Recurrence risks for schizophrenia in a Swedish National Cohort
Recurrence risks for schizophrenia in a Swedish National Cohort
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DOI：
10.1017/s0033291706008385
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发表时间：
2006-10-01
影响因子：
6.9
通讯作者：
Sullivan, Patrick F.
中科院分区：
文献类型：
--
作者：
Lichtenstein, Paul;Bjork, Camilla;Sullivan, Patrick F.
背景资料。精神分裂症复发风险的估计是我们理解这种复杂疾病的基础。被广泛引用的估计来自较小/较老的样本。如果这些估计是偏高的，那么精神分裂症的分子遗传学研究的理论基础可能并不可靠。我们通过将两个瑞典国家登记册连接到一个关系数据库(瑞典医院出院登记册和多代登记册)，创建了一个以人口为基础的瑞典国家队列。情感被定义为一生中至少两次住院并被核心诊断为精神分裂症的患者。合并瑞典国家登记册，产生了一个以人口为基础的队列，包括7,739,202名血统已知的人。狭义精神分裂症的终生患病率为0(407%)，我们估计每79个瑞典大家庭中就有一个受到精神分裂症的影响。有多名受影响成员的受影响家庭比例为3(.)81%。所有相关类型的复发风险估计与较小和较老的研究报告的结果惊人地相似。例如，我们估计lambda(Sibs)为8(.)55[95%可信区间(CI)7(.)86-9(.)57]，而文献估计为8(.)6。在迄今最大和最全面的样本中，我们确认了对精神分裂症复发风险的公认估计，并提供了对亲属精神分裂症复发风险的更准确估计，对精神分裂症的家庭影响的估计，以及多元化比例(对于衡量来自多元化家系的研究结果的概括性是必不可少的)。这些数据可能对计划和解释精神分裂症的基因研究有价值。
Background. Recurrence risk estimates for schizophrenia are fundamental to our understanding of this complex disease. Widely cited estimates are from small/older samples. If these estimates are biased upwards, then the rationale for molecular genetic studies of schizophrenia may not be as solid.Method. We created a population-based, Swedish national cohort by linking two Swedish national registers into a relational database (the Swedish Hospital Discharge Register and the MultiGeneration Register). Affection was defined as the lifetime presence of at least two in-patient hospitalizations with a core schizophrenia diagnosis.Results. Merging the Swedish national registers created a population-based cohort of 7 739 202 individuals of known parentage. The lifetime prevalence of the narrow definition of schizophrenia was 0(.)407% and we estimated that one in every 79 extended Swedish families had been impacted by schizophrenia. The proportion of affected families with multiple affected members was 3(.)81%. Recurrence risk estimates for all relative types were strikingly similar to those reported in smaller and older studies. For example, we estimated lambda(sibs) at 8(.)55 [95% confidence interval (CI) 7(.)86-9(.)57] compared with a literature estimate of 8(.)6.Conclusions. In the largest and most comprehensive sample yet studied, we confirm the accepted estimates of recurrence risks for schizophrenia, and provide more accurate estimates of recurrence risks of schizophrenia in relatives, an estimate of the familial impact of schizophrenia, and the multiplex proportion (essential for gauging the generalizability of findings from multiplex pedigrees). These data may be valuable for planning and interpreting genetic studies of schizophrenia.