児童および青少年の行動

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Familial Risk Across Three Generations and Psychosocial Correlates for Developing Psychopathology in a Changing World

Jorge Javier Caraveo

Background: Human development is a highly complex, environment-dependent process including mental health and psychopathology among its outcomes. Thus, it needs to be studied comprehensively in order to identify correlations and interactions among different biological, economical and psychosocial variables across time and generations. Objective: Is familial psychopathology risk across three generations significantly associated with ongoing psychosocial variables reported by probands? Methods: The study was designed as a household survey on a representative sample of the adult population aged 18 - 65 years in Mexico City. The family-history method was used to obtain information about psychiatric antecedents on their parents and a validated screening instrument was used to evaluate caseness in their offspring. Lifetime prevalence of psychiatric disorders on probands was evaluated using the Composite International Diagnostic Interview. Morbid risk in terms of the odds ratio and prevalence ratio were calculated using logistic regression with fixed effects as well as with generalized estimating equations (GEE) population-averaged models with an exchangeable structure. Aditionally, the population attributable risk percent was also calculated for selected variables associated with the outcome in the complete models. Results: The strenght of the association of familial psychiatric antecedents is moderate between generations on either direction: backwards in regards of proband’s parents or downwards in regards of their children. However, when interaction between the two previous generations was considered, the strenght of the association was higher, crude OR=7.8, and showing significant variations when controlling for the effect of the rest of the variables and especially for probands’ psychosocial correlates. The population attributable risk percent for these variables across generations is sometimes higher than the obtained for familial risk. Conclusions: Findings suggest that besides psychiatric familial risk, socioeconomial and psychodynamic risk factors have been interacting across time and generations contributing to the high prevalence of psychiatric disorders recently reported on youth Mexican population