Krantz Mette Falkenberg, Hjorthøj Carsten, Ellersgaard Ditte, Hemager Nicoline, Christiani Camilla, Spang Katrine Søborg, Burton Birgitte Klee, Gregersen Maja, Søndergaard Anne, Greve Aja, Ohland Jessica, Mortensen Preben Bo, Plessen Kerstin Jessica, Bliksted Vibeke, Jepsen Jens Richardt Møllegaard, Thorup Anne A E, Mors Ole, Nordentoft Merete
CORE- Copenhagen Research Center for Mental Health, Mental Health Center Copenhagen, The Danish High Risk and Resilience Study VIA 7 and VIA 11, Capital Region of Denmark, Copenhagen University Hospital, Gentofte Hospitalsvej 15, opg. 15, 1. Sal., 2900, Hellerup, Denmark.
Faculty of Health and Medical Sciences, Institute of Clinical Medicine, University of Copenhagen, Blegdamsvej 3B, 2200, Copenhagen, Denmark.
Soc Psychiatry Psychiatr Epidemiol. 2023 Jan;58(1):113-140. doi: 10.1007/s00127-022-02338-3. Epub 2022 Sep 10.
Knowledge about representativity of familial high-risk studies of schizophrenia and bipolar disorder is essential to generalize study conclusions. The Danish High Risk and Resilience Study (VIA 7), a population-based case-control familial high-risk study, creates a unique opportunity for combining assessment and register data to examine cohort representativity.
Through national registers, we identified the population of 11,959 children of parents with schizophrenia (FHR-SZ) or bipolar disorder (FHR-BP) and controls from which the 522 children participating in The VIA 7 Study (202 FHR-SZ, 120 FHR-BP and 200 controls) were selected. Socio-economic and health data were obtained to compare high-risk groups and controls, and participants versus non-participants. Selection bias impact on results was analyzed through inverse probability weights.
In the total sample of 11,959 children, FHR-SZ and FHR-BP children had more socio-economic and health disadvantages than controls (p < 0.001 for most). VIA 7 non-participants had a poorer function, e.g. more paternal somatic and mental illness (p = 0.02 and p = 0.04 for FHR-SZ), notifications of concern (FHR-BP and PBC p < 0.001), placements out of home (p = 0.03 for FHR-SZ), and lower level of education (p ≤ 0.01 for maternal FHR-SZ and FHR-BP, p = 0.001 for paternal FHR-BP). Inverse probability weighted analyses of results generated from the VIA Study showed minor changes in study findings after adjustment for the found selection bias.
Familial high-risk families have multiple socio-economic and health disadvantages. In The VIA 7 Study, although comparable regarding mental illness severity after their child's birth, socioeconomic and health disadvantages are more profound amongst non-participants than amongst participants.
了解精神分裂症和双相情感障碍家族性高危研究的代表性对于推广研究结论至关重要。丹麦高危与复原力研究（VIA 7）是一项基于人群的病例对照家族性高危研究，为结合评估数据和登记数据以检验队列代表性创造了独特机会。
通过国家登记系统，我们确定了11959名父母患有精神分裂症（FHR-SZ）或双相情感障碍（FHR-BP）的儿童以及对照组的人群，从中选取了参与VIA 7研究的522名儿童（202名FHR-SZ、120名FHR-BP和200名对照组）。获取社会经济和健康数据以比较高危组与对照组，以及参与者与非参与者。通过逆概率权重分析选择偏倚对结果的影响。
在11959名儿童的总样本中，FHR-SZ和FHR-BP儿童比对照组存在更多社会经济和健康方面的劣势（大多数p<0.001）。VIA 7的非参与者功能较差，例如更多父亲患有躯体和精神疾病（FHR-SZ中p = 0.02和p = 0.04）、受到关注通知（FHR-BP和PBC中p<0.001）、离家安置（FHR-SZ中p = 0.03）以及教育水平较低（母亲FHR-SZ和FHR-BP中p≤0.01，父亲FHR-BP中p = 0.001）。对VIA研究结果进行的逆概率加权分析显示，在对发现的选择偏倚进行调整后，研究结果有轻微变化。
家族性高危家庭存在多种社会经济和健康方面的劣势。在VIA 7研究中，尽管孩子出生后在精神疾病严重程度方面具有可比性，但非参与者的社会经济和健康劣势比参与者更为明显。
