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精神分裂症合并强迫症患者的父母精神障碍:一项全国性家庭关联研究。

Parental mental disorders in patients with comorbid schizophrenia and obsessive-compulsive disorder: a nationwide family-link study.

作者信息

Hsu Tien-Wei, Tsai Shih-Jen, Bai Ya-Mei, Cheng Chih-Ming, Su Tung-Ping, Chen Tzeng-Ji, Liang Chih-Sung, Chen Mu-Hong

机构信息

Department of Psychiatry, E-DA Dachang Hospital, I-Shou University, Kaohsiung, Taiwan.

Graduate Institute of Clinical Medicine, College of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.

出版信息

Eur Child Adolesc Psychiatry. 2024 Dec;33(12):4325-4334. doi: 10.1007/s00787-024-02480-0. Epub 2024 May 30.

Abstract

Schizophrenia is highly comorbid with obsessive-compulsive disorder (OCD); both conditions share numerous pathophysiological etiologies. We, thus, examined the risk of mental disorders in the parents of probands with schizophrenia, OCD, or both conditions. Between 2001 and 2011, we enrolled a nationwide cohort of 69,813 patients with schizophrenia, OCD, or both. The control cohort included 698,130 individuals matched for demographics. Poisson regression models were employed to examine the risk of six mental disorders in their parents, including schizophrenia, bipolar disorder, depressive disorder, OCD, alcohol use disorder, and substance use disorder. We stratified patients into schizophrenia-only, OCD-only, and dual-diagnosis groups, and the dual-diagnosis group was further divided into schizophrenia-first, OCD-first, and simultaneously diagnosed groups. Compared with controls, the schizophrenia, OCD, and dual-diagnosis groups had higher risks for the six mental disorders in their parents (range of odds ratio [OR] 1.50-7.83). The sub-analysis of the dual-diagnosis group showed that the schizophrenia-first, OCD-first, and simultaneously diagnosed groups had higher odds for schizophrenia, bipolar disorder, depressive disorder, and OCD (range of OR 1.64-6.45) in their parents than the control group; the simultaneously diagnosed and OCD-first diagnosed groups had a higher odds of parental substance use disorder, while the schizophrenia-first diagnosed group had a higher odds of parental alcohol use disorder. The interrelationship between OCD and schizophrenia is linked to bipolar disorder, depressive disorder, alcohol use disorder, and substance use disorder. The results have implications for mental health policy and future research.

摘要

精神分裂症与强迫症(OCD)高度共病;这两种疾病有许多共同的病理生理病因。因此,我们研究了精神分裂症、强迫症或两种疾病都有的先证者父母患精神障碍的风险。在2001年至2011年期间,我们纳入了一个全国性队列,其中有69813名患有精神分裂症、强迫症或两者皆有的患者。对照组包括698130名在人口统计学上匹配的个体。采用泊松回归模型来研究其父母患六种精神障碍的风险,包括精神分裂症、双相情感障碍、抑郁症、强迫症、酒精使用障碍和物质使用障碍。我们将患者分为仅患精神分裂症组、仅患强迫症组和双重诊断组,双重诊断组又进一步分为精神分裂症首发组、强迫症首发组和同时诊断组。与对照组相比,精神分裂症组、强迫症组和双重诊断组的父母患这六种精神障碍的风险更高(优势比[OR]范围为1.50 - 7.83)。双重诊断组的亚分析表明,精神分裂症首发组、强迫症首发组和同时诊断组的父母患精神分裂症、双相情感障碍、抑郁症和强迫症的几率(OR范围为1.64 - 6.45)高于对照组;同时诊断组和强迫症首发诊断组的父母患物质使用障碍的几率更高,而精神分裂症首发诊断组的父母患酒精使用障碍的几率更高。强迫症与精神分裂症之间的相互关系与双相情感障碍、抑郁症、酒精使用障碍和物质使用障碍有关。这些结果对心理健康政策和未来研究具有启示意义。

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