Fisher Helen L, McGuffin Peter, Boydell Jane, Fearon Paul, Craig Thomas K, Dazzan Paola, Morgan Kevin, Doody Gillian A, Jones Peter B, Leff Julian, Murray Robin M, Morgan Craig
MRC Social Genetic & Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, UK;
Psychosis Studies, Institute of Psychiatry, King's College London, London, UK;
Schizophr Bull. 2014 Nov;40(6):1443-51. doi: 10.1093/schbul/sbt201. Epub 2014 Jan 7.
Childhood abuse is considered one of the main environmental risk factors for the development of psychotic symptoms and disorders. However, this association could be due to genetic factors influencing exposure to such risky environments or increasing sensitivity to the detrimental impact of abuse. Therefore, using a large epidemiological case-control sample, we explored the interplay between a specific form of childhood abuse and family psychiatric history (a proxy for genetic risk) in the onset of psychosis.
Data were available on 172 first presentation psychosis cases and 246 geographically matched controls from the Aetiology and Ethnicity of Schizophrenia and Other Psychoses study. Information on childhood abuse was obtained retrospectively using the Childhood Experience of Care and Abuse Questionnaire and occurrence of psychotic and affective disorders in first degree relatives with the Family Interview for Genetic Studies.
Parental psychosis was more common among psychosis cases than unaffected controls (adjusted OR = 5.96, 95% CI: 2.09-17.01, P = .001). Parental psychosis was also associated with physical abuse from mothers in both cases (OR = 3.64, 95% CI: 1.06-12.51, P = .040) and controls (OR = 10.93, 95% CI: 1.03-115.90, P = .047), indicative of a gene-environment correlation. Nevertheless, adjusting for parental psychosis did not measurably impact on the abuse-psychosis association (adjusted OR = 3.31, 95% CI: 1.22-8.95, P = .018). No interactions were found between familial liability and maternal physical abuse in determining psychosis caseness.
This study found no evidence that familial risk accounts for associations between childhood physical abuse and psychotic disorder nor that it substantially increases the odds of psychosis among individuals reporting abuse.
儿童期虐待被认为是导致精神病症状和障碍的主要环境风险因素之一。然而，这种关联可能是由于遗传因素影响了个体接触此类风险环境，或增加了对虐待有害影响的敏感性。因此，我们利用一个大型流行病学病例对照样本，探讨了一种特定形式的儿童期虐待与家族精神病史（遗传风险的一个指标）在精神病发病中的相互作用。
我们从精神分裂症及其他精神病的病因与种族研究中获取了172例首发精神病病例和246例地理匹配对照的数据。使用儿童期照料与虐待问卷回顾性获取儿童期虐待信息，并通过遗传研究家族访谈获取一级亲属中精神病和情感障碍的发生情况。
精神病病例中父母患精神病的情况比未受影响的对照更为常见（调整后的比值比 = 5.96，95%置信区间：2.09 - 17.01，P = 0.001）。父母患精神病也与病例组（比值比 = 3.64，95%置信区间：1.06 - 12.51，P = 0.040）和对照组（比值比 = 10.93，95%置信区间：1.03 - 115.90，P = 0.047）中来自母亲的身体虐待相关，这表明存在基因 - 环境相关性。然而，对父母患精神病进行调整并没有显著影响虐待与精神病之间的关联（调整后的比值比 = 3.31，95%置信区间：1.22 - 8.95，P = 0.018）。在确定精神病病例状态时，未发现家族易感性与母亲身体虐待之间存在相互作用。
本研究未发现证据表明家族风险可解释儿童期身体虐待与精神病性障碍之间的关联，也未发现其显著增加报告有虐待经历个体患精神病的几率。
