Sarah Tosato, Branko Ristic, Alice Zanini, Simone Schimmenti, Francesca Maria Camilla Maselli, Evangelos Vassos
{"title":"全球范围内精神分裂症谱系障碍的环境风险因素:文献综述。","authors":"Sarah Tosato, Branko Ristic, Alice Zanini, Simone Schimmenti, Francesca Maria Camilla Maselli, Evangelos Vassos","doi":"10.1017/S204579602510022X","DOIUrl":null,"url":null,"abstract":"<p><strong>Aims: </strong>There is a substantial body of literature on environmental risk associated with schizophrenia. Most research has largely been conducted in Europe and North America, with little representation of the rest of the world; hence generalisability of findings is questionable. For this reason, we performed a mapping review of studies on environmental risk for schizophrenia spectrum disorders, recording the country where they were conducted, and we linked our findings with publicly available data to identify correlates with the uneven global distribution. Our aim was to evaluate how universal is the 'common knowledge' of environmental risk for psychosis collating the availability of evidence across different countries and to generate suggestions for future research identifying gaps in evidence.</p><p><strong>Methods: </strong>We performed a systematic search and mapping of studies in the PubMed and PsycINFO electronic databases reporting on exposure to environmental risk for schizophrenia including obstetric complications, paternal age, migration, urbanicity, childhood trauma, and cannabis use and subsequent onset of schizophrenia spectrum disorders. This search focused on articles published from the date of the first available publication until 31 May 2023. We recorded the country where they were conducted. We downloaded publicly available data on population size, measures of wealth, medical provisions, research investment, and of quality research outputs per country and performed regression analyses of each predictor with the number of studies and recruited cases in each country.</p><p><strong>Results: </strong>We identified 308 publications that included a sample size of 445,000 patients with schizophrenia spectrum disorders. The majority were conducted in northern Europe and North America, with large parts of the world totally unrepresented. In the associations between the number of environmental risk studies for schizophrenia with potential predictors, we found that neither population nor wealth or research investment were strong predictors of research outputs in the field. Interestingly, the stronger correlations were found for number of researchers per population and for indicators of top-end scientific achievements, such as number of Nobel laureates per country.</p><p><strong>Conclusions: </strong>Our results demonstrate a gap of knowledge due to the underrepresentation of studies on environmental risk of schizophrenia spectrum disorders in large parts of the world. This has implications not only in the generalisability of any findings from research conducted in the Northern hemisphere but also in our ability to progress in efforts to make causal inferences about biological pathways to schizophrenia. These findings reinforce the need to focus research on populations that are underrepresented in research and underserved in health care.</p>","PeriodicalId":11787,"journal":{"name":"Epidemiology and Psychiatric Sciences","volume":"34 ","pages":"e47"},"PeriodicalIF":6.1000,"publicationDate":"2025-09-05","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12450536/pdf/","citationCount":"0","resultStr":"{\"title\":\"Environmental risk factors for schizophrenia spectrum disorders around the globe: a mapping review of the literature.\",\"authors\":\"Sarah Tosato, Branko Ristic, Alice Zanini, Simone Schimmenti, Francesca Maria Camilla Maselli, Evangelos Vassos\",\"doi\":\"10.1017/S204579602510022X\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Aims: </strong>There is a substantial body of literature on environmental risk associated with schizophrenia. Most research has largely been conducted in Europe and North America, with little representation of the rest of the world; hence generalisability of findings is questionable. For this reason, we performed a mapping review of studies on environmental risk for schizophrenia spectrum disorders, recording the country where they were conducted, and we linked our findings with publicly available data to identify correlates with the uneven global distribution. Our aim was to evaluate how universal is the 'common knowledge' of environmental risk for psychosis collating the availability of evidence across different countries and to generate suggestions for future research identifying gaps in evidence.</p><p><strong>Methods: </strong>We performed a systematic search and mapping of studies in the PubMed and PsycINFO electronic databases reporting on exposure to environmental risk for schizophrenia including obstetric complications, paternal age, migration, urbanicity, childhood trauma, and cannabis use and subsequent onset of schizophrenia spectrum disorders. This search focused on articles published from the date of the first available publication until 31 May 2023. We recorded the country where they were conducted. We downloaded publicly available data on population size, measures of wealth, medical provisions, research investment, and of quality research outputs per country and performed regression analyses of each predictor with the number of studies and recruited cases in each country.