167 ISSN 1741-0541 Pers. Med. (2014) 11(2), 167–172
part of
10.2217/PME.13.103 © 2014 Future Medicine Ltd
Special Report
Genotype-based prevention of psychosis
onset and schizophrenia: a personalized
approach in a target population
Schizophrenia imposes a significant burden on public health, affecting approximately
25 million individuals worldwide and generating an extensive healthcare burden.
It is important to consider that the disease onset in schizophrenia stems from
gene–environment interactions. Early interventions in order to prevent schizophrenia
are of high clinical interest, and this is where personalized healthcare and medicine
comes in. In this article, we bring a genotype-based personalized, preventive perspective
to psychosis onset and schizophrenia. Our objective relies on the possibility of making
use of a specific gene–environment interaction in the emergence of schizophrenia as
a personalized preventive tool. In particular, we discuss screening of a specific AKT1
allelic variation and its interaction with cannabis use as a preventive approach in a
target population with early symptoms of psychosis.
Keywords: AKT1•cannabis•diseaseonset•gene–environmentinteraction•personalized
medicine•psychosis•schizophrenia
Personalized healthcare
& medicine
In the personalized genomics era, medi-
cine and healthcare are moving towards a
more individualized approach and towards
being predictive, preventive, personalized
and participatory [1]. Personalized health-
care and medicine bring the advantages of
genome-based diagnosis and targeted treat-
ment, which require a thorough understand-
ing of the molecular bases of diseases [2].
Hence, successful implementation of per-
sonalized healthcare and medicine depends
on accurate diagnostic tests [3]. Nonethe-
less, not all genetic tests precisely predict
disease outcomes. This is especially the case
when it comes to common complex diseases
(CCDs) with environmental risk factors [4];
this is where the power of gene–environment
(G×E) interactions comes in. Knowledge
integration of the G×E interaction contribu-
tions to the emergence of CCDs presents an
opportunity for prediction and prevention,
as illustrated in this article with a focus on
schizophrenia.
Schizophrenia as a public mental
health issue
As a CCD, schizophrenia imposes a signifi-
cant burden on public health (PH), affecting
approximately 25 million individuals glob-
ally [5]. It is a mental disorder with extensive
burden on patients, families, societies and
healthcare systems worldwide [6–9]. In fact,
when compared with some other CCDs, such
as diabetes or certain types of cancers, the
PH impact of schizophrenia in some cases
is higher [10–12]. Indeed, as an example, the
disability-adjusted life-years (percentage of
total years of life lost to disability or premature
death) value for schizophrenia is reported to be
1.1, while this value is 0.4 for cervical cancer
and 0.1 for Type 1 diabetes [11]. Schizophre-
nia, as the most common form of psychosis, is
one of the most severe mental disorders [13,14].
Due to their symptoms, schizophrenia patients
suffer from impairments including disruption
of relationships, education and occupation,
as well as somatic symptoms [15]. Moreover,
the prevalence of cardiovascular disease is
increased in schizophrenia patients [16], gener-
Bahar Taneri*
,1,2
, Mevhibe B
Hocaoglu
3
, Angela Brand
2
& Jim van Os
4
1
DepartmentofBiologicalSciences,
ProgramofMolecularBiology
&Genetics,FacultyofArts&Sciences,
EasternMediterraneanUniversity,
Famagusta,Cyprus
2
InstituteforPublicHealthGenomics,
ClusterofGenetics&CellBiology,
FacultyofHealth,Medicine&Life
Sciences,MaastrichtUniversity,
Maastricht,TheNetherlands
3
DepartmentofPsychology,Facultyof
Arts&Sciences,EasternMediterranean
University,Famagusta,Cyprus
4
DepartmentofPsychiatry,Maastricht
UniversityMedicalCenter,Maastricht
University,Maastricht,TheNetherlands
*Authorforcorrespondence:
Tel.:+905488418780
Fax:+903923651604
b.taneri@maastrichtuniversity.nl
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