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强迫症症状的风险因素。基于社区的青年队列研究随访。

Risk factors for obsessive-compulsive symptoms. Follow-up of a community-based youth cohort.

机构信息

Institute of Psychiatry, University of São Paulo, R. Dr. Ovídio Pires de Campos, 785, São Paulo, 05403-903, Brazil.

Child and Adolescent Psychiatry Unit (UPIA), Department of Psychiatry, Federal University of São Paulo, São Paulo, Brazil.

出版信息

Eur Child Adolesc Psychiatry. 2021 Jan;30(1):89-104. doi: 10.1007/s00787-020-01495-7. Epub 2020 Feb 19.

Abstract

Environmental factors are at least as important as genetic factors for the development of obsessive-compulsive symptoms (OCS), but the identification of such factors remain a research priority. Our study aimed to investigate the association between a broad scope of potential risk factors and OCS in a large community cohort of children and adolescents. We evaluated 1877 participants and their caregivers at baseline and after 3 years to assess various demographic, prenatal, perinatal, childhood adversity, and psychopathological factors. Mean age at baseline was 10.2 years (SD 1.9) and mean age at follow-up was 13.4 years (SD 1.9). Reports of OCS at baseline and follow-up were analyzed using latent variable models. At preliminary regression analysis, 15 parameters were significantly associated with higher OCS scores at follow-up. At subsequent regression analysis, we found that eight of these parameters remained significantly associated with higher follow-up OCS scores while being controlled by each other and by baseline OCS scores. The significant predictors of follow-up OCS were: lower socioeconomic status (p = 0.033); lower intelligence quotient (p = 0.013); lower age (p < 0.001); higher maternal stress level during pregnancy (p = 0.028); absence of breastfeeding (p = 0.017); parental baseline OCS (p = 0.038); youth baseline anxiety disorder (p = 0.023); and youth baseline OCS scores (p < 0.001). These findings may better inform clinicians and policymakers engaged in the mental health assessment and prevention in children and adolescents.

摘要

环境因素对于强迫症症状(OCS)的发展至少与遗传因素同样重要,但这些因素的识别仍然是研究的重点。我们的研究旨在调查广泛潜在风险因素与儿童和青少年大社区队列中 OCS 之间的关联。我们在基线和 3 年后评估了 1877 名参与者及其照顾者,以评估各种人口统计学、产前、围产期、儿童逆境和精神病理因素。基线时的平均年龄为 10.2 岁(SD=1.9),随访时的平均年龄为 13.4 岁(SD=1.9)。使用潜在变量模型分析基线和随访时的 OCS 报告。在初步回归分析中,有 15 个参数与随访时更高的 OCS 评分显著相关。在随后的回归分析中,我们发现这 15 个参数中有 8 个在相互控制和基线 OCS 评分控制下仍与更高的随访 OCS 评分显著相关。随访 OCS 的显著预测因素为:较低的社会经济地位(p=0.033);较低的智商(p=0.013);较低的年龄(p<0.001);怀孕期间母亲压力水平较高(p=0.028);未进行母乳喂养(p=0.017);父母基线 OCS(p=0.038);青少年基线焦虑障碍(p=0.023);以及青少年基线 OCS 评分(p<0.001)。这些发现可能为从事儿童和青少年心理健康评估和预防的临床医生和政策制定者提供更好的信息。

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