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精神分裂症的产科并发症和精神病理学:系统评价和荟萃分析。

Obstetric complications and psychopathology in schizophrenia: A systematic review and meta-analysis.

机构信息

Bipolar and Depressive Disorders Unit, Hospital Clínic de Barcelona, Barcelona, Spain; Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Institut de Neurociències (UBNeuro), Universitat de Barcelona (UB), Barcelona, Spain; Fundació Clínic-Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain; Barcelona Clínic Schizophrenia Unit, Hospital Clínic de Barcelona, Spain.

Bipolar and Depressive Disorders Unit, Hospital Clínic de Barcelona, Barcelona, Spain; Departament de Medicina, Facultat de Medicina i Ciències de la Salut, Institut de Neurociències (UBNeuro), Universitat de Barcelona (UB), Barcelona, Spain; Fundació Clínic-Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Barcelona, Spain; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.

出版信息

Neurosci Biobehav Rev. 2024 Dec;167:105913. doi: 10.1016/j.neubiorev.2024.105913. Epub 2024 Oct 1.

Abstract

Schizophrenia (SZ) is a severe mental health condition involving gene-environment interactions, with obstetric complications (OCs) conferring an elevated risk for the disease. Current research suggests that OCs may exacerbate SZ symptoms. This study conducted a systematic review and meta-analysis to comprehensively evaluate differences in psychopathology between individuals with and without exposure to OCs in relation to SZ and related disorders. We systematically searched PubMed, PsycINFO, and SCOPUS to identify eligible studies. A total of 4091 records were retrieved through systematic and citation searches. 14 studies were included in the review, and 12 met the criteria for meta-analysis, involving 2992 patients. The analysis revealed that SZ patients who had been exposed to OCs exhibited significantly higher levels of positive symptoms (SMD=0.10, 95 %CI=0.01,0.20; p=0.03), general psychopathology (SMD=0.37, 95 %CI=0.22,0.52; p<0.001), total clinical symptomatology (SMD=0.44, 95 %CI=0.24,0.64; p<0.001) and depressive symptoms (SMD=0.47, 95 %CI=0.09,0.84; p=0.01). No significant differences were found in negative symptomatology and functioning. Our results suggest that OCs are not only associated with an increased risk of developing psychosis but with more severe symptomatology.

摘要

精神分裂症(SZ)是一种严重的精神健康状况,涉及基因-环境相互作用,产科并发症(OCs)使患病风险增加。目前的研究表明,OCs 可能会使 SZ 症状恶化。本研究进行了系统评价和荟萃分析,以全面评估暴露于 OCs 的个体与未暴露于 OCs 的个体在 SZ 和相关障碍方面的精神病理学差异。我们系统地搜索了 PubMed、PsycINFO 和 SCOPUS,以确定符合条件的研究。通过系统和引文搜索共检索到 4091 条记录。有 14 项研究被纳入综述,其中 12 项符合荟萃分析标准,涉及 2992 名患者。分析显示,暴露于 OCs 的 SZ 患者阳性症状(SMD=0.10,95%CI=0.01,0.20;p=0.03)、一般精神病理学(SMD=0.37,95%CI=0.22,0.52;p<0.001)、总临床症状(SMD=0.44,95%CI=0.24,0.64;p<0.001)和抑郁症状(SMD=0.47,95%CI=0.09,0.84;p=0.01)显著更高。阴性症状和功能无显著差异。我们的结果表明,OCs 不仅与增加患精神病的风险有关,而且与更严重的症状有关。

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