瑞典卡罗林斯卡学院Alicia Nevriana团队在研究中取得进展。他们分析了父母精神疾病与儿童和青少年受伤风险之间的关联。2020年4月8日，《英国医学杂志》发表了这一成果。

为了确定父母精神疾病与后代受伤风险之间的关系，研究组在瑞典进行了一项基于人口的回顾性队列研究。参与者包括1996-2011年出生的1542000个孩子以及他们的893334位母亲和873935名父亲。

父母的精神疾病包括非情感性精神病、情感性精神病、酗酒或滥用药物、情绪障碍、焦虑和压力相关疾病、饮食失调和人格障碍等。儿童的受伤风险包括交通伤害、摔倒、烧伤、溺水和窒息、中毒、遭受暴力等。

父母有精神疾病的孩子的随访时间为201670.5人年，而父母无精神疾病的孩子的随访时间为2434161.5人年。父母有精神疾病的孩子比父母没有精神疾病的孩子更容易受伤。在0-1岁时，与父母没有精神疾病的孩子相比，父母有精神病的孩子每10万人年中，交通事故造成的伤害增加了18例，摔倒伤害增加了1716例。从出生到青春期，受伤的校正比率较高，且在出生后的第一年受伤风险最高。0-1岁时的校正比率范围从跌倒伤害的1.28到暴力相关伤害的3.54。普通和严重的母系父系精神疾病与儿童受伤风险增加有关，且普通精神障碍的风险更高。

总之，父母患精神疾病会增加后代受伤的风险，尤其是在孩子出生后的头几年。在二级保健中充分认识和治疗父母的围产期精神病，可能会预防儿童受伤。

附：英文原文

Title: Association between maternal and paternal mental illness and risk of injuries in children and adolescents: nationwide register based cohort study in Sweden

Author: Alicia Nevriana, Matthias Pierce, Christina Dalman, Susanne Wicks, Marie Hasselberg, Holly Hope, Kathryn M Abel, Kyriaki Kosidou

Issue&Volume: 2020/04/08

Abstract: 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 1542000 children born in 1996-2011 linked to 893334 mothers and 873935 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 201670.5 person years of follow-up, while children without parental mental illness contributed to 2434161.5 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 100000 person years; number of injuries for children with and without parental mental illness was 10235 and 72723, respectively). At age 0-1, the rate differences ranged from 18 additional transport injuries to 1716 additional fall injuries per 100000 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.

DOI: 10.1136/bmj.m853

Source: https://www.bmj.com/content/369/bmj.m853