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所有儿童和青少年精神障碍后精神分裂症风险增加:一项全国性研究

Risk of Schizophrenia Increases After All Child and Adolescent Psychiatric Disorders: A Nationwide Study.

作者信息

Maibing Cecilie Frejstrup, Pedersen Carsten Bøcker, Benros Michael Eriksen, Mortensen Preben Bo, Dalsgaard Søren, Nordentoft Merete

机构信息

Mental Health Centre Copenhagen, University of Copenhagen, Copenhagen, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Denmark;

Mental Health Centre Copenhagen, University of Copenhagen, Copenhagen, Denmark; National Centre for Register-Based Research, Aarhus University, Aarhus, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Denmark;

出版信息

Schizophr Bull. 2015 Jul;41(4):963-70. doi: 10.1093/schbul/sbu119. Epub 2014 Sep 5.

Abstract

OBJECTIVE

Earlier smaller studies have shown associations between child and adolescent psychiatric disorders and schizophrenia. Particularly, attention-deficit/hyperactivity-disorder and autism have been linked with schizophrenia. However, large-scale prospective studies have been lacking. We, therefore, conducted the first large-scale study on the association between a broad spectrum of child and adolescent psychiatric disorders and the risk of being diagnosed with schizophrenia.

METHODS

Danish nationwide registers were linked to establish a cohort consisting of all persons born during 1990-2000 and the cohort was followed until December 31, 2012. Data were analyzed using survival analyses and adjusted for calendar year, age, and sex.

RESULTS

A total of 25138 individuals with child and adolescent psychiatric disorders were identified, out of which 1232 individuals were subsequently diagnosed with schizophrenia spectrum disorders. The risk of schizophrenia spectrum disorders was highly elevated, particularly within the first year after onset of the child and adolescent psychiatric disorder, and remained significantly elevated >5 years with an incidence rate ratio of 4.93 (95% confidence interval: 4.37-5.54).We utilized the cumulated incidences and found that among persons diagnosed with a child and adolescent psychiatric disorder between the ages 0-13 years and 14-17 years, 1.68% and 8.74 %, respectively, will be diagnosed with a schizophrenia spectrum disorder <8 years after onset of the child and adolescent psychiatric disorder.

CONCLUSIONS

The risk of being diagnosed with schizophrenia spectrum disorders after a child and adolescent psychiatric disorder was significantly increased particularly in the short term but also in the long-term period.

摘要

目的

早期的小规模研究表明儿童和青少年精神障碍与精神分裂症之间存在关联。特别是,注意力缺陷多动障碍和自闭症与精神分裂症有关。然而,缺乏大规模的前瞻性研究。因此,我们开展了第一项关于广泛的儿童和青少年精神障碍与被诊断为精神分裂症风险之间关联的大规模研究。

方法

将丹麦全国登记册相链接,建立一个由1990年至2000年出生的所有人组成的队列,并对该队列进行随访直至2012年12月31日。使用生存分析对数据进行分析,并对历年、年龄和性别进行调整。

结果

共识别出25138名患有儿童和青少年精神障碍的个体,其中1232人随后被诊断为精神分裂症谱系障碍。精神分裂症谱系障碍的风险大幅升高,尤其是在儿童和青少年精神障碍发病后的第一年,并且在5年以上仍显著升高,发病率比为4.93(95%置信区间:4.37 - 5.54)。我们利用累积发病率发现,在0至13岁和14至17岁被诊断患有儿童和青少年精神障碍的人群中,分别有1.68%和8.74%将在儿童和青少年精神障碍发病后8年内被诊断为精神分裂症谱系障碍。

结论

儿童和青少年精神障碍后被诊断为精神分裂症谱系障碍的风险显著增加,特别是在短期内,但在长期内也是如此。

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