Brochard A, Escande M, Schmitt L, Granier F, Girard M, Charlet J P, Moron P
Clinique Psychothérapique de Rozès, secteur A, Saint-Lizier.
Encephale. 1994 Sep-Oct;20(5):459-72.
In a retrospective study, we compared the months of birth of 3,106 psychiatric inpatients to those of 1,943 surgical patients collected during the same period 1981-1991 in the same hospital, and of a sample of 10,003,572 births in France in 1977-1989. DSM III-R categories were modified so to allow a comparison with former studies, and psychiatric patients were distributed among seven categories: Bipolars (N = 294), Unipolars (N = 287), Neurotic-reactive depressions (N = 582), First Major Depressive episode (N = 214), Schizophrenia (N = 244), Schizo-Affectives (N = 52) and Other Diagnosies (N = 1,433). Months of birth were grouped in quarters and semesters, according to the usual calendar, but also to temperature and the photoperiodic cycle. The main results were: 1. A seasonnality of births in the General Population sample, with a spring maximum (p < 0.001). 2. An absence of deviation from the general population and the surgical sample among Neurotic-reactive Depressions and Other Diagnoses. 3. A deviation from the general population and from other comparison groups (surgical cases and Other Diagnoses) among Unipolars and First Major Depressive Episodes (most of those being late episodes), with a significant excess of births during the "dark" or "cold" season of the year, especially around the winter solstice. The Bipolar group followed the same tendency, though to a lesser degree and for subjects born before 1940 only. The most significant results were found among Unipolars, which differ from the general population either by quarters (p < 0.0005) or by semesters (p < 0.0005) and from surgical cases by quarters (p < 0.01) and by semesters (p < 0.001). The results were similar for First Major Depressive episodes, although this category was theoretically "anosological". As the median age was high in this category, it might group a number of late depressive episodes, near to "involutionnal melancholia". Thus, our results seem to be relevant to the traditional endogenous-psychogenetic dichotomy, with a "cold" or "dark" seasonnality of births in the first case, and no particular seasonnality in the second case. Some former studies showed the same results, but the most significant deviation was found in mania. Our results cannot be explained by differences in the sex-ratio among the categories, and only partially by an age-incidence effect or an age-cohort effect.(ABSTRACT TRUNCATED AT 400 WORDS)
在一项回顾性研究中,我们将3106名精神科住院患者的出生月份与1943名同期(1981 - 1991年)在同一家医院收集的外科手术患者的出生月份进行了比较,并与1977 - 1989年法国10003572例出生样本进行了比较。对《精神疾病诊断与统计手册》第三版修订版(DSM III-R)的类别进行了修改,以便与以前的研究进行比较,精神科患者被分为七类:双相情感障碍患者(N = 294)、单相情感障碍患者(N = 287)、神经症反应性抑郁症患者(N = 582)、首次重度抑郁发作患者(N = 214)、精神分裂症患者(N = 244)、分裂情感性障碍患者(N = 52)和其他诊断患者(N = 1433)。出生月份按照常规日历,同时也根据温度和光周期被分组为季度和学期。主要结果如下:1. 普通人群样本中存在出生季节性,春季出生人数最多(p < 0.001)。2. 神经症反应性抑郁症患者和其他诊断患者与普通人群及外科手术样本相比无偏差。3. 单相情感障碍患者和首次重度抑郁发作患者(其中大多数为晚期发作)与普通人群及其他比较组(外科手术病例和其他诊断患者)存在偏差,在一年中“黑暗”或“寒冷”季节出生人数显著过多,尤其是在冬至前后。双相情感障碍组也呈现相同趋势,但程度较轻,且仅适用于1940年以前出生的患者。在单相情感障碍患者中发现的结果最为显著,其与普通人群按季度比较(p < 0.0005)或按学期比较(p < 0.0005)均有差异,与外科手术病例按季度比较(p < 0.01)和按学期比较(p < 0.001)也有差异。首次重度抑郁发作患者的结果类似,尽管该类别在理论上“无明确诊断学意义”。由于该类别患者的年龄中位数较高,可能包含一些接近“更年期忧郁症”的晚期抑郁发作病例。因此,我们的结果似乎与传统的内源性 - 心理发生二分法相关,第一种情况是出生存在“寒冷”或“黑暗”季节性,第二种情况则无特定季节性。一些以前的研究也得出了相同的结果,但最显著的偏差出现在躁狂症中。我们的结果无法用各类别之间的性别比例差异来解释,仅部分可由年龄发病率效应或年龄队列效应来解释。(摘要截断于400字)