The Incidence of Nonaffective, Nonorganic Psychotic Disorders in Older People: A Population-based Cohort Study of 3 Million People in Sweden
The Incidence of Nonaffective, Nonorganic Psychotic Disorders in Older People: A Population-based Cohort Study of 3 Million People in Sweden
复制标题
老年人非情感性、非器质性精神病的发病率：对瑞典 300 万人进行的一项基于人群的队列研究
作者：
J. Stafford;R. Howard;C. Dalman;J. Kirkbride
摘要背景极晚发性精神分裂症样精神病（VLOSLP）的流行病学数据有限，以及这与潜在危险因素（包括迁移、感觉障碍、创伤性生活事件和社会隔离）的关系。
方法：我们随访了一个队列的3 007 378人生活在瑞典，出生于1920-1949年，从他们的60岁生日（最早：1980年1月15日）到2011年12月30日，移民，死亡，或首次记录诊断为非情感性精神病。我们通过年龄、性别、出生地、收入、伴侣或子女死亡、出生期和感觉障碍来研究VLOSLP的发病率。
结果我们确定了14977例病例，总发病率为37.7/10万人年（95%CI = 37.1-38.3），有证据表明，女性发病率随年龄增长而急剧增加（似然比检验：χ2（6）= 31.56，P <0.001）。调整混杂因素后，来自非洲的移民中VLOSLP的发生率较高（风险比[HR] = 2.0，95% CI = 1.4-2.7），北美（HR = 1.4，95% CI = 1.0-1.9，P = 0.04），欧洲（HR = 1.3，95% CI = 1.2-1.4）、俄罗斯-波罗的海地区（HR = 1.6，95% CI = 1.4-1.9）和芬兰（HR = 1.6，95% CI = 1.5-1.7）。最低收入四分位数人群的VLOSLP风险最高（HR = 3.1，95% CI = 2.9-3.3）。伴侣在队列退出前2年死亡的患者中，（HR = 1.1，95% CI = 1.0-1.3，P = 0.02）或其子女在婴儿期死亡（HR = 1.2，95% CI = 1.0-1.4，P = 0.05），无伴侣者（HR = 1.9，95% CI = 1.8-1.9）或儿童（HR = 2.4，95% CI = 2.3-2.5）以及儿童患有精神障碍的患者（HR = 2.4，95% CI = 2.2-2.6）。
解释我们确定了一个巨大的负担，精神病发病率在老年，在妇女和大多数移民群体中具有较高的优势。生活过程中暴露于环境因素，包括标记的剥夺，隔离，逆境与VLOSLP的风险。
Abstract Background There are limited data on the epidemiology of very late-onset schizophrenia-like psychosis (VLOSLP) and how this relates to potential risk factors including migration, sensory impairment, traumatic life events, and social isolation.
Methods We followed up a cohort of 3 007 378 people living in Sweden, born 1920–1949, from their 60th birthday (earliest: January 15, 1980) until December 30 2011, emigration, death, or first recorded diagnosis of nonaffective psychosis. We examined VLOSLP incidence by age, sex, region of origin, income, partner or child death, birth period, and sensory impairments.
Results We identified 14 977 cases and an overall incidence of 37.7 per 100 000 person-years at-risk (95% CI = 37.1–38.3), with evidence that rates increased more sharply with age for women (likelihood ratio test: χ2(6) = 31.56, P < .001). After adjustment for confounders, rates of VLOSLP were higher among migrants from Africa (hazard ratio [HR] = 2.0, 95% CI = 1.4–2.7), North America (HR = 1.4, 95% CI = 1.0–1.9, P = .04), Europe (HR = 1.3, 95% CI = 1.2–1.4), Russian-Baltic regions (HR = 1.6, 95% CI = 1.4–1.9), and Finland (HR = 1.6, 95% CI = 1.5–1.7). VLOSLP risk was highest for those in the lowest income quartile (HR = 3.1, 95% CI = 2.9–3.3). Rates were raised in those whose partner died 2 years before cohort exit (HR = 1.1, 95% CI = 1.0–1.3, P = .02) or whose child died in infancy (HR = 1.2, 95% CI = 1.0–1.4, P = .05), those without a partner (HR = 1.9, 95% CI = 1.8–1.9) or children (HR = 2.4, 95% CI = 2.3–2.5), and those whose child had a psychotic disorder (HR = 2.4, 95% CI = 2.2–2.6).
Interpretation We identified a substantial burden of psychosis incidence in old age, with a higher preponderance in women and most migrant groups. Life course exposure to environmental factors including markers of deprivation, isolation, and adversity were associated with VLOSLP risk.
影响因子：
25.8
作者：
Pedersen, Carsten Bocker;Mors, Ole;Eaton, William W.
通讯作者：
Eaton, William W.