背景:围产期危险因素与精神病理学的发展有关,但它们在双相情感障碍(BD)和轻躁狂中的作用尚不清楚。使用来自前瞻性社区队列的数据,这是第一项调查一系列围产期危险因素之间关联的研究,轻度躁狂症状,和一般人群中BD的“高风险”。
方法:双胞胎早期发育研究的26,040名18个月儿童的围产期事件的父母报告。随后的自我报告轻躁狂在16岁(轻躁狂清单-16;N=2943)和26岁(情绪障碍问卷;N=7748)进行了测量。使用已建立的分类将参与者归类为BD的“高风险”。在广义估计方程框架内进行线性和逻辑回归,以说明样本中的相关性。
结果:产前酒精暴露(β=0.08,SE=0.04,p=.0002)和饮酒单位数(β=0.09,SE=0.02,p<.0001)与16岁时的轻度躁动症状和酒精单位数(OR=1.13,95%CI:1.06-1.21,p=.0003)和产妇压力(OR=1.68'2.68,p=2产前烟草暴露(β=0.10,SE=0.04,p<.0001)和吸烟数量(β=0.10,SE=0.01,p<.0001)与轻度躁动症状和“高风险”相关26岁的BD,尽管这些结果对父母精神病史的控制有所减弱。
结论:无法完全调整家族混杂因素。评估者报告包括一些偏见。
结论:这些研究结果表明,围产期危险因素与亚临床轻度躁狂和BD的“高风险”相关。未来的工作应该探索这些纵向关联的潜在机制,这可以揭示预防和干预努力。
BACKGROUND: Perinatal risk factors are implicated in the development of psychopathology, but their role in bipolar disorder (BD) and hypomania is unclear. Using data from a prospective community cohort, this is the first
study to investigate the association between a range of perinatal risk factors, hypomanic symptoms, and \'high-risk\' for BD in the general population.
METHODS: Parent report of perinatal events were available for 26,040 eighteen-month-olds from the Twins Early Development
Study. Subsequent self-report hypomania was measured at ages 16 (Hypomania Checklist-16; N = 2943) and 26 (Mood Disorders Questionnaire; N = 7748). Participants were categorised as \'high-risk\' for BD using established classifications. Linear and logistic regressions were conducted within a generalised estimating equations framework to account for relatedness in the sample.
RESULTS: Prenatal alcohol exposure (β = 0.08, SE = 0.04, p = .0002) and number of alcohol units consumed (β = 0.09, SE = 0.02, p < .0001) were associated with hypomanic symptoms at age 16, and number of alcohol units (OR = 1.13, 95 % CI:1.06-1.21, p = .0003) and maternal stress (OR = 1.68, 95 % CI:1.21-2.34, p = .002) were associated with \'high-risk\' for BD age 16. Prenatal tobacco exposure (β = 0.10, SE = 0.04, p < .0001) and number of cigarettes smoked (β = 0.10, SE = 0.01, p < .0001) were associated with hypomanic symptoms and \'high-risk\' for BD at age 26, although these result were attenuated controlling for parental psychiatric history.
CONCLUSIONS: Familial confounding could not be fully adjusted for. Rater reports include some biases.
CONCLUSIONS: These findings show perinatal risk factors to be associated with subclinical hypomania and \'high-risk\' for BD. Future work should explore the mechanisms underlying these longitudinal associations, which could shed light on prevention and intervention efforts.