Schizophrenia has no universal symptom, and therefore when considering the link between a specific PE, such as hallucinations, and clinical schizophrenia, not all individuals with clinical schizophrenia will have the specific experience. Schizophrenia is also often characterised by social dysfunction, which is not captured by many existing measures of PEs. In terms of systematic Belinostat solubility dmso gene-discovery work, so far there is one genome-wide association study of PEs. With N = 3483 and a categorical assessment of PEs, this study yielded no genome-wide significant loci [22••]. On the basis of the known effect sizes of common
variants associated with other complex traits, it is likely that a GWAS of PEs requires a sample size of over 10,000 individuals to identify genome-wide significant loci [24]. Candidate genes, most notably those related to activity of the dopamine neurotransmitter,
such as catechol-O-methyltransferase (COMT), have been investigated in relation to PEs with mixed results (e.g. 22•• and 25]). A systematic review of gene–environment interaction studies on candidate genes is available elsewhere [26]. Importantly, large-scale projects this website underway will address some of the methodological challenges in this type PLEK2 of research [27]. Twin studies reviewed in Table 1 demonstrate that nonshared, rather than shared, environment is important in explaining variance in PEs. It is clear from estimates of nonshared environment and the known measurement error (estimated from test–retest reliability and internal consistency values), that there is significant nonshared environmental influence on PEs above and beyond variance explained by measurement error, for example [10••]. In terms of the types of environments involved, examples include cannabis use and stressful life events, which have both been associated with
PEs in young people, for example 28 and 29]. Largely similar environmental risk factors are found for PEs as for psychotic disorders [30]. Many apparent ‘environments’ are themselves partly heritable, a process termed gene–environment correlation [31]. For example, bullying victimisation, cannabis use and stressful life events are all themselves partly heritable 32, 33, 34 and 35]. To disentangle the role of nonshared environment from the impact of inherited genetic variation, the strongest design is the discordant MZ twin design 36 and 37••]. If the twins with more PEs have had on average more exposure to ‘environmental’ risk factors than their genetically identical cotwins, this demonstrates an association driven by nonshared environment.