BIRTH RISK AND SEVERE MENTAL DISORDERS IN DENMARK

丹麦的出生风险和严重精神障碍

• 批准号: 6286278
• 负责人: WILLIAM W EATON
• 金额: $ 20.8万
• 依托单位: JOHNS HOPKINS UNIVERSITY
• 依托单位国家: 美国
• 财政年份: 1996
• 资助国家: 美国
• 起止时间: 1996-09-30 至 2005-01-31
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/6286278
• 关键词: Asperger syndrome; Scandinavian country; autism; bipolar depression; case history; clinical research; disease /disorder proneness /risk; family genetics; hospital utilization; human data; labor complications; mental disorders; mental health epidemiology; mood disorders; schizophrenia; social mobility; socioeconomics

DESCRIPTION (Applicant's Abstract): It is now accepted that pregnancy and birth complications (PBC's) are associated with increased risk for schizophrenia. It is not known whether PBC's are associated with increased risk for bipolar disorder and other affective psychoses; whether the increase in risk is explained by life style factors of the mother associated with lower socioeconomic status; whether the increased risk is an expression of genetic predisposition to disorder; whether PBC'S, and/or family history of disorder, are associated with early age of onset; the degree to which intergenerational transmission of socioeconomic status is explained by PBC's, in the general population; and in general, how the major risk factors for severe mental disorders combine in raising risk. Continuation of research on the relationship of PBC's to severe mental disorder (especially schizophrenia, bipolar disorder, autism, and their associated disorders) is proposed. Prior analyses, based on linkage of the medical birth register and psychiatric case register of Denmark for births 1973-1993, showed that PBC's were related prospectively to the entire range of hospitalized mental disorders, in both adults and children, with the possible exception of affective psychosis. This continuation expands: 1) the data collection years through 1999; 2) the case-finding beyond hospitals to include specialty outpatient clinics; and 3) the linkage to include the Central Population Register and the National Bureau of Statistics. A reference sample of 5 percent sample of the population of Denmark, including over 60,000 births after 1973 will be linked as well. The expansion will: 1) generate an expected 1200 cases of schizophrenia, 350 cases of affective psychosis, and 1150 cases of autism; 2) permit linkage of first degree relatives, including siblings, mothers and fathers; and 3) permit linkage to socioeocomic variables, obtained on yearly basis, when taxes are paid, such as occupation, income, education, employment, and wealth. Analytic procedures are mostly in the form of logistic regression, and its extensions to time-to-event models (Proportional Hazards); dependent variables with more than two categories (Polytomous Logistic); and to dependent observations (Generalized Estimating Equations). Denmark's system of social medicine provides free care for all, minimizing leakage of cases; and the system of registers is as highly developed and reliable as anywhere in the world. Results will clarify the etiologies of the severe mental disorders; improve understanding of nosologic relationships between the several disorders; provide quantitative information relevant to planning of longitudinal observational and preventive intervention research; and suggest subsets of cases to improve power for genetic analyses.

描述（申请人摘要）：现在人们普遍认为怀孕和分娩 并发症（PBC）与精神分裂症风险增加有关。它 尚不清楚 PBC 是否与双相情感障碍风险增加相关 精神障碍和其他情感性精神病；风险是否增加 与母亲的生活方式因素有关的较低的解释 社会经济地位；风险增加是否是遗传因素的表现 紊乱倾向；无论是 PBC，和/或疾病家族史， 与发病年龄早有关；代际传递的程度 社会经济地位的传递是由 PBC 来解释的，一般而言 人口;一般来说，严重精神疾病的主要危险因素是如何 疾病结合起来会增加风险。 PBC与严重精神障碍关系的继续研究 （尤其是精神分裂症、双相情感障碍、自闭症及其相关疾病） 障碍）提出。先前的分析，基于医学出生的联系 丹麦 1973 年至 1993 年出生登记册和精神病病例登记册显示 PBC 与整个住院患者范围前瞻性相关 成人和儿童的精神障碍，可能的例外 情感性精神病。此延续扩展了：1）数据收集年份 到 1999 年； 2）跨医院、专科的病例发现 门诊诊所； 3) 包括中心人口的联系 登记和国家统计局。 5%的参考样本 丹麦人口样本，包括 1973 年以后出生的 60,000 多人 也将被链接。此次扩建将：1) 预计产生 1200 个病例 精神分裂症、情感性精神病 350 例、自闭症 1150 例； 2) 允许一级亲属的联系，包括兄弟姐妹、母亲和 父亲们； 3）允许与每年获得的社会经济变量联系起来 纳税时的依据，例如职业、收入、教育、就业、 和财富。 分析过程大多采用逻辑回归的形式，其 事件发生时间模型的扩展（比例风险）；因变量 具有两个以上类别（Polytomous Logistic）；和依赖 观察结果（广义估计方程）。丹麦的社会制度 医学为所有人提供免费护理，最大限度地减少病例泄漏；和 寄存器系统与世界上任何地方一样高度发达和可靠 世界。结果将阐明严重精神障碍的病因； 提高对几种疾病之间的疾病学关系的理解； 提供与纵向规划相关的定量信息 观察性和预防性干预研究；并建议子集 案例以提高遗传分析的能力。