A population-based study of the risk of schizophrenia and bipolar disorder associated with parent-child separation during development.
A population-based study of the risk of schizophrenia and bipolar disorder associated with parent-child separation during development.
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DOI：
10.1017/s0033291715000781
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发表时间：
2015-10
影响因子：
6.9
通讯作者：
Pedersen CB
中科院分区：
文献类型：
--
作者：
Paksarian D;Eaton WW;Mortensen PB;Merikangas KR;Pedersen CB
人们越来越关注童年不幸（包括父母死亡和分居）在精神障碍病因学中的作用。然而，很少有研究使用前瞻性收集的数据来专门调查父母在成长过程中的分离，或评估分离持续时间和家庭特征的重要性。我们对 1971 年至 1991 年出生于丹麦的 985,058 名个体进行了调查，测量了三种非死亡原因的分离：母亲、父亲和父母双方的分离，年龄跨度为 1-15 岁。从分离发生率、分离年龄和分离年数方面评估了精神病登记册中狭义和广义精神分裂症和双相情感障碍与狭义和广义精神分裂症和双相情感障碍的关联。评估了与父母精神障碍史的相互作用。每种类型的分离都与所有三种结果相关，并根据年龄、性别、出生时期、历年、精神障碍家族史、出生时的都市生活和父母年龄进行调整。父亲分居的年数与精神分裂症和双相情感障碍呈正相关。当分离发生在较晚的年龄时，与父母分离与精神分裂症之间的关联性更强，而双相情感障碍患者在整个发育过程中保持稳定。当第一次发生父亲分居发生在儿童时期时，似乎会增加更多的风险。尽管在任何情况下都没有分离保护作用，但关联根据父母的精神障碍史而有所不同。父母分离的影响可能因类型、发育时间和家庭特征而异。这些发现凸显了在儿童逆境研究中考虑这些因素的重要性。
There is growing interest in the role of childhood adversities, including parental death and separation, in the etiology of psychotic disorders. However, few studies have used prospectively-collected data to specifically investigate parental separation across development, or assessed the importance of duration of separation, and family characteristics. We measured three types of separation not due to death: maternal, paternal, and from both parents, across ages 1–15 among a cohort of 985,058 individuals born in Denmark 1971–1991 and followed through 2011. Associations with narrowly- and broadly- defined schizophrenia and bipolar disorder in the psychiatric register were assessed in terms of separation occurrence, age of separation, and number of years separated. Interactions with parental history of mental disorder were assessed. Each type of separation was associated with all three outcomes, adjusting for age, sex, birth period, calendar year, family history of mental disorder, urbanicity at birth, and parental age. Number of years of paternal separation was positively associated with both schizophrenia and bipolar disorder. Associations between separation from both parents and schizophrenia were stronger when separation occurred at later ages, while those with bipolar disorder remained stable across development. The first occurrence of paternal separation appeared to increase risk more when it occurred earlier in childhood. Associations differed according to parental history of mental disorder, although in no situation was separation protective. Effects of parental separation may differ by type, developmental timing, and family characteristics. These findings highlight the importance of considering such factors in studies of childhood adversity.