Singh Swaran P, Winsper Catherine, Wolke Dieter, Bryson Alex
University of Warwick, Coventry, UK.
University of Warwick, Coventry, UK.
J Am Acad Child Adolesc Psychiatry. 2014 May;53(5):518-27.e1. doi: 10.1016/j.jaac.2014.01.016. Epub 2014 Feb 13.
Social adversity and urban upbringing increase the risk of psychosis. We tested the hypothesis that these risks may be partly attributable to school mobility and examined the potential pathways linking school mobility to psychotic-like symptoms.
A community sample of 6,448 mothers and their children born between 1991 and 1992 were assessed for psychosocial adversities (i.e., ethnicity, urbanicity, family adversity) from birth to 2 years, school and residential mobility up to 9 years, and peer difficulties (i.e., bullying involvement and friendship difficulties) at 10 years. Psychotic-like symptoms were assessed at age 12 years using the Psychosis-like Symptoms Interview (PLIKSi).
In regression analyses, school mobility was significantly associated with definite psychotic-like symptoms (odds ratio [OR] =1.60; 95% CI =1.07-2.38) after controlling for all confounders. Within path analyses, school mobility (probit coefficient [β] = 0.108; p = .039), involvement in bullying (β = 0.241; p < .001), urbanicity (β = 0.342; p = .016), and family adversity (β = 0.034; p < .001) were all independently associated with definite psychotic-like symptoms. School mobility was indirectly associated with definite psychotic-like symptoms via involvement in bullying (β = 0.018; p = .034).
School mobility is associated with increased risk of psychotic-like symptoms, both directly and indirectly. The findings highlight the potential benefit of strategies to help mobile students to establish themselves within new school environments to reduce peer difficulties and to diminish the risk of psychotic-like symptoms. Awareness of mobile students as a possible high-risk population, and routine inquiry regarding school changes and bullying experiences, may be advisable in mental health care settings.
社会逆境和城市成长环境会增加患精神病的风险。我们检验了这样一种假设，即这些风险可能部分归因于学校流动，并研究了将学校流动与类精神病症状联系起来的潜在途径。
对1991年至1992年出生的6448名母亲及其子女组成的社区样本进行评估，内容包括从出生到2岁的心理社会逆境（即种族、城市化程度、家庭逆境）、到9岁时的学校和居住流动情况，以及10岁时的同伴问题（即受欺凌情况和交友困难）。使用类精神病症状访谈（PLIKSi）在12岁时评估类精神病症状。
在回归分析中，在控制所有混杂因素后，学校流动与明确的类精神病症状显著相关（优势比[OR]=1.60；95%置信区间=1.07 - 2.38）。在路径分析中，学校流动（概率系数[β]=0.108；p = 0.039）、受欺凌情况（β = 0.241；p < 0.001）、城市化程度（β = 0.342；p = 0.016）和家庭逆境（β = 0.034；p < 0.001）均与明确的类精神病症状独立相关。学校流动通过受欺凌情况与明确的类精神病症状间接相关（β = 0.018；p = 0.034）。
学校流动与类精神病症状风险的增加直接和间接相关。研究结果凸显了帮助流动学生在新学校环境中安顿下来以减少同伴问题并降低类精神病症状风险的策略的潜在益处。在精神卫生保健环境中，将流动学生视为可能的高危人群并常规询问学校变动和受欺凌经历可能是明智的。
