Universal interventions for the primary prevention of schizophrenia

Objective: To speculate on the role of universal (population-based) interventions designed to prevent schizophrenia. Method: A nonsystematic review of candidate risk factors for schizophrenia, with particular emphasis on the quality of the evidence, effect size of the risk factor, population attributable risk and potential for population-based intervention. Results: In order to design population-based interventions for the prevention of schizophrenia, we need to identify weak but prevalent risk factors. Based on current knowledge, the leading risk factors for schizophrenia include genes, season and place of birth, obstetric complications, prenatal exposure to viruses and prenatal nutrition. For the nongenetic exposures, we need to consider if potential interventions are effective, safe, cheap and acceptable. Conclusions: Vaccinations and interventions related to improving prenatal nutrition and antenatal care appear to be the most plausible options for universal prevention.