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父母的精神障碍与子女严重精神障碍的发病年龄:一项全国性的家庭关联研究。

Parental mental disorders and ages of onset of severe mental disorders in offspring: A nationwide family-link study.

机构信息

Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan.

Department of Psychiatry, E-DA Hospital, Kaohsiung, Taiwan; Department of Psychiatry, E-DA Dachang Hospital, Kaohsiung, Taiwan.

出版信息

J Psychiatr Res. 2024 Dec;180:443-450. doi: 10.1016/j.jpsychires.2024.11.018. Epub 2024 Nov 9.

Abstract

OBJECTIVE

The current study used a retrospective study design to investigate the association between age of onset of severe mental disorders in offspring and the likelihood of diagnoses of parental mental disorder.

METHOD

We enrolled 212,333 people with severe mental disorder, including schizophrenia, bipolar disorder (BD), or major depressive disorder (MDD) and 2,123,329 controls matched for age, sex, and demographics from the National Health Insurance Database of Taiwan. Poisson regression models were used to examine the likelihood of diagnoses of five mental disorders in their parents compared to the parents of the controls (reported as odds ratio (OR) with 95% confidence interval), including schizophrenia, BD, MDD, alcohol use disorder (AUD), and substance use disorder (SUD). The study cohort was classified into child-onset, adolescent-onset, and adult-onset groups according to the onset of severe mental disorders in the offspring.

RESULT

The parents of people with child-, adolescent-, and adult-onset schizophrenia (OR range: 1.73-9.08, all p < 0.05) or BD (OR range: 1.97-8.17, all p < 0.05) were more likely to be diagnosed with schizophrenia, BD, MDD, AUD, and substance use disorder (SUD) than controls except for AUD in the child-onset group. However, the parents of people with child-, adolescent-, and adult-onset depressive disorder were more likely to be diagnosed with schizophrenia, BD, MDD, AUD, and SUD (OR range: 1.82-4.76, all p < 0.05) than controls. Sub-analyses stratified by sex showed different patterns of associations between parental mental disorders and offspring mental disorders.

CONCLUSION

No matter when the severe mental disorder of the offsprings occurred at different onset stages, their parents had a higher likelihood of being diagnosed with schizophrenia, BD, MDD, AUD, and SUD.

摘要

目的

本研究采用回顾性研究设计,探讨子女重度精神障碍发病年龄与父母精神障碍诊断可能性之间的关系。

方法

我们从台湾全民健康保险数据库中纳入了 212333 例患有精神分裂症、双相情感障碍(BD)或重度抑郁症(MDD)的重度精神障碍患者和 2123339 名年龄、性别和人口统计学特征相匹配的对照者。使用泊松回归模型比较了其父母与对照组父母的五种精神障碍诊断可能性(报告为比值比[OR]及其 95%置信区间),包括精神分裂症、BD、MDD、酒精使用障碍(AUD)和物质使用障碍(SUD)。根据子女重度精神障碍的发病年龄,研究队列分为儿童发病、青少年发病和成年发病组。

结果

患有儿童发病、青少年发病和成年发病精神分裂症(OR 范围:1.73-9.08,均 p<0.05)或 BD(OR 范围:1.97-8.17,均 p<0.05)的患者的父母更有可能被诊断为精神分裂症、BD、MDD、AUD 和物质使用障碍(SUD),除儿童发病组的 AUD 外,均高于对照组。然而,患有儿童发病、青少年发病和成年发病抑郁障碍的患者的父母更有可能被诊断为精神分裂症、BD、MDD、AUD 和物质使用障碍(OR 范围:1.82-4.76,均 p<0.05),高于对照组。按性别分层的亚分析显示,父母精神障碍与子女精神障碍之间的关联模式不同。

结论

无论子女的重度精神障碍在哪个发病阶段发生,其父母都更有可能被诊断为精神分裂症、BD、MDD、AUD 和 SUD。

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