Background and Hypothesis Psychotic disorders (PDs) have huge personal and societal impact, and efforts to improve outcomes in patients are continuously needed. Environmental risk factors (ERFs), especially modifiable risk factors, are important to study because they pose a target for intervention and prevention. No studies have investigated ERFs, cognition, and psychotic symptoms together in a network approach. Study Design We explored interactions between 3 important ERFs (tobacco smoking, cannabis use, and childhood trauma), 6 cognitive domains, and 3 dimensions of symptoms in psychosis. From the Genetic Risk and Outcome of Psychosis (GROUP) cohort, we used data from patients, siblings, and healthy controls to construct networks using Bayesian analyses of all 12 variables. We constructed networks of the combined sample and of patients and siblings separately. Study Results We found that tobacco smoking was directly associated with cognition and psychotic symptoms. The cognitive variable processing speed was the most central node, connecting clusters of psychotic symptoms and substance use through the variables of positive symptoms and tobacco smoking. Comparing the networks of patients and siblings, we found that networks were relatively similar between patients and siblings. Conclusions Our results support a potential central role of processing speed deficits in PDs. Findings highlight the importance of integrating tobacco smoking as potential ERFs in the context of PDs and to broaden the perspective from cannabis discontinuation to smoking cessation programs in patients or people at risk of PDs.

中文翻译：

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探索精神病症状、认知和环境风险因素之间的相互作用：网络的贝叶斯分析


背景和假设 精神障碍 （PD） 具有巨大的个人和社会影响，需要不断努力改善患者的预后。环境风险因素 （ERF），尤其是可改变的风险因素，研究很重要，因为它们构成了干预和预防的目标。没有研究以网络方法将 ERF、认知和精神病症状一起调查。研究设计 我们探讨了 3 个重要的 ERF （吸烟、大麻使用和童年创伤）、6 个认知领域和精神病症状的 3 个维度之间的相互作用。在精神病的遗传风险和结果 （GROUP） 队列中，我们使用来自患者、兄弟姐妹和健康对照者的数据，使用所有 12 个变量的贝叶斯分析构建网络。我们分别构建了组合样本以及患者和兄弟姐妹的网络。研究结果 我们发现吸烟与认知和精神病症状直接相关。认知变量处理速度是最中心的节点，通过阳性症状和吸烟变量将精神病症状和物质使用的集群连接起来。比较患者和兄弟姐妹的网络，我们发现患者和兄弟姐妹之间的网络相对相似。结论 我们的研究结果支持 PD 中处理速度缺陷的潜在核心作用。研究结果强调了在 PD 背景下将吸烟作为潜在 ERF 的重要性，并拓宽了从大麻停药到患者或有 PD 风险人群的戒烟计划的视角。