Title: Psychosocial stress and psychosis. A review of the neurobiological mechanisms and the evidence for gene-stress interaction
Authors: van Winkel, Ruud ×
Stefanis, Nicholas C
Myin-Germeys, Inez
Issue Date: Nov-2008
Series Title: Schizophrenia bulletin vol:34 issue:6 pages:1095-105
Abstract: This article presents evidence suggesting that psychosocial stress may increase risk for psychosis, especially in the case of cumulative exposure. A heuristically useful framework to study the underlying mechanisms is the concept of "behavioral sensitization" that stipulates that exposure to psychosocial stress-such as life events, childhood trauma, or discriminatory experiences-may progressively increase the behavioral and biological response to subsequent exposures. The neurobiological substrate of sensitization may involve dysregulation of the hypothalamus-pituitary-adrenal axis, contributing to a hypothesized final common pathway of dopamine sensitization in mesolimbic areas and increased stress-induced striatal dopamine release. It is argued that, in order to reconcile genetic and environmental influences on the development of psychosis, gene-environment interactions may be an important mechanism in explaining between-subject differences in risk following (cumulative) exposure to psychosocial stress. To date, most studies suggestive of gene-stress interaction have used proxy measures for genetic vulnerability such as a family history of psychosis; studies investigating interactions between molecular genetic measures and psychosocial stressors are still relatively scarce. Preliminary evidence suggests that polymorphisms within the catechol-O-methyltransferase and brain-derived neurotrophic factor genes may interact with psychosocial stress in the development of psychosis; however, extensive further investigations are required to confirm this.
ISSN: 0586-7614
Publication status: published
KU Leuven publication type: IT
Appears in Collections:University Centre Sint Jozef (-)
Research Group Psychiatry
× corresponding author

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