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Association between maternal and paternal mental illness and risk of injuries in children and adolescents: nationwide register based cohort study in Sweden.
The BMJ ( IF 105.7 ) Pub Date : 2020-04-08 , DOI: 10.1136/bmj.m853
Alicia Nevriana 1 , Matthias Pierce 2 , Christina Dalman 3, 4 , Susanne Wicks 3, 4 , Marie Hasselberg 3 , Holly Hope 2 , Kathryn M Abel 2, 5 , Kyriaki Kosidou 3, 4
Affiliation  

OBJECTIVE To determine the association between parental mental illness and the risk of injuries among offspring. DESIGN Retrospective cohort study. SETTING Swedish population based registers. PARTICIPANTS 1 542 000 children born in 1996-2011 linked to 893 334 mothers and 873 935 fathers. EXPOSURES Maternal or paternal mental illness (non-affective psychosis, affective psychosis, alcohol or drug misuse, mood disorders, anxiety and stress related disorders, eating disorders, personality disorders) identified through linkage to inpatient or outpatient healthcare registers. MAIN OUTCOME MEASURES Risk of injuries (transport injury, fall, burn, drowning and suffocation, poisoning, violence) at ages 0-1, 2-5, 6-9, 10-12, and 13-17 years, comparing children of parents with mental illness and children of parents without mental illness, calculated as the rate difference and rate ratio adjusted for confounders. RESULTS Children with parental mental illness contributed to 201 670.5 person years of follow-up, while children without parental mental illness contributed to 2 434 161.5 person years. Children of parents with mental illness had higher rates of injuries than children of parents without mental illness (for any injury at age 0-1, these children had an additional 2088 injuries per 100 000 person years; number of injuries for children with and without parental mental illness was 10 235 and 72 723, respectively). At age 0-1, the rate differences ranged from 18 additional transport injuries to 1716 additional fall injuries per 100 000 person years among children with parental mental illness compared with children without parental mental illness. A higher adjusted rate ratio for injuries was observed from birth through adolescence and the risk was highest during the first year of life (adjusted rate ratio at age 0-1 for the overall association between any parental mental illness that has been recorded in the registers and injuries 1.30, 95% confidence interval 1.26 to 1.33). Adjusted rate ratios at age 0-1 ranged from 1.28 (1.24 to 1.32) for fall injuries to 3.54 (2.28 to 5.48) for violence related injuries. Common and serious maternal and paternal mental illness was associated with increased risk of injuries in children, and estimates were slightly higher for common mental disorders. CONCLUSIONS Parental mental illness is associated with increased risk of injuries among offspring, particularly during the first years of the child's life. Efforts to increase access to parental support for parents with mental illness, and to recognise and treat perinatal mental morbidity in parents in secondary care might prevent child injury.

中文翻译:

产妇和父亲的精神疾病与儿童和青少年受伤风险之间的关联:瑞典全国范围的队列研究。

目的确定父母心理疾病与后代受伤风险之间的关系。设计回顾性队列研究。设置瑞典基于人口的登记簿。参加者1996-2011年出生的1542,000名儿童与893,334名母亲和873,935名父亲有联系。暴露通过与住院或门诊医疗保健机构的联系确定的母体或父亲精神疾病(非情感性精神病,情感性精神病,酗酒或滥用药物,情绪障碍,与焦虑和压力相关的疾病,饮食失调,人格障碍)。主要观察指标:比较父母子女的0-1岁,2-5岁,6-9岁,10-12岁和13-17岁的受伤风险(交通伤害,摔倒,烧伤,溺水和窒息,中毒,暴力)有精神病和父母的孩子没有精神病,计算为混杂因素调整的比率差异和比率。结果患有父母精神疾病的孩子的随访时间为201 670.5人年,而没有父母精神疾病的孩子的随访时间为2 434 161.5人年。患有精神疾病的父母的孩子比没有精神疾病的父母的孩子受伤率更高(对于0-1岁的任何伤害,这些孩子每10万人年额外受伤2088人;有父母和没有父母的孩子受伤的次数精神疾病分别为10 235和72 723)。在0-1岁时,与没有父母精神疾病的孩子相比,有父母精神病的孩子每10万人年的交通伤害增加18起,跌落伤害增加1716起。从出生到青春期,受伤的调整比率比率较高,风险在生命的第一年最高(0-1岁年龄段的调整比率比率是登记在册的父母心理疾病与伤害1.30,95%置信区间1.26至1.33)。0-1岁时的调整比率比率范围从跌倒伤害的1.28(1.24至1.32)到暴力相关伤害的3.54(2.28至5.48)。常见和严重的母体和父系精神疾病与儿童受伤风险增加有关,并且常见精神障碍的估计值略高。结论父母的精神疾病与后代之间受伤的风险增加有关,特别是在孩子生命的头几年。
更新日期:2020-04-09
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