Abstract
Schizophrenia and other psychotic disorders (SOP) are highly prevalent with significant morbidity and mortality. However, data on the incidence and course of SOP across the globe are still scarce, especially in developing countries. The etiology of SOP is multifactorial, involving biological and social factors, and a genuine advance in the understanding SOP depends crucially on an integrated approach of the different factors involved in the incidence, pathogenesis, outcome, prognosis and response to treatment of mental disorders, particularly in the early onset of the disorders. This proposal is part of a multicenter study, the European Network of National Networks Studying Schizophrenia Gene-Environment Interactions (EU-GEI; http://www.eu-gei.eu/), an international consortium that aims to investigate etiology, mechanisms and prognosis of SOP. This proposal aims to estimate the incidence of SOP in the region of Ribeirão Preto and to investigate possible interactions between social and biological factors in the occurrence of mental disorders. Specifically, we will investigate: a) possible variations in the incidence of SOP, considering urbanicity and internal migration; b) the association between individual, familiar and geographical risk factors and the incidence of SOP; c) the existence of anatomical and functional changes in the brains of individuals with SOP compared with healthy controls and individuals at risk of SOP (healthy siblings); d) the occurrence of genetic and immunological changes in patients with SOP, compared with healthy controls and individuals at risk of SOP (healthy siblings), using Genome Wide Associations; e) the occurrence of interactions between social, genetic, immunological, neuroanatomical and neurofunctional factor on the incidence of SOP. In a period of three years, a case-control study of incident cases of SOP will be conducted. In a population of about 800,000 people at risk per year, or 2.4 million person-years for a total of three years, we estimate a sample of 300 incident cases, 150 siblings and 300 controls. All participants will undergo an extensive battery of socio-demographic, environmental, clinical, neuropsychological and family history assessments, as well as genetic, immunological and neuroimaging evaluations. The novelty of this study is based on this broad and integrated approach of the different components of the etiology and mechanisms involved in SOP. Moreover, this international multicenter consortium, with specific consistent and uniform protocols, is a pioneering strategy that will enable greater integration and cooperation among diverse groups of researchers involved in this research network. (AU)
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