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围产期措施与青少年心理健康有关吗?利用精神科队列的原始数据进行的回顾性探讨。

Are perinatal measures associated with adolescent mental health? A retrospective exploration with original data from psychiatric cohorts.

机构信息

Faculty of Medicine, Department of Child and Adolescent Psychiatry, Technische Universität Dresden, Fetscherstrasse 74, 01307, Dresden, Germany.

Dept. of Psychology, Division of Clinical Psychology and Psychotherapy, Philipps-University of Marburg, Marburg, Germany.

出版信息

BMC Psychiatry. 2022 Oct 28;22(1):668. doi: 10.1186/s12888-022-04302-6.

Abstract

BACKGROUND

Perinatal markers of prenatal development are associated with offspring psychiatric symptoms. However, there is little research investigating the specificity of perinatal markers for the development of specific disorders. This study aimed to explore if perinatal markers are specifically associated with adolescent substance use disorder (SUDs).

METHODS

Adolescent participants from two study centers, one for SUD patients (n = 196) and one for general psychopathology (n = 307), were recruited for participation. Since the SUD participants presented with a number of comorbid disorders, we performed a 1-on-1 matching procedure, based on age, gender, and specific pattern of comorbid disorders. This procedure resulted in n = 51 participants from each group. From all participants and their mothers we recorded perinatal markers (mode of birth, weeks of completed pregnancy, birth weight, Apgar score after 5 min) as well as intelligence quotient (IQ). The SUD sample additionally filled out the Youth Safe Report (YSR) as well as the PQ-16 and the DUDIT. We aimed to distinguish the two groups (SUD sample vs. general psychiatric sample) based on the perinatal variables via a logistic regression analysis. Additionally, linear regressions were performed for the total group and the subgroups to assess the relationship between perinatal variables and IQ, YSR, DUDIT and PQ-16.

RESULTS

The perinatal variables were not able to predict group membership (X [4] = 4.77, p = .312, Cox & Snell R² = 0.053). Odds ratios indicated a small increase in probability to belonging to the general psychiatric sample instead of the SUD sample if birth was completed via C-section. After Bonferroni-correction, the linear regression models showed no relation between perinatal markers and IQ (p = .60, R² = 0.068), YSR (p = .09, R² = 0.121), DUDIT (p = .65, R² = 0.020), and PQ-16 (p = .73, R² =0.021).

CONCLUSION

Perinatal markers were not able to distinguish SUD patients from patients with diverse psychopathologies. This pattern contradicts previous findings, perhaps because our chosen markers reflect general processes instead of specific mechanistic explanations. Future studies should take care to investigate specific prenatal markers and associate them with psychopathology on the symptom level.

摘要

背景

产前发育的围产期标志物与后代的精神症状有关。然而,很少有研究调查围产期标志物与特定障碍发展的特异性。本研究旨在探讨围产期标志物是否与青少年物质使用障碍(SUD)有特定关联。

方法

从两个研究中心招募青少年参与者,一个是 SUD 患者(n=196),另一个是一般精神病理学(n=307)。由于 SUD 参与者表现出多种共病障碍,我们进行了一对一的匹配程序,基于年龄、性别和特定的共病障碍模式。该程序导致每组有 n=51 名参与者。我们从所有参与者及其母亲那里记录了围产期标志物(分娩方式、完成妊娠的周数、出生体重、5 分钟后 Apgar 评分)以及智商(IQ)。SUD 样本还填写了青少年安全报告(YSR)以及 PQ-16 和 DUDIT。我们旨在通过逻辑回归分析根据围产期变量将两组(SUD 样本与一般精神病样本)区分开来。此外,还对总样本和亚组进行了线性回归,以评估围产期变量与 IQ、YSR、DUDIT 和 PQ-16 之间的关系。

结果

围产期变量无法预测组别的归属(X [4]=4.77,p=0.312,Cox 和 Snell R²=0.053)。优势比表明,如果通过剖腹产完成分娩,则属于一般精神病样本的可能性略有增加,而不是 SUD 样本。经过 Bonferroni 校正后,线性回归模型显示围产期标志物与 IQ(p=0.60,R²=0.068)、YSR(p=0.09,R²=0.121)、DUDIT(p=0.65,R²=0.020)和 PQ-16(p=0.73,R²=0.021)之间没有关系。

结论

围产期标志物无法将 SUD 患者与具有多种精神病理学的患者区分开来。这种模式与之前的发现相矛盾,也许是因为我们选择的标志物反映了一般过程而不是特定的机制解释。未来的研究应注意调查特定的产前标志物,并将其与症状水平上的精神病理学相关联。

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