Risks of major mental disorders after parental death in children, adolescents, and young adults and the role of premorbid mental comorbidities: a population-based cohort study.
Risks of major mental disorders after parental death in children, adolescents, and young adults and the role of premorbid mental comorbidities: a population-based cohort study.
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DOI：
10.1007/s00127-022-02334-7
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发表时间：
2022-12
影响因子：
4.4
通讯作者：
Chen, Mu-Hong
中科院分区：
文献类型：
--
作者：
Li, Dian-Jeng;Tsai, Shih-Jen;Chen, Tzeng-Ji;Liang, Chih-Sung;Chen, Mu-Hong
先前的研究表明，父母过早死亡与失去亲人的儿童和青少年随后出现重大精神障碍（MMDs）的风险之间存在关联；然而，尚不清楚这种风险是否存在于年轻人和有病前精神合并症的个体中。我们的目的是探讨儿童、青少年和年轻人在父母死亡后患烟雾病风险的差异。指标队列为父母死亡的后代（分为4组：< 6岁、6 - 11岁、12-17岁和18-29岁）。对照队列是人口统计学上匹配的父母仍然在世的后代。采用人口统计学校正的Cox回归来估计指数组和对照组之间随后发生烟雾病的风险，包括精神分裂症、双相情感障碍和抑郁症。我们纳入了202,837例病例和2,028,370例匹配对照。与失去亲人的儿童和青少年一样，失去亲人的年轻人患精神分裂症（95%可信区间：5.63;5.01-6.33）、双相情感障碍（3.37;2.96-3.84）和抑郁症（2.78;2.68-2.90）的风险显著高于对照组。母亲死亡和父亲死亡的烟雾病风险相似。在病前精神合并症中，患有病前物质使用障碍的丧亲者患精神分裂症（10.43;8.57-12.71）、双相情感障碍（12.93;10.59-15.79）和抑郁症（10.97;10.22-11.78）的风险最高。卫生保健工作者应该意识到，在父母去世后，年轻人和有病前精神合并症的人比没有病前精神合并症的人患烟雾病的风险更高。
Previous studies have shown an association between early parental death and the risk of subsequent major mental disorders (MMDs) among the bereaved children and adolescents; however, it is unclear whether this risk exists in young adults and in individuals with premorbid mental comorbidities. We aimed to explore differences between children, adolescents, and young adults in the risk of MMDs after parental death. We analyzed data from the Taiwan National Health Research Database. The index cohort was offspring (divided into four groups: aged < 6, 6–11, 12–17, and 18–29 years) whose parents had died. The control cohort was demographically matched offspring whose parents were still alive. Cox regression with adjustments for demographics was used to estimate the risk of subsequent MMDs between the index and control cohorts, including schizophrenia, bipolar disorder, and depressive disorder. We included 202,837 cases and 2,028,370 matched controls. As with the bereaved children and adolescents, the bereaved young adults had a significantly higher risk of schizophrenia (hazard ratio with 95% confidence interval: 5.63; 5.01–6.33), bipolar disorder (3.37; 2.96–3.84), and depressive disorder (2.78; 2.68–2.90) than the control cohort. The risk of MMDs was similar for maternal death and paternal death. Among premorbid mental comorbidities, bereaved individuals with premorbid substance use disorder were associated with the highest risk of schizophrenia (10.43; 8.57–12.71), bipolar disorder (12.93; 10.59–15.79), and depressive disorder (10.97; 10.22–11.78). Healthcare workers should be aware that young adults and individuals with premorbid mental comorbidities are at a higher risk of subsequent MMDs than those without premorbid mental comorbidities after parental death.
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