School of Psychological Science, University of Bristol, Bristol, UK.
MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK.
Eur Child Adolesc Psychiatry. 2019 Aug;28(8):1079-1086. doi: 10.1007/s00787-018-1266-1. Epub 2019 Jan 2.
Previous cohort studies have observed higher birth order to be associated with increased risk of suicidal behaviour. However, the mechanisms underlying this association are unclear. Using data from the Avon Longitudinal Study of Parents and Children (ALSPAC), we used multivariable logistic regression models and mediation analysis to investigate the associations of birth order with adolescent suicide attempts and psychiatric disorder. We investigated whether the number of maternal depressive episodes and father absence mediated the associations found. In fully adjusted models (n = 2571), higher birth order was associated with an increased risk of both suicide attempts (OR = 1.42, CI = 1.10-1.84) and psychiatric disorder (OR = 1.29, CI = 0.99-1.69). Maternal depression and father absence only partially mediated (8%; 12%) these associations. Whilst maternal depression and paternal absence partially mediated the associations between birth order, and suicidal behaviour and psychiatric disorder, other pathways may account for much of these associations. Future studies should investigate alternative mediating pathways.
先前的队列研究表明，出生顺序较高与自杀行为的风险增加有关。然而，这种关联的机制尚不清楚。本研究使用来自阿冯纵向研究父母和儿童（ALSPAC）的数据，采用多变量逻辑回归模型和中介分析来调查出生顺序与青少年自杀未遂和精神障碍之间的关联。我们调查了母亲抑郁发作次数和父亲缺失是否可以中介这些关联。在完全调整的模型中（n=2571），较高的出生顺序与自杀未遂（OR=1.42，CI=1.10-1.84）和精神障碍（OR=1.29，CI=0.99-1.69）的风险增加有关。母亲抑郁和父亲缺失仅部分中介（8%；12%）了这些关联。虽然母亲抑郁和父亲缺失部分中介了出生顺序与自杀行为和精神障碍之间的关联，但其他途径可能在很大程度上解释了这些关联。未来的研究应该调查替代的中介途径。
