Deutsches Arzteblatt international · 2026
Effects of the Genome and Exposome on Mental Health in Childhood and Adolescence.
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Hebebrand Johannes, Correll Christoph, Brunner Romuald
Аннотация
BACKGROUND: According to the most recent nationwide representative survey, 17% of 3-to-17-year-olds in Germany are considered by their parents to be struggling with mental health issues. We discuss the current state of research about the effects of interacting genetic and environmental factors on the development of mental disorders and mental traits in childhood and adolescence.
METHODS: This narrative review is based on pertinent publications retrieved by a selective search in PubMed with the aid of OpenEvidence.
RESULTS: The mental health of a child depends on a complex interaction of genetic and environmental factors (nature and nurture). The relative contributions of the two types of factors to the development of mental illness cannot be judged conclusively from current evidence. Molecular genetic studies have yielded lower estimates of heritability than pedigree-based studies; this gap awaits a satisfactory explanation. As an example, for autism-spectrum disorder, the relevant figures are 0.13 versus >0.6, respectively. Gene-environment interactions may have led to an overestimation of heritability in pedigree-based studies. The genetic and environmental factors predisposing to mental illness exert their effects in age-dependent fashion and are, for the most part, not disorder-specific, with generally low effect sizes. The earlier and the more intensely the brain is subjected to harmful substances and adverse events during sensitive and critical periods in its development, the greater the frequency and severity of their effects on the mental health of the child.
CONCLUSION: Resilience arises from the absence of risk factors, the presence of protective factors, and an environment that is beneficial for children, in which the individual temperament, personality, emotionality, cognition, and social skills of each child are given due consideration. Alterable environmental factors are important leverage points for mental health.
METHODS: This narrative review is based on pertinent publications retrieved by a selective search in PubMed with the aid of OpenEvidence.
RESULTS: The mental health of a child depends on a complex interaction of genetic and environmental factors (nature and nurture). The relative contributions of the two types of factors to the development of mental illness cannot be judged conclusively from current evidence. Molecular genetic studies have yielded lower estimates of heritability than pedigree-based studies; this gap awaits a satisfactory explanation. As an example, for autism-spectrum disorder, the relevant figures are 0.13 versus >0.6, respectively. Gene-environment interactions may have led to an overestimation of heritability in pedigree-based studies. The genetic and environmental factors predisposing to mental illness exert their effects in age-dependent fashion and are, for the most part, not disorder-specific, with generally low effect sizes. The earlier and the more intensely the brain is subjected to harmful substances and adverse events during sensitive and critical periods in its development, the greater the frequency and severity of their effects on the mental health of the child.
CONCLUSION: Resilience arises from the absence of risk factors, the presence of protective factors, and an environment that is beneficial for children, in which the individual temperament, personality, emotionality, cognition, and social skills of each child are given due consideration. Alterable environmental factors are important leverage points for mental health.