Objective:

Most mental disorders, when examined individually, are associated with an increased risk of cardiometabolic complications. However, these associations might be attributed to a general liability to psychopathology or confounded by unmeasured familial factors. The authors investigated the association between psychiatric conditions in young adulthood and the risk of cardiometabolic complications in middle adulthood, up to 40 years later.

Methods:

This cohort study (N=672,823) identified all individuals and their siblings born in Sweden between 1955 and 1962 and followed the cohort through 2013. Logistic regression models were used to estimate the bivariate associations between 10 psychiatric conditions or criminal convictions and five cardiometabolic complications in individuals. A general factor model was used to identify general, internalizing, externalizing, and psychotic factors based on the comorbidity among psychiatric conditions and criminal convictions. The cardiometabolic complications were then regressed on the latent general factor and three uncorrelated specific factors within a structural equation modeling framework in individuals and across sibling pairs.

Results:

Each psychiatric condition significantly increased the risk of cardiometabolic complications. These associations appeared nonspecific, as multivariate models indicated that most were attributable to the general factor of psychopathology, rather than to specific psychiatric conditions. There were no or only small associations between individuals’ general psychopathology and their siblings’ cardiometabolic complications. The same pattern was evident for the specific internalizing and psychotic factors.

Conclusions:

Associations between mental disorders in early life and later long-term risk of cardiometabolic complications appeared to be attributable to a general liability to psychopathology. Familial coaggregation analyses suggested that the elevated risk could not be attributed to confounders shared within families. One possibility is that lifestyle-based interventions may reduce the risk of later cardiometabolic complications for patients with several mental disorders.

中文翻译：

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青年期一般和特定心理健康状况与中年期心脏代谢并发症之间的关联：一项针对 672,823 名瑞典人的 40 年纵向家族聚合研究

 客观的：

大多数精神障碍在单独检查时都与心脏代谢并发症的风险增加有关。然而，这些关联可能归因于精神病理学的一般责任或受到未测量的家庭因素的混淆。作者调查了成年早期的精神疾病与成年中期（长达 40 年后）心脏代谢并发症风险之间的关联。

 方法：

这项队列研究 (N=672,823) 确定了 1955 年至 1962 年间出生在瑞典的所有个人及其兄弟姐妹，并在 2013 年对队列进行了跟踪。使用 Logistic 回归模型来估计 10 种精神疾病或刑事定罪与 5 种心脏代谢并发症之间的双变量关联。个人。一般因素模型用于根据精神疾病和刑事定罪之间的共病来识别一般因素、内化因素、外化因素和精神病因素。然后，在个体和兄弟姐妹对的结构方程模型框架内，对潜在的一般因素和三个不相关的特定因素进行心脏代谢并发症的回归。

 结果：

每种精神疾病都会显着增加心脏代谢并发症的风险。这些关联似乎是非特异性的，因为多变量模型表明大多数归因于精神病理学的一般因素，而不是特定的精神状况。个体的一般精神病理学与其兄弟姐妹的心脏代谢并发症之间没有或只有很小的关联。对于特定的内化因素和精神病因素，同样的模式也很明显。

 结论：

生命早期的精神障碍与后来的心脏代谢并发症的长期风险之间的关联似乎可归因于精神病理学的一般责任。家庭共聚集分析表明，风险升高不能归因于家庭内部共有的混杂因素。一种可能性是，基于生活方式的干预措施可能会降低患有多种精神障碍的患者日后出现心脏代谢并发症的风险。