感染性、特应性和炎症性疾病、儿童期逆境和家族聚集性与精神障碍风险独立相关：一项大型瑞士流行病学研究的结果
Infectious, atopic and inflammatory diseases, childhood adversities and familial aggregation are independently associated with the risk for mental disorders: Results from a large Swiss epidemiological study.
作者信息
Ajdacic-Gross Vladeta, Aleksandrowicz Aleksandra, Rodgers Stephanie, Mutsch Margot, Tesic Anja, Müller Mario, Kawohl Wolfram, Rössler Wulf, Seifritz Erich, Castelao Enrique, Strippoli Marie-Pierre F, Vandeleur Caroline, von Känel Roland, Paolicelli Rosa, Landolt Markus A, Witthauer Cornelia, Lieb Roselind, Preisig Martin
机构信息
Vladeta Ajdacic-Gross, Aleksandra Aleksandrowicz, Stephanie Rodgers, Anja Tesic, Mario Müller, Wolfram Kawohl, Wulf Rössler, Erich Seifritz, Department of Psychiatry, Psychotherapy and Psychosomatics, Psychiatric Hospital, University of Zurich, 8021 Zurich, Switzerland.
出版信息
World J Psychiatry. 2016 Dec 22;6(4):419-430. doi: 10.5498/wjp.v6.i4.419.
AIM
To examine the associations between mental disorders and infectious, atopic, inflammatory diseases while adjusting for other risk factors.
METHODS
We used data from PsyCoLaus, a large Swiss Population Cohort Study ( = 3720; age range 35-66). Lifetime diagnoses of mental disorders were grouped into the following categories: Neurodevelopmental, anxiety (early and late onset), mood and substance disorders. They were regressed on infectious, atopic and other inflammatory diseases adjusting for sex, educational level, familial aggregation, childhood adversities and traumatic experiences in childhood. A multivariate logistic regression was applied to each group of disorders. In a complementary analysis interactions with sex were introduced nested effects.
RESULTS
Associations with infectious, atopic and other chronic inflammatory diseases were observable together with consistent effects of childhood adversities and familial aggregation, and less consistent effects of trauma in each group of mental disorders. Streptococcal infections were associated with neurodevelopmental disorders (men), and measles/mumps/rubella-infections with early and late anxiety disorders (women). Gastric inflammatory diseases took effect in mood disorders (both sexes) and in early disorders (men). Similarly, irritable bowel syndrome was prominent in a sex-specific way in mood disorders in women, and, moreover, was associated with early and late anxiety disorders. Atopic diseases were associated with late anxiety disorders. Acne (associations with mood disorders in men) and psoriasis (associations with early anxiety disorders in men and mood disorders in women) contributed sex-specific results. Urinary tract infections were associated with mood disorders and, in addition, in a sex-specific way with late anxiety disorders (men), and neurodevelopmental and early anxiety disorders (women).
CONCLUSION
Infectious, atopic and inflammatory diseases are important risk factors for all groups of mental disorders. The sexual dimorphism of the associations is pronounced.
目的
在调整其他风险因素的同时，研究精神障碍与感染性、特应性、炎症性疾病之间的关联。
方法
我们使用了来自瑞士大型人群队列研究PsyCoLaus的数据（n = 3720；年龄范围35 - 66岁）。精神障碍的终生诊断分为以下几类：神经发育障碍、焦虑症（早发性和晚发性）、情绪障碍和物质使用障碍。针对感染性、特应性和其他炎症性疾病进行回归分析，并对性别、教育水平、家族聚集性、童年逆境和童年创伤经历进行调整。对每组障碍应用多变量逻辑回归分析。在一项补充分析中，引入了与性别的交互作用（嵌套效应）。
结果
在每组精神障碍中，均可观察到与感染性、特应性和其他慢性炎症性疾病的关联，以及童年逆境和家族聚集性的一致影响，而创伤的影响则不太一致。链球菌感染与神经发育障碍相关（男性），麻疹/腮腺炎/风疹感染与早发性和晚发性焦虑症相关（女性）。胃部炎症性疾病对情绪障碍（男女均有）和早发性障碍（男性）有影响。同样，肠易激综合征在女性情绪障碍中以性别特异性方式显著，此外，还与早发性和晚发性焦虑症相关。特应性疾病与晚发性焦虑症相关。痤疮（与男性情绪障碍相关）和银屑病（与男性早发性焦虑症和女性情绪障碍相关）产生了性别特异性结果。尿路感染与情绪障碍相关，此外，还以性别特异性方式与晚发性焦虑症（男性）、神经发育障碍和早发性焦虑症（女性）相关。
结论
感染性、特应性和炎症性疾病是所有精神障碍组的重要风险因素。这些关联的性别差异很明显。
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