Koponen Hannu, Rantakallio Paula, Veijola Juha, Jones Peter, Jokelainen Jari, Isohanni Matti
Department of Psychiatry, University of Oulu, PO Box 5000, 90014 Oulu, Finland.
Eur Arch Psychiatry Clin Neurosci. 2004 Feb;254(1):9-13. doi: 10.1007/s00406-004-0485-2.
Central nervous system (CNS) viral infections have been suggested to increase the risk of schizophrenia, although most of the evidence is indirect and comes from rather few studies on exposure to various infections in general. In the Northern Finland 1966 Birth Cohort the association between schizophrenia and other psychoses and childhood CNS infections has been analysed, and in this paper we present the follow-up results up to the end of 1994 and 1997. Data regarding the infections were collected prospectively between 1966-1980 and data on psychoses from 1982. The registered psychiatric diagnoses were validated using the DSM-III-R classification. Out of the 11017 subjects (96% of all births in that year) 145 had suffered a CNS infection during childhood, which in 102 cases was a viral infection. In the follow-up to the end of 1994, 76 had schizophrenia, and their number increased to 100 to the end of 1997. In addition, up to the end of 1994, 52 patients had a non-schizophrenic psychosis. Four cases in the schizophrenia patient group and none of the patients with other psychosis had suffered a viral CNS infection. None of the schizophrenia cases and two of the patients with other psychosis had had a bacterial infection. The adjusted odds ratio for schizophrenia after a viral CNS infection was 4.8 (95% confidence intervals [CI] 1.6-14.0) in the follow-up to the end of 1994 and 2.5 (0.9-7.0) in the follow-up to the end of 1997. The clinical course variables did not differ between the schizophrenia patients with or without CNS infection. Our results suggest that viral CNS infections during childhood may have a role as a risk factor for schizophrenia. Their role may be modest at the population level due to their relative rareness.
尽管大多数证据是间接的,且来自于对一般人群接触各种感染的少数研究,但中枢神经系统(CNS)病毒感染被认为会增加患精神分裂症的风险。在芬兰北部1966年出生队列中,分析了精神分裂症及其他精神病与儿童期中枢神经系统感染之间的关联,本文呈现了截至1994年底和1997年底的随访结果。关于感染的数据是在1966 - 1980年间前瞻性收集的,而精神病数据则从1982年开始收集。已登记的精神病诊断依据《精神疾病诊断与统计手册》第三版修订版(DSM - III - R)分类进行验证。在11017名受试者(占该年所有出生人数的96%)中,有145人在儿童期遭受过中枢神经系统感染,其中102例为病毒感染。到1994年底的随访中,有76人患精神分裂症,到1997年底这一数字增至100人。此外,到1994年底,有52名患者患有非精神分裂症性精神病。精神分裂症患者组中有4例曾患病毒性中枢神经系统感染,而其他精神病患者中无人有此经历。精神分裂症病例中无人曾患细菌性感染,其他精神病患者中有2人曾患细菌性感染。在到1994年底的随访中,病毒性中枢神经系统感染后患精神分裂症的校正比值比为4.8(95%置信区间[CI] 1.6 - 14.0),到1997年底的随访中为2.5(0.9 - 7.0)。有或无中枢神经系统感染的精神分裂症患者在临床病程变量方面并无差异。我们的结果表明,儿童期病毒性中枢神经系统感染可能是精神分裂症的一个风险因素。由于其相对罕见,它们在人群层面的作用可能较小。