Misra Supriya, Gelaye Bizu, Koenen Karestan C, Williams David R, Borba Christina P C, Quattrone Diego, Di Forti Marta, La Cascia Caterina, La Barbera Daniele, Tarricone Ilaria, Berardi Domenico, Szöke Andrei, Arango Celso, Tortelli Andrea, de Haan Lieuwe, Velthorst Eva, Bobes Julio, Bernardo Miguel, Sanjuán Julio, Santos Jose Luis, Arrojo Manuel, Del-Ben Cristina Marta, Menezes Paulo Rossi, Selten Jean-Paul, Jones Peter B, Kirkbride James B, Rutten Bart P F, van Os Jim, Murray Robin M, Gayer-Anderson Charlotte, Morgan Craig
Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA 02115, USA.
J Clin Med. 2019 Jul 23;8(7):1081. doi: 10.3390/jcm8071081.
Evidence for early parental death as a risk factor for psychosis in offspring is inconclusive. We analyzed data from a six-country, case-control study to examine the associations of early parental death, type of death (maternal, paternal, both), and child's age at death with psychosis, both overall and by ethnic group. In fully adjusted multivariable mixed-effects logistic regression models, experiencing early parental death was associated with 1.54-fold greater odds of psychosis (95% confidence interval (CI): 1.23, 1.92). Experiencing maternal death had 2.27-fold greater odds (95% CI: 1.18, 4.37), paternal death had 1.14-fold greater odds (95% CI: 0.79, 1.64), and both deaths had 4.42-fold greater odds (95% CI: 2.57, 7.60) of psychosis compared with no early parental death. Experiencing parental death between 11 and 16 years of age had 2.03-fold greater odds of psychosis than experiencing it before five years of age (95% CI: 1.02, 4.04). In stratified analyses, experiencing the death of both parents had 9.22-fold greater odds of psychosis among minority ethnic groups (95% CI: 2.02-28.02) and no elevated odds among the ethnic majority (odds ratio (OR): 0.96; 95% CI: 0.10-8.97), which could be due in part to the higher prevalence of early parental death among minority ethnic groups but should be interpreted cautiously given the wide confidence intervals.
早期父母死亡作为后代患精神病风险因素的证据尚无定论。我们分析了一项六国病例对照研究的数据，以检验早期父母死亡、死亡类型（母亲、父亲、双亲）以及孩子死亡时的年龄与精神病之间的关联，包括总体关联以及按种族分组的关联。在完全调整的多变量混合效应逻辑回归模型中，经历早期父母死亡与患精神病的几率高出1.54倍相关（95%置信区间（CI）：1.23，1.92）。经历母亲死亡的几率高出2.27倍（95%CI：1.18，4.37），父亲死亡的几率高出1.14倍（95%CI：0.79，1.64），与未经历早期父母死亡相比，双亲死亡的几率高出4.42倍（95%CI：2.57，7.60）。11至16岁时经历父母死亡患精神病的几率比5岁前经历父母死亡高出2.03倍（95%CI：1.02，4.04）。在分层分析中，少数族裔中经历双亲死亡患精神病的几率高出9.22倍（95%CI：2.02 - 28.02），而在多数族裔中无升高的几率（优势比（OR）：0.96；95%CI：0.10 - 8.97），这可能部分归因于少数族裔中早期父母死亡的患病率较高，但鉴于置信区间较宽，应谨慎解释。
