Centre for Women's Mental Health, Faculty of Biology, Medicine and Health Sciences, University of Manchester, Manchester, UK; Greater Manchester Mental Health NHS Foundation Trust, Prestwich, Manchester, UK.
Center for Epidemiology and Community Medicine, Stockholm, Sweden.
Lancet Public Health. 2020 Nov;5(11):e583-e591. doi: 10.1016/S2468-2667(20)30202-4.
Children of parents with mental illness are a vulnerable group, but their numbers and their exposure to adversity have rarely been examined. We examined the prevalence of children with parents with mental illness in Sweden, trends in prevalence from 2006 to 2016, and these children's exposure to socioeconomic adversity.
We did a population-based cohort study among all children (aged <18 years) born in Sweden between Jan 1, 1991, and Dec 31, 2011, and their parents, followed up between Jan 1, 2006, and Dec 31, 2016. We included children who were identified in the Total Population Register and linked to their birth parents, excluding adopted children and those with missing information on both birth parents. We used a comprehensive register linkage, Psychiatry Sweden, to follow up for indicators of parental mental illness and socioeconomic adversity. Marginal predictions from a standard logistic regression model were used to estimate age-specific, 3-year period prevalence of parental mental illness and trends in prevalence for 2006-16. Using cross-sectional data on each child, indicators of socioeconomic adversity were compared between children with and without concurrent parental mental illness using logistic regression.
Of 2 198 289 children born in Sweden between Jan 1, 1991, and Dec 31, 2011, we analysed 2 110 988 children (96·03% of the total population). The overall prevalence of children with diagnosed parental mental illness between 2006 and 2016 was 9·53% (95% CI 9·50-9·57). This prevalence increased with age of the child, from 6·72% (6·65-6·78) of the youngest children (0 to <3 years) to 10·80% (10·73-10·89) in the oldest (15 to <18 years). The prevalence of diagnosed parental mental illness increased from 8·62% (8·54-8·69) in 2006-09 up to 10·95% (10·86-11·03) in 2013-16. Children with any type of parental mental illness had markedly higher risk of socioeconomic adversity, such as living in poorer households or living separately from their parents.
Currently, 11% of all Swedish children have a parent with a mental illness treated within secondary care. These children have markedly higher risk of broad socioeconomic adversity than do other children. There is a need to understand how socioeconomic adversity and parental mental illness influence vulnerability to poor life outcomes in these children.
European Research Council, National Institute for Health Research, Region Stockholm, and the Swedish Research Council.
父母患有精神疾病的儿童是一个弱势群体，但他们的数量及其面临逆境的情况很少被研究。我们研究了瑞典患有精神疾病父母的儿童的患病率，2006 年至 2016 年的患病率趋势，以及这些儿童面临的社会经济逆境情况。
我们在瑞典进行了一项基于人群的队列研究，纳入了所有（年龄<18 岁）于 1991 年 1 月 1 日至 2011 年 12 月 31 日期间出生的儿童及其父母，随访时间为 2006 年 1 月 1 日至 2016 年 12 月 31 日。我们纳入了在总人口登记册中识别出的儿童，并与他们的亲生父母进行了关联，排除了被收养的儿童和父母双方信息缺失的儿童。我们利用全面的登记册关联 Psychiatry Sweden 来追踪父母精神疾病和社会经济逆境的指标。使用标准逻辑回归模型的边缘预测来估计特定年龄的、3 年期间的父母精神疾病患病率和 2006-16 年的患病率趋势。我们利用每个儿童的横断面数据，使用逻辑回归比较了同时患有和不患有父母精神疾病的儿童之间的社会经济逆境指标。
在 1991 年 1 月 1 日至 2011 年 12 月 31 日期间在瑞典出生的 2198289 名儿童中，我们分析了 2110988 名儿童（占总人口的 96.03%）。2006 年至 2016 年期间，患有确诊父母精神疾病的儿童的总体患病率为 9.53%（95%CI 9.50-9.57）。这一患病率随着儿童年龄的增长而增加，从最年幼的儿童（0 至<3 岁）的 6.72%（6.65-6.78）增加到最年长的儿童（15 至<18 岁）的 10.80%（10.73-10.89）。患有确诊父母精神疾病的儿童的患病率从 2006-09 年的 8.62%（8.54-8.69）上升至 2013-16 年的 10.95%（10.86-11.03）。任何类型的父母精神疾病儿童都明显有更高的社会经济逆境风险，例如生活在较贫困的家庭或与父母分开生活。
目前，瑞典有 11%的儿童的父母患有需要二级护理的精神疾病。这些儿童比其他儿童明显面临更大的广泛社会经济逆境风险。需要了解社会经济逆境和父母精神疾病如何影响这些儿童的不良生活结果的易感性。
欧洲研究理事会、英国国家卫生研究院、斯德哥尔摩地区和瑞典研究理事会。
