Schizophrenia : The new etiological synthesis

Copyright © 2022 The Authors. Published by Elsevier Ltd.. All rights reserved..

Schizophrenia has been an evolutionary paradox: it has high heritability, but it is associated with decreased reproductive success. The causal genetic variants underlying schizophrenia are thought to be under weak negative selection. To unravel this paradox, many evolutionary explanations have been suggested for schizophrenia. We critically discuss the constellation of evolutionary hypotheses for schizophrenia, highlighting the lack of empirical support for most existing evolutionary hypotheses-with the exception of the relatively well supported evolutionary mismatch hypothesis. It posits that evolutionarily novel features of contemporary environments, such as chronic stress, low-grade systemic inflammation, and gut dysbiosis, increase susceptibility to schizophrenia. Environmental factors such as microbial infections (e.g., Toxoplasma gondii) can better predict the onset of schizophrenia than polygenic risk scores. However, researchers have not been able to explain why only a small minority of infected people develop schizophrenia. The new etiological synthesis of schizophrenia indicates that an interaction between host genotype, microbe infection, and chronic stress causes schizophrenia, with neuroinflammation and gut dysbiosis mediating this etiological pathway. Instead of just alleviating symptoms with drugs, the parasite x genotype x stress model emphasizes that schizophrenia treatment should focus on detecting and treating possible underlying microbial infection(s), neuroinflammation, gut dysbiosis, and chronic stress.

Medienart:

E-Artikel

Erscheinungsjahr:

2022

Erschienen:

2022

Enthalten in:

Zur Gesamtaufnahme - volume:142

Enthalten in:

Neuroscience and biobehavioral reviews - 142(2022) vom: 20. Nov., Seite 104894

Sprache:

Englisch

Beteiligte Personen:

Rantala, Markus J [VerfasserIn]
Luoto, Severi [VerfasserIn]
Borráz-León, Javier I [VerfasserIn]
Krams, Indrikis [VerfasserIn]

Links:

Volltext

Themen:

Evolutionary mismatch
Evolutionary psychiatry
Journal Article
Microbiota
Parasites
Psychoneuroimmunology
Psychosis
Review
Schizophrenia
Stress
Toxoplasmosis
Western lifestyles

Anmerkungen:

Date Completed 08.11.2022

Date Revised 09.11.2022

published: Print-Electronic

Citation Status MEDLINE

doi:

10.1016/j.neubiorev.2022.104894

funding:

Förderinstitution / Projekttitel:

PPN (Katalog-ID):

NLM346974291