵ 

[1] Brain Centre Rudolf Magnus, University Medical Center Utrecht, Utrecht, Netherlands;Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, Netherlands;Department of Psychiatry, University of Health Sciences Ankara Diskapi Training and Research Hospital, Ankara, Turkey;Department of Psychiatry, Yale University School of Medicine, New Haven, CT, United States;King's Health Partners, Department of Psychosis Studies, King's College London, Institute of Psychiatry, London, United Kingdom;

关键词: exposome;    prediction;    risk;    environment;    schizophrenia;    psychosis;   

DOI  :  10.3389/fpsyt.2021.671334

来源: DOAJ

【 摘 要 】

To understand the role of environment in the pathoetiology of psychosis spectrum disorders, research has thus far mainly investigated the effects of single exposures in isolation, such as the association between cannabis use and schizophrenia. However, this approach fails to acknowledge the complexity of the exposome, which represents the totality of the environment involving many exposures over an individual's lifetime. Therefore, contemporary research adopting the exposome paradigm has aimed at capturing the combined effect of different environmental exposures by utilizing an aggregate environmental vulnerability score for schizophrenia: the exposome score for schizophrenia. Here, we attempt to provide a comprehensive overview of studies applying the exposome score for schizophrenia. First, we describe several approaches estimating exposomic vulnerability for schizophrenia, which falls into three categories: simple environmental sum scores (sum of dichotomized exposures), meta-analysis-based environmental risk score (sum scores weighted by estimates from meta-analyses), and the exposome score (sum score weighted by estimates from an analysis in an independent training dataset). Studies show that the exposome score for schizophrenia that assumes interdependency of exposures performs better than scores that assume independence of exposures, such as the environmental sum score and the meta-analysis-based environmental risk score. Second, we discuss findings on the pluripotency of the exposome score for schizophrenia and summarize findings from gene-environment studies using the exposome score for schizophrenia. Finally, we discuss possible scientific, clinical, and population-based applications of exposome score for schizophrenia, as well as limitations and future directions for exposome research to understand the etiology of psychosis spectrum disorders.

【 授权许可】

Unknown