Foley Debra L, Mackinnon Andrew, Morgan Vera A, Watts Gerald F, Castle David J, Waterreus Anna, Galletly Cherrie A
Orygen - The National Centre of Excellence in Youth Mental Health and Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia
Orygen - The National Centre of Excellence in Youth Mental Health and Centre for Youth Mental Health, The University of Melbourne, Melbourne, VIC, Australia.
Aust N Z J Psychiatry. 2016 May;50(5):488-94. doi: 10.1177/0004867415595715. Epub 2015 Jul 24.
The co-occurrence of type 2 diabetes and psychosis is an important form of medical comorbidity within individuals, but no large-scale study has evaluated comorbidity within families. The aim of this study was to determine whether there is evidence for familial comorbidity between type 2 diabetes and psychosis.
Data were analysed from an observational study of a nationally representative sample of 1642 people with psychosis who were in contact with psychiatric services at the time of survey (The 2010 Australian National Survey of Psychosis). Participants were aged 18-64 years and met World Health Organization's International Classification of Diseases, 10th Revision diagnostic criteria for a psychotic disorder (857 with schizophrenia, 319 with bipolar disorder with psychotic features, 293 with schizoaffective disorder, 81 with depressive psychosis and 92 with delusional disorder or other non-organic psychoses). Logistic regression was used to estimate the association between a family history of diabetes and a family history of schizophrenia.
A positive family history of diabetes was associated with a positive family history of schizophrenia in those with a psychotic disorder (odds ratio = 1.35, p = 0.01, adjusted for age and gender). The association was different in those with an affective versus non-affective psychosis (odds ratio = 0.613, p = 0.019, adjusted for age and gender) and was significant only in those with a non-affective psychosis, specifically schizophrenia (odds ratio = 1.58, p = 0.005, adjusted for age and sex). Adjustment for demographic factors in those with schizophrenia slightly strengthened the association (odds ratio = 1.74, p = 0.001, adjusted for age, gender, diagnosis, ethnicity, education, employment, income and marital status).
Elevated risk for type 2 diabetes in people with schizophrenia is not simply a consequence of antipsychotic medication; type 2 diabetes and schizophrenia share familial risk factors.
2型糖尿病与精神病共病是个体中一种重要的医学合并症形式，但尚无大规模研究评估家庭内的合并症情况。本研究的目的是确定2型糖尿病与精神病之间是否存在家族性合并症的证据。
对一项观察性研究的数据进行分析，该研究样本为1642名有精神病的人，具有全国代表性，在调查时与精神科服务机构有接触（2010年澳大利亚全国精神病调查）。参与者年龄在18 - 64岁之间，符合世界卫生组织《疾病和有关健康问题的国际统计分类》第十次修订版精神病性障碍诊断标准（857例精神分裂症、319例伴有精神病性特征的双相情感障碍、293例分裂情感性障碍、81例抑郁性精神病以及92例妄想性障碍或其他非器质性精神病）。采用逻辑回归来估计糖尿病家族史与精神分裂症家族史之间的关联。
在患有精神病性障碍的人群中，糖尿病家族史阳性与精神分裂症家族史阳性相关（比值比 = 1.35，p = 0.01，经年龄和性别校正）。在伴有情感性与非情感性精神病的人群中，该关联有所不同（比值比 = 0.613，p = 0.019，经年龄和性别校正），且仅在患有非情感性精神病（特别是精神分裂症）的人群中显著（比值比 = 1.58，p = 0.005，经年龄和性别校正）。对精神分裂症患者的人口统计学因素进行校正后，该关联略有增强（比值比 = 1.74，p = 0.001，经年龄、性别、诊断、种族、教育程度、就业情况、收入及婚姻状况校正）。
精神分裂症患者患2型糖尿病风险升高并非仅仅是抗精神病药物所致；2型糖尿病和精神分裂症存在家族性风险因素。
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