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Vigod SN, Rochon-Terry G, Fung K, Gruneir A, Dennis CL, Grigoriadis S, Kurdyak PA, Ray JG, Rochon P, Seeman MV. Factors associated with postpartum psychiatric admission in a population-based cohort of women with schizophrenia. Acta Psychiatr Scand 2016; 134:305-13. [PMID: 27437875 DOI: 10.1111/acps.12622] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/30/2016] [Indexed: 12/16/2022]
Abstract
OBJECTIVE We aimed to identify factors associated with postpartum psychiatric admission in schizophrenia. METHOD In a population-based cohort study of 1433 mothers with schizophrenia in Ontario, Canada (2003-2011), we compared women with and without psychiatric admission in the 1st year postpartum on demographic, maternal medical/obstetrical, infant and psychiatric factors and identified factors independently associated with admission. RESULTS Admitted women (n = 275, 19%) were less likely to be adolescents, more likely to be low income and less likely to have received prenatal ultrasound before 20 weeks gestation compared to non-admitted women. They also had higher rates of predelivery psychiatric comorbidity and mental health service use. Factors independently associated with postpartum admission were age (<20 vs. ≥35 years: adjusted risk ratio, aRR, 0.48, 95% CI 0.24-0.96), income (lowest vs. highest income: aRR 1.67, 1.13-2.47) and the following mental health service use factors in pregnancy: admission (≥35 days/year vs. no days, aRR 4.54, 3.65-5.65), outpatient mental health care (no visits vs. ≥2 visits aRR 0.35, 0.27-0.47) and presence of a consistent mental health care provider during pregnancy (aRR 0.69, 0.54-0.89). CONCLUSION Certain subgroups of women with schizophrenia may benefit from targeted intervention to mitigate risk for postpartum admission.
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Affiliation(s)
- S N Vigod
- Women's College Hospital, Toronto, ON, Canada. .,University of Toronto, Toronto, ON, Canada. .,Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.
| | | | - K Fung
- Women's College Hospital, Toronto, ON, Canada.,Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
| | - A Gruneir
- Women's College Hospital, Toronto, ON, Canada.,Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.,University of Alberta, Edmonton, AB, Canada
| | - C-L Dennis
- Women's College Hospital, Toronto, ON, Canada.,University of Toronto, Toronto, ON, Canada.,Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
| | - S Grigoriadis
- University of Toronto, Toronto, ON, Canada.,Sunnybrook Health Sciences Centre, Toronto, ON, Canada
| | - P A Kurdyak
- University of Toronto, Toronto, ON, Canada.,Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.,Centre for Addiction and Mental Health, Toronto, ON, Canada
| | - J G Ray
- University of Toronto, Toronto, ON, Canada.,Institute for Clinical Evaluative Sciences, Toronto, ON, Canada.,St. Michael's Hospital, Toronto, ON, Canada
| | - P Rochon
- Women's College Hospital, Toronto, ON, Canada.,University of Toronto, Toronto, ON, Canada.,Institute for Clinical Evaluative Sciences, Toronto, ON, Canada
| | - M V Seeman
- University of Toronto, Toronto, ON, Canada
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Rasic D, Hajek T, Alda M, Uher R. Risk of mental illness in offspring of parents with schizophrenia, bipolar disorder, and major depressive disorder: a meta-analysis of family high-risk studies. Schizophr Bull 2014; 40:28-38. [PMID: 23960245 PMCID: PMC3885302 DOI: 10.1093/schbul/sbt114] [Citation(s) in RCA: 442] [Impact Index Per Article: 44.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
OBJECTIVE Offspring of parents with severe mental illness (SMI; schizophrenia, bipolar disorder, major depressive disorder) are at an increased risk of developing mental illness. We aimed to quantify the risk of mental disorders in offspring and determine whether increased risk extends beyond the disorder present in the parent. METHOD Meta-analyses of absolute and relative rates of mental disorders in offspring of parents with schizophrenia, bipolar disorder, or depression in family high-risk studies published by December 2012. RESULTS We included 33 studies with 3863 offspring of parents with SMI and 3158 control offspring. Offspring of parents with SMI had a 32% probability of developing SMI (95% CI: 24%-42%) by adulthood (age >20). This risk was more than twice that of control offspring (risk ratio [RR] 2.52; 95% CI 2.08-3.06, P < .001). High-risk offspring had a significantly increased rate of the disorder present in the parent (RR = 3.59; 95% CI: 2.57-5.02, P < .001) and of other types of SMI (RR = 1.92; 95% CI: 1.48-2.49, P < .001). The risk of mood disorders was significantly increased among offspring of parents with schizophrenia (RR = 1.62; 95% CI: 1.02-2.58; P = .042). The risk of schizophrenia was significantly increased in offspring of parents with bipolar disorder (RR = 6.42; 95% CI: 2.20-18.78, P < .001) but not among offspring of parents with depression (RR = 1.71; 95% CI: 0.19-15.16, P = .631). CONCLUSIONS Offspring of parents with SMI are at increased risk for a range of psychiatric disorders and one third of them may develop a SMI by early adulthood.
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Affiliation(s)
- Daniel Rasic
- *To whom correspondence should be addressed; Department of Psychiatry, Canada Research Chair in Early Intervention in Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, Room 3089, Abbie J. Lane Memorial Building, Halifax, Nova Scotia B3H 2E2, Canada; fax: 902-473-4877, e-mail:
| | - Tomas Hajek
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia B3H 2E2, Canada;,Department of Psychiatry and Medical Psychology, Prague Psychiatric Center, Charles University, Prague, Czech Republic
| | - Martin Alda
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia B3H 2E2, Canada
| | - Rudolf Uher
- Department of Psychiatry, Dalhousie University, Halifax, Nova Scotia B3H 2E2, Canada;,MRC Social, Genetic and Developmental Psychiatry Centre at the Institute of Psychiatry, King’s College London, UK,*To whom correspondence should be addressed; Department of Psychiatry, Canada Research Chair in Early Intervention in Psychiatry, Dalhousie University, 5909 Veterans’ Memorial Lane, Room 3089, Abbie J. Lane Memorial Building, Halifax, Nova Scotia B3H 2E2, Canada; fax: 902-473-4877, e-mail:
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