Department of Public Finance, National Taipei University, Taipei, Taiwan.
Compr Psychiatry. 2010 May-Jun;51(3):250-5. doi: 10.1016/j.comppsych.2009.07.004. Epub 2009 Aug 27.
The objective of this study was to investigate the incidence of mortality risk among children of parents with mental illness.
The study sample comprised all women giving birth in Taiwan between 1999 and 2001; the dataset was created by linking birth certificate, death certificate, and National Health Insurance research databases. The deaths of the subjects were classified into 5 groups: stillbirths, early neonatal death, late neonatal death, postneonatal death, and early childhood death. A Cox proportional hazard regression was then performed on a pooled 3-year population-based dataset to examine the relationship between parental mental status and survival rates for children younger than 3 years, with the crude and adjusted hazard ratios (HRs) being calculated.
Around 2316 affected children were compared with a general population of 605 107. No stillbirths were observed among any children of parents with schizophrenia or affective disorder. Mothers with affective disorder are prone to higher risk of child death, with a crude HR of 4.86 (95% confidence interval, 3.06-7.73), and a reduced adjusted HR of 3.51 (95% confidence interval, 2.22-5.57). However, fathers with affective disorder played no role. Children born to schizophrenic women have a significant higher risk of child death with a crude HR of 2.47, whereas those born to schizophrenic fathers have a similarly high risk with a crude HR of 2.69.
A focus needs to be placed on the identification and treatment of parental schizophrenia and affective disorder through antenatal and postnatal intervention, so as to reduce mortality risks for children exposed to risk during their first 3 years of life.
本研究旨在探讨父母患有精神疾病的儿童的死亡率风险。
研究样本包括 1999 年至 2001 年期间在台湾分娩的所有女性;数据集通过链接出生证明、死亡证明和国家健康保险研究数据库创建。将研究对象的死亡分为 5 组:死产、早期新生儿死亡、晚期新生儿死亡、新生儿后死亡和婴幼儿早期死亡。然后对一个汇集的 3 年基于人群的数据集进行 Cox 比例风险回归,以检验父母精神状态与 3 岁以下儿童生存率之间的关系,计算粗死亡率和调整后的危险比(HRs)。
大约 2316 名受影响的儿童与一般人群 605107 人进行了比较。精神分裂症或情感障碍父母的任何孩子都没有观察到死产。患有情感障碍的母亲更有可能导致孩子死亡,粗 HR 为 4.86(95%置信区间,3.06-7.73),调整后的 HR 降低至 3.51(95%置信区间,2.22-5.57)。然而,患有情感障碍的父亲则没有作用。患有精神分裂症的女性所生的孩子死亡风险显著增加,粗 HR 为 2.47,而患有精神分裂症的父亲所生的孩子死亡风险也同样较高,粗 HR 为 2.69。
需要通过产前和产后干预来关注识别和治疗父母的精神分裂症和情感障碍,以降低暴露于风险的儿童在前 3 年的死亡率风险。