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October 2018

The Exposome Paradigm and the Complexities of Environmental Research in Psychiatry

Author Affiliations
  • 1Department of Psychiatry and Psychology, School for Mental Health and Neuroscience, Maastricht University Medical Centre, Maastricht, the Netherlands
  • 2Department of Psychiatry, Yale University School of Medicine, New Haven, Connecticut
  • 3Department of Psychiatry, Brain Centre Rudolf Magnus, University Medical Centre Utrecht, Utrecht, the Netherlands
JAMA Psychiatry. 2018;75(10):985-986. doi:10.1001/jamapsychiatry.2018.1211

“But a great advantage of possession of the habit of reflective activity is that failure is not mere failure. It is instructive. The person who really thinks learns quite as much from his failures as from his successes.”

John Dewey

Decades of epidemiologic research into environmental factors in psychiatry have yielded consistent findings and identified several (proxy) environmental risk factors associated with mental disorders. These risk factors include childhood adversities, immigration and minority status, urbanicity, cannabis use, and obstetric and pregnancy complications.1 Although the effects of these risk factors may be genetically confounded to a degree (ie, gene-environment correlation), evidence from controlled studies1,2 suggests that a substantial part is environmental.