Estimating Aggregate Environmental Risk Score in Psychiatry: The Exposome Score for Schizophrenia

To understand the role of environment in the pathoetiology of psychosis spectrum disorders, research has thus far mainly investigated the effects of single exposures in isolation, such as the association between cannabis use and schizophrenia. However, this approach fails to acknowledge the complexi...

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Main Authors: Lotta-Katrin Pries, Gamze Erzin, Bart P. F. Rutten, Jim van Os, Sinan Guloksuz
Format: Article
Language:English
Published: Frontiers Media S.A. 2021-05-01
Series:Frontiers in Psychiatry
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fpsyt.2021.671334/full
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author Lotta-Katrin Pries
Gamze Erzin
Bart P. F. Rutten
Jim van Os
Jim van Os
Jim van Os
Sinan Guloksuz
Sinan Guloksuz
Sinan Guloksuz
author_facet Lotta-Katrin Pries
Gamze Erzin
Bart P. F. Rutten
Jim van Os
Jim van Os
Jim van Os
Sinan Guloksuz
Sinan Guloksuz
Sinan Guloksuz
author_sort Lotta-Katrin Pries
collection DOAJ
description To understand the role of environment in the pathoetiology of psychosis spectrum disorders, research has thus far mainly investigated the effects of single exposures in isolation, such as the association between cannabis use and schizophrenia. However, this approach fails to acknowledge the complexity of the exposome, which represents the totality of the environment involving many exposures over an individual's lifetime. Therefore, contemporary research adopting the exposome paradigm has aimed at capturing the combined effect of different environmental exposures by utilizing an aggregate environmental vulnerability score for schizophrenia: the exposome score for schizophrenia. Here, we attempt to provide a comprehensive overview of studies applying the exposome score for schizophrenia. First, we describe several approaches estimating exposomic vulnerability for schizophrenia, which falls into three categories: simple environmental sum scores (sum of dichotomized exposures), meta-analysis-based environmental risk score (sum scores weighted by estimates from meta-analyses), and the exposome score (sum score weighted by estimates from an analysis in an independent training dataset). Studies show that the exposome score for schizophrenia that assumes interdependency of exposures performs better than scores that assume independence of exposures, such as the environmental sum score and the meta-analysis-based environmental risk score. Second, we discuss findings on the pluripotency of the exposome score for schizophrenia and summarize findings from gene-environment studies using the exposome score for schizophrenia. Finally, we discuss possible scientific, clinical, and population-based applications of exposome score for schizophrenia, as well as limitations and future directions for exposome research to understand the etiology of psychosis spectrum disorders.
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spelling doaj.art-b845c005a15042f1ae5f7c03869f571c2022-12-21T22:33:54ZengFrontiers Media S.A.Frontiers in Psychiatry1664-06402021-05-011210.3389/fpsyt.2021.671334671334Estimating Aggregate Environmental Risk Score in Psychiatry: The Exposome Score for SchizophreniaLotta-Katrin Pries0Gamze Erzin1Bart P. F. Rutten2Jim van Os3Jim van Os4Jim van Os5Sinan Guloksuz6Sinan Guloksuz7Sinan Guloksuz8Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, NetherlandsDepartment of Psychiatry, University of Health Sciences Ankara Diskapi Training and Research Hospital, Ankara, TurkeyDepartment of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, NetherlandsDepartment of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, NetherlandsBrain Centre Rudolf Magnus, University Medical Center Utrecht, Utrecht, NetherlandsKing's Health Partners, Department of Psychosis Studies, King's College London, Institute of Psychiatry, London, United KingdomDepartment of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience, Maastricht University Medical Center, Maastricht, NetherlandsBrain Centre Rudolf Magnus, University Medical Center Utrecht, Utrecht, NetherlandsDepartment of Psychiatry, Yale University School of Medicine, New Haven, CT, United StatesTo understand the role of environment in the pathoetiology of psychosis spectrum disorders, research has thus far mainly investigated the effects of single exposures in isolation, such as the association between cannabis use and schizophrenia. However, this approach fails to acknowledge the complexity of the exposome, which represents the totality of the environment involving many exposures over an individual's lifetime. Therefore, contemporary research adopting the exposome paradigm has aimed at capturing the combined effect of different environmental exposures by utilizing an aggregate environmental vulnerability score for schizophrenia: the exposome score for schizophrenia. Here, we attempt to provide a comprehensive overview of studies applying the exposome score for schizophrenia. First, we describe several approaches estimating exposomic vulnerability for schizophrenia, which falls into three categories: simple environmental sum scores (sum of dichotomized exposures), meta-analysis-based environmental risk score (sum scores weighted by estimates from meta-analyses), and the exposome score (sum score weighted by estimates from an analysis in an independent training dataset). Studies show that the exposome score for schizophrenia that assumes interdependency of exposures performs better than scores that assume independence of exposures, such as the environmental sum score and the meta-analysis-based environmental risk score. Second, we discuss findings on the pluripotency of the exposome score for schizophrenia and summarize findings from gene-environment studies using the exposome score for schizophrenia. Finally, we discuss possible scientific, clinical, and population-based applications of exposome score for schizophrenia, as well as limitations and future directions for exposome research to understand the etiology of psychosis spectrum disorders.https://www.frontiersin.org/articles/10.3389/fpsyt.2021.671334/fullexposomepredictionriskenvironmentschizophreniapsychosis
spellingShingle Lotta-Katrin Pries
Gamze Erzin
Bart P. F. Rutten
Jim van Os
Jim van Os
Jim van Os
Sinan Guloksuz
Sinan Guloksuz
Sinan Guloksuz
Estimating Aggregate Environmental Risk Score in Psychiatry: The Exposome Score for Schizophrenia
Frontiers in Psychiatry
exposome
prediction
risk
environment
schizophrenia
psychosis
title Estimating Aggregate Environmental Risk Score in Psychiatry: The Exposome Score for Schizophrenia
title_full Estimating Aggregate Environmental Risk Score in Psychiatry: The Exposome Score for Schizophrenia
title_fullStr Estimating Aggregate Environmental Risk Score in Psychiatry: The Exposome Score for Schizophrenia
title_full_unstemmed Estimating Aggregate Environmental Risk Score in Psychiatry: The Exposome Score for Schizophrenia
title_short Estimating Aggregate Environmental Risk Score in Psychiatry: The Exposome Score for Schizophrenia
title_sort estimating aggregate environmental risk score in psychiatry the exposome score for schizophrenia
topic exposome
prediction
risk
environment
schizophrenia
psychosis
url https://www.frontiersin.org/articles/10.3389/fpsyt.2021.671334/full
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