Paksarian D, Eaton W W, Mortensen P B, Merikangas K R, Pedersen C B
Johns Hopkins Bloomberg School of Public Health,Baltimore,MD,USA.
The National Center For Register-Based Research,Aarhus,Denmark.
Psychol Med. 2015 Oct;45(13):2825-37. doi: 10.1017/S0033291715000781. Epub 2015 May 8.
There is growing interest in the role of childhood adversities, including parental death and separation, in the etiology of psychotic disorders. However, few studies have used prospectively collected data to specifically investigate parental separation across development, or assessed the importance of duration of separation, and family characteristics.
We measured three types of separation not due to death: maternal, paternal, and from both parents, across the ages of 1-15 years among a cohort of 985 058 individuals born in Denmark 1971-1991 and followed to 2011. Associations with narrowly and broadly defined schizophrenia and bipolar disorder in the psychiatric register were assessed in terms of separation occurrence, age of separation, and number of years separated. Interactions with parental history of mental disorder were assessed.
Each type of separation was associated with all three outcomes, adjusting for age, sex, birth period, calendar year, family history of mental disorder, urbanicity at birth and parental age. Number of years of paternal separation was positively associated with both schizophrenia and bipolar disorder. Associations between separation from both parents and schizophrenia were stronger when separation occurred at later ages, while those with bipolar disorder remained stable across development. The first occurrence of paternal separation appeared to increase risk more when it occurred earlier in childhood. Associations differed according to parental history of mental disorder, although in no situation was separation protective.
Effects of parental separation may differ by type, developmental timing and family characteristics. These findings highlight the importance of considering such factors in studies of childhood adversity.
童年逆境，包括父母死亡和分离，在精神障碍病因学中的作用正受到越来越多的关注。然而，很少有研究使用前瞻性收集的数据来专门调查不同发育阶段的父母分离情况，或评估分离持续时间和家庭特征的重要性。
我们对1971年至1991年在丹麦出生并随访至2011年的985058名个体队列，测量了1至15岁期间三种非因死亡导致的分离类型：与母亲分离、与父亲分离以及与父母双方分离。根据分离的发生情况、分离年龄和分离年数，评估了与精神病登记册中狭义和广义定义的精神分裂症和双相情感障碍的关联。还评估了与父母精神障碍病史的相互作用。
在对年龄、性别、出生时期、日历年份、精神障碍家族史、出生时的城市化程度和父母年龄进行调整后，每种分离类型都与所有三种结局相关。父亲分离的年数与精神分裂症和双相情感障碍均呈正相关。父母双方分离与精神分裂症之间的关联在分离发生较晚时更强，而与双相情感障碍的关联在整个发育过程中保持稳定。父亲首次分离在童年早期发生时似乎会增加更多风险。根据父母的精神障碍病史，关联有所不同，尽管在任何情况下分离都没有保护作用。
父母分离的影响可能因类型、发育时间和家庭特征而异。这些发现凸显了在童年逆境研究中考虑这些因素的重要性。
