We examined associations between common psychiatric disorders and fecundity in a population-based cohort of 1,252 twins prospectively assessed from adolescence into adulthood. Major depressive disorder, anxiety disorders, and alcohol use disorders were associated with lower likelihood of having children and having fewer children. Survival analyses yielded similar results accounting for timing and recurrence. Although both early- and adult-onset psychiatric disorders were associated with decreased fecundity, early-onset major depressive disorder, anxiety disorders (among boys), and alcohol use disorders (among girls) were associated with greater likelihood of having a child during adolescence. Among twin pairs discordant for psychiatric disorders (i.e., one twin affected and one twin unaffected by major depressive disorder, anxiety disorders, or alcohol use disorders), twins affected by anxiety and alcohol use disorders but not major depressive disorder were less likely to have children than their unaffected co-twins. However, unaffected twins with an affected co-twin were no more likely to have children than twins from unaffected twin pairs, inconsistent with the balancing-selection hypothesis that increased fecundity in unaffected relatives accounts for persistence of psychiatric disorders.

我们在一个基于人群的队列中研究了常见精神疾病和生育能力之间的关联，该队列对从青春期到成年的 1,252 对双胞胎进行了前瞻性评估。重度抑郁症、焦虑症和酒精使用障碍与生育孩子的可能性较低和生育较少的孩子有关。生存分析产生了类似的结果，说明了时间和复发。尽管早发和成人精神疾病都与生育能力下降有关，但早发性重度抑郁症、焦虑症（男孩）和酒精使用障碍（女孩）与青春期生育的可能性更大有关。在精神疾病不一致的双胞胎中（即一对双胞胎受影响，一对双胞胎未受重度抑郁症、焦虑症、或酒精使用障碍），受焦虑症和酒精使用障碍影响但不是重度抑郁症的双胞胎比未受影响的双胞胎更不可能生孩子。然而，与未患病双胞胎的双胞胎相比，未患病的双胞胎与患病的同胞双胞胎生孩子的可能性并不高，这与平衡选择假设不一致，即未患病亲属的生育能力增加导致精神疾病持续存在。