背景:关于父母人格障碍与儿童精神障碍之间关系的知识有限。目的研究父母人格障碍与后代精神障碍风险之间的关系。
方法:我们链接了丹麦的健康登记册,以创建1995年1月1日至2016年12月31日出生的儿童队列。孩子们被跟踪到18岁生日,诊断集,移民,死亡,或2016年12月31日。根据国际疾病分类(ICD)第八或第十次修订的父母人格障碍。使用泊松回归分析来估计后代(0-17岁)ICD第10种精神障碍的发生率风险比(IRR)和累积发生率。
结果:研究队列包括1,406,965名儿童。对于女孩来说,母系或父系人格障碍(MPD/PPD)与精神障碍相关:MPD女孩(IRR,2.74;95%CI,2.59-2.89)和PPD女孩(IRR,2.10;95%CI,1.94-2.27)。同样,两个MPD男孩的风险都增加了(IRR,2.44;95%CI,2.33-2.56)和PPD男孩(IRR,2.04;95%CI,1.91-2.18)。对于女孩和男孩来说,暴露于两名患有人格障碍的父母与最高风险相关(IRR,3.69;95%CI,3.15-4.33)。在18岁时,一个或两个患有人格障碍的父母的儿童中任何精神障碍的累积发生率为34.1%(95%CI,33.0-35.1)。这是非暴露儿童精神障碍累积发病率的两倍(15.2%[95%CI,15.1-15.3]).
结论:父母有人格障碍的子女患精神障碍的风险是未接触子女的2-3.5倍。从父母到孩子传播精神障碍的可能机制涉及遗传,环境,和基因-环境途径。有必要对这些机制进行更多的研究,并对预防性干预措施进行研究。
Knowledge of the association between parental personality disorders and mental disorders in children is limited. To examine the association between parental personality disorders and the risk of mental disorders in offspring.
We linked Danish health registers to create a cohort of children born from January 1, 1995, to December 31, 2016. Children were followed until their 18th birthday, diagnosis set, emigration, death, or December 31, 2016. Parental personality disorders according to the International Classification of Diseases (ICD) Eighth or 10th Revision. Poisson regression analyses were used to estimate the incidence risk ratio (IRR) and cumulative incidence of ICD 10th mental disorders in offspring (age 0-17).
The study cohort included 1,406,965 children. For girls, maternal or paternal personality disorder (MPD/PPD) was associated with mental disorders: MPD girls (IRR, 2.74; 95% CI, 2.59-2.89) and PPD girls (IRR, 2.10; 95% CI, 1.94-2.27). Likewise, the risk was increased for both MPD boys (IRR, 2.44; 95% CI, 2.33-2.56) and PPD boys (IRR, 2.04; 95% CI, 1.91-2.18). For girls and boys combined, exposure to two parents with a personality disorder was associated with the highest risk (IRR, 3.69; 95% CI, 3.15-4.33). At age 18, the cumulative incidence of any mental disorder in children of one or two parents with a personality disorder was 34.1% (95% CI, 33.0-35.1), which was twice the cumulative incidence of mental disorders in nonexposed children (15.2% [95% CI, 15.1-15.3]).
Children of parents with a personality disorder were at a 2 to 3.5 times higher risk of mental disorders compared with nonexposed offspring. Possible mechanisms of transmission of mental disorders from parent to child involve genetic, environmental, and gene-environment pathways. More research into these mechanisms and research into preventive interventions is warranted.