M239. ENVIRONMENTAL POLLUTION AND RISK FOR PSYCHOTIC DISORDERS: AN UPDATE
Authors: Pauselli Luca , Attademo Luigi , Bernardini Francesco , Compton Michael 
Published: May 2020

Abstract

Background
Environmental pollution is a well-known cause of disease worldwide. According to the World Health Organization, air pollution kills an estimated seven million people worldwide every year. Over the past decade, increasing attention has been drawn to the impact of environmental pollution on mental health. In 2016, our research team (Attademo et al., 2016) performed a literature review focusing on the association with psychotic disorders. The aim of this presentation is to give an update of the science, given the marked increase in the body of literature on this topic.

Methods
We repeated a search using the Pubmed electronic database for all articles from February 20, 2016 (date of out last search for the previous review) to November 20, 2019, using the same terms that we used in the first review. The search included all languages. Thirty-eight articles were identified. We selected 9 studies related to pollution’s effects on human subjects: seven were research reports and two were review articles. We excluded 29 articles, on the basis of the following exclusion criteria: a) studies unrelated to the topic, and b) letters or commentaries not reporting research findings. For this update, we focus only on research reports.

Results
Six of the seven research reports (Bai et al., 2019; Duan et al., 2018; Eguchi et al., 2018; Liang et al., 2019; Ma et al., 2018; Newbury et al., 2019; Qiu et al., 2019) focused on air pollution. Only one (Ma et al., 2018) explored the association between serum concentration of six typical toxic metals and risk of schizophrenia in a earth mining area in China and found higher serum levels of antimony, uranium, and lanthanum in patients with schizophrenia. All studies focusing on air pollution considered the following pollutants: particulate matter (PM) 10, PM2.5, and nitrogen dioxide. Some of them also included carbon monoxide, sulfur dioxide, nitric oxide, and carbon dioxide. All the studies found significant associations between pollutant concentrations and psychosis-associated outcomes (adolescent psychotic experience, hospital admissions, and higher Brief Psychiatric Rating Scale scores). Five of the six studies investigating air pollutants also looked into the lag effect between pollutant concentrations and the outcome of the study, supporting the hypothesis of short-term effects (same day or within the first 2–3 days after high concentrations of pollutants).

Discussion
During our previous review, we found 13 research reports from 1964 to 2016, while in this update in the past 2.5 years, there has been a marked increase in publications on the topic. The association between air pollutants and different aspects of psychotic disorders presentation and manifestation is gaining support and the approaches of looking into this phenomenon are becoming more sophisticated. Nevertheless, further research is needed both at the molecular level to determine the mechanisms that mediate the effects of these pollutants, and at clinical and environmental levels to improve health and well-being of patient with psychotic disorders.