精神分裂症患者后代学业成绩不佳：机制是什么？
Poor school performance in offspring of patients with schizophrenia: what are the mechanisms?
机构信息
Department of Epidemiology and Public Health, National University of Singapore, Singapore.
出版信息
Psychol Med. 2012 Jan;42(1):111-23. doi: 10.1017/S0033291711001127. Epub 2011 Jul 7.
BACKGROUND
Offspring of patients with schizophrenia exhibit poorer school performance compared with offspring of non-schizophrenic parents. We aimed to elucidate the mechanisms behind this association.
METHOD
We linked longitudinal national population registers in Sweden and compared school performance among offspring of schizophrenic parents with offspring of non-schizophrenic parents (1 439 215 individuals with final grades from compulsory school 1988-2006). To investigate the mechanisms, we studied offspring of schizophrenic patients and controls within the same extended families. We investigated genetic effects by stratifying analyses of parent-child associations according to genetic relatedness (half-cousins, full cousins and half-siblings). Environmental effects were investigated by comparing school performance of offspring of schizophrenic fathers and of schizophrenic mothers, respectively, and by stratifying the analyses according to environmental relatedness while controlling genetic relatedness (paternal and maternal half-cousins, paternal and maternal half-siblings).
RESULTS
Offspring of parents with schizophrenia had poorer overall school performance than unrelated offspring of non-schizophrenic parents (-0.31 s.d.). Variability in genetic relatedness greatly moderated the strength of the within-family association (β=-0.23 within exposure-discordant half-cousins, β=-0.13 within exposure-discordant full cousins, β=0.04 within exposure-discordant half-siblings), while no evidence was found that the environment affected offspring school performance.
CONCLUSIONS
Genetic factors account for poorer school performance in children of parents with schizophrenia. This supports that cognitive deficits found in individuals with schizophrenia and their relatives might be genetically inherited. Early detection of prodromal signs and impaired functioning of offspring of patients with schizophrenia could lead to earlier and better tailored interventions.
背景
与非精神分裂症父母的子女相比，精神分裂症患者的子女在校表现较差。我们旨在阐明这种关联的背后机制。
方法
我们在瑞典将纵向全国人口登记处进行了关联，并比较了精神分裂症父母的子女与非精神分裂症父母的子女（1439215 名个体，1988-2006 年完成义务教育的最终成绩）在校表现。为了研究这些机制，我们在同一大家庭内研究了精神分裂症患者子女和对照组。我们通过根据遗传相关性（半表亲、全表亲、半同胞）对亲子关联的分层分析来研究遗传效应。我们通过比较精神分裂症父亲和母亲的子女的在校表现，以及在控制遗传相关性的同时根据环境相关性对分析进行分层（父亲和母亲的半表亲、父亲和母亲的半同胞），来研究环境效应。
结果
与非精神分裂症父母的无血缘关系子女相比，父母患有精神分裂症的子女总体在校表现较差（-0.31 个标准差）。遗传相关性的变异性极大地调节了家庭内关联的强度（在暴露不一致的半表亲中为-0.23，在暴露不一致的全表亲中为-0.13，在暴露不一致的半同胞中为 0.04），而没有证据表明环境会影响子女的学业成绩。
结论
遗传因素导致精神分裂症患者子女的在校表现较差。这支持了在精神分裂症患者及其亲属中发现的认知缺陷可能是遗传继承的观点。早期发现患者子女的前驱症状和功能受损可能会导致更早和更有针对性的干预。
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