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精神分裂症-双相谱系障碍患者的产科并发症与智力。

Obstetric complications and intelligence in patients on the schizophrenia-bipolar spectrum and healthy participants.

机构信息

Department of Psychiatric Research, Diakonhjemmet Hospital, Oslo, Norway.

NORMENT, Division of Mental Health and Addiction, Oslo University Hospital & Institute of Clinical Medicine, University of Oslo, Oslo, Norway.

出版信息

Psychol Med. 2020 Aug;50(11):1914-1922. doi: 10.1017/S0033291719002046. Epub 2019 Aug 28.

Abstract

BACKGROUND

Whether severe obstetric complications (OCs), which harm neural function in offspring, contribute to impaired cognition found in psychiatric disorders is currently unknown. Here, we sought to evaluate how a history of severe OCs is associated with cognitive functioning, indicated by Intelligence Quotient (IQ).

METHODS

We evaluated the associations of a history of OCs and IQ in 622 healthy controls (HC) and 870 patients on the schizophrenia (SCZ) - bipolar disorder (BIP) spectrum from the ongoing Thematically Organized Psychosis study cohort, Oslo, Norway. Participants underwent assessments using the NART (premorbid IQ) and the WASI (current IQ). Information about OCs was obtained from the Medical Birth Registry of Norway. Multiple linear regression models were used for analysis.

RESULTS

Severe OCs were equally common across groups. SCZ patients with OCs had lower performances on both premorbid and current IQ measures, compared to those without OCs. However, having experienced more than one co-occurring severe OC was associated with lower current IQ in all groups.

CONCLUSIONS

Severe OCs were associated with lower IQ in the SCZ group and in the BIP and HC groups, but only if they had experienced more than one severe OC. Low IQ might be a neurodevelopmental marker for SCZ; wherein, severe OCs influence cognitive abilities and increase the risk of developing SCZ. Considering OCs as a variable of neurodevelopmental risk for severe mental illness may promote the development of neuroprotective interventions, improve outcome in vulnerable newborns and advance our ability to make clinical prognoses.

摘要

背景

严重产科并发症(OCs)会损害后代的神经功能,目前尚不清楚其是否会导致精神疾病中发现的认知障碍。在这里,我们试图评估严重 OCs 病史与认知功能(由智商表示)的关联。

方法

我们评估了挪威奥斯陆正在进行的主题性精神病研究队列中 622 名健康对照者(HC)和 870 名精神分裂症(SCZ)-双相障碍(BIP)谱系患者的 OCs 病史与智商的关联。参与者使用 NART(前期智商)和 WASI(当前智商)进行评估。OCs 信息从挪威医学出生登记处获得。使用多元线性回归模型进行分析。

结果

严重 OCs 在各组中同样常见。患有 OCs 的 SCZ 患者在前期和当前智商测试中的表现均较低,而没有 OCs 的患者则没有。然而,经历过一次以上同时发生的严重 OCs 与所有组的当前智商较低有关。

结论

严重 OCs 与 SCZ 组以及 BIP 和 HC 组的智商降低有关,但前提是他们经历了不止一次严重的 OCs。低智商可能是 SCZ 的神经发育标志物;在这种情况下,严重 OCs 会影响认知能力并增加患 SCZ 的风险。将 OCs 视为严重精神疾病的神经发育风险变量可能会促进神经保护干预措施的发展,改善易受影响的新生儿的预后,并提高我们进行临床预后的能力。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/fa17/7477368/47404d7e37d0/S0033291719002046_fig1.jpg

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