Brown A S, Susser E S, Lin S P, Neugebauer R, Gorman J M
Department of Psychiatry, Columbia University, New York State Psychiatric Institute, NY 10032, USA.
Br J Psychiatry. 1995 May;166(5):601-6. doi: 10.1192/bjp.166.5.601.
Prenatal and perinatal factors have been linked to affective disorders. We therefore undertook an exploratory study to determine whether prenatal exposure to severe famine was associated with an increased risk of affective disorders.
Monthly birth cohorts that were exposed and unexposed to the Dutch Hunger Winter of 1944-45 were identified. The cumulative incidences of affective psychoses and neurotic depression (ICD-9 criteria) were compared between exposed and unexposed cohorts during each trimester of gestation.
The relative risk (RR) of affective psychosis (broad and restricted definitions) among persons exposed to famine during the second trimester was significantly increased (broad: RR (95% confidence interval) = 1.62 (1.19, 2.20); restricted: 1.59 (1.14, 2.21)). Separate analysis by gender showed a significant association among males (broad: 2.26 (1.43, 3.57); restricted: 2.40 (1.49, 3.89), but not females (broad: 1.28 (0.84, 1.94); restricted: 1.17 (0.73, 1.76)). The risk of neurotic depression was not increased after prenatal famine exposure.
These results suggest a possible relationship between prenatal famine during the second trimester and affective psychosis, lending plausibility to reports that have associated affective psychoses with prenatal exposures. Further studies of this relationship are warranted.
产前和围产期因素与情感障碍有关。因此，我们进行了一项探索性研究，以确定产前暴露于严重饥荒是否与情感障碍风险增加有关。
确定了1944 - 1945年荷兰饥荒冬季期间暴露和未暴露的每月出生队列。比较了暴露组和未暴露组在妊娠各阶段情感性精神病和神经症性抑郁（国际疾病分类第九版标准）的累积发病率。
孕中期暴露于饥荒的人群中，情感性精神病（广义和狭义定义）的相对风险（RR）显著增加（广义：RR（95%置信区间）= 1.62（1.19，2.20）；狭义：1.59（1.14，2.21））。按性别进行的单独分析显示，男性之间存在显著关联（广义：2.26（1.43，3.57）；狭义：2.40（1.49，3.89）），而女性则无（广义：1.28（0.84，1.94）；狭义：1.17（0.73，1.76））。产前饥荒暴露后，神经症性抑郁的风险没有增加。
这些结果表明孕中期产前饥荒与情感性精神病之间可能存在关联，这使得将情感性精神病与产前暴露联系起来的报告具有可信度。有必要对这种关系进行进一步研究。
