Sex differences in the risk of schizophrenia - Evidence from meta-analysis
Sex differences in the risk of schizophrenia - Evidence from meta-analysis
复制标题
DOI：
10.1001/archpsyc.60.6.565
复制
发表时间：
2003-06-01
影响因子：
--
通讯作者：
Selten, JP
中科院分区：
文献类型：
--
作者：
Aleman, A;Kahn, RS;Selten, JP
背景：在特定疾病的风险中，性别差异可以提供关于其发病机制的重要线索。精神分裂症风险存在性别差异的证据尚不确定。本研究的目的是整合从已发表的文献的结果，并提供一个定量指标的男女比例的发病率schizophrenia.Methods：MEDLINE和PsychLIT数据库进行了搜索的英文出版物的“发病率和精神分裂症”，出现在1980年1月至2001年9月期间。如果报告了性别特异性发病率，则纳入使用标准临床诊断标准的基于人群的发病率研究。直接从每项研究中提取性别特异性发病率数据。对符合特定方法学标准的研究子集进行分类分析（以尽量减少标准偏倚、医院偏倚和年龄偏倚）。研究分类和数据提取由我们中的2人独立进行（A。A.和J。- P.S.）。结果：使用随机效应模型进行了对数风险比荟萃分析。男性相对于女性精神分裂症的发病风险比为1.42（95%置信区间[CI]，1.30-1.56），当所有研究均纳入分析时（49个效应量），1.31（95% CI，1.13-1.51）当单独分析最小化选择偏倚的研究时（23个效应量），和1.39（95%CI，1.15-1.68）时，只有高质量的研究包括（I/I效应量）。在1980年之前的样本年的研究中，性别差异显着小于1980年之后的样本年。在发展中国家的研究中没有报告显著的性别差异。最后的分析，仅限于研究的年龄截止值为64岁或以上（16个效应量），产生的平均风险比为1.32（95%CI，1.13-1.55）。结论：这项荟萃分析提供了证据的性别差异的风险发展为精神分裂症，报告在过去20年的文献。
Background: Sex differences in the risk of a particular disorder can yield important clues regarding its pathogenesis. The evidence for a sex difference in the risk of schizophrenia is inconclusive. The purpose of this study was to integrate results from the published literature and to provide a quantitative index of the male-female ratio for the incidence of schizophrenia.Methods: The MEDLINE and PsychLIT databases were searched for English-language publications on "incidence and schizophrenia" that appeared during the period between January 1980 and September 2001. Population-based incidence studies using standard clinical diagnostic criteria were included if they reported sex-specific incidence rates. Sex-specific incidence figures were extracted directly from each study. Categorical analyses were conducted on a subset of studies that met specific methodological criteria (to minimize criterion bias, hospital bias, and age bias). Study categorization and data extraction were performed independently by 2 of us (A. A. and J.-P.S.).Results: Log risk ratio meta-analysis was conducted using a random-effects model. The incidence risk ratios for men to develop schizophrenia relative to women were 1.42 (95% confidence interval [CI], 1.30-1.56) when all studies were included in the analysis (49 effect sizes), 1.31 (95% CI, 1.13-1.51) when studies that minimized selection biases were analyzed separately (23 effect sizes), and 1.39 (95% CI, 1.15-1.68) when only high-quality studies were included (I I effect sizes). The sex difference was significantly smaller in studies with sample years before 1980 than those with sample years after 1980. No significant sex differences were reported in studies from developing countries. A final analysis, limited to studies with an age cutoff of 64 years or older (16 effect sizes), yielded a mean risk ratio of 1.32 (95% Cl, 1.13-1.55).Conclusion: This meta-analysis provides evidence for a sex difference in the risk of developing schizophrenia, as reported in the published literature from the last 2 decades.