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围产期和新生儿因素与儿童和青少年精神障碍:寻找早期环境对精神病理学常见和可分离方面的贡献。

Perinatal and neonatal factors and mental disorders in children and adolescents: looking for the contributions of the early environment to common and dissociable aspects of psychopathology.

机构信息

Section On Negative Affect and Social Process, Hospital de Clínicas de Porto Alegre, Universidade Federal do Rio Grande do Sul, Porto Alegre, Brazil.

National Institute of Developmental Psychiatry for Children and Adolescents (INCT-CNPq), São Paulo, Brazil.

出版信息

Eur Child Adolesc Psychiatry. 2024 Oct;33(10):3571-3581. doi: 10.1007/s00787-024-02402-0. Epub 2024 Mar 22.

Abstract

High rates of co-occurrence of mental disorders have been hypothesized to represent a result of common susceptibility to overall psychopathology. The purpose of this study is to test the hypothesis that commonalities among psychiatric disorders might be partially driven by sharable perinatal and neonatal environmental factors for mental disorders. Participants were 6-14 years of age children and their parents. Primary caregivers provided data on perinatal and neonatal information assessed retrospectively (n = 2231). Psychiatric disorders diagnoses were assessed using the Development and Well Being Behavior Assessment (DAWBA). We used bifactor models to disentangle common from dissociable aspects of psychopathology. These models allow modeling psychiatric disorders as the result of a common domain of psychopathology (p-factor) and three dissociable domains (fear, distress, and externalizing symptoms). Associations were tested using linear and tobit regression models. The p-factor was associated with male sex, low socioeconomic status, gestational smoking, gestational drinking, low levels of maternal education and presence of mental disorder in the mother. Associations with specific factors also emerged suggesting some risk factors might also have some role for fear, distress and externalizing factors. Our study supports the hypothesis that overall susceptibility to psychopathology might be partially driven by sharable perinatal and neonatal factors.

摘要

精神障碍的高共病率一直被假设为代表了对整体精神病理学的共同易感性的结果。本研究旨在检验这样一种假设,即精神障碍之间的共性可能部分是由可共享的围产期和新生儿环境因素驱动的。参与者为 6-14 岁的儿童及其父母。主要照顾者提供了回顾性评估的围产期和新生儿信息数据(n=2231)。使用发展和健康行为评估(DAWBA)评估精神障碍诊断。我们使用双因素模型来区分精神病理学的共同和可分离方面。这些模型允许将精神障碍建模为精神病理学共同领域(p 因素)和三个可分离领域(恐惧、痛苦和外化症状)的结果。使用线性和 Tobit 回归模型测试关联。p 因素与男性、社会经济地位低、妊娠期吸烟、妊娠期饮酒、母亲受教育程度低以及母亲存在精神障碍有关。与特定因素的关联也出现了,这表明一些风险因素可能也对恐惧、痛苦和外化因素有一定的作用。我们的研究支持了这样一种假设,即对精神病理学的总体易感性可能部分是由可共享的围产期和新生儿因素驱动的。

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