Scholastic achievement at age 16 and risk of schizophrenia and other psychoses:: a national cohort study
Scholastic achievement at age 16 and risk of schizophrenia and other psychoses:: a national cohort study
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DOI：
10.1017/s0033291707002048
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发表时间：
2008-08-01
影响因子：
6.9
通讯作者：
Hultman, C. M.
中科院分区：
文献类型：
--
作者：
MacCabe, J. H.;Lambe, M. P.;Hultman, C. M.
背景。有大量证据表明精神分裂症与儿童时期的认知缺陷有关。然而，之前调查学校表现的研究尚无定论。此外，还有一些生物和社会因素可能会混淆这种关联。我们在一个大型全国队列中调查了 16 岁时的学校表现是否与成人精神分裂症和其他精神病的风险相关，同时控制了多个混杂因素。方法。我们使用 1973 年至 1983 年间出生于瑞典的 907011 名全国样本，利用 Cox 回归来评估 15-16 岁的学业成绩是否可以预测 17 岁至 31 岁之间因精神病入院，并调整了潜在的混杂因素。结果。学校表现不佳与精神分裂症[风险比 (HR) 3.9, 95%，置信区间 (Cl) 2.8-5.3]、精神分裂情感障碍 (HR 4.2，95% CI 1.9-9.1) 和其他精神病 (HR 3.0，95% CI 2.3-4.0) 发病率增加相关。在每个学校科目中，获得最低（E）成绩与精神分裂症和其他精神病的风险显着相关。没有证据表明移民身份、低出生体重、缺氧、父母教育水平或社会经济群体会造成混淆。结论。所有领域的学校表现不佳与精神分裂症和其他精神病的风险密切相关。
Background. There is abundant evidence that schizophrenia is associated with cognitive deficits in childhood. However, previous studies investigating school performance have been inconclusive. Furthermore, there are several biological and social factors that could confound the association. We investigated whether school performance at age 16 is associated with risk of adult schizophrenia and other psychoses in a large national cohort, while controlling for multiple confounders.Method. Using a national sample of 907011 individuals born in Sweden between 1973 and 1983, we used Cox regression to assess whether scholastic achievement at age 15-16 predicted hospital admission for psychosis between ages 17 and 31, adjusting for potential confounders.Results. Poor school performance was associated with increased rates of schizophrenia [hazard ratio (HR) 3.9, 95%, confidence interval (Cl) 2.8-5.3], schizo-affective disorder (HR 4.2, 95 % CI 1.9-9.1) and other psychoses (HR 3.0, 95% CI 2.3-4.0). Receiving the lowest (E) grade was significantly associated with risk for schizophrenia and other psychoses in every school subject. There was no evidence of confounding by migrant status, low birthweight, hypoxia, parental education level or socio-economic group.Conclusions. Poor school performance across all domains is strongly associated with risk for schizophrenia and other psychoses.