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青少年扩展型精神病表型发展中的早期创伤和家族风险。

Early trauma and familial risk in the development of the extended psychosis phenotype in adolescence.

机构信息

Department of Interdisciplinary Social Science, University of Utrecht, the Netherlands.

出版信息

Acta Psychiatr Scand. 2012 Oct;126(4):266-73. doi: 10.1111/j.1600-0447.2012.01857.x. Epub 2012 Apr 6.

Abstract

OBJECTIVE

Both genetic and environmental factors are thought to play a role in the development of psychotic outcomes; however, their respective contributions over time, including possible developmental interactions, remain largely unknown.

METHOD

The contribution of parental general and psychotic psychopathology as proxies of genetic risk to the development of subthreshold psychosis and its hypothesized interaction with childhood trauma were studied in a general population sample of 2230 adolescents, followed from age 10-16 years. Outcome measures were: i) level of psychotic experiences at age 16 years and ii) persistence of such experiences over the total follow-up period.

RESULTS

General parental psychopathology was associated with CAPE score (OR = 1.08; P < 0.043 for highest quintile) and suggestively predicted psychosis persistence (OR, 1.16; P < 0.072). Psychotic parental psychopathology was suggestively associated with CAPE score (OR, 2.25; P < 0.063 for highest quintile), predicted membership of the Persistent group (OR, 3.72; P < 0.039) and suggestively predicted membership of the Decreasing group (OR 2.04; P < 0.051). Childhood trauma was associated with CAPE score and with all developmental trajectories of subclinical psychosis. No evidence was found for an interaction between trauma and parental psychopathology.

CONCLUSION

The development and persistence of subthreshold psychotic symptoms may be conditional on non-interacting proxy genetic and environmental influences.

摘要

目的

遗传和环境因素被认为在精神分裂症结果的发展中都起着作用;然而,它们各自随时间的贡献,包括可能的发育相互作用,在很大程度上仍然未知。

方法

本研究以 2230 名青少年为研究对象,从 10 岁到 16 岁进行随访,研究了父母一般和精神病性精神病理学作为遗传风险的代表对亚阈值精神病发展的贡献,以及其与儿童创伤的假设相互作用。结果测量为:i)16 岁时的精神病体验水平,ii)在整个随访期间持续存在这种体验。

结果

一般父母的精神病理学与 CAPE 评分相关(OR = 1.08;P < 0.043 为最高五分位数),并提示预测精神病的持续存在(OR,1.16;P < 0.072)。精神病父母的精神病理学与 CAPE 评分呈显著相关(OR,2.25;P < 0.063 为最高五分位数),提示预测持久性组(OR,3.72;P < 0.039)的成员资格,并提示预测下降组(OR 2.04;P < 0.051)的成员资格。儿童创伤与 CAPE 评分以及亚临床精神病的所有发展轨迹都相关。没有发现创伤和父母精神病理学之间存在相互作用的证据。

结论

亚临床精神病症状的发展和持续可能取决于非相互作用的遗传和环境影响的条件。

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