National Centre for Register-based Research, Aarhus BSS, Aarhus University, Aarhus, 8210, Denmark; Department of Psychiatry, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA, 27599-7160; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, 171 77, Sweden.
National Centre for Register-based Research, Aarhus BSS, Aarhus University, Aarhus, 8210, Denmark; Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus University, Aarhus, 8000, Denmark; Centre for Integrated Register-based Research (CIRRAU), Aarhus University, Aarhus, 8210, Denmark.
J Psychiatr Res. 2022 May;149:18-27. doi: 10.1016/j.jpsychires.2022.02.004. Epub 2022 Feb 16.
Research on early-life family environment on obsessive-compulsive disorder (OCD) risk is limited, and sex differences have not been sufficiently studied. We investigated early-life family composition and parental socio-economic status (SES) as OCD risk factors while stratifying for sex in a sample of 1,154,067 individuals from the Danish population (7550 of whom had OCD). Data on early-life family composition (birth order, number of siblings, number of parents in household at proband age 6), parental SES at age 6 (parental income, occupation, and education level), history of parental psychiatric illness, and parental age at birth on OCD risk (i.e., an ICD-10 diagnosis of F42.x) were obtained from Danish population registers. Survival analyses using Cox regression were performed with age as the underlying time variable. Analyses were adjusted for calendar time, and differential effect by sex was tested for exposures. We found that birth order and advanced maternal age were risk factors for OCD in males, and being an only child was associated with increased OCD risk in both sexes. Early childhood SES variables including parental education, occupation, and income were associated with OCD risk, and these effects were more pronounced in females. Significant interaction effects for parental education/occupation and the presence of non-OCD psychiatric diagnoses in the proband also emerged. Our results suggest that early-life SES and family composition may be important risk factors for OCD, and heterogeneity in OCD cases in terms of psychiatric comorbidities, as well as sex differences should be carefully examined in relation to risk factors.
关于生命早期家庭环境对强迫症（OCD）风险的研究有限，且性别差异尚未得到充分研究。我们在丹麦人群的 1154067 名个体样本中（其中 7550 名患有 OCD），通过分层分析来研究生命早期家庭构成和父母社会经济地位（SES）作为 OCD 风险因素，同时考虑了性别差异。生命早期家庭构成（出生顺序、兄弟姐妹数量、受检者 6 岁时家庭中的父母数量）、父母在受检者 6 岁时的 SES（父母收入、职业和教育水平）、父母精神病史以及父母生育年龄与 OCD 风险（即 ICD-10 诊断为 F42.x）的数据来自丹麦人口登记处。使用 Cox 回归进行生存分析，年龄为潜在时间变量。分析调整了日历时间，并针对暴露因素测试了性别差异的影响。我们发现，出生顺序和母亲高龄是男性 OCD 的危险因素，而独生子是两性 OCD 风险增加的一个因素。包括父母教育、职业和收入在内的儿童早期 SES 变量与 OCD 风险相关，这些影响在女性中更为明显。在受检者中存在非 OCD 精神疾病诊断时，父母的教育/职业与存在交互作用的显著影响。我们的研究结果表明，生命早期 SES 和家庭构成可能是 OCD 的重要风险因素，而在考虑风险因素时，应仔细研究 OCD 病例中与精神共病有关的异质性以及性别差异。
