Joint Effects of Exposure to Prenatal Infection and Peripubertal Psychological Trauma in Schizophrenia
Joint Effects of Exposure to Prenatal Infection and Peripubertal Psychological Trauma in Schizophrenia
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DOI：
10.1093/schbul/sbw083
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发表时间：
2017-01-01
影响因子：
6.6
通讯作者：
Petersen, Liselotte
中科院分区：
文献类型：
--
作者：
Debost, Jean-Christophe P. G.;Larsen, Janne Tidselbak;Petersen, Liselotte
内容：产前感染和创伤经历都与精神分裂症有关，但这些因素似乎都不足以导致这种疾病。然而，最近的证据表明，这些环境损伤协同作用，以增加精神分裂症的风险。目的：评估产前感染和青春期心理创伤对精神分裂症风险的独立和联合影响。设计：丹麦全国性登记在这个前瞻性队列研究。我们使用生存分析报告发病率比（IRR）和相应的95%置信区间（95%CI）。根据年龄和日历周期调整分析，并按性别分层。参会人员：从1995年1月1日到2013年12月31日，共有979，701名1980年至1998年出生的人接受了随访，其中9，656人与医院有精神分裂症接触。结果如下：暴露于产前感染的女性患精神分裂症的风险显著增加（IRR：1.61，95% CI：1.30-2.00），但男性则无此风险（IRR：0.99，95% CI：0.77-1.28）。青春期创伤与男女的风险增加有关。然而，男性在暴露于产前感染和青春期心理创伤后患精神分裂症的风险显著更高（IRR：2.85，95%CI：2.32-3.51），在乘法量表上感染和青春期创伤之间存在显著的相互作用（P =.007）。结论：我们的研究首次证明，产前感染和青春期生活中的心理创伤可以协同作用，增加精神分裂症的风险，男性的易感性可能更强。
Context: Prenatal infection and traumatizing experiences have both been linked with schizophrenia, but none of these factors seem sufficient to cause the disorder. However, recent evidence suggests that these environmental insults act in synergy to increase schizophrenia risk. Objective: To estimate the independent and joint effects of exposure to prenatal infection and peripubertal psychological trauma on the risk of schizophrenia. Design: Danish nationwide registers were linked in this prospective cohort study. We used survival analysis to report incidence rate ratios (IRRs) and corresponding 95% confidence intervals (95% CIs). Analyses were adjusted for age and calendar period and stratified by sex. Participants: A total of 979 701 persons born between 1980 and 1998 were followed up from January 1, 1995 through December 31, 2013, with 9656 having a hospital contact for schizophrenia. Results: Females exposed to prenatal infection had a significantly increased risk of schizophrenia (IRR: 1.61, 95% CI: 1.30-2.00), but not males (IRR: 0.99, 95% CI: 0.77-1.28). Peripubertal trauma was associated with increased risk in both sexes. Males, however, had a significantly higher risk of schizophrenia after exposure to both prenatal infection and peripubertal psychological trauma (IRR: 2.85, 95% CI: 2.32-3.51), with significant interaction between infection and peripubertal trauma on the multiplicative scale (P =.007). Conclusions: Our study demonstrated for the first time that prenatal infection and psychological trauma in peripubertal life can act in synergy to increase the risk of schizophrenia, with a potentially stronger susceptibility in males.