A new public health genomics model for common complex diseases, with an application to common behavioral disorders

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.

Rethinking our public health genetics research paradigm

Since the sequencing of the human genome, tremendous resources have been dedicated to understanding how genetic determinants may drive the production of disease. Despite some successes, the promise of genetics research in these areas remains largely unrealized. The focus on isolating individual (or clusters of) genes that may be associated with narrowly defined phenotypes in large part explains this discrepancy. In particular, efforts to identify genotypes associated with narrow phenotypes force the field to use study designs that capitalize on homogeneous samples to minimize the potential for competing influences or confounders, which imposes important limitations on understanding the role of genes in human health. We argue that a population health genetics that incorporates genetics into large, multiwave, multilevel cohorts has the best potential to clarify how genes, in combination and with the environment, jointly influence population health.