| Objective:To explore the influence of early exposure to environmental stress on the susceptibility of individuals to schizophrenia,and to investigate the differences in susceptibility of individuals exposed to schizophrenia in different periods..Methods:This investigation takes Tangshan earthquake as the investigation background,and establishes the unexposed cohort and early earthquake exposure cohort according to the relationship between the birth time of Tangshan people and the occurrence time of earthquake,so as to carry out cohort research.(According to the difference of exposure period,the infant and fetus earthquake exposure groups were established.Seismic exposure groups in the first,second and third trimester of pregnancy were established according to different gestation periods of mothers).According to the statistical annuals of Hebei Province,the population characteristics of Tangshan were obtained.Based on the International Classification of Disease(ICD),the American Diagnostic and Statistical Manual of Mental Disorders(DSM),and the Chinese Classification and Diagnostic Criteria of Mental Disorders(CCMD)as diagnostic criteria,the population characteristics of patients with schizophrenia were obtained from the medical records of psychiatric hospitals.Patients were assigned to different cohorts according to their birth time.Relative Risk of schizophrenia and characteristics of schizophrenia were investigated by cohort.Results:1.In this study,423960 residents born in Tangshan between 1972 and 1981were surveyed,including 3312 patients with schizophrenia.There were 103653residents in the unexposed cohort,including 623 schizophrenics.There were 320307residents in the early earthquake exposure cohort,among whom 2689 were schizophrenic patients.In the subgroup,there were 170088 residents in the infant earthquake exposure cohort,including 1316 patients with schizophrenia;A total of78958 residents were enrolled in the infant earthquake exposure cohort,including710 schizophrenia patients.A total of 71261 residents were enrolled in the fetal earthquake exposure cohort,including 663 schizophrenics.A total of 21712 residents were enrolled in the earthquake exposure cohort in early pregnancy,including 183schizophrenics.A total of 28213 residents were enrolled in the earthquake exposure cohort during the second trimester of pregnancy,including 310 schizophrenics.There were a total of 21336 residents in the earthquake exposure cohort in the late pregnancy,including 170 schizophrenic patients.2.Relative risk:Individuals exposed to earthquakes in early life have a significantly increased relative risk of schizophrenia(RR=1.40,95%CI:1.28,1.53).The relative risk of schizophrenia was highest among the offspring of the maternal earthquake exposure cohort in the middle of pregnancy(RR=1.84,95%CI:1.60,2.11).In gender analysis,the impact of male individual’s exposure to earthquake in infancy(~2=13.52,p<0.001)and early pregnancy(~2=16.25,p<0.001)on the relative risk of disease was statistically significant.Seismic exposure experiences in early childhood(~2=45.64,p<0.001),infancy(~2=38.81,p<0.001),middle pregnancy(~2=33.69,p<0.001)and late pregnancy(~2=16.92,p<0.001)had statistically significant effects on the relative risk of schizophrenia.3.The occurrence of non-suicidalself-injury(NSSI):There was no significant difference between earthquake exposure in early life and NSSI rate in schizophrenia patients(~2=3.32,p=0.078),In the subgroup analysis,the relative risk of NSSI was significantly increased in schizophrenia patients with earthquake exposure only in early childhood(RR=1.63,95%CI:1.09,2.44),In gender analysis,the relative risk of NSSI was significantly increased in male schizosis patients with earthquake exposure in early childhood(RR=1.85,95%CI:1.02,3.36),There was no correlation between early life earthquake exposure and NSSI in female schizophrenic patients at any time.4.The occurrence of suicide:The relative rate of suicide in schizophrenics who exposed earthquakes in early life is significantly higher(~2=10.49,p=0.004).In the subgroup,there was a statistically significant difference in the relative rate of suicide between the infant(~2=6.96,p=0.008)and fetal(~2=21.90,p<0.001)earthquake exposed schizophrenia patients;There was a linear relationship between early earthquake exposure and suicidal behavior levels(~2=8.43,p=0.004),The level of suicidal behavior increased with decreasing age at earthquake exposure(RR=0.068,p<0.001).In gender analysis,the relative risk of suicide was significantly increased in male with schizophrenia who were exposed to earthquakes in the early life(RR=1.83,95%CI:1.53,2.69).There was no statistically significant effect of early earthquake exposure on relative risk of suicide in female patients.5.There was a correlation between the age of first onset of schizophrenia and earthquake exposure in early life(U=341079,p<0.001).Individuals with schizophrenia who exposed earthquake in early life developed at an earlier first onset of schizophrenia.Conclusion:Earthquake exposure in early life has a certain influence on schizophrenia susceptibility,and the influence has gender difference.The effects of early exposure to earthquakes on the onset of schizophrenia are different in different periods.Early exposure to earthquakes has an effect on the incidence of NSSI and suicide in schizophrenic patients,and the influence has gender difference.Exposure to earthquakes in early life was associated with the age at first onset of schizophrenia... |
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