産後精神病の家族歴と発症リスクの関連(Women Whose Sister Experienced Postpartum Psychosis Are More Than 10 Times as Likely to Experience It Themselves)

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2025-05-19 マウントサイナイ医療システム(MSHS)

マウントサイナイ医科大学の研究チームは、産後精神病(postpartum psychosis)を発症した姉妹を持つ女性は、発症していない姉妹を持つ女性に比べて、同疾患を発症するリスクが10倍以上高いことを明らかにしました。この研究は、スウェーデンの全国登録データを用いて約160万人の女性を対象に行われ、初産後3か月以内に産後精神病を発症した2,514人の女性が特定されました。また、姉妹が双極性障害を持つ場合、産後精神病のリスクは2倍に、姉妹が双極性障害と産後精神病の両方を持つ場合は14倍に増加することも示されました。これらの結果は、遺伝的および環境的要因の影響を示唆しています。産後精神病はまれな疾患でありながら、早期発見と予防が重要であり、今後の研究では、疾患の発症メカニズムや予防戦略の開発が期待されています。

<関連情報>

産後精神病の家族性リスク Familial Risk of Postpartum Psychosis

Adrianna P. Kępińska, Ph.D., Thalia K. Robakis, M.D., Ph.D., Keith Humphreys, Ph.D., Xiaoqin Liu, Ph.D., René S. Kahn, M.D., Ph.D., Trine Munk-Olsen, Ph.D., Veerle Bergink, M.D., Ph.D., and Behrang Mahjani, Ph.D.
American Journal of Psychiatry  Published:19 May 2025
DOI:https://doi.org/10.1176/appi.ajp.20230576

産後精神病の家族歴と発症リスクの関連(Women Whose Sister Experienced Postpartum Psychosis Are More Than 10 Times as Likely to Experience It Themselves)

Abstract

Objective:

Postpartum psychosis is one of the most severe psychiatric conditions, with high risks of suicide and infanticide if untreated. Although genetic factors contribute to the risk of postpartum psychosis, the extent of familial risk remains to be determined. The authors compared relative recurrence risk across different family relationship types, hypothesizing that relative recurrence risk for postpartum psychosis varies by degree of genetic relatedness and is higher in female full siblings than in cousins.

Methods:

This cohort study consisted of 1,648,759 women from the Swedish nationwide registers, of whom 2,514 (0.15%) experienced postpartum psychosis within 3 months of their first-ever childbirth. The authors estimated the relative recurrence risk of postpartum psychosis for female full siblings and cousins as a measure of familial risk.

Results:

The relative recurrence risk of postpartum psychosis in full siblings was 10.69 (95% CI=6.60, 16.26) when adjusted for year of and age at childbirth. Although cousins showed an elevated relative recurrence risk, these results did not reach statistical significance (1.78, 95% CI=0.70, 3.62). Despite the higher familial risk of postpartum psychosis among full siblings, the absolute risk for women with an affected sibling was relatively low, estimated at 1.60% within the entire population.

Conclusions:

The observed increased risk of postpartum psychosis in full siblings suggests both genetic and shared environmental influences. However, the lack of significant results in cousins hampers a more accurate distinction between these factors. Furthermore, despite increased relative recurrence risk in siblings, their overall likelihood of developing postpartum psychosis remains low. This study underscores the need for further research to better understand the intricate interplay of genetics and shared environment in the development of postpartum psychosis.

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