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Abstract
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Mental health disorders are not different from other medical disorders in that they too are preventable. Unfortunately, the mounting evidence that cost-effective primary preventive mental health strategies might reduce the incidence of mental health disorders or shift expected trajectories to less debilitating outcomes has not yet translated into the investment seen in other areas of medicine [1]. Continual identification of powerful risk factors offers the prospect of a future for preventive and public heath psychiatry. Many of those factors are potentially amenable to change through preventive interventions. An evidence-based atlas of risk and protective factors for mental disorders potentially manageable through primary preventive intervention has recently been published [2].
One of the most replicable risk factors is child maltreatment in its many forms: sexual and physical abuse, bullying (discrimination), neglect, and even war crimes. In fact, in a recent meta-umbrella systematic review, the largest global population attributable fraction for all risk factors and all mental disorders was childhood adversity, which accounted for some 38% of global cases of schizophrenia spectrum disorders [3]. This means that reducing such childhood adversity and maltreatment should be a priority in national public health roadmaps. In this issue, many important papers deal with risk factors for mental disorders and are therefore relevant for potential implementation of preventive strategies.
Prevention would benefit from a better understanding of the etiopathophysiology of mental disorders. In fact, in most instances, the link between certain psychological risk factors and the neurobiology of various mental disorders is still unknown. In this issue, Derome et al. report that subjects with high child trauma scores showed abnormal hippocampal activation and hippocampal-temporal-prefrontal connectivity during novelty detection as a salient event paradigm [4]. This study adds evidence to the link between early stressful life experiences and environments and dysfunction of key areas for psychopathology in disorders such as psychosis. Another piece of evidence--in this case memory impairment rather than hippocampal abnormality--is reported by Guo et al. in a large sample of untreated patients with major depression [5]. In this study, child maltreatment contributed to memory impairment independently of a major depression diagnosis...
Language: en |