Vinueza Veloz María Fernanda, Bhatta Laxmi, Jones Paul Remy, Tesli Martin, Smith George Davey, Davies Neil Martin, Brumpton Ben M, Næss Øyvind Erik
Department of Community Medicine and Global Health, Institute of Health and Society, Faculty of Medicine, University of Oslo, Post box 1130, 0318 Oslo, Norway.
K.G. Jebsen Center for Genetic Epidemiology, Department of Public Health and Nursing, Norwegian University of Science and Technology - NTNU, Post box 8905, 7491 Trondheim, Norway.
medRxiv. 2024 Aug 11:2024.08.10.24311789. doi: 10.1101/2024.08.10.24311789.
Observational studies have demonstrated consistent protective effects of higher educational attainment (EA) on the risk of suffering mental health conditions (MHC). Determining whether these beneficial effects are causal is challenging given the potential role of dynastic effects and demographic factors (assortative mating and population structure) in this association.
To evaluate to what extent the relationship between EA and various MHC is independent from dynastic effects and demographic factors.
Within-sibship Mendelian randomization (MR) study.
One-sample MR analyses included participants' data from the Trøndelag Health Study (HUNT, Norway) and UK Biobank (United Kingdom). For two-sample MR analyses we used summary statistics from publicly available genome-wide-association-studies.
61 880 siblings (27 507 sibships).
Years of education.
Scores for symptoms of anxiety, depression and neuroticism using the Hospital Anxiety Depression Scale (HADS), the 7-item Generalized Anxiety Disorder Scale (GAD-7), the 9-item Patient Health Questionnaire (PHQ-9), and the Eysenck Personality Questionnaire, as well as self-reported consumption of psychotropic medication.
One standard deviation (SD) unit increase in years of education was associated with a lower symptom score of anxiety (-0.20 SD [95%CI: -0.26, -0.14]), depression (-0.11 SD [-0.43, 0.22]), neuroticism (-0.30 SD [-0.53, -0.06]), and lower odds of psychotropic medication consumption (OR: 0.60 [0.52, 0.69]). Estimates from the within-sibship MR analyses showed some attenuation, which however were suggestive of a causal association (anxiety: -0.17 SD [-0.33, -0.00]; depression: -0.18 SD [-1.26, 0.89]; neuroticism: -0.29 SD [-0.43, -0.15]); psychotropic medication consumption: OR, 0.52 [0.34, 0.82]).
Associations between EA and MHC in adulthood, although to some extend explained by dynastic effects and demographic factors, overall remain robust, indicative of a causal effect. However, larger studies are warranted to improve statistical power and further validate our conclusions.
观察性研究表明，较高的教育程度（EA）对患心理健康疾病（MHC）的风险具有持续的保护作用。鉴于王朝效应和人口因素（选型交配和人口结构）在这种关联中可能发挥的作用，确定这些有益影响是否具有因果关系具有挑战性。
评估EA与各种MHC之间的关系在多大程度上独立于王朝效应和人口因素。
同胞内孟德尔随机化（MR）研究。
单样本MR分析纳入了来自挪威特隆赫姆健康研究（HUNT）和英国生物银行（英国）的参与者数据。对于两样本MR分析，我们使用了公开可用的全基因组关联研究的汇总统计数据。
61880名兄弟姐妹（27507个同胞对）。
受教育年限。
使用医院焦虑抑郁量表（HADS）、7项广泛性焦虑症量表（GAD-7）、9项患者健康问卷（PHQ-9）和艾森克人格问卷评估焦虑、抑郁和神经质症状的得分，以及自我报告的精神药物消费情况。
受教育年限每增加一个标准差（SD）单位，焦虑症状得分降低（-0.20 SD [95%CI：-0.26，-0.14]）、抑郁症状得分降低（-0.11 SD [-0.43，0.22]）、神经质症状得分降低（-0.30 SD [-0.53，-0.06]），精神药物消费几率降低（OR：0.60 [0.52，0.69]）。同胞内MR分析的估计值显示出一定程度的衰减，但仍提示存在因果关联（焦虑：-0.17 SD [-0.33，-0.00]；抑郁：-0.18 SD [-1.26，0.89]；神经质：-0.29 SD [-0.43，-0.15]）；精神药物消费：OR为0.52 [0.34，0.82]）。
成年期EA与MHC之间的关联，虽然在一定程度上可由王朝效应和人口因素解释，但总体上仍然稳健，表明存在因果效应。然而，需要进行更大规模的研究以提高统计效力并进一步验证我们的结论。
