NYU School of Medicine, Dept. of Psychiatry, InSPIRES, NY, USA.
Schizophr Res. 2013 Dec;151(1-3):185-90. doi: 10.1016/j.schres.2013.10.001. Epub 2013 Oct 18.
Advanced paternal age (APA) is associated with increased risk for schizophrenia, but its effect on treatment response has not been longitudinally studied.
Association of parental ages at the time of the child's birth with age of onset, initial symptom severity and treatment response (to placebo and three different weight-based doses of paliperidone ER) in adolescents with schizophrenia was assessed in a post-hoc analysis using data from a 6-week double-blind study, the primary results of which are published (NCT00518323).
The mean (SD) paternal age was 29.2 (6.2) years, range (16-50) and maternal age was 26.8 (5.7) years, range (17-42) at childbirth for the 201 adolescents (ages 12-17 years) included in the analysis. While parental ages were uncorrelated with age of onset or initial symptom severity, both maternal and paternal ages showed significant effects on treatment response (p<0.03) of all paliperidone ER arms versus placebo. Paternal age was significantly correlated to improvement in positive symptoms and maternal age significantly related to negative symptoms, although only paternal age remained significantly associated with the treatment response in analyses that included both parents' ages.
APA was associated with greater treatment response to both paliperidone ER and placebo, but not to age of onset or initial symptom severity in adolescents with schizophrenia. The results support the contention that APA-related schizophrenia has distinct underpinnings from other cases. Further studies are required to explore the role of genetic and environmental factors, and their interactions, in treatment response in this complex disorder.
高龄父亲(Advanced Paternal Age,APA)与精神分裂症风险增加相关,但尚未对其对治疗反应的影响进行纵向研究。
使用来自一项 6 周双盲研究的数据(NCT00518323),对青少年精神分裂症患者的父母生育时的年龄与发病年龄、初始症状严重程度和治疗反应(安慰剂和三种不同体重剂量的帕利哌酮 ER)进行了事后分析。主要研究结果已经发表。
在纳入分析的 201 名青少年(年龄 12-17 岁)中,父亲的平均(SD)年龄为 29.2(6.2)岁,范围(16-50),母亲的年龄为 26.8(5.7)岁,范围(17-42)。虽然父母年龄与发病年龄或初始症状严重程度无关,但母亲和父亲年龄均对所有帕利哌酮 ER 组与安慰剂相比的治疗反应有显著影响(p<0.03)。父亲年龄与阳性症状的改善显著相关,母亲年龄与阴性症状显著相关,但在包括父母双方年龄的分析中,只有父亲年龄与治疗反应仍显著相关。
APA 与青少年精神分裂症患者对帕利哌酮 ER 和安慰剂的治疗反应增加相关,但与发病年龄或初始症状严重程度无关。结果支持 APA 相关精神分裂症与其他病例有不同基础的观点。需要进一步研究以探讨遗传和环境因素及其相互作用在该复杂疾病治疗反应中的作用。