Impact of Early-Life Factors on Risk for Schizophrenia and Bipolar Disorder.
Impact of Early-Life Factors on Risk for Schizophrenia and Bipolar Disorder.
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早期生活因素对精神分裂症和双相情感障碍风险的影响。
DOI：
10.1093/schbul/sbac205
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发表时间：
2023
影响因子：
6.6
通讯作者：
Bergen,SarahE
中科院分区：
文献类型：
--
作者：
Robinson,Natassia;Ploner,Alexander;Leone,Marica;Lichtenstein,Paul;Kendler,KennethS;Bergen,SarahE
背景和假设精神分裂症（SCZ）和双相情感障碍（BD）具有共同的遗传风险和临床症状，但环境风险因素的共同程度尚不清楚。我们的目的是检查早期生活环境暴露与SCZ和BD风险的关联。研究设计我们进行了一项基于瑞典登记的巢式病例对照研究，使用1988-2013年诊断的4184例SCZ和18681例BD病例，分别与出生年份，性别和出生地的5个基于人群的对照进行匹配。条件Logistic回归被用来评估的风险SCZ和BD的季节性，严重的产前感染，围产期factors.Study ResultsSeasonality有类似的模式，这两种疾病的风险：较高的风险出生11月至12月，较低的风险4月至6月。经历任何围产期因素与SCZ风险显著升高相关（发病率比[IRR] 1.19，95%CI 1.11-1.63），与BD风险较低相关（IRR 1.08，95%CI 1.05-1.12）。产前感染仅与SCZ风险增加相关（IRR 1.30，95%CI 1.04-1.63）。在相互校正模型中，只有围产期因素与结局相关。几个围产期因素与这两种疾病，但估计显着较高的SCZ低出生体重，低APGAR，高产次。先天性畸形仅与SCZ的风险，和黄疸与BD。ConclusionsAdverse围产期因素和冬季出生的危险因素，这两种疾病，而严重的产前感染SCZ的风险因素。早期生活暴露与这两种疾病的风险较高，但可能发挥更大的作用，SCZ的发展比BD。
Background and HypothesisSchizophrenia (SCZ) and bipolar disorder (BD) have shared genetic risk and clinical symptoms, yet the extent to which environmental risk factors are shared is not well known. We aimed to examine the associations of early-life environmental exposures with the risk of SCZ and BD.Study DesignWe conducted a Swedish register-based nested case–control study using 4184 SCZ and 18 681 BD cases diagnosed 1988–2013, individually matched to 5 population-based controls by birth year, sex and birthplace. Conditional logistic regression was used to evaluate the risk of SCZ and BD by seasonality, severe prenatal infections, and perinatal factors.Study ResultsSeasonality had similar patterns of risk for both disorders: Higher risk for births November–December; lower risk April–June. Experiencing any perinatal factor was associated with a significantly higher risk of SCZ (incidence rate ratio [IRR] 1.19, 95%CI 1.11–1.63) and to a lesser extent BD (IRR 1.08, 95%CI 1.05–1.12). Prenatal infections were only associated with a greater risk of SCZ (IRR 1.30, 95%CI 1.04–1.63). In the mutually adjusted model, only perinatal factors were associated with outcomes. Several perinatal factors were associated with both disorders, but estimates were significantly higher for SCZ for low birth weight, low APGAR, and high parity. Congenital malformations were only associated with risk of SCZ, and jaundice with BD.ConclusionsAdverse perinatal factors and winter birth were the risk factors for both disorders, while severe prenatal infections were only risk a factor for SCZ. Early-life exposures were associated with a higher risk of both disorders, but may play a larger role in the development of SCZ than BD.