Research Centre for Child Psychiatry, Institute of Clinical Medicine, Faculty of Medicine, University of Turku, Lemminkäisenkatu 3 / Teutori (3rd floor), 20014, Turku, Finland.
Turku University Central Hospital, Turku, Finland.
BMC Psychiatry. 2020 May 12;20(1):221. doi: 10.1186/s12888-020-02637-6.
Selective mutism (SM) is nowadays considered a relatively rare anxiety disorder characterized by children failing to speak in certain situations. Research on risk factors for SM are limited in comparison to other psychiatric disorders. The aim of this study was to examine several potential risk factors for SM in a large nationwide cohort, namely parental psychopathology, parental age, maternal SES, urbanicity, maternal marital status and parental immigration status.
This nested case-control study comprised 860 cases with SM, identified from the Finnish Hospital Discharge Register and 3250 controls matched for sex and age from the Finnish Central Population Register. Conditional logistic regression was used to examine the association between the risk factors and SM.
If both parents had any psychiatric disorder, this almost tripled their odds of having a child with SM (OR 2.8, 95% CI 2.0-4.0). There were increased rates of all types of psychiatric disorders in the parents of the children with SM, with a wider range of diagnoses among the mothers than fathers. Fathers over 35 years (OR 1.4, 95% CI 1.1-1.8) were significantly more likely to have children with SM. Offspring of a single mother had a 2-fold (OR = 2.0, 95% CI 1.4-3.0) increased odds of SM than mothers who were married or in a relationship.
Several parental psychiatric disorders were associated with offspring SM. This points towards a shared aetiology of psychiatric disorders. Findings on paternal age and single motherhood help to improve our understanding of risk factors for SM.
选择性缄默症(SM)如今被认为是一种相对罕见的焦虑症,其特征是儿童在某些情况下无法说话。与其他精神障碍相比,SM 的风险因素研究有限。本研究旨在通过全国性大型队列研究来检查 SM 的几种潜在风险因素,即父母的精神病理学、父母的年龄、母亲的社会经济地位、城市化程度、母亲的婚姻状况和父母的移民状况。
这项嵌套病例对照研究包括 860 例 SM 病例,他们是从芬兰住院登记处确定的,3250 名对照是从芬兰中央人口登记处按照性别和年龄匹配的。条件逻辑回归用于检查风险因素与 SM 之间的关联。
如果父母双方都有任何精神疾病,那么他们的孩子患有 SM 的几率几乎增加了两倍(OR 2.8,95%CI 2.0-4.0)。SM 儿童的父母患有各种精神疾病的比例增加,母亲的诊断范围比父亲更广泛。父亲年龄超过 35 岁(OR 1.4,95%CI 1.1-1.8),其子女患有 SM 的几率显著增加。单身母亲的子女患有 SM 的几率是已婚或处于恋爱关系中的母亲的 2 倍(OR=2.0,95%CI 1.4-3.0)。
几种父母的精神疾病与子女的 SM 有关。这表明精神疾病存在共同的发病机制。关于父亲年龄和单身母亲的研究结果有助于提高我们对 SM 风险因素的理解。