在精神分裂症、双相情感障碍家族高风险儿童及基于人群的对照儿童中，幼儿期逆境暴露与童年中期精神病性体验之间的关联：丹麦高风险与复原力研究——VIA 7和VIA 11
Associations between exposure to early childhood adversities and middle childhood psychotic experiences in children at familial high risk of schizophrenia, bipolar disorder, and population-based controls: The Danish high risk and resilience study - VIA 7 and VIA 11.
作者信息
Brandt Julie Marie, Gregersen Maja, Søndergaard Anne, Krantz Mette Falkenberg, Knudsen Christina Bruun, Andreassen Anna Krogh, Veddum Lotte, Ohland Jessica, Hjorthøj Carsten, Wilms Martin, Rohd Sinnika Birkehøj, Greve Aja, Burton Birgitte Klee, Bliksted Vibeke, Mors Ole, Nordentoft Merete, Thorup Anne Amalie Elgaard, Hemager Nicoline
机构信息
CORE - Copenhagen Research Center for Mental Health, Mental Health Services in the Capital Region of Denmark, Mental Health Center Copenhagen, Copenhagen, Denmark.
The Lundbeck Foundation Initiative for Integrative Psychiatric Research - iPSYCH, Aarhus, Denmark.
出版信息
Psychol Med. 2023 Oct;53(14):6635-6645. doi: 10.1017/S0033291722004020. Epub 2023 Feb 2.
BACKGROUND
Exposure to adversities in early childhood is associated with psychotic experiences and disorders in adulthood. We aimed to examine whether early childhood adversities are associated with middle childhood psychotic experiences in a cohort of children at familial high risk of schizophrenia (FHR-SZ), bipolar disorder (FHR-BP) and population-based controls (controls).
METHODS
Four hundred and forty-six children from The Danish High Risk and Resilience Study - VIA7 and VIA11 participated in this study (FHR-SZ = 170; FHR-BP = 103; controls = 173). Exposure to early childhood adversities and psychotic experiences were assessed using face-to-face interviews. Having childhood adversities assessed at baseline (age 7) was used as predictor. Psychotic experiences assessed at follow-up (age 11) were used as outcome.
RESULTS
Across the sample, exposure to early childhood interpersonal adversities was associated with an increased risk for any middle childhood psychotic experiences and subclinical delusions when adjusting for relevant confounders (OR 1.8, 95% CI 1.0-3.1, = 0.05; OR 3.0, 95% CI 1.6-5.6, < 0.001). There was no significant dose-response effect of exposure to multiple types of childhood adversities on any psychotic experiences. There were no interaction effects between early childhood adversities and FHR on middle childhood psychotic experiences. Exploratory analyses revealed that experiencing domestic violence in early childhood was associated with any middle childhood psychotic experiences (OR 2.8, 95% CI 1.5-5.1, = 0.001).
CONCLUSIONS
Exposure to interpersonal adversities during early childhood is associated with an increased risk for middle childhood psychotic experiences including specifically subclinical delusions. Future studies should examine associations between exposure to childhood adversities and conversion to psychosis within this cohort.
背景
儿童早期经历逆境与成年期的精神病性体验及障碍有关。我们旨在研究在一组有精神分裂症家族高风险（FHR-SZ）、双相情感障碍家族高风险（FHR-BP）的儿童及基于人群的对照组（对照组）中，儿童早期逆境是否与童年中期的精神病性体验有关。
方法
来自丹麦高风险与复原力研究-VIA7和VIA11的446名儿童参与了本研究（FHR-SZ = 170；FHR-BP = 103；对照组 = 173）。通过面对面访谈评估儿童早期逆境暴露情况和精神病性体验。将在基线（7岁）时评估的童年逆境作为预测因素。将在随访（11岁）时评估的精神病性体验作为结果。
结果
在整个样本中，在调整相关混杂因素后，儿童早期人际逆境暴露与童年中期出现任何精神病性体验及亚临床妄想的风险增加有关（比值比[OR] 1.8，95%置信区间[CI] 1.0 - 3.1，P = 0.05；OR 3.0，95% CI 1.6 - 5.6，P < 0.001）。多种类型童年逆境暴露对任何精神病性体验均无显著的剂量反应效应。儿童早期逆境与FHR对童年中期精神病性体验之间无交互作用。探索性分析显示，儿童早期经历家庭暴力与童年中期出现任何精神病性体验有关（OR 2.8，95% CI 1.5 - 5.1，P = 0.001）。
结论
儿童早期人际逆境暴露与童年中期精神病性体验风险增加有关，特别是亚临床妄想。未来研究应在此队列中考察童年逆境暴露与精神病转化之间的关联。
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