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精神分裂症或双相情感障碍家族高风险的 7 岁儿童的精神病性体验:丹麦高危和弹性研究-VIA7;一项基于人群的队列研究。

Psychotic experiences in seven-year-old children with familial high risk of schizophrenia or bipolar disorder in: The Danish High Risk and Resilience Study - VIA 7; A population-based cohort study.

机构信息

Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Mental Health Services, Capital Region of Denmark, Copenhagen, Gentofte Hospitalsvej 15, 4th floor, DK-2900 Hellerup, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Fuglesangs Allé 26, DK-8210 Aarhus, Denmark.

Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Mental Health Services, Capital Region of Denmark, Copenhagen, Gentofte Hospitalsvej 15, 4th floor, DK-2900 Hellerup, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Fuglesangs Allé 26, DK-8210 Aarhus, Denmark.

出版信息

Schizophr Res. 2021 Feb;228:510-518. doi: 10.1016/j.schres.2020.11.045. Epub 2020 Dec 9.

Abstract

We aimed to examine the prevalence of psychotic experiences (PEs) in children with familial high risk of schizophrenia (FHR-SZ) or bipolar disorder (FHR-BP) and, in exploratory analyses, to examine the possible associations between PEs and mental disorders as well as level of functioning. A cohort of seven-year-old children with FHR-SZ (N = 199), FHR-BP (N = 118) and controls (N = 196) was recruited through Danish nationwide registers. Lifetime PEs were assessed through interviews using the psychosis section of the 'Schedule for Affective Disorders and Schizophrenia for School-Age Children - Present and Lifetime Version' (K-SADS-PL). Lifetime DSM-IV diagnoses were ascertained through K-SADS-PL and the level of functioning of the children through 'Children's Global Assessment Scale'. Both children with FHR-SZ (OR = 2.9, 95% CI = 1.4-6.2, p = 0.005) and FHR-BP (OR = 2.9, 95% CI = 1.3-6.7, p = 0.011) had an increased risk of having experienced "severe" PEs compared with controls. In the overall cohort PEs were associated with any lifetime mental disorder, Attention-Deficit/Hyperactivity Disorder, anxiety disorders and a lower level of functioning. The findings of a higher proportion of high risk children reporting PEs could represent an early manifestation of later more severe psychopathology or simply an unspecific transitory symptom. Future follow-up studies of this cohort will explore the predictive value of the occurrence of PEs at age seven.

摘要

我们旨在研究有精神分裂症家族高危史(FHR-SZ)或双相障碍家族高危史(FHR-BP)的儿童中出现精神病性体验(PEs)的流行率,并在探索性分析中,研究 PEs 与精神障碍以及功能水平之间可能存在的关联。通过丹麦全国登记册招募了一个由 7 岁儿童组成的队列,其中包括 FHR-SZ(N=199)、FHR-BP(N=118)和对照组(N=196)。通过使用“儿童情感障碍和精神分裂症谱系及终身版本访谈时间表”(K-SADS-PL)的精神病部分对终生 PEs 进行评估。通过 K-SADS-PL 确定终生 DSM-IV 诊断,通过“儿童总体评估量表”确定儿童的功能水平。与对照组相比,FHR-SZ 儿童(OR=2.9,95%CI=1.4-6.2,p=0.005)和 FHR-BP 儿童(OR=2.9,95%CI=1.3-6.7,p=0.011)出现“严重”PEs 的风险增加。在整个队列中,PEs 与任何终生精神障碍、注意力缺陷/多动障碍、焦虑障碍和较低的功能水平相关。高危儿童报告出现更多 PEs 的发现可能代表了以后更严重的精神病理学的早期表现,或者只是一种非特异性的短暂症状。本队列的未来随访研究将探索 7 岁时出现 PEs 的预测价值。

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