Integrative Etiopathogenetic Models of Psychotic Disorders: Methods, Evidence and Concepts

Abstract

Integrative models of the etiopathogesnesis of psychotic disorders are needed since a wealth of information from such diverse fields as neurobiology, psychology, and the social sciences is currently changing the concepts of mental disorders. Several approaches to integrate these streams of information into coherent concepts of psychosis are feasible and will need to be assessed in future experimental studies. Common to these concepts are the notion of psychotic disorders as brain disorders and a polythetic approach in that it is increasingly realized that a multitude of interindividually partially different pathogenetic factors interact in individual persons in a complex fashion resulting in the clinical symptoms of psychosis.

Structural and functional asymmetry of the neonatal cerebral cortex

“…Moreover, previous work has shown that structural asymmetries in preterm (18) and term (19,20) neonates are similar, and recently, (89) reported no differences in white matter asymmetry between preterm and term-born neonates at TEA. Together, these findings indicate that brain asymmetries may be robust to the effects of preterm birth, and that "multiple hits" are required to disrupt brain asymmetry (for example, preterm birth and polygenic risk) (90,91). This may explain why cortical asymmetry is altered in psychiatric and neurodevelopmental disorders like schizophrenia (7,8) and autism spectrum disorder (5,6), which have complex and multifactorial aetiologies (92,93).…”

Preventive strategies for mental health

“…genetic risk or early environmental factors such as severe deprivation) are present, in the absence of additional "hits", a disorder ultimately may not develop. This has been shown to be especially important in the development of disorders such as schizophrenia and bipolar disorder 21 and offers a unique opportunity for targeted prevention in high-risk individuals by reducing exposure to further risk factors and enhancing protective factors. 9 Among the possible additional risk factors, bullying victimization has been strongly associated with short-and long-term vulnerability to mental illness.…”

Involvement of Genetic an d Environmental Factors in the Onset of Depression

“…However, with depression, the genetic factors are 30~40%, and environmental factors play a more important role [ 29 ]. Resilience and resistance to stress are common; therefore, although a certain extent of stress might be received during the embryonic or perinatal period, having a genetic predisposition to mental disorders does not imply that a mental disorder will develop [ 42 ].…”