The neural diathesis-stress model of schizophrenia revisited: An update on recent findings considering illness stage and neurobiological and methodological complexities

NEUROSCIENCE AND BIOBEHAVIORAL REVIEWS

卷:73

Review

Pruessner, Marita^1,5  Cullen, Alexis E.²  Aas, Monica³  Walker, Elaine F.⁴ 

[1] McGill Univ, Douglas Mental Hlth Univ Inst, Dept Psychiat, Prevent & Early Intervent Program Psychosis, Montreal, PQ, Canada

[2] Kings Coll London, Dept Psychosis Studies, Inst Psychiat Psychol & Neurosci, London, England

[3] Univ Oslo, Inst Clin Med, Div Mental Hlth & Addict, NORMENT,KG Jebsen Psychosis Res Unit, Oslo, Norway

[4] Emory Univ, Dept Psychol, Mental Hlth & Dev Program, Atlanta, GA 30322 USA

[5] Univ Konstanz, Dept Psychol, Constance, Germany

关键词: Stress;    Psychosis;    Clinical high-risk for psychosis;    Schizophrenia;    Neural diathesis-stress model;    Hypothalamus-pituitary-adrenal axis;    Cortisol;    Brain;    Hippocampus;    Pituitary;    Stress vulnerability;   

DOI  :  10.1016/j.neubiorev.2016.12.013

来源: Elsevier

【 摘 要 】

Over the past decade, our understanding of the role of stress in serious mental illness has become more sophisticated. In this paper, we revisit the neural diathesis-stress model of schizophrenia that was initially proposed in 1997 and updated in 2008. In light of cumulative research findings, we must now encompass evidence on the premorbid periods of psychosis, and our more nuanced understanding of hypothalamic-pituitary-adrenal (HPA) axis function and its association with neurodevelopmental, epigenetic, neurotransmitter, and inflammatory processes, as well as brain structure and function. Giving consideration to the methodological complexities that have become more apparent as research in this area has burgeoned, the various indices of HPA axis function, and the different stages of illness, we review relevant research published since the 2008 update of the model. We conclude by proposing an extended neural diathesis-stress model that addresses the broader neurobiological context of stress psychobiology in psychosis progression. Implications of this model for best practice, with regards to both future research and treatment strategies, are discussed. (C) 2016 Elsevier Ltd. All rights reserved.

【 授权许可】

Free