Cognitive Ability in Early Adulthood and Risk of 5 Specific Psychiatric Disorders in Middle Age The Vietnam Experience Study
Cognitive Ability in Early Adulthood and Risk of 5 Specific Psychiatric Disorders in Middle Age The Vietnam Experience Study
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DOI：
10.1001/archpsyc.65.12.1410
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发表时间：
2008-12-01
影响因子：
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通讯作者：
Batty, David
中科院分区：
文献类型：
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作者：
Gale, Catharine R.;Deary, Ian J.;Batty, David
背景：认知能力低下是某些形式的精神病理学的风险因素，但风险的大部分证据是基于需要专家护理的个人。目前尚不清楚能力低下是否会影响某些特定类型的合并症的风险。目的：研究成年前认知能力与严重抑郁症、广泛性焦虑症(GAD)、创伤后应激障碍(PTSD)、酗酒和其他药物滥用或依赖的风险以及中年这些疾病的共病形式的关系。设计：前瞻性队列研究，在平均年龄20.4岁应征入伍时测量认知能力，在平均年龄38.3岁时通过结构化诊断性访谈评估精神障碍。背景：美国。参与者：总共3258名男性退伍军人，越南体验研究的参与者。主要结果测量：入伍以来的严重抑郁、GAD、PTSD和酒精或其他药物滥用或依赖，目前根据DSM-III诊断。结果：认知能力低下与抑郁、GAD、酗酒或依赖、PTSD的风险增加以及某些共病模式有关。对于认知能力下降的1-SD，目前患有这些障碍的未调整优势比(95%可信区间)为：抑郁症1.32(1.12-1.56)，GAD 1.43(1.27-1.64)，酗酒或依赖1.20(1.08-1.35)，PTSD 1.39(1.18-1.67)，PTSD+GAD 2.50(1.41-4.55)，PTSD+GAD+抑郁2.17(1.47-3.22)，4种疾病均为2.77(1.12~6.66)。结论：认知能力低下是几种特定精神疾病的危险因素，包括某些形式的共病。了解能力与精神病理学的个体模式相关的机制可能有助于干预。
Context: Lower cognitive ability is a risk factor for some forms of psychopathology, but much of the evidence for risk is based on individuals who required specialist care. It is unclear whether lower ability influences the risk of particular patterns of comorbidity.Objective: To examine the relation between premorbid cognitive ability in early adulthood and the risk of major depression, generalized anxiety disorder ( GAD), posttraumatic stress disorder ( PTSD), alcohol and other drug abuse or dependence, and comorbid forms of these conditions in midlife.Design: Prospective cohort study in which cognitive ability was measured on enlistment into military service at a mean age of 20.4 years and psychiatric disorder was assessed by structured diagnostic interview at a mean age of 38.3 years.Setting: The United States.Participants: A total of 3258 male veterans, participants in the Vietnam Experience Study.Main Outcome Measures: Major depression, GAD, PTSD, and alcohol or other drug abuse or dependence since enlistment and currently, diagnosed according to the DSM-III.Results: Lower cognitive ability was associated with an increased risk of depression, GAD, alcohol abuse or dependence, and PTSD and with some patterns of comorbidity. For a 1-SD decrease in cognitive ability, unadjusted odds ratios ( 95% confidence interval) for having these disorders currently were 1.32 ( 1.12-1.56) for depression, 1.43 ( 1.27-1.64) for GAD, 1.20 ( 1.08-1.35) for alcohol abuse or dependence, 1.39 ( 1.18-1.67) for PTSD, 2.50 ( 1.41-4.55) for PTSD plus GAD, 2.17 ( 1.47-3.22) for PTSD plus GAD plus depression, and 2.77 ( 1.12-6.66) for all 4 disorders. Most associations remained statistically significant after adjustment for confounders.Conclusions: Lower cognitive ability is a risk factor for several specific psychiatric disorders, including some forms of comorbidity. Understanding the mechanisms whereby ability is linked to individual patterns of psychopathology may inform intervention.