Epigenic factors play an important role in schizophrenia. In genetically vulnerable people, environmental factors may increase the risk and trigger schizophrenia. Which of the following statements is true?

Appeared in: AIIMS Jodhpur SNO-2023

Explanation

This statement correctly identifies that environmental stressors, such as childhood trauma and poverty, can trigger the onset of schizophrenia in individuals with a genetic predisposition.
This aligns with the stress-diathesis model, where a combination of genetic vulnerability (diathesis) and environmental stress leads to the development of the disorder.
Research confirms that adverse childhood experiences can lead to epigenetic changes that alter gene expression related to brain development and stress response, increasing the risk for psychosis.

Option A: This is the opposite of what is true. Social isolation and withdrawal are risk factors and common symptoms of schizophrenia, while social companionship and support are protective.
Option B: This statement is false. Numerous studies show a strong association between poverty, material deprivation, and an increased risk of schizophrenia.
Option D: This is incorrect. The risk for schizophrenia is significantly higher in urban areas compared to rural areas. This is a well-documented finding in psychiatric research.

Visual 1: Diagram: A flowchart illustrating the Stress-Diathesis Model, showing how genetic vulnerability combined with environmental stressors (like trauma, urbanicity, substance use) can cross a threshold to trigger a psychotic episode.
Visual 2: Infographic: A visual summary of the key genetic, environmental, and psychosocial risk factors for schizophrenia.

Clinical Relevance

Nursing practice connection: This is primarily an exam-oriented knowledge point with limited direct bedside application, so retain Risk factors for schizophrenia, focusing on the interplay of genetics and environment (epigenetics) as background academic context rather than a clinical decision trigger.
Nurses must conduct thorough psychosocial assessments, including screening for childhood adversity and trauma, as this history is critical for understanding a patient's risk and overall clinical picture.
Understanding these risk factors helps in identifying at-risk individuals for early intervention programs, which can improve long-term outcomes.
Patient and family education should include information about the role of stress in relapse, emphasizing the importance of a supportive, low-stress environment and adherence to treatment.

How to Approach the Question

First, identify the core concepts in the question stem: 'epigenic factors,' 'genetically vulnerable,' and 'environmental factors.' This tells you the question is about the gene-environment interaction in schizophrenia.
The question asks for the 'true' statement, so you must evaluate each option for its factual accuracy based on established knowledge of schizophrenia risk factors.
Evaluate Option A: Recall that social isolation, not companionship, is a risk factor. This option is incorrect.
Evaluate Option B: Recall that poverty and socioeconomic stress are well-known risk factors. This option, stating poverty is not a risk, is incorrect.
Evaluate Option C: This option links childhood trauma/poverty to triggering the illness, which perfectly aligns with the stress-diathesis model and the concept of environmental triggers. This is likely the correct answer.
Evaluate Option D: Recall that urbanicity, not rural living, is a documented risk factor. This option is incorrect.

Concept Tested & Keywords

Concept Tested: Risk factors for schizophrenia, focusing on the interplay of genetics and environment (epigenetics).
Stem keywords: schizophrenia, epigenic factors, genetically vulnerable, environmental factors
Lead-in keywords: true
Negative lead-in flag: false

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E6 Guide to Mental Health & PSYCHIATRIC NURSING R Sreevani 6th Edition — Part 1 (pp 26-289 of 579) p. 31-32

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