RESUMEN
Prenatal sex hormone levels affect physical and behavioral sexual differentiation in animals and humans. Although prenatal hormones are theorized to influence sexual orientation in humans, evidence is sparse. Sexual orientation variables for 34 prenatally progesterone-exposed subjects (17 males and 17 females) were compared to matched controls (M age = 23.2 years). A case-control double-blind design was used drawing on existing data from the US/Denmark Prenatal Development Project. Index cases were exposed to lutocyclin (bioidentical progesterone = C21H30O2; M W : 314.46) and no other hormonal preparation. Controls were matched on 14 physical, medical, and socioeconomic variables. A structured interview conducted by a psychologist and self-administered questionnaires were used to collect data on sexual orientation, self-identification, attraction to the same and other sex, and history of sexual behavior with each sex. Compared to the unexposed, fewer exposed males and females identified as heterosexual and more of them reported histories of same-sex sexual behavior, attraction to the same or both sexes, and scored higher on attraction to males. Measures of heterosexual behavior and scores on attraction to females did not differ significantly by exposure. We conclude that, regardless of sex, exposure appeared to be associated with higher rates of bisexuality. Prenatal progesterone may be an underappreciated epigenetic factor in human sexual and psychosexual development and, in light of the current prevalence of progesterone treatment during pregnancy for a variety of pregnancy complications, warrants further investigation. These data on the effects of prenatal exposure to exogenous progesterone also suggest a potential role for natural early perturbations in progesterone levels in the development of sexual orientation.
Asunto(s)
Efectos Tardíos de la Exposición Prenatal/epidemiología , Progesterona , Conducta Sexual/efectos de los fármacos , Adulto , Bisexualidad/efectos de los fármacos , Estudios de Casos y Controles , Femenino , Humanos , Masculino , Embarazo , Adulto JovenRESUMEN
This study explored labeling of penile-anal intercourse (PAI), manual-anal (MA), and oral-anal (OA) behaviors as having "had sex" among heterosexual men and women with such experience residing in the United States (n = 3,218). Adult men and women completed an online questionnaire assessing sexual behaviors and whether each counted as having had sex. With the exception of anal intercourse, there was high variation in whether a behavior was labeled having had sex. There was not consensus on which anal sexual behaviors constituted having had sex, with