Mednick S A, Machon R A, Huttunen M O, Bonett D
Social Science Research Institute, University of Southern California, Los Angeles 90089-MC-1111.
Arch Gen Psychiatry. 1988 Feb;45(2):189-92. doi: 10.1001/archpsyc.1988.01800260109013.
In the context of a Finnish birth cohort, we tested the hypothesis that viral infection during the latter two thirds of fetal development would increase the risk of adult schizophrenic outcome. Psychiatric hospital diagnoses were recorded for all individuals in greater Helsinki who were fetuses during the 1957 type A2 influenza epidemic. Those exposed to the viral epidemic during their second trimester of fetal development were at elevated risk of being admitted to a psychiatric hospital with a diagnosis of schizophrenia. This was true for both males and females and independently in several psychiatric hospitals. The second-trimester effect was seen in the elevated proportion of schizophrenics among those admitted to a psychiatric hospital and also in higher rates of schizophrenia per 1000 live births in the city of Helsinki. The study has several limitations: (1) We have no direct evidence that the subjects actually suffered a viral infection. (2) The psychiatric data were obtained only for subjects up to the age of 26 years, 56 days. (3) The findings are based on hospital diagnoses. (4) The determination of stage of gestation at time of exposure to the epidemic is based on date of birth. The viral infection might have occurred outside the official epidemic window; the infant may have had a preterm or postterm delivery. These sources of error, however, should not serve to enhance the findings. The observed viral effect is interpreted as being one of many potential perturbations of gestation. We suggest that it is less the type than the timing of the disturbance during fetal neural development that is critical in determining risk for schizophrenia.
在芬兰出生队列的背景下，我们检验了这样一个假设：胎儿发育后三分之二期间的病毒感染会增加成年后患精神分裂症的风险。对1957年甲型2流感疫情期间大赫尔辛基地区所有胎儿时期的个体进行了精神病医院诊断记录。在胎儿发育中期接触病毒疫情的个体被诊断为精神分裂症而入住精神病医院的风险有所增加。这在男性和女性中均如此，且在几家精神病医院中是独立出现的。在入住精神病医院的患者中，精神分裂症患者比例升高以及在赫尔辛基市每1000例活产中精神分裂症发病率较高的情况都体现了中期效应。该研究有几个局限性：（1）我们没有直接证据表明这些受试者实际感染了病毒。（2）精神病学数据仅获取到26岁零56天的受试者。（3）研究结果基于医院诊断。（4）接触疫情时妊娠阶段的确定基于出生日期。病毒感染可能发生在官方疫情窗口期之外；婴儿可能早产或过期产。然而，这些误差来源不应强化研究结果。观察到的病毒效应被解释为妊娠众多潜在干扰因素之一。我们认为，在确定精神分裂症风险时，胎儿神经发育过程中干扰的时间比类型更为关键。
