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普通人群中的精神病性体验与死亡风险:流行病学集水区研究的24 - 27年随访

Psychotic experiences and risk of death in the general population: 24-27 year follow-up of the Epidemiologic Catchment Area study.

作者信息

Sharifi Vandad, Eaton William W, Wu Li Tzy, Roth Kimberly B, Burchett Bruce M, Mojtabai Ramin

机构信息

Vandad Sharifi, MD, Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA and Department of Psychiatry, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran; William W. Eaton, PhD, Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Li Tzy Wu, ScD, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Duke University Medical Center, Durham, North Carolina, USA; Kimberly B. Roth, MHS, Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Bruce M. Burchett, PhD, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Duke University Medical Center, Durham, North Carolina; Ramin Mojtabai, MD, PhD, MPH, Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA

Vandad Sharifi, MD, Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA and Department of Psychiatry, Roozbeh Hospital, Tehran University of Medical Sciences, Tehran, Iran; William W. Eaton, PhD, Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Li Tzy Wu, ScD, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Duke University Medical Center, Durham, North Carolina, USA; Kimberly B. Roth, MHS, Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA; Bruce M. Burchett, PhD, Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Duke University Medical Center, Durham, North Carolina; Ramin Mojtabai, MD, PhD, MPH, Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland, USA.

出版信息

Br J Psychiatry. 2015 Jul;207(1):30-6. doi: 10.1192/bjp.bp.113.143198. Epub 2015 May 7.

Abstract

BACKGROUND

Psychotic experiences are common in the general population and are associated with adverse psychiatric and social outcomes, even in the absence of a psychotic disorder.

AIMS

To examine the association between psychotic experiences and mortality over a 24-27 year period.

METHOD

We used data on 15 049 adult participants from four sites of the Epidemiologic Catchment Area baseline survey in the USA in the early 1980s, linked to the National Death Index and other sources of vital status up until 2007. Psychotic experiences were assessed by the Diagnostic Interview Schedule.

RESULTS

Lifetime psychotic experiences at baseline (n = 855; weighted prevalence, 5.5%) were significantly associated with all-cause mortality at follow-up after adjustment for sociodemographic characteristics and psychiatric diagnoses, including schizophrenia spectrum disorders (P<0.05). Baseline psychotic experiences were associated with over 5 years' shorter median survival time. Among the underlying causes of death, suicide had a particularly high hazard ratio (9.16, 95% CI 3.19-26.29).

CONCLUSIONS

Future research needs to explore the association of psychotic experiences with physical health and lifestyle factors that may mediate the relationship of psychotic experiences with mortality.

摘要

背景

精神病性体验在普通人群中很常见,即使在没有精神障碍的情况下,也与不良的精神和社会后果相关。

目的

研究24至27年间精神病性体验与死亡率之间的关联。

方法

我们使用了20世纪80年代初美国流行病学集水区基线调查四个地点的15049名成年参与者的数据,并与国家死亡指数及其他生命状况信息来源相链接,直至2007年。通过诊断访谈表评估精神病性体验。

结果

在对社会人口学特征和精神疾病诊断(包括精神分裂症谱系障碍)进行调整后,基线时的终生精神病性体验(n = 855;加权患病率5.5%)与随访时的全因死亡率显著相关(P<0.05)。基线时的精神病性体验与中位生存时间缩短超过5年相关。在潜在死因中,自杀的风险比特别高(9.16,95%可信区间3.19 - 26.29)。

结论

未来的研究需要探索精神病性体验与身体健康及生活方式因素之间的关联,这些因素可能介导精神病性体验与死亡率之间的关系。

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