产前饥荒后的精神分裂症。进一步的证据。

Schizophrenia after prenatal famine. Further evidence.

作者信息

Susser E, Neugebauer R, Hoek H W, Brown A S, Lin S, Labovitz D, Gorman J M

机构信息

Department of Psychiatry, Columbia University, New York, NY, USA.

出版信息

Arch Gen Psychiatry. 1996 Jan;53(1):25-31. doi: 10.1001/archpsyc.1996.01830010027005.

DOI:10.1001/archpsyc.1996.01830010027005

PMID:8540774

Abstract

BACKGROUND

Suggestive findings of an earlier study that prenatal nutritional deficiency was a determinant of schizophrenia prompted us to undertake a second test of the hypothesis using more precise data on both exposure and outcome.

METHODS

Among persons born in the cities of western Netherlands during 1944 through 1946, we compared the risk for schizophrenia in those exposed and unexposed during early gestation to the Dutch Hunger Winter of 1944/1945. The frequency of hospitalized patients with schizophrenia at age 24 to 48 years in the exposed and unexposed birth cohorts was ascertained from a national psychiatric registry.

RESULTS

The most exposed birth cohort, conceived at the height of the famine, showed a twofold and statistically significant increase in the risk for schizophrenia (relative risk [RR] = 2.0; 95% confidence interval [CI] = 1.2 to 3.4; P < .01) in both men (RR = 1.9; 95% CI = 1.0 to 3.7; P = .05) and women (RR = 2.2; 95% CI = 1.0 to 4.7; P = .04). Among all birth cohorts of 1944 through 1946, the risk for schizophrenia clearly peaked in this exposed cohort.

CONCLUSION

Prenatal nutritional deficiency may play a role in the origin of some cases of schizophrenia.

摘要

背景

一项早期研究的提示性结果表明，产前营养缺乏是精神分裂症的一个决定因素，这促使我们使用关于暴露因素和结局的更精确数据对该假设进行第二次检验。

方法

在1944年至1946年出生于荷兰西部城市的人群中，我们比较了在妊娠早期暴露于1944/1945年荷兰饥荒冬季和未暴露人群中患精神分裂症的风险。通过国家精神病学登记处确定暴露和未暴露出生队列中24至48岁精神分裂症住院患者的频率。

结果

在饥荒最严重时受孕的暴露程度最高的出生队列中，男性（相对风险[RR]=1.9；95%置信区间[CI]=1.0至3.7；P=0.05）和女性（RR=2.2；95%CI=1.0至4.7；P=0.04）患精神分裂症的风险均增加了两倍，且具有统计学意义（RR=2.0；95%CI=1.2至3.4；P<0.01）。在1944年至1946年的所有出生队列中，精神分裂症的风险在这个暴露队列中明显达到峰值。