Peer-Reviewed Publication
World Psychiatry2026;25(3):427-443.October 1, 2026Journal Article
Evidence-based atlas of risk and protective factors for psychotic disorders: an umbrella review to inform personalized prognosis and prevention.
Claudia Aymerich1,2,3, Michele De Prisco3,4,5,6, Antonio Melillo7,8, Borja Pedruzo2,3,9,10, Ana Catalan2,3,9,10, Dominic Oliver8,11,12,13,14, Kelly Diederen15, James MacCabe15,16,17, Ricardo Twumasi15, Rudolf Uher18, Cathy Davies8,19, Luis Alameda15,20,21, Celso Arango22,23, Eduard Vieta3,4,5,6, Christoph U Correll24,25,26,27, Crick Lund28,29, Merete Nordentoft30,31, Thomas A Pollak15, Dong Keon Yon32, Samuele Cortese33,34,35,36,37, Laura Fusar-Poli38,39, Stefano Damiani38, Sameer Jauhar40, Luigi Grassi41,42, Alessio Maria Monteleone7, Manuel Capra39, Ilaria Stirpe39, Giovanni de Girolamo43, Gonzalo Salazar de Pablo1,44,45, Simon Cervenka46,47, Marco Solmi27,48,49,50, Matteo Tonna51,52, Robin Murray15,44, Oliver Howes15,53, Joaquim Radua8,54, Paolo Fusar-Poli8,38,55,56
1Department of Child and Adolescent Psychiatry, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
2Biobizkaia Health Research Institute, OSI Bilbao-Basurto, University of Basque Country, Bilbao, Spain.
3Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.
4Institute of Neurosciences, Department of Medicine, Faculty of Medicine and Health Sciences, Universitat de Barcelona, Barcelona, Spain.
5Bipolar and Depressive Disorders Unit, Hospital Clínic de Barcelona, Barcelona, Spain.
6Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain.
7Department of Psychiatry, University of Campania "Luigi Vanvitelli", Naples, Italy.
8Early Psychosis: Interventions & Clinical-detection (EPIC) Lab, Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
9Department of Psychiatry, Basurto University Hospital, Osakidetza, Bilbao, Spain.
10Department of Neuroscience, University of Basque Country, Leioa, Spain.
11Department of Psychiatry, University of Oxford, Oxford, UK.
12NIHR Oxford Health Biomedical Research Centre, Oxford, UK.
13OPEN Early Detection Service, Oxford Health NHS Foundation Trust, Oxford, UK.
14Institute for Mental Health and Centre for Human Brain Health, University of Birmingham, Birmingham, UK.
15Department of Psychosis Studies, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
16NIHR Biomedical Research Centre for Mental Health South London and Maudsley NHS, London, UK.
17National Psychosis Service, South London and Maudsley NHS Foundation Trust, London, UK.
18Department of Psychiatry, Dalhousie University, Halifax, NS, Canada.
19Department of Neuroimaging, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
20Service of General Psychiatry, Treatment and Early Intervention in Psychosis Program, Lausanne University Hospital, Lausanne, Switzerland.
21Department of Psychiatry, Hospital Universitario Virgen del Rocío, Universidad de Sevilla, Sevilla, Spain.
22Hospital Universitario La Paz, Madrid, Spain.
23CIBERSAM, School of Medicine, Universidad Autónoma de Madrid, Madrid, Spain.
24Division of Psychiatry Research, Zucker Hillside Hospital, Northwell Health, Glen Oaks, NY, USA.
25Department of Psychiatry and Molecular Medicine, Zucker School of Medicine Hofstra/Northwell, Hempstead, NY, USA.
26Center for Psychiatric Neuroscience, Feinstein Institute for Medical Research, Manhasset, NY, USA.
27Department of Child and Adolescent Psychiatry, Charité Universitätsmedizin Berlin, Berlin, Germany; German Center for Mental Health, partner site Berlin, Berlin, Germany.
28Centre for Global Mental Health, Health Service and Population Research Department, King's College London, London, UK.
29Alan J. Flisher Centre for Public Mental Health, Department of Psychiatry and Mental Health, University of Cape Town, Cape Town, South Africa.
30Copenhagen Research Center for Mental Health, Copenhagen University Hospital - Mental Health Services, Copenhagen, Denmark.
31Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark.
32Department of Pediatrics, Kyung Hee University Medical Center, Kyung Hee University College of Medicine, Seoul, Republic of Korea.
33Developmental EPI (Evidence synthesis, Prediction, Implementation) Lab, Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK.
34Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK.
35Hampshire and Isle of Wight Healthcare Foundation NHS Trust, Southampton, UK.
36Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York, NY, USA.
37Department of Precision and Regenerative Medicine and Ionian Area, University of Bari "Aldo Moro", Bari, Italy.
38Department of Brain and Behavioral Sciences, University of Pavia, Pavia, Italy.
39IRCCS Istituti Clinici Scientifici Maugeri, Pavia, Italy.
40Centre for Affective Disorders, Psychological Medicine, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.
41Institute of Psychiatry, Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy.
42Department of Mental Health and Pathological Addiction, Local Health Trust and Sant'Anna University Hospital, Ferrara, Italy.
43Unit of Epidemiological Psychiatry and Digital Mental Health, IRCCS Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy.
44South London and Maudsley NHS Foundation Mental Health Trust, London, UK.
45Institute of Psychiatry and Mental Health, University Hospital "G. Marañón", Madrid, Spain.
46Centre for Psychiatry Research, Department of Clinical Neuroscience, Karolinska Institutet, and Stockholm Health Care Services, Region Stockholm, Stockholm, Sweden.
47Department of Medical Sciences, Psychosis Research and Preventive Psychiatry, Uppsala University, Uppsala, Sweden.
48SCIENCES lab, Department of Psychiatry, Faculty of Medicine, University of Ottawa, ON, Canada.
49Department of Mental Health, Ottawa Hospital, Ottawa, ON, Canada.
50Ottawa Hospital Research Institute, Ottawa, ON, Canada.
51Department of Medicine and Surgery, Psychiatric Unit, University of Parma, Parma, Italy.
52Department of Mental Health, Local Health Service, Parma, Italy.
53Psychiatric Imaging Group, Institute of Clinical Sciences, Faculty of Medicine, Imperial College London, London, UK.
54Imaging of Mood- and Anxiety-Related Disorders Group, Institut d'Investigacions Biomèdiques August Pi i Sunyer, CIBERSAM, University of Barcelona, Barcelona, Spain.
55Outreach and Support in South-London Service (OASIS), South London and Maudsley NHS Foundation Trust, London, UK.
56Department of Psychiatry and Psychotherapy, Ludwig-Maximilian-University, Munich, Germany.
Abstract
Identifying updated, evidence-based risk and protective factors for psychotic disorders is essential to advancing scientific and clinical knowledge of their etiology. Since the most recent umbrella review published in this journal, the evidence base has expanded substantially. Following a pre-registered protocol, we searched the Web of Science for systematic reviews with meta-analyses of observati…
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