New research has revealed that individuals with schizophrenia have a genetic predisposition to smoking and a reduced genetic risk of obesity. This study, published in The American Journal of Psychiatry, also found genetic overlap between schizophrenia and cardiovascular disease risk factors, particularly smoking and body mass index.
The research team, led by Linn Rødevand, Ph.D., from the Norwegian Center for Mental Disorders Research at the University of Oslo, examined the results of recent genome-wide association studies to estimate the number of shared genetic variants and identify specific shared locations. They discovered extensive genetic overlap between schizophrenia and CVD risk factors, including smoking initiation and BMI, as well as specific shared locations between schizophrenia and waist-to-hip ratio, type 2 diabetes, lipids, systolic and diastolic blood pressure, and coronary artery disease.
The genetic overlap between schizophrenia and smoking behavior implies that individuals with schizophrenia may be more vulnerable to nicotine addiction, as they experience more severe withdrawal symptoms during abstinence and greater reinforcing effects of nicotine. Additionally, smoking may serve as a form of self-medication for people with schizophrenia, as it may compensate for genetically determined dysfunction of nicotinic acetylcholine receptors (nAChRs).
The study's results also suggest that individuals with schizophrenia have a genetic predisposition to lower BMI, consistent with previous findings of a higher prevalence of low BMI before the onset of schizophrenia. However, obesity is more common in individuals with schizophrenia than in the general population. The study's authors point out that factors other than common genetic variants, such as adverse effects of antipsychotics and symptoms, depression, and socioeconomic challenges, contribute to unhealthy lifestyles and weight gain in schizophrenia. Furthermore, genetic factors likely play a role in antipsychotic-induced weight gain.
The overlapping locations between schizophrenia and lipids, blood pressure, waist-to-hip ratio, type 2 diabetes, and coronary artery disease had mixed effects, with half of the genetic variants influencing schizophrenia associated with increased CVD risk and the other half associated with reduced CVD risk. This suggests that subgroups of people with schizophrenia may vary in their genetic susceptibility to CVD, accounting for some differences in CVD comorbidity.
The World Health Organization (WHO) estimates that approximately 24mn people worldwide, or 1 in 300 people (0.32%), suffer from schizophrenia. This rate is higher among adults, with 1 in 222 people (0.45%) affected.
Schizophrenia is less common than other mental disorders, often appearing during late adolescence and the twenties, with earlier onset among men than women.
Schizophrenia can cause significant distress and impairment in various areas of one's life, including personal, family, social, educational, and occupational aspects.
People with schizophrenia frequently face human rights violations inside mental health institutions and in community settings. The stigma surrounding the condition is intense and widespread, causing social exclusion and affecting relationships with family and friends. This leads to discrimination, limiting access to general healthcare, education, housing, and employment.
During humanitarian and public health emergencies, people with schizophrenia are more vulnerable than others to various human rights violations, including neglect, abandonment, homelessness, abuse, and exclusion. Extreme stress, fear, and breakdown of social supports can exacerbate existing symptoms, negatively impacting their lives.
In 2018, mental health was identified as an area requiring immediate action by the WHO Director-General, Dr. Tedros Adhanom Ghebreyesus.
This led to the establishment of the WHO Special Initiative for Mental Health, which covers the five-year period from 2019 to 2023. The initiative was launched in 2019, but its work began following a cross-country meeting held in Geneva in January 2020 with six early adopter countries: Bangladesh, Jordan, Paraguay, the Philippines, Ukraine, and Zimbabwe. Since then, Argentina, Ghana, and Nepal have joined the WHO Special Initiative for Mental Health, which aims to ensure access to mental health services for 100mn more people across WHOs six regions. Each country has already conducted an initial assessment to gain a broad understanding of the mental health needs, available services, opportunities, and main challenges for scaling up.
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