Research in Medical Sciences, Direction of Epidemiological and Psychosocial Research, 42584National Institute of Psychiatry Ramon de la Fuente Muñiz, Mexico City, Mexico.
Carlos Beyer Center for Investigation of Animal Reproduction (CIRA), Autonomous University of Tlaxcala and Center for Investigation and Advanced Studies of the National Polytechnical Institute (UATx - CINVESTAV), Tlaxcala, Mexico.
Inquiry. 2021 Jan-Dec;58:469580211060797. doi: 10.1177/00469580211060797.
Schizophrenia (SCH) and bipolar disorder (BD) have both shared and unique genetic risk factors and clinical characteristics. The aim of the present study was to identify potential risk factors significantly associated with SCH, relative to a BD reference group.
Data were obtained from medical records of patients that entered a major Mexico City hospital during 2009-2010 presenting psychotic symptoms (n = 1132; 830 cases of SCH, 302 cases of BD; 714 men and 418 women). SCH and BD diagnoses were compared with respect to a number of family and clinical characteristics. Logistic and linear regression analyses were used to respectively identify factors selectively associated with the SCH diagnosis relative to the BD diagnosis and explore the relationship between PANSS scores and parental age at time of birth to the age of SCH onset.
Patients with SCH showed greater functional impairment than those with BD. Family history of mental illness, premorbid schizoid-like personality, and obstetric trauma were significantly associated with the SCH diagnosis. The association of obstetric trauma with SCH was greatest in male patients with a family history of mental illness. In women, increased paternal and decreased maternal age at time of the patient's birth were associated with an earlier age of SCH onset.
Male gender, showing premorbid schizoid-like personality, familial SCH, and obstetric trauma are risk factors that distinguish SCH from BD. Additionally, our results suggest that risk for SCH relative to BD may be importantly influenced by interactions between familial risk, gender, and obstetric trauma.
精神分裂症（SCH）和双相情感障碍（BD）既有共同的遗传风险因素，也有独特的临床特征。本研究的目的是确定与 SCH 相关的潜在风险因素，相对于 BD 参考组。
数据来自 2009 年至 2010 年期间进入墨西哥城一家主要医院就诊的出现精神病症状的患者病历（n = 1132；830 例 SCH，302 例 BD；714 名男性和 418 名女性）。比较了 SCH 和 BD 诊断在一系列家庭和临床特征方面的差异。分别使用逻辑和线性回归分析来确定与 SCH 诊断相关的因素，这些因素相对于 BD 诊断具有选择性，并探讨 PANSS 评分与父母出生时年龄与 SCH 发病年龄之间的关系。
与 BD 相比，SCH 患者的功能障碍更为严重。精神疾病家族史、病前类精神分裂症人格和产科创伤与 SCH 诊断显著相关。有精神疾病家族史的男性患者中，产科创伤与 SCH 的关联最大。在女性中，患者出生时父亲年龄增加和母亲年龄减少与 SCH 发病年龄较早相关。
男性、病前类精神分裂症人格、家族性 SCH 和产科创伤是区分 SCH 与 BD 的风险因素。此外，我们的结果表明，与 BD 相比，SCH 的风险可能受到家族风险、性别和产科创伤之间相互作用的重要影响。
