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产前抑郁母亲所生孩子成年后患严重情绪障碍和精神分裂症:与父母严重精神障碍的关系。

Severe mood disorders and schizophrenia in the adult offspring of antenatally depressed mothers in the Northern Finland 1966 Birth Cohort: Relationship to parental severe mental disorder.

机构信息

Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, P.O. Box 5000, FIN-90014 Oulu, Finland.

Department of Psychiatry, Research Unit of Clinical Neuroscience, University of Oulu, P.O. Box 5000, FIN-90014 Oulu, Finland; Department of Psychiatry, Oulu University Hospital, Oulu, Finland; Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland.

出版信息

J Affect Disord. 2019 Apr 15;249:63-72. doi: 10.1016/j.jad.2019.02.011. Epub 2019 Feb 6.

Abstract

BACKGROUND

Maternal antenatal depression may alter offspring neurodevelopment, but long follow-up studies are lacking. We studied the risks for mood disorders and schizophrenia in adult offspring of antenatally depressed mothers, taking account parental severe mental disorders.

METHODS

In the general population-based Northern Finland 1966 Birth Cohort with 12,058 children, 13.9% of the mothers reported themselves depressed at mid-gestation. The offspring were followed 43 years. Severe mood disorders and schizophrenia in the offspring and severe mental disorders in the parents were detected using the Care Register for Healthcare. Maternal smoking during pregnancy, perinatal complications, fathers´ social class, family type at birth, and grand multiparity were considered as confounding variables.

RESULTS

The offspring of antenatally depressed mothers had an elevated risk for depression (adjusted OR 1.5; 95% CI 1.03-2.2), compared to cohort members without maternal antenatal depressed mood. The offspring with maternal antenatal depressed mood and parental severe mental disorder had markedly elevated risks for depression (3.3; 1.8-6.2), and schizophrenia (3.9; 2.0-7.5), compared to the offspring without one or both of these risk factors.

LIMITATIONS

Maternal antenatal depressed mood was determined by one question and did not necessarily signify a clinical condition. Data on maternal postnatal mood was not available.

CONCLUSION

The offspring with maternal antenatal depressed mood and parental severe mental disorder had high risk for depression and schizophrenia. Early interventions in parental severe mental disorder might present an opportunity for decreasing the risk for mood disorders and schizophrenia in the offspring.

摘要

背景

母亲产前抑郁可能会改变后代的神经发育,但缺乏长期随访研究。我们研究了患有产前抑郁症母亲的成年后代患情绪障碍和精神分裂症的风险,同时考虑了父母的严重精神障碍。

方法

在基于一般人群的芬兰北部 1966 年出生队列中,有 12058 名儿童,其中 13.9%的母亲在妊娠中期报告自己抑郁。对后代进行了 43 年的随访。使用医疗保健关怀登记册来检测后代中的严重情绪障碍和精神分裂症以及父母中的严重精神障碍。考虑了母亲在怀孕期间吸烟、围产期并发症、父亲的社会阶层、出生时的家庭类型和多胎妊娠等混杂变量。

结果

与没有母亲产前抑郁情绪的队列成员相比,产前抑郁母亲的后代患抑郁症的风险升高(调整后的 OR 1.5;95%CI 1.03-2.2)。有母亲产前抑郁情绪和父母严重精神障碍的后代患抑郁症的风险显著升高(3.3;1.8-6.2),患精神分裂症的风险也显著升高(3.9;2.0-7.5),与没有这些危险因素的后代相比。

局限性

母亲产前抑郁情绪是通过一个问题来确定的,并不一定代表临床情况。没有关于母亲产后情绪的数据。

结论

有母亲产前抑郁情绪和父母严重精神障碍的后代患抑郁症和精神分裂症的风险较高。早期干预父母的严重精神障碍可能为降低后代患情绪障碍和精神分裂症的风险提供机会。

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