Center for Life Course Health Research, University of Oulu, Oulu, Finland.
Cancer Research and Translational Medicine Research Unit, University of Oulu, Oulu, Finland.
Eur Psychiatry. 2020 Feb 21;63(1):e24. doi: 10.1192/j.eurpsy.2020.25.
We studied the cumulative incidence of physical illnesses, and the effect of early environmental factors (EEFs) on somatic comorbidity in schizophrenia, in nonschizophrenic psychosis and among nonpsychotic controls from birth up to the age of 50 years.
The sample included 10,933 members of the Northern Finland Birth Cohort 1966, of whom, 227 had schizophrenia and 205 had nonschizophrenic psychosis. Diagnoses concerning physical illnesses were based on nationwide registers followed up to the end of 2016 and classified into 13 illness categories. Maternal education and age, family type at birth and paternal socioeconomic status were studied as EEFs of somatic illnesses.
When adjusted by gender and education, individuals and especially women with nonschizophrenic psychosis had higher risk of morbidity in almost all somatic illness categories compared to controls, and in some categories, compared to individuals with schizophrenia. The statistically significant adjusted hazard ratios varied from 1.27 to 2.42 in nonschizophrenic psychosis. Regarding EEFs, single-parent family as the family type at birth was a risk factor for a higher somatic score among men with schizophrenia and women with nonschizophrenic psychosis. Maternal age over 35 years was associated with lower somatic score among women with nonschizophrenic psychosis.
Persons with nonschizophrenic psychoses have higher incidence of somatic diseases compared to people with schizophrenia and nonpsychotic controls, and this should be noted in clinical work. EEFs have mostly weak association with somatic comorbidity in our study.
我们研究了身体疾病的累积发病率,以及早期环境因素(EEFs)对精神分裂症、非精神分裂性精神病和非精神病对照者从出生到 50 岁时躯体共病的影响。
该样本包括来自 1966 年芬兰北部出生队列的 10933 名成员,其中 227 人患有精神分裂症,205 人患有非精神分裂性精神病。根据全国性登记册,对涉及身体疾病的诊断进行了随访,直至 2016 年底,并将其分为 13 种疾病类别。母体教育和年龄、出生时的家庭类型以及父亲的社会经济地位被研究为躯体疾病的 EEFs。
在调整性别和教育因素后,与对照组相比,患有非精神分裂性精神病的个体,尤其是女性,在几乎所有躯体疾病类别中都有更高的发病风险,在某些类别中,与患有精神分裂症的个体相比,也有更高的发病风险。非精神分裂性精神病的调整后危险比在统计学上从 1.27 到 2.42 不等。关于 EEFs,单亲家庭作为出生时的家庭类型,是男性精神分裂症患者和女性非精神分裂性精神病患者躯体评分较高的一个危险因素。母亲年龄超过 35 岁与非精神分裂性精神病女性的躯体评分较低有关。
与精神分裂症患者和非精神病对照者相比,非精神分裂性精神病患者躯体疾病的发病率更高,在临床工作中应注意这一点。在我们的研究中,EEFs 与躯体共病的关联大多较弱。