Social, familial and psychological risk factors for psychosis: A birth cohort study using the Danish Registry System

The nature and extent of child maltreatment in Denmark: Using self-report and administrative data from the 1984 birth cohort

BACKGROUND

Research on child maltreatment (CM) has few longitudinal studies that combine self-report data with objective administrative data that has been collected continuously for decades.

OBJECTIVE

To give an overview of 20 studies investigating the impact of CM in a Danish representative sample.

PARTICIPANTS AND SETTING

From the full 1984 Danish birth cohort, 2980 24-years old were randomly selected. There was an oversampling of child protection cases.

METHODS

The participants were interviewed by trained interviewers and Computer Assisting Methods were used for sensitive topics. The survey data were linked to several national registers using the Civil Registry Number for a series of studies on risk factors and outcomes. Linkage with parental data enabled parental risk factors before the birth to be analysed as well as several physical, psychological, and social events during their lifetime. These factors were studied in relation to the CM classes that were identified via the survey.

RESULTS

The maltreatment classes had both several specific and shared effects pertaining to risk factors before birth, during childhood through to early adulthood. Their problems included many arenas within health, mental and social life.

CONCLUSIONS

Data linkage studies provide an opportunity to conduct research using accurate sources of information which can be used to explore risk and protective factors. The prospective nature of this combined data facilitates temporal ordering which strengthen the conclusions based on longer-term follow-up.

Risks and Protective Factors of the Prodromal Stage of Psychosis: A Literature Review

Psychosis is a syndrome characterized by features of reality distortion such as delusions and hallucinations. It may occur as a primary mental disorder or secondary to a medical or neurological illness or substance abuse. Several genetic, environmental, and protective risk factors have been identified and require further study. Neurobiological damage at the onset of schizophrenia is the most active and destructive. Therefore, it is important to detect the prodromal phase of psychosis so that interventions can be started early and the onset of psychosis delayed. Herein, we review the relevant epidemiological data on psychosis, particularly in Saudi Arabia. In addition, the risk and protective factors of psychosis will be discussed. Recent findings have shown that psychosis development is affected by genetic and environmental factors. Psychotic disorders are considered a cause of disability and are, therefore, a substantial economic burden. Consequently, it is important to try and detect the psychosis in its prodromal stage, where intervention may slow its progression and improve general wellbeing. Several tools have been identified to screen for the prodrome of psychosis, one of which is the prodromal questionnaire-brief version. This has been shown to be a promising tool that can be self-administered by the patient in contrast to long interview-based tools, which are time-consuming and require a physician to perform. Despite the limited evidence in the literature, there have been significant improvements in the outcomes of patients with psychosis when treated in the prodromal period. In summary, this article provides psychiatrists and researchers with an overview of psychosis, its risk factors, the prodromal stage of psychosis, tools to detect the prodromal phase, and potential treatments during this phase.

Psychosis in children of separated parents: A systematic review and meta-analysis

BACKGROUND

Parental separation is a very common childhood adversity. The association between other adverse childhood experiences and an increased risk of psychosis has been reported. However, the evidence on the risk of psychosis for children of separated parents is limited. In this systematic review, cohort, case-control, and cross-sectional studies, comparing the risk of psychotic disorders for people with and without separated parents, were searched, critically appraised, and summarized.

METHODS

Studies were searched in PubMed, EMBASE, PsycINFO, and the Web of Science, from database inception to September 2019. A meta-analysis, using random-effects models, was undertaken to obtain pooled estimates of the risk of psychosis among participants with separated parents.

RESULTS

Twelve studies, with 305,652 participants from 22 countries, were included in the review. A significantly increased risk of psychosis for those with separated parents was observed, with a pooled odds ratio: 1.53 (95% confidence interval [CI]: 1.29-1.76), p < 0.001. The association remained significant when cohort, case-control, and cross-sectional studies were analyzed separately. The five cohort studies included in this review showed and increased risk of psychosis with odds ratio: 1.47 (95% CI: 1.26-1.69), p < 0.001.

CONCLUSIONS

Parental separation is a common childhood adversity associated with an increased risk of psychosis. Although the risk for an individual child of separated parents is still low, given the high proportion of couple that separate, the increased rates of psychosis may be substantial in the population. Further studies on the risk of psychosis in those with separated parents, and the explanatory factors for this association, are required.