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Curr Opin Pediatr. 2016 Apr;28(2):243-9. doi: 10.1097/MOP.0000000000000332.

Environmental exposure to metals, neurodevelopment, and psychosis.

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aDepartment of Psychiatry bSeaver Center for Autism Research and Treatment cDepartment of Preventive Medicine dFriedman Brain Institute, Icahn School of Medicine at Mount Sinai, New York City, New York, USA.



This article presents a new hypothesis about the possible relation between early life exposure to metals and psychosis. We review limitations of available research, and discuss novel approaches to overcome previous methodological barriers.


Mechanistic studies suggest a possible association between excess lead, manganese, cadmium, arsenic, or copper, and zinc deficiency, and several biochemical disturbances related to psychosis, such as altered neurotransmitters levels, excitotoxicity, and inflammation. Furthermore, studies suggest that some metals (lead, manganese, cadmium excess, and zinc deficiency) are associated with schizophrenia or psychosis-related phenotype. However, previous studies had multiple methodological limitations. Importantly, metal exposure was often measured after disease development and seldom determined during critical developmental periods. Most studies fell short of depicting the exact timing of exposure and the change in exposure over time. Here, we propose several methods to overcome these methodological limitations.


There is a plausible role of early life exposure to metals in the cause of psychosis. Owing to methodological limitations in exposure measurement, this has not been well characterized. Considering the wide exposure to metals and the high cost of psychosis to society, this hypothesis should be rigorously examined.

[Indexed for MEDLINE]

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