Fryers Tom, Brugha Traolach
International and Public Health, School of Health Sciences, New York Medical College, USA ; Department of Health Sciences, University of Leicester, UK.
Clin Pract Epidemiol Ment Health. 2013;9:1-50. doi: 10.2174/1745017901309010001. Epub 2013 Feb 22.
The aim of this project was to assess the current evidence from longitudinal studies for childhood determinants of adult mental illness. Because of the variable and often prolonged period between factors in childhood and the identification of mental illness in adults, prospective studies, particularly birth cohorts, offer the best chance of demonstrating associations in individuals. A review was undertaken in 2006 of the published literature from longitudinal studies, together with some large-scale retrospective studies and relevant reviews which provided supplementary evidence. The main focus was upon potentially ameliorable characteristics, experiences or situations of childhood; however, other factors, not determinants but pre-cursors, associated with later mental illness could not be left out. Seven major electronic data-bases of published research were interrogated with a range of key-words and the results supplemented from personal searches, enquiries and reference trails. In excess of 1,500 abstracts were read to select 250 papers for full review. The material was assessed in relation to ten factors: Psychological disturbance; Genetic Influences; Neurological Deviance; Neuroticism; Behaviour; School Performance; Adversity; Child Abuse or Neglect; Parenting and parent-child relationships; Disrupted and Disfunctional Families. In 2011 the search was repeated for the period 2006 to mid-2011, using the same search terms and supplemented in the same manner. Over 1,800 abstracts emerged and almost 200 papers selected for more detailed review. These were then integrated into the original text with modifications where necessary. The whole text was then revised and edited in January / February 2012. There is continuing evidence for the association with later mental ill-health for each of these ten factors, but with different degrees of conviction. The evidence for each is discussed in detail and weighed both separately and in relation to others. These are then summarised, and the research implications are considered. Finally, the implications for prevention are discussed together with the practical potential for preventive and health-promoting programmes.
本项目的目的是评估纵向研究关于成年期精神疾病童年期决定因素的现有证据。由于童年期因素与成年期精神疾病确诊之间存在变数且往往间隔时间较长，前瞻性研究，尤其是出生队列研究，最有可能证明个体之间的关联。2006年对纵向研究的已发表文献以及一些大规模回顾性研究和提供补充证据的相关综述进行了回顾。主要关注童年期潜在可改善的特征、经历或状况；然而，与后期精神疾病相关的其他因素，虽不是决定因素而是先兆因素，也不能被忽视。通过一系列关键词检索了七个主要已发表研究的电子数据库，并通过个人搜索、咨询和参考文献追踪对结果进行补充。阅读了超过1500篇摘要，从中挑选出250篇论文进行全面审查。根据十个因素对材料进行了评估：心理障碍；遗传影响；神经偏差；神经质；行为；学业成绩；逆境；虐待或忽视儿童；养育方式及亲子关系；破裂和功能失调的家庭。2011年，使用相同的检索词并以相同方式进行补充，对2006年至2011年年中期间进行了重复检索。出现了超过1800篇摘要，挑选了近200篇论文进行更详细的审查。然后在必要时进行修改后将这些内容整合到原文中。然后在2012年1月/2月对全文进行了修订和编辑。有持续证据表明这十个因素中的每一个都与后期精神健康不良有关，但确信程度不同。对每个因素的证据进行了详细讨论，并分别以及相互关联地进行了权衡。然后对这些进行了总结，并考虑了研究意义。最后，讨论了预防的意义以及预防和促进健康计划的实际潜力。
