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This umbrella review aimed to classify the strength of evidence for the associations between each factor and psychotic disorders whilst controlling for several biases. The Web of Knowledge database was searched to identify systematic reviews and meta\u2010analyses of observational studies which examined associations between socio\u2010demographic, parental, perinatal, later factors or antecedents and psychotic disorders, and which included a comparison group of healthy controls, published from 1965 to January 31, 2017. The literature search and data extraction followed PRISMA and MOOSE guidelines. The association between each factor and ICD or DSM diagnoses of non\u2010organic psychotic disorders was graded into convincing, highly suggestive, suggestive, weak, or non\u2010significant according to a standardized classification based on: number of psychotic cases, random\u2010effects p value, largest study 95% confidence interval, heterogeneity between studies, 95% prediction interval, small study effect, and excess significance bias. In order to assess evidence for temporality of association, we also conducted sensitivity analyses restricted to data from prospective studies. Fifty\u2010five meta\u2010analyses or systematic reviews were included in the umbrella review, corresponding to 683 individual studies and 170 putative risk or protective factors for psychotic disorders. Only the ultra\u2010high\u2010risk state for psychosis (odds ratio, OR=9.32, 95% CI: 4.91\u201017.72) and Black\u2010Caribbean ethnicity in England (OR=4.87, 95% CI: 3.96\u20106.00) showed convincing evidence of association. Six factors were highly suggestive (ethnic minority in low ethnic density area, second generation immigrants, trait anhedonia, premorbid IQ, minor physical anomalies, and olfactory identification ability), and nine were suggestive (urbanicity, ethnic minority in high ethnic density area, first generation immigrants, North\u2010African immigrants in Europe, winter\/spring season of birth in Northern hemisphere, childhood social withdrawal, childhood trauma, Toxoplasma gondii IgG, and non\u2010right handedness). When only prospective studies were considered, the evidence was convincing for ultra\u2010high\u2010risk state and suggestive for urbanicity only. In summary, this umbrella review found several factors to be associated with psychotic disorders with different levels of evidence. These risk or protective factors represent a starting point for further etiopathological research and for the improvement of the prediction of psychosis.<\/jats:p>","DOI":"10.1002\/wps.20490","type":"journal-article","created":{"date-parts":[[2018,1,19]],"date-time":"2018-01-19T20:40:17Z","timestamp":1516394417000},"page":"49-66","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":514,"title":["What causes psychosis? 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