Department of Obstetrics and Gynecology, Columbia University, New York, New York, USA.
Department of Psychiatry, Jewish General Hospital, Montreal, Quebec, Canada.
Dev Psychobiol. 2023 Jul;65(5):e22395. doi: 10.1002/dev.22395.
Dysregulation is a combination of emotion, behavior, and attention problems associated with lifelong psychiatric comorbidity. There is evidence for the stability of dysregulation from childhood to adulthood, which would be more fully characterized by determining the likely stability from infancy to childhood. Early origins of dysregulation can further be validated and contextualized in association with environmental and biological factors, such as prenatal stress and polygenic risk scores (PRS) for overlapping child psychiatric problems. We aimed to determine trajectories of dysregulation from 3 months to 5 years (N = 582) in association with maternal prenatal depression moderated by multiple child PRS (N = 232 pairs with available PRS data) in a prenatal cohort. Mothers reported depression symptoms at 24-26 weeks' gestation and child dysregulation at 3, 6, 18, 36, 48, and 60 months. The PRS were for major depressive disorder, attention deficit hyperactivity disorder, cross disorder, and childhood psychiatric problems. Covariates were biological sex, maternal education, and postnatal depression. Analyses included latent classes and regression. Two dysregulation trajectories emerged: persistently low dysregulation (94%), and increasingly high dysregulation (6%). Stable dysregulation emerged at 18 months. High dysregulation was associated with maternal prenatal depression, moderated by PRS for child comorbid psychiatric problems. Males were at greater risk of high dysregulation.
失调是与终身精神共病相关的情绪、行为和注意力问题的组合。有证据表明,从儿童期到成年期,失调具有稳定性,通过确定从婴儿期到儿童期的可能稳定性,将可以更全面地描述失调。失调的早期起源可以通过与环境和生物因素(如产前压力和重叠儿童精神疾病的多基因风险评分 (PRS))相关联来进一步验证和背景化。我们旨在确定与多个儿童 PRS(N=232 对具有可用 PRS 数据的儿童)相关的母亲产前抑郁(N=582)从 3 个月到 5 岁(N=582)的失调轨迹,在产前队列中。母亲在妊娠 24-26 周时报告抑郁症状,在 3、6、18、36、48 和 60 个月时报告儿童失调。PRS 用于评估重度抑郁症、注意缺陷多动障碍、跨障碍和儿童精神疾病。协变量为生物性别、母亲教育和产后抑郁。分析包括潜在类别和回归。出现了两种失调轨迹:持续低度失调(94%)和逐渐高度失调(6%)。稳定的失调出现在 18 个月。高失调与母亲产前抑郁有关,受儿童共患精神疾病 PRS 调节。男性患高度失调的风险更高。