title: Schizophrenia: genetics, prevention and rehabilitation.
abstract: OBJECTIVE
  Genetic factors are largely implicated in predisposing to schizophrenia. Environmental factors contribute to the onset of the disorder in individuals at increased genetic risk. Cognitive deficits have emerged as endophenotypes and potential therapeutic targets for schizophrenia because of their association with functional outcome. The aims of this review were to analyse the joint effect of genetic and environmental (G×E) factors on liability to schizophrenia and to investigate relationships between genes and cognitive endophenotypes focusing on practical applications for prevention and rehabilitation.
  
  
  METHODS
  Medline search of relevant studies published between 1990 and 2008.
  
  
  RESULTS
  In schizophrenia, examples of G×E interaction include the catechol-O-methyl transferase (COMT) (Val158Met) polymorphism, which was found to moderate the onset of psychotic manifestations in response to stress and to increase the risk for psychosis related to cannabis use, and neurodevelopmental genes such as AKT1 (serine-threonine kinase), brain-derived neurotrophic factor (BDNF), DTNBP1 (dysbindin) and GRM3 (metabotropic glutamate receptor 3), which were associated with development of schizophrenia in adulthood after exposure to perinatal obstetric complications. Neurocognitive deficits are recognised as core features of schizophrenia that facilitate the onset of the disorder and have a great impact on functional outcome. Neurocognitive deficits are also endophenotypes that have been linked to a variety of genes [COMT, neuregulin (NRG1), BDNF, Disrupted-In-Schizophrenia 1 (DISC1) and dysbindin] conferring susceptibility to schizophrenia. Recently, it has emerged that cognitive improvement during rehabilitation therapy was under control of COMT (Val158Met) polymorphism.
  
  
  CONCLUSIONS
  This review could indicate a pivotal role of psychiatric genetics in prevention and rehabilitation of schizophrenic psychoses.
authors.affiliation: 1Department of Psychiatry, Institute of Psychiatry, Bologna University, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Olgiati
authors.affiliation: 1Department of Psychiatry, Institute of Psychiatry, Bologna University, Italy.
authors.forename: Laura
authors.initials: L
authors.lastname: Mandelli
authors.affiliation: 2Department of Psychiatry, Istituto Scientifico San Raffaele, Vita-Salute University, Milan, Italy.
authors.forename: Cristina
authors.initials: C
authors.lastname: Lorenzi
authors.affiliation: 2Department of Psychiatry, Istituto Scientifico San Raffaele, Vita-Salute University, Milan, Italy.
authors.forename: Elena
authors.initials: E
authors.lastname: Marino
authors.affiliation: 2Department of Psychiatry, Istituto Scientifico San Raffaele, Vita-Salute University, Milan, Italy.
authors.forename: Pirovano
authors.initials: P
authors.lastname: Adele
authors.affiliation: 1Department of Psychiatry, Institute of Psychiatry, Bologna University, Italy.
authors.forename: Barbara
authors.initials: B
authors.lastname: Ferrari
authors.affiliation: 1Department of Psychiatry, Institute of Psychiatry, Bologna University, Italy.
authors.forename: Diana
authors.initials: D
authors.lastname: De Ronchi
authors.affiliation: 1Department of Psychiatry, Institute of Psychiatry, Bologna University, Italy.
authors.forename: Alessandro
authors.initials: A
authors.lastname: Serretti