考察丹麦综合剥夺指数与患精神分裂症风险之间的关系：一项国家多层次分析

IF 3.5 2区医学 Q1 PSYCHIATRY

Schizophrenia Research Pub Date : 2025-09-08 DOI:10.1016/j.schres.2025.09.001

Henriette T. Horsdal , Anja S. Jensen , Sussie Antonsen , Marianne G. Pedersen , Betina B. Trabjerg , Wesley K. Thompson , Chun C. Fan , Clive E. Sabel , Esben Agerbo , Carsten B. Pedersen , Roger T. Webb

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引用次数: 0

摘要

背景：很少有以人群为基础的多水平分析研究了精神分裂症的个体和社区水平的危险因素。方法对1990 - 1999年在丹麦出生的所有人进行精神分裂症诊断随访。随访在10岁生日时开始，并在死亡、移民、事件诊断或2018年12月31日（以先到者为准）时终止。丹麦综合剥夺指数是利用1990-1999年10年加权平均邻里一级指数得出的，分为五个领域：收入；就业;教育、技能及培训；健康和残疾；和犯罪。通过拟合多水平对数线性泊松回归模型，在调整和不调整个人水平协变量的情况下，对邻里水平剥夺指标进行了检验。结果就业、教育、技能与培训、健康与残疾和犯罪这四个社区层面的剥夺领域，以及丹麦综合剥夺指数（调整后的IRR为1.14；95%可信区间为1.10-1.17），与独立于个人层面剥夺措施的风险升高相关。与最高调整后风险升高相关的具体社区水平指标是：18 - 22岁居民在18岁之前未完成小学教育的比例（调整后内部风险比1.23;1.20-1.27）；因任何暴力犯罪被定罪的居民比例（调整后的内部比率1.19;1.16-1.23）；因任何罪行而被判监禁的居民比例（调整后的IRR 1.15; 1.12-1.18）。结论这一新颖的基于人群的多水平分析证明了社区水平剥夺指标与精神分裂症风险升高之间的独立关联。需要在其他人群中进行复制，以便为改进预防战略提供信息。

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Examining relationships between the Danish Composite Deprivation Index and risk of developing schizophrenia: A national multilevel analysis

Background

Few population-based multilevel analyses examining individual- and neighborhood-level risk factors for schizophrenia have been conducted.

Methods

A study cohort of all persons born in Denmark from 1990 to 1999 was followed for diagnosis with schizophrenia. Follow-up was initiated at 10th birthday and terminated at death, emigration, incident diagnosis, or 31st December 2018, whichever came first. A Danish Composite Deprivation Index was derived using 10-year weighted average neighborhood-level indicators in 1990–1999 categorized into five domains: Income; Employment; Education, Skills & Training; Health & Disability; and Crime. By fitting multilevel log-linear Poisson regression models, neighborhood-level deprivation indicators were examined with and without adjustment for individual-level covariates.

Results

Four neighborhood-level deprivation domains, Employment, Education, Skills & Training, Health & Disability, and Crime, as well as the Danish Composite Deprivation Index (adjusted IRR 1.14; 95 % credibility interval 1.10–1.17), were associated with elevated risk independent of individual-level deprivation measures. The specific neighborhood-level indicators linked with the highest adjusted elevations in risk were: Proportion of inhabitants aged 18–22 years who did not complete primary school before age 18 (adjusted IRR 1.23; 1.20–1.27); Proportion of inhabitants convicted for any violent crime (adjusted IRR 1.19; 1.16–1.23); and Proportion of inhabitants convicted for any crime resulting in a custodial sentence (adjusted IRR 1.15; 1.12–1.18).

Conclusion

This novel population-based multilevel analysis has evidenced the independent associations of neighborhood-level deprivation indicators on schizophrenia risk elevation. Replication is needed in other populations to inform the refinement of preventive strategies.

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来源期刊

Schizophrenia Research 医学-精神病学

CiteScore

7.50

自引率

8.90%

发文量

429

审稿时长

10.2 weeks

期刊介绍： As official journal of the Schizophrenia International Research Society (SIRS) Schizophrenia Research is THE journal of choice for international researchers and clinicians to share their work with the global schizophrenia research community. More than 6000 institutes have online or print (or both) access to this journal - the largest specialist journal in the field, with the largest readership! Schizophrenia Research''s time to first decision is as fast as 6 weeks and its publishing speed is as fast as 4 weeks until online publication (corrected proof/Article in Press) after acceptance and 14 weeks from acceptance until publication in a printed issue. The journal publishes novel papers that really contribute to understanding the biology and treatment of schizophrenic disorders; Schizophrenia Research brings together biological, clinical and psychological research in order to stimulate the synthesis of findings from all disciplines involved in improving patient outcomes in schizophrenia.