Suvisaari J, Häkkinen L, Haukka J, Lönnqvist J
Department of Mental Health and Alcohol Research, National Public Health Institute, Helsinki, Finland.
Psychol Med. 2008 Aug;38(8):1203-10. doi: 10.1017/S0033291707002383. Epub 2007 Nov 30.
Previous studies suggest that offspring of mothers with psychotic disorders have an almost two-fold higher mortality risk from birth until early adulthood. We investigated predictors of mortality from late adolescence until middle age in offspring of mothers with psychotic disorders.
The Helsinki High-Risk Study follows up offspring (n=337) of women treated for schizophrenia spectrum disorders in mental hospitals in Helsinki before 1975. Factors related to mortality up to 2005 among offspring of these mothers was investigated with a survival model. Hazard rate ratios (HRR) were calculated using sex, diagnosis of psychotic disorder, childhood socio-economic status, maternal diagnosis, and maternal suicide attempts and aggressive symptoms as explanatory variables. The effect of family was investigated by including a frailty term in the model. We also compared mortality between the high-risk group and the Finnish general population.
Within the high-risk group, females had lower all-cause mortality (HRR 0.43, p=0.05) and mortality from unnatural causes (HRR 0.24, p=0.03) than males. Having themselves been diagnosed with a psychotic disorder was associated with higher mortality from unnatural causes (HRR 4.76, p=0.01), while maternal suicide attempts were associated with higher suicide mortality (HRR 8.64, p=0.03). Mortality in the high-risk group was over two-fold higher (HRR 2.44, p<0.0001) than in the general population, and remained significantly higher when high-risk offspring who later developed psychotic disorders were excluded from the study sample (HRR 2.30, p<0.0001).
Offspring of mothers with psychotic disorder are at increased risk of several adverse outcomes, including premature death.
先前的研究表明，患有精神疾病的母亲的子女从出生到成年早期的死亡风险几乎高出两倍。我们调查了患有精神疾病的母亲的子女从青春期后期到中年的死亡预测因素。
赫尔辛基高危研究对1975年前在赫尔辛基精神病院接受精神分裂症谱系障碍治疗的女性的后代（n = 337）进行了随访。使用生存模型研究了这些母亲的后代在2005年前与死亡相关的因素。以性别、精神疾病诊断、童年社会经济地位、母亲诊断、母亲自杀未遂和攻击症状作为解释变量计算风险率比（HRR）。通过在模型中纳入脆弱项来研究家庭的影响。我们还比较了高危组与芬兰普通人群之间的死亡率。
在高危组中，女性的全因死亡率（HRR 0.43，p = 0.05）和非自然原因死亡率（HRR 0.24，p = 0.03）低于男性。自身被诊断患有精神疾病与非自然原因导致的较高死亡率相关（HRR 4.76，p = 0.），而母亲自杀未遂与较高的自杀死亡率相关（HRR 8.64，p = 0.03）。高危组的死亡率比普通人群高出两倍多（HRR 2.44，p < 0.0001），当将后来患精神疾病的高危后代从研究样本中排除后，死亡率仍显著较高（HRR 2.30，p < 0.0001）。
患有精神疾病的母亲的子女出现包括过早死亡在内的多种不良后果的风险增加。
