自身免疫性疾病与严重感染性疾病增加患精神分裂症的风险

　　这篇文章发表在最近一期的《美国精神病学杂志》，1次自身免疫性疾病增加29%患精神分裂症的风险（与基础患病率比较，下同）；若因感染而住院，则患精神分裂症的风险增加60%；若两者都有，则风险更大。广州医学院第一附属医院心理咨询科余金龙

　　去年在《自然》杂志上发表的几篇文章指出，有证据支持精神病是一种“神经发育性障碍”， 这种观点对精神病的预防、治疗和研究有重要的指导意义。任何影响神经发育的因素，都有可能增加患精神病的风险；任何促进神经发育的因素，都有可能减少患精神病的风险。（余金龙）

 

附：Autoimmune Diseases and Severe Infections as Risk Factors for Schizophrenia: A 30-Year Population-Based Register Study

Abstract

Objective: 

Autoimmune diseases have been associated with an increased risk of schizophrenia. It has been suggested that brain-reactive autoantibodies are part of the mechanisms behind this association. Furthermore, an increased permeability of the blood-brain barrier has been observed during periods of infection and inflammation. The authors therefore investigated whether autoimmune diseases combined with exposures to severe infections may increase the risk of schizophrenia

Method: 

Nationwide population-based registers in Denmark were linked, and the data were analyzed in a cohort study using survival analysis. All analyses were adjusted for calendar year, age, and sex. Incidence rate ratios and accompanying 95% confidence intervals (CIs) as measures of relative risk were used.

Results: 

A prior autoimmune disease increased the risk of schizophrenia by 29% (incidence rate ratio=1.29; 95% CI=1.18?1.41). Any history of hospitalization with infection increased the risk of schizophrenia by 60% (incidence rate ratio=1.60; 95% CI=1.56?1.64). When the two risk factors were combined, the risk of schizophrenia was increased even further (incidence rate ratio=2.25; 95% CI=2.04?2.46). The risk of schizophrenia was increased in a dose-response relationship, where three or more infections and an autoimmune disease were associated with an incidence rate ratio of 3.40 (95% CI=2.91?3.94). The results remained significant after adjusting for substance use disorders and family history of psychiatric disorders. Hospital contact with infection occurred in nearly 24% of individuals prior to a schizophrenia diagnosis.

Conclusions: 

Autoimmune disease and the number of infections requiring hospitalization are risk factors for schizophrenia. The increased risk is compatible with an immunological hypothesis in subgroups of schizophrenia patients.

注：以上这些观点，未必正确，仅供参考。