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Resilience Factors Preventing Schizophrenia in Ultra-high Risk Patients: Lessons from Genetics

Published online by Cambridge University Press:  01 September 2022

B. Chaumette ,
C. Jiao  and
Q. He
B. Chaumette*
Affiliation:
University of Paris, INSERM, U1266 Institute of Psychiatry and Neuroscience of Paris, Paris, France GHU Paris Psychiatrie et Neurosciences, PEPIT, U1266 Institute of Psychiatry and Neuroscience of Paris, Paris, France McGill University, Department of Psychiatry, Montréal, Canada
C. Jiao
Affiliation:
University of Paris, INSERM, U1266 Institute of Psychiatry and Neuroscience of Paris, Paris, France
Q. He
Affiliation:
University of Paris, INSERM, U1266 Institute of Psychiatry and Neuroscience of Paris, Paris, France
*
*Corresponding author.

Abstract

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Over the past decades, researchers and psychiatrists in the field of psychosis have moved from a conception of a chronic presentation to a more dynamic paradigm. Accordingly, schizophrenia is now conceptualized as a progressive illness that typically emerges during late adolescence and follows different stages: early vulnerability, ultra-high risk state, first episode of psychosis, and chronic disease. Only one-quarter of the ultra-high risk patients will convert to a full-blown psychotic episode within 3 years while the others, called non-converters, will remain at-risk, develop other psychiatric disorders, or fully recover. The reasons for this differential outcome are not yet understood but this concept opens the way to scientific research to determine the protective factors involved in resilience for non-converters. Based on the Gene X Environment interaction model, schizophrenia results from genetic vulnerability and environmental aggressions which can have an impact on the epigenome and gene expression. Recent studies have shown that genetic variants play a role in the resilience of psychosis. Polygenic risk scores, computed as the addition of genetic polymorphisms, can modulate the effects of genetic at-risk deletions (i.e. del22q11) that predispose to psychosis and may also influence the cognitive symptoms of ultra-high risk patients. Resilience, defined as the ability to withstand adversity, is not only related to external skills or psychotherapeutic care but could also be explained by internal molecular factors. Identifying the genetic factors of resilience might help to stratify the risk and to develop precision medicine in psychiatry.

Disclosure

No significant relationships.

Type
European
Information
European Psychiatry , Volume 65 , Special Issue S1: Abstracts of the 30th European Congress of Psychiatry , June 2022 , pp. S9 - S10
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
© The Author(s), 2022. Published by Cambridge University Press on behalf of the European Psychiatric Association
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