Schizophrenia is a chronic brain disorder that affects around 24 million people worldwide. Psychosis is one of the main diagnostic symptoms. Individuals with schizophrenia, as well as those at clinical high-risk for psychosis (CHR-P), are disproportionately exposed to adverse social determinants of health. These exposures are key drivers of health inequity in schizophrenia, being consistently linked to earlier illness onset and poorer long-term outcomes. Yet, the brain-based mechanisms through which structural disadvantage becomes biologically embedded are unknown.
We first investigated the relationship between life events and global structural brain metrics in CHR-P and healthy control (HC) individuals recruited from the 9-site North American Prodrome Longitudinal Study 3 (NAPLS3).
Part two of the project will examine whether premature brain aging, leading to a brain age gap (BAG), mediates the relationship between SBDHs and conversion to psychosis. Because this is an observatory study, causation cannot be confirmed, but identifying a correlation between SBDHs, BAG, and CHR-P patients shows how social determinants become biologically embedded. This research is essential to advancing mechanistic understanding and informing targeted, equitable care.