早发性儿童精神病性体验在精神分裂症或双相情感障碍家族高危儿童中的发展途径和临床结局：一项前瞻性、纵向队列研究-丹麦高危和弹性研究，VIA 11.
Developmental Pathways and Clinical Outcomes of Early Childhood Psychotic Experiences in Preadolescent Children at Familial High Risk of Schizophrenia or Bipolar Disorder: A Prospective, Longitudinal Cohort Study - The Danish High Risk and Resilience Study, VIA 11.
机构信息
Copenhagen Research Center for Mental Health-CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen (Gregersen, Møllegaard, Jepsen, Rohd, Søndergaard, Brandt, Ellersgaard, Hjorthøj, Ohland, Krantz, Wilms, Clemmensen, Nordentoft, Hemager); The Lundbeck Foundation Initiative for Integrative Psychiatric Research-iPSYCH, Aarhus, Denmark (Gregersen, Møllegaard Jepsen, Rohd, Søndergaard, Brandt, Hjorthøj, Ohland, Krantz, Wilms, Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors, Nordentoft, Hemager, Thorup); Faculty of Health and Medical Sciences, University of Copenhagen, Denmark (Gregersen, Søndergaard, Brandt, Nordentoft, Hemager, Thorup); Mental Health Services in the Capital Region of Denmark, Child and Adolescent Mental Health Center, Copenhagen (Møllegaard, Jepsen, Clemmensen, Thorup); Mental Health Services in the Capital Region of Denmark, Center for Neuropsychiatric Schizophrenia Research and Center for Clinical Intervention and Neuropsychiatric Schizophrenia Research, Copenhagen (Møllegaard, Jepsen); Department of Public Health, Section of Epidemiology, University of Copenhagen (Hjorthøj); Faculty of Health and Medical Sciences, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark (Andreassen, Veddum, Knudsen, Bliksted, Mors); Psychosis Research Unit, Aarhus University Hospital Psychiatry, Skejby, Denmark (Andreassen, Veddum, Knudsen, Greve, Bliksted, Mors).
出版信息
Am J Psychiatry. 2022 Sep;179(9):628-639. doi: 10.1176/appi.ajp.21101076.
OBJECTIVE
Psychotic experiences are common in children and adolescents and are associated with concurrent and subsequent psychopathology. Most findings originate from general population studies, whereas little is known of the clinical outcomes of psychotic experiences in children and adolescents at familial high risk of psychosis. We examined the prevalence of psychotic experiences in middle childhood and whether early childhood psychotic experiences and developmental pathways of psychotic experiences predicted mental disorders in middle childhood in children at familial high risk of schizophrenia (FHR-SZ), bipolar disorder (FHR-BP), and a population-based control group.
METHODS
In a longitudinal population-based cohort study children at FHR-SZ (N=170), FHR-BP (N=103), and the control group (N=174) were assessed for psychotic experiences and axis I disorders with face-to-face interviews in early and middle childhood (at 7 and 11 years of age).
RESULTS
Psychotic experiences were more prevalent in children at FHR-SZ (31.8%, odds ratio 2.1, 95% CI 1.3-3.4) than in the control group (18.4%) in middle childhood. Early childhood psychotic experiences predicted mental disorders in middle childhood after adjusting for early childhood disorders and familial risk (odds ratio 2.0, 95% CI 1.2-3.1). Having three or more psychotic experiences increased odds the most (odds ratio 2.5, 95% CI 1.1-5.7). Persistent psychotic experiences were associated with increased odds of middle childhood disorders (odds ratio 4.1, 95% CI 2.1-8.4). Psychotic experiences were nondifferentially associated with mental disorders across the three familial risk groups.
CONCLUSIONS
Early childhood psychotic experiences predict mental disorders in middle childhood. Psychotic experiences index vulnerability for psychopathology nondifferentially in children at familial high risk and the control group. Psychotic experiences should be included in mental health screenings including children at familial high risk.
目的
儿童和青少年中常见的精神病性体验与同时期和随后的精神病理学有关。大多数研究结果来源于一般人群研究，而对于精神分裂症家族高风险儿童和青少年的精神病性体验的临床结果知之甚少。我们研究了儿童中期精神病性体验的发生率，以及早期儿童精神病性体验和精神病性体验的发展轨迹是否能预测精神分裂症家族高风险儿童（FHR-SZ）、双相情感障碍家族高风险儿童（FHR-BP）和基于人群的对照组儿童中期的精神障碍。
方法
在一项纵向基于人群的队列研究中，对 FHR-SZ（N=170）、FHR-BP（N=103）和对照组（N=174）的儿童进行了精神病性体验和轴 I 障碍的评估，使用面对面访谈的方式在早期和中期儿童期（7 岁和 11 岁时）进行。
结果
与对照组（18.4%）相比，FHR-SZ 儿童在中期的精神病性体验更为常见（31.8%，优势比 2.1，95%置信区间 1.3-3.4）。在调整了早期儿童障碍和家族风险后，早期儿童的精神病性体验预测了中期的精神障碍（优势比 2.0，95%置信区间 1.2-3.1）。有 3 次或更多次精神病性体验的可能性最大（优势比 2.5，95%置信区间 1.1-5.7）。持续的精神病性体验与中期儿童障碍的几率增加有关（优势比 4.1，95%置信区间 2.1-8.4）。精神病性体验与三个家族风险组的精神障碍无差异相关。
结论
早期儿童的精神病性体验预测了中期儿童的精神障碍。精神病性体验在家族高风险儿童和对照组儿童中都可以作为精神病理学的易感性指标，而且无差异。精神病性体验应纳入精神健康筛查，包括家族高风险儿童。
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