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Gene x environment (G×E) interactions, i.e. genetic modulation of the sensitivity to environmental factors and/or environmental control of the gene expression, have not been reliably established regarding aetiology of psychotic disorders. Moreover, recent studies have shown associations between the polygenic risk scores for schizophrenia (PRS-SZ) and some risk factors of psychotic disorders, challenging the traditional gene v. environment dichotomy. In the present article, we studied the role of GxE interaction between psychosocial stressors (childhood trauma, stressful life-events, self-reported discrimination experiences and low social capital) and the PRS-SZ on subclinical psychosis in a population-based sample.
Methods
Data were drawn from the EUropean network of national schizophrenia networks studying Gene-Environment Interactions (EU-GEI) study, in which subjects without psychotic disorders were included in six countries. The sample was restricted to European descendant subjects (n = 706). Subclinical dimensions of psychosis (positive, negative, and depressive) were measured by the Community Assessment of Psychic Experiences (CAPE) scale. Associations between the PRS-SZ and the psychosocial stressors were tested. For each dimension, the interactions between genes and environment were assessed using linear models and comparing explained variances of ‘Genetic’ models (solely fitted with PRS-SZ), ‘Environmental’ models (solely fitted with each environmental stressor), ‘Independent’ models (with PRS-SZ and each environmental factor), and ‘Interaction’ models (Independent models plus an interaction term between the PRS-SZ and each environmental factor). Likelihood ration tests (LRT) compared the fit of the different models.
Results
There were no genes-environment associations. PRS-SZ was associated with positive dimensions (β = 0.092, R2 = 7.50%), and most psychosocial stressors were associated with all three subclinical psychotic dimensions (except social capital and positive dimension). Concerning the positive dimension, Independent models fitted better than Environmental and Genetic models. No significant GxE interaction was observed for any dimension.
Conclusions
This study in subjects without psychotic disorders suggests that (i) the aetiological continuum hypothesis could concern particularly the positive dimension of subclinical psychosis, (ii) genetic and environmental factors have independent effects on the level of this positive dimension, (iii) and that interactions between genetic and individual environmental factors could not be identified in this sample.
By
Kathryn M. Abel, Senior Lecturer and Honourary Consultant, Centre for Women's Mental Health Research, Division of Psychiatry, University of Manchester, Manchester, UK,
Jayashri Kulkarni, Professor of Psychiatry, The Alfred, Melbourne, Australia; Professor Monash University, Faculty of Medicine, Melbourne, Australia
Women have an increased vulnerability to depressive disorders during their child-bearing years. Women experience very different physiological changes in gonadal steroids and psychosocial stressors compared to men. This chapter considers hormonal influences on depression and overviews the actions of the gonadal steroids. The gonadal steroid effects are classified into organisational or activational, depending on the duration and timing of the effect. Hormonal treatments for premenstrual dysphoric disorder (PMDD) have encompassed both oestrogen and progesterone. Several studies have now reported that unintentional foetal loss is associated with subsequent risk of depression, post traumatic stress disorder (PTSD) or an exacerbation of obsessive compulsive symptoms. The factors contributing to postnatal depression (PND) include a personal or family history of mood disorder. The use of oestrogen replacement therapy (ERT) is still controversial, particularly with the recent publication of the results of the Women's Mental Health Initiative Randomised Controlled Trial studies.
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