de Sousa Paulo, Varese Filippo, Sellwood William, Bentall Richard P
Institute of Psychology, Health and Society, University of Liverpool, Liverpool, UK;
Division of Clinical Psychology, School of Psychological Sciences, University of Manchester, Manchester, UK.
Schizophr Bull. 2014 Jul;40(4):756-68. doi: 10.1093/schbul/sbt088. Epub 2013 Jun 25.
Parental communication deviance (CD) has long been suggested as a potential risk factor for the development of psychosis and thought disorder in genetically sensitive offspring. However, the findings of the studies on the prevalence of CD in parents of psychotic patients have never been submitted to quantitative synthesis.
PsycINFO was searched from January 1959 to January 2012 for studies on the prevalence of CD in parents of psychotic patients. This search was supplemented with the results from a much larger systematic search (PsycINFO, PubMed, EMBASE, and Web of Science) on childhood trauma and psychosis.
A total of 20 retrieved studies (n = 1753 parents) yielded a pooled g of large magnitude (0.97; 95% CI [0.76; 1.18]) with a significant amount of heterogeneity (Q = 33.63; P = .014; I (2) = 46.47). Subgroup and sensitivity analysis of methodological features (study's design, comparison group, diagnostic criteria, CD rating method, inter-rater reliability not reported, year of publication, and verbosity) and demographic characteristics (level of education or offspring's age) revealed that pooled effect size was stable and unlikely to have been affected by these features.
CD is highly prevalent in parents of psychotic offspring. This is discussed in the broader context of adoption and longitudinal studies that have reported a G × E interaction in the development of psychosis and thought disorder. A potential developmental mechanism is suggested to explain how CD may affect the developing offspring. The importance of further studies on CD and its potential value as a clinical concept are discussed.
长期以来，父母沟通偏差（CD）一直被认为是遗传易感性后代发生精神病和思维障碍的潜在危险因素。然而，关于精神病患者父母中CD患病率的研究结果从未进行过定量综合分析。
检索了1959年1月至2012年1月的PsycINFO数据库，以查找关于精神病患者父母中CD患病率的研究。此次检索还补充了一项关于儿童期创伤与精神病的规模大得多的系统检索（PsycINFO、PubMed、EMBASE和科学引文索引）的结果。
总共检索到20项研究（n = 1753名父母），合并效应量g值较大（0.97；95%可信区间[0.76；1.18]），且存在显著异质性（Q = 33.63；P = 0.014；I² = 46.47）。对方法学特征（研究设计、对照组、诊断标准、CD评分方法、未报告的评分者间信度、发表年份和详细程度）和人口统计学特征（教育水平或后代年龄）进行亚组分析和敏感性分析后发现，合并效应量稳定，不太可能受这些特征影响。
CD在患有精神病后代的父母中高度流行。这在收养研究和纵向研究的更广泛背景下进行了讨论，这些研究报告了精神病和思维障碍发展过程中的基因×环境相互作用。提出了一种潜在的发育机制来解释CD可能如何影响发育中的后代。讨论了对CD进一步研究的重要性及其作为临床概念的潜在价值。
