Social Determinants Associated With Exposure to Childhood Parental Bereavement and Subsequent Risk for Psychiatric Disorders.
Social Determinants Associated With Exposure to Childhood Parental Bereavement and Subsequent Risk for Psychiatric Disorders.
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DOI：
10.1001/jamanetworkopen.2022.39616
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发表时间：
2022-10-03
影响因子：
13.8
通讯作者：
Koenen, Karestan C.
中科院分区：
文献类型：
--
作者：
Denckla, Christy A.;Averkamp, Natalie M.;Slopen, Natalie;Dice, Ana Lucia Espinosa;Williams, David;Shear, M. Katherine;Koenen, Karestan C.
种族、民族和父母教育是否与父母死亡和精神障碍的风险有关？在这项使用国家共病研究：青少年补充资料(NCS-A)数据的队列研究中，黑人和西班牙裔青年中父母死亡的流行率大约是白人青年的两倍。单独考虑，无论是种族、民族还是父母教育都不能缓和丧亲和终生精神障碍风险之间的显著联系；然而，当联合考虑时，注意到这种联系的差异。这些发现表明，与白人青年相比，黑人和西班牙裔青年的父母死亡负担更重，但终生精神障碍的风险也同样增加。这项队列研究评估了种族和民族以及父母教育与美国年轻人父母死亡和随后的精神障碍的风险之间的关系。儿童父母死亡的发生率随种族、民族和社会经济地位的不同而不同，但类似的变化是否与终生精神障碍有关尚不清楚。评估种族和族裔以及父母的教育程度是否与父母的死亡风险有关；确定与父母的死亡相关的终生精神障碍的风险是否受到种族和族裔以及父母最高教育程度的调节；以及审查种族和族裔与父母的教育程度在与父母死亡相关的终生精神障碍的风险方面的潜在交集。这项回溯性队列研究使用了2001年至2004年国家共病研究：青少年补充(NCS-A)的数据。参与者包括13至18岁的青年，由于权力限制，仅限于黑人、西班牙裔和白人青年。对2021年2月26日至2022年4月21日的数据进行了分析。父母在童年时死亡。主要研究结果是任何终生精神障碍诊断和统计手册(第四版)精神障碍，通过结构化的临床访谈进行评估。在9501名青年(平均年龄15.2[1.5]岁；女性50.9%)中，包括经历过父母死亡的511名青年和未经历过父母死亡的8990名青年，西班牙裔(10.1%；95%CI，6.9%-14.7%)和黑人(14.0%；95%CI，10.6%-18.4%)18岁前父母死亡的累积风险大约是白人青年(6.0%；95%CI，4.7%-7.8%)的两倍。父母的教育程度也有类似的模式：父母受教育程度较低的年轻人的父母死亡累积风险几乎是父母受教育程度较高的年轻人(6.6%；95%可信区间，5.2%-8.4%)的两倍(10.1%；95%可信区间，8.1%-12.6%)。与未曾经历过父母死亡的年轻人相比，父母的死亡与任何终生精神障碍的风险呈正相关且显著相关(AOR，1.34；95%CI，1.03-1.75)。然而，这种联系并没有受到种族和民族(AOR，1.05；95%CI，0.58-1.92)或父母教育程度(AOR，1.19；95%，0.70-2.04)的影响，尽管力量分析表明，需要更大的样本量。在这项横断面研究中，黑人和西班牙裔青年的父母死亡人数高于白人青年，但父母死亡后患上任何终生精神障碍的风险并未因种族和民族或父母教育而显著降低。可能需要个人和人群层面的干预措施来解决精神疾病风险增加的问题，尽管还需要进行更大样本量的额外研究。
Are race and ethnicity and parental education associated with risk of parental death and psychiatric disorder? In this cohort study using National Comorbidity Study: Adolescent Supplement (NCS-A) data, the prevalence of parental death among Black and Hispanic youth was approximately twice that of White youth. Considered separately, neither race and ethnicity nor parental education moderated the significant association between bereavement and lifetime risk of psychiatric disorder; however, when considered jointly, variation in the association was noted. These findings suggest that Black and Hispanic youth have a higher burden of parental death compared with White youth, yet lifetime risk of psychiatric disorder was similarly elevated. This cohort study assesses associations of race and ethnicity, as well as parental education, with risk of parental death and subsequent psychiatric disorders in US youth. Prevalence of childhood parental death varies by race and ethnicity and socioeconomic status, yet whether similar variation persists in the association with lifetime psychiatric disorder is unknown. To assess whether race and ethnicity and parental educational attainment are associated with the risk of death of a parent; to determine whether the risk for lifetime psychiatric disorder associated with death of a parent was moderated by race and ethnicity and highest parental educational attainment; and to examine a potential intersection of race and ethnicity with parental educational attainment in the risk of lifetime psychiatric disorder associated with death of a parent. This retrospective cohort study used data from the National Comorbidity Study: Adolescent Supplement (NCS-A), 2001 to 2004. Participants included youth aged 13 to 18 years, restricted to Black, Hispanic, and White youth due to power limitations. Data were analyzed from February 26, 2021, to April 21, 2022. Death of a parent during childhood. The primary study outcome was any lifetime Diagnostic and Statistical Manual of Mental Disorders (Fourth Edition) psychiatric disorder, assess via assessed via structured clinical interviews. Among 9501 youth (mean [SD] age, 15.2 [1.5] years; 50.9% female), including 511 youth who had experienced parental death and 8990 youth who had not, the cumulative hazard of parental death by age 18 years was approximately doubled for Hispanic (10.1%; 95% CI, 6.9%-14.7%) and Black (14.0%; 95% CI, 10.6%-18.4%) youth compared with White youth (6.0%; 95% CI, 4.7%-7.8%). Similar patterns were noted by parental educational attainment: the cumulative hazard of parental death for youth of parents with less educational attainment was nearly double (10.1%; 95% CI, 8.1%-12.6%) compared with youth of parents with more education (6.6%; 95% CI, 5.2%-8.4%). Death of a parent was positively and significantly associated with risk of any lifetime psychiatric disorder (aOR, 1.34; 95% CI, 1.03-1.75) compared with youth who had not experienced death of a parent. However, this association was not moderated by race and ethnicity (aOR, 1.05; 95% CI, 0.58-1.92) or parental educational attainment (aOR, 1.19; 95%, 0.70-2.04), although power analyses suggest that larger sample sizes are needed. In this cross-sectional study, Black and Hispanic youth experienced elevated parental death compared with White youth, yet the risk for any lifetime psychiatric disorder after parental death was not significantly moderated by race and ethnicity or parental education. Both individual- and population-level interventions may be needed to address the increased risk of psychiatric disorders, although additional studies with larger sample sizes are needed.
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影响因子：
9.1
作者：
Miech, Richard;Pampel, Fred;Rogers, Richard G.
通讯作者：
Rogers, Richard G.
影响因子：
2.4
作者：
Cross, Christina J.
通讯作者：
Cross, Christina J.
影响因子：
17.7
作者：
Boelen, Paul A.;Lenferink, Lonneke I. M.;Spuij, Mariken
通讯作者：
Spuij, Mariken
影响因子：
17.7
作者：
Keyes, Katherine M.;Pratt, Charissa;Shear, M. Katherine
通讯作者：
Shear, M. Katherine
DOI：
10.1073/pnas.2007476117
发表时间：
2020-07-28
影响因子：
11.1
作者：
Verdery, Ashton M.;Smith-Greenaway, Emily;Daw, Jonathan
通讯作者：
Daw, Jonathan