创作:兵兵 审核:Epi汪 2019年02月22日
  • 纳入HUNT项目中6696对父母及其8773名13-19岁的孩子,根据父母的健康风险( 包括饮酒频率和总量、心理健康以及受教育水平),采用潜在轮廓分析(LP),将其分为5类家庭;
  • 在8年的随访中,24.3%的孩子有至少一次的焦虑或抑郁的医疗记录;
  • LP1类(父母双方的受教育水平低)和LP5类(父母饮酒多且父亲的心理健康症状重)父母与孩子的焦虑/抑郁的风险增加相关;
  • 在家庭层面,父母的一些看似无害的行为、精神状态都与孩子心理健康状况相关。
孩子的心理健康与家庭成长环境息息相关。JAMA Pediatrics近期的研究表明,父母受教育程度低、经常饮酒以及心理症状重都可能增加孩子的焦虑/抑郁风险。但是本文对父母健康风险的评估仅局限在饮酒、受教育水平以及心理健康上,期待有更全面的评估方法,能够综合儿童成长家庭环境中的方方面面,从而更全面揭示儿童焦虑/抑郁发生的危险因素,为精神类疾病的防控提供指导。
JAMA Pediatrics [IF:13.946]

Association of Constellations of Parental Risk With Children's Subsequent Anxiety and Depression: Findings From a HUNT Survey and Health Registry Study



2019-01-07, Article

Abstract & Authors:展开

Importance: The research focus on children of parents with alcohol use disorder has eclipsed the potentially wider-reaching detrimental effects of subclinical parental drinking, both alone and in combination with other parental risk factors.
Objective: To identify constellations of early parental risk characterized by variations in drinking, mental health, and education in both parents and examine their prospective associations with children's contact with the health care system for anxiety and/or depression (ie, diagnoses or treatment).
Design, Setting, and Participants: This prospective study was based on linked survey and health registries data. The sample included 8773 children from 6696 two-parent families in Norway who participated in the Nord-Trøndelag Health Study (HUNT) survey in 1995 to 1997 or 2006 to 2008, when the children were aged 13 to 19 years. Data were analyzed from January to September 2018.
Exposures: Five constellations of early parental risks, characterized by variations in drinking frequencies and amounts, mental health, and education for both parents, as identified through latent profile analysis.
Main Outcomes and Measures: Children's diagnoses or treatment of anxiety and/or depression from 2008 to 2016 were recorded in 3 health registries. The primary outcome was the total number of registries where participants presented (ranging from 0 to 3).
Results: Of the 8773 included children, 4404 (50.2%) were boys, and the mean (SD) age at the time of participation in the Nord-Trøndelag Health Study was 16.1 (1.8) years. Prevalence of anxiety and/or depression, as evidenced in at least 1 registry record, was 24.3% (2132 of 8773). Early parental risk profiles risks marked by (1) the lowest parental education (adjusted relative risk, 1.13; 95% CI, 1.01-1.25) and (2) elevated drinking in both parents and elevated mental health symptoms in fathers (adjusted relative risk, 1.52; 95% CI, 1.03-2.22) were associated with a significant increase in risk of anxiety and/or depression in children from those families compared with children from no-risk families.
Conclusions and Relevance: Studies seeking to understand prospective associations of parental drinking with children's mental health need to consider additional risk factors in combination with one another as well as parental behaviors and characteristics below clinically defined levels. When accumulated at a family level, even seemingly innocuous characteristics contributed to meaningful increases in risk of anxiety and/or depression among children, potentially translating into poorer mental health outcomes for many young people.

First Authors:
Ingunn Olea Lund

Correspondence Authors:
Ingunn Olea Lund

All Authors:
Ingunn Olea Lund,Svetlana Skurtveit,Marte Handal,Anne Bukten,Fartein Ask Torvik,Eivind Ystrøm,Jasmina Burdzovic Andreas