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Association Between Parental Income During Childhood and Risk of Schizophrenia Later in Life.
JAMA Psychiatry ( IF 22.5 ) Pub Date : 2019-10-23 , DOI: 10.1001/jamapsychiatry.2019.2299
Christian Hakulinen 1, 2, 3, 4 , Roger T Webb 5, 6, 7 , Carsten B Pedersen 2, 3, 4 , Esben Agerbo 2, 3, 4 , Pearl L H Mok 5, 6
Affiliation  

Importance Evidence linking parental socioeconomic position and offspring's schizophrenia risk has been inconsistent, and how risk is associated with parental socioeconomic mobility has not been investigated. Objective To elucidate the association between parental income level and income mobility during childhood and subsequent schizophrenia risk. Design, Setting, and Participants National cohort study of all persons born in Denmark from January 1, 1980, to December 31, 2000, who were followed up from their 15th birthday until schizophrenia diagnosis, emigration, death, or December 31, 2016, whichever came first. Data analyses were from March 2018 to June 2019. Exposure Parental income, measured at birth year and at child ages 5, 10, and 15 years. Main Outcomes and Measures Hazard ratios (HRs) for schizophrenia were estimated using Cox proportional hazard regression. Cumulative incidence values (absolute risks) were also calculated. Results The cohort included 1 051 033 participants, of whom 51.3% were male. Of the cohort members, 7544 (4124 [54.7%] male) were diagnosed with schizophrenia during 11.6 million person-years of follow-up. There was an inverse association between parental income level and subsequent schizophrenia risk, with children from lower income families having especially elevated risk. Estimates were attenuated, but risk gradients remained after adjustment for urbanization, parental mental disorders, parental educational levels, and number of changes in child-parent separation status. A dose-response association was observed with increasing amount of time spent in low-income conditions being linked with higher schizophrenia risk. Regardless of parental income level at birth, upward income mobility was associated with lower schizophrenia risk compared with downward mobility. For example, children who were born and remained in the lowest income quintile at age 15 years had a 4.12 (95% CI, 3.71-4.58) elevated risk compared with the reference group, those who were born in and remained in the most affluent quintile, but even a rise from the lowest income quintile at birth to second lowest at age 15 years appeared to lessen the risk elevation (HR, 2.80; 95% CI, 2.46-3.17). On the contrary, for those born in the most affluent quintile, downward income mobility between birth and age 15 years was associated with increased risks of developing schizophrenia. Conclusions and Relevance This study's findings suggest that parental income level and income mobility during childhood may be linked with schizophrenia risk. Although both causation and selection mechanisms could be involved, enabling upward income mobility could influence schizophrenia incidence at the population level.

中文翻译:

童年时期父母的收入与以后生活中的精神分裂症风险之间的关联。

重要性将父母的社会经济地位与后代精神分裂症风险联系起来的证据一直不一致,并且尚未研究风险与父母的社会经济流动性如何相关。目的阐明儿童时期父母收入水平与收入流动性及随后的精神分裂症风险之间的关系。设计,背景和参加者:从1980年1月1日至2000年12月31日在丹麦出生的所有人群的全国队列研究,从其15岁生日直至精神分裂症的诊断,移民,死亡或2016年12月31日,以较高者为准首先。数据分析是从2018年3月至2019年6月。暴露父母的收入,以出生年份和5岁,10岁和15岁的孩子为准。主要结果和措施使用Cox比例风险回归估算精神分裂症的危险比(HRs)。还计算了累积发生值(绝对风险)。结果该队列包括1 051 033名参与者,其中51.3%是男性。在这组队列成员中,有1,544万人-年的随访中,有7544名患者(4124 [54.7%]名男性)被诊断为精神分裂症。父母的收入水平与随后的精神分裂症风险之间呈负相关,来自低收入家庭的儿童的风险尤其高。估计数减少了,但在针对城市化,父母精神障碍,父母教育水平和儿童-父母分离状态的变化数量进行调整后,风险梯度仍然存在。观察到剂量-反应关联,即在低收入条件下花费的时间增加与精神分裂症风险增加相关。不论出生时父母的收入水平如何,与向下流动相比,向上流动的精神分裂症患病风险较低。例如,与参考组相比,出生并保持在最富裕的五分之一人群中的儿童在15岁时出生并保持在收入最低的五分位数中的儿童的风险升高了4.12(95%CI,3.71-4.58)。 ,但即使从出生时收入最低的五分之一人口上升到15岁年龄第二低的人口,也似乎降低了风险上升的风险(HR,2.80; 95%CI,2.46-3.17)。相反,对于那些出生在最富裕的五分之一人口中的人,出生至15岁之间的收入流动性下降与患精神分裂症的风险增加有关。结论与相关性这项研究的发现表明,儿童时期父母的收入水平和收入流动性可能与精神分裂症的风险有关。尽管可能同时涉及因果关系和选择机制,但实现收入的向上流动可能会影响人群中精神分裂症的发病率。
更新日期:2020-01-02
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