Daniels Julie L, Forssen Ulla, Hultman Christina M, Cnattingius Sven, Savitz David A, Feychting Maria, Sparen Par
Department of Epidemiology, CB 7435, University of North Carolina, Chapel Hill, NC 27599-7435, USA.
Pediatrics. 2008 May;121(5):e1357-62. doi: 10.1542/peds.2007-2296.
Autism is a developmental disorder defined by impaired social interaction, communication, and behavior. Causes and correlates of autism are largely unknown, but elevated frequencies of psychiatric disorders and distinct personality traits have been reported among the family members of individuals with autism. Linkage of data from Swedish registries was used to investigate whether hospitalization for psychiatric conditions was higher among parents of children with autism compared with control subjects.
Data sources included the Swedish Medical Birth Register (child's birth), the Swedish Multi-Generation Register (linking parents to children), and Swedish Hospital Discharge Register (hospitalization records). Children born between 1977 and 2003 who had a hospitalization record indicating autism before 10 years of age (n = 1227) were matched with 30,693 control subjects from the Swedish Medical Birth Register by gender, year of birth, and hospital. Parent diagnoses were based on an inpatient hospital diagnostic evaluation and included schizophrenia, other nonaffective psychoses, affective disorders, neurotic and personality disorders and other nonpsychotic disorders, alcohol and drug addiction and abuse, and autism. Odds ratios and 95% confidence intervals were estimated by using conditional logistic regression, adjusted for child's age, gender, hospital of birth, parents' age, country of birth and socioeconomic status, and diagnosis of a mental disorder in the other parent.
Parents of children with autism were more likely to have been hospitalized for a mental disorder than parents of control subjects. Schizophrenia was more common among case mothers and fathers compared with respective control parents. Depression and personality disorders were more common among case mothers but not fathers. CONCLUSIONS; This large population study supports the potential for familial aggregation of psychiatric conditions that may provide leads for future investigations of heritable forms of autism.
自闭症是一种发育障碍,其特征为社交互动、沟通及行为受损。自闭症的病因及相关因素大多未知,但据报道,自闭症患者的家庭成员中精神疾病的发病率较高,且具有独特的人格特质。利用瑞典登记处的数据进行关联研究,以调查自闭症儿童的父母因精神疾病住院的比例是否高于对照组。
数据来源包括瑞典医学出生登记处(儿童出生信息)、瑞典多代登记处(将父母与子女关联起来)以及瑞典医院出院登记处(住院记录)。1977年至2003年间出生、10岁前有自闭症住院记录的儿童(n = 1227),按性别、出生年份和医院与瑞典医学出生登记处的30693名对照对象进行匹配。父母的诊断基于住院诊断评估,包括精神分裂症、其他非情感性精神病、情感障碍、神经症和人格障碍以及其他非精神病性障碍、酒精和药物成瘾及滥用,以及自闭症。采用条件逻辑回归估计比值比和95%置信区间,并对儿童年龄、性别、出生医院、父母年龄、出生国家和社会经济地位以及另一方父母的精神障碍诊断进行调整。
自闭症儿童的父母因精神障碍住院的可能性高于对照组父母。与各自的对照父母相比,精神分裂症在自闭症儿童的母亲和父亲中更为常见。抑郁症和人格障碍在自闭症儿童的母亲中更为常见,但在父亲中并非如此。结论:这项大规模人群研究支持精神疾病存在家族聚集性的可能性,这可能为未来遗传性自闭症的研究提供线索。