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Lancet Psychiatry:50年的研究数据——精神分裂症患者教育程度正在改善!

2022-06-28 MedSci原创 MedSci原创

精神分裂症患者在教育程度方面持续面临不平等

教育程度与幸福程度和健康有关,但精神分裂症患者的教育水平低于非患者。一些有效的干预措施可以改善这种状况。然而,精神分裂症患者的教育差距的大小及其随时间的变化还不清楚。来自智利的学者旨在重建精神分裂症患者的受教育程度的轨迹,结果发表在Lancet Psychiatry杂志上。

研究人员开展了一项系统回顾和荟萃分析,包括所有报告精神分裂症患者(平均年龄≥18岁)并描述参与者教育年限的研究。排除了只包括其他精神分裂症谱系障碍患者的研究和没有说明参与者教育年限的研究。根据参与者的平均年龄和发表日期估计了他们的出生日期,并使用随机效应模型对这些数据进行了元分析,重点是教育程度、教育差距和随时间的变化。主要结果是受教育的年限。

从32593条最初的参考文献中,纳入了3321项研究,报告了318632名患者和138675名健康对照者(170941名女性和275821名男性)。患者的教育程度随着时间的推移而增加,这与对照组的情况相同。然而,高收入国家的精神分裂症患者比对照组少受19个月的教育(-1.59年),这相当于Cohen's d为-0.56,意味着与对照组相比,患者未完成12年的教育(即未完成中等教育)的几率为2.58。

这一差距在整个几十年中保持稳定;总教育年限在时间上的变化率并不明显(年变化:0.0047年)。对于低收入和中等收入国家的患者来说,教育差距明显小于高收入国家(小了0.72年),然而这一差距在逐年扩大,接近于高收入国家的差距(年变化:-0.024年)。

尽管在社会心理和药物治疗方面取得了进展,但在上个世纪,精神分裂症患者在教育程度方面持续面临不平等。缩小这种差距应该成为改善他们功能结果的优先事项。

 

参考文献:

The enduring gap in educational attainment in schizophrenia according to the past 50 years of published research: a systematic review and meta-analysis

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    2023-04-19 howi
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    2022-06-23 younei

    lancet上果然牛,感谢梅斯更新及时

    0

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文献汇总-抗精神病药维持治疗带来哪些获益?

本文介绍多项研究表明精神分裂症急性期后抗精神病药维持治疗重要,不同研究展示抗精神病药剂量与复发等风险关系及各类治疗策略对比,2024 年中国专家共识结合循证为维持治疗提供指导。

Schizophrenia:我国学者解开心脑轴的谜团:心血管疾病与精神分裂症的共享遗传机制

TRIM27、CENPM和MYH7B等基因在两者的共享遗传变异中起着重要作用。分析还揭示了与免疫反应、代谢因素和神经发育相关的多个生物学通路,为未来的治疗干预提供了新的研究方向。

Schizophrenia:FMR1与DISC1基因相互作用调节谷氨酸能突触生成

FMR1基因(dfmr1)与精神分裂症风险基因DISC1在果蝇模型中存在遗传相互作用,共同调节谷氨酸能突触的发育。

Molecular Psychiatry:精神分裂症初发患者海马亚区体积与海马谷氨酸水平的纵向研究

抗精神病药物治疗前后16周的初发精神分裂症患者的海马亚区体积存在进行性丧失,特别是在CA1、前海马皮层、CA4及齿状回分子层。谷氨酸水平未见显著变化,且与体积变化无显著相关性。

Schizophrenia: 精神分裂症或首次发作精神病的表观遗传年龄加速和GrimAge成分的Meta分析

精神分裂症患者和首次发作精神病患者的表观遗传年龄加速显著高于对照组,尤其在GrimAge、DunedinPACE及其相关蛋白质预测值(如腺苷髓素、胱抑素C)中显现显著差异。

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