</p><p><strong>Results: </strong>We identified 308 publications that included a sample size of 445,000 patients with schizophrenia spectrum disorders. The majority were conducted in northern Europe and North America, with large parts of the world totally unrepresented. In the associations between the number of environmental risk studies for schizophrenia with potential predictors, we found that neither population nor wealth or research investment were strong predictors of research outputs in the field. Interestingly, the stronger correlations were found for number of researchers per population and for indicators of top-end scientific achievements, such as number of Nobel laureates per country.</p><p><strong>Conclusions: </strong>Our results demonstrate a gap of knowledge due to the underrepresentation of studies on environmental risk of schizophrenia spectrum disorders in large parts of the world. This has implications not only in the generalisability of any findings from research conducted in the Northern hemisphere but also in our ability to progress in efforts to make causal inferences about biological pathways to schizophrenia. These findings reinforce the need to focus research on populations that are underrepresented in research and underserved in health care.</p>\",\"PeriodicalId\":11787,\"journal\":{\"name\":\"Epidemiology and Psychiatric Sciences\",\"volume\":\"34 \",\"pages\":\"e47\"},\"PeriodicalIF\":6.1000,\"publicationDate\":\"2025-09-05\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12450536/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Epidemiology and Psychiatric Sciences\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1017/S204579602510022X\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"PSYCHIATRY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Epidemiology and Psychiatric Sciences","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1017/S204579602510022X","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"PSYCHIATRY","Score":null,"Total":0}
Environmental risk factors for schizophrenia spectrum disorders around the globe: a mapping review of the literature.
Aims: There is a substantial body of literature on environmental risk associated with schizophrenia. Most research has largely been conducted in Europe and North America, with little representation of the rest of the world; hence generalisability of findings is questionable. For this reason, we performed a mapping review of studies on environmental risk for schizophrenia spectrum disorders, recording the country where they were conducted, and we linked our findings with publicly available data to identify correlates with the uneven global distribution. Our aim was to evaluate how universal is the 'common knowledge' of environmental risk for psychosis collating the availability of evidence across different countries and to generate suggestions for future research identifying gaps in evidence.
Methods: We performed a systematic search and mapping of studies in the PubMed and PsycINFO electronic databases reporting on exposure to environmental risk for schizophrenia including obstetric complications, paternal age, migration, urbanicity, childhood trauma, and cannabis use and subsequent onset of schizophrenia spectrum disorders. This search focused on articles published from the date of the first available publication until 31 May 2023. We recorded the country where they were conducted. We downloaded publicly available data on population size, measures of wealth, medical provisions, research investment, and of quality research outputs per country and performed regression analyses of each predictor with the number of studies and recruited cases in each country.
Results: We identified 308 publications that included a sample size of 445,000 patients with schizophrenia spectrum disorders. The majority were conducted in northern Europe and North America, with large parts of the world totally unrepresented. In the associations between the number of environmental risk studies for schizophrenia with potential predictors, we found that neither population nor wealth or research investment were strong predictors of research outputs in the field. Interestingly, the stronger correlations were found for number of researchers per population and for indicators of top-end scientific achievements, such as number of Nobel laureates per country.
Conclusions: Our results demonstrate a gap of knowledge due to the underrepresentation of studies on environmental risk of schizophrenia spectrum disorders in large parts of the world. This has implications not only in the generalisability of any findings from research conducted in the Northern hemisphere but also in our ability to progress in efforts to make causal inferences about biological pathways to schizophrenia. These findings reinforce the need to focus research on populations that are underrepresented in research and underserved in health care.
期刊介绍:
Epidemiology and Psychiatric Sciences is a prestigious international, peer-reviewed journal that has been publishing in Open Access format since 2020. Formerly known as Epidemiologia e Psichiatria Sociale and established in 1992 by Michele Tansella, the journal prioritizes highly relevant and innovative research articles and systematic reviews in the areas of public mental health and policy, mental health services and system research, as well as epidemiological and social psychiatry. Join us in advancing knowledge and understanding in these critical fields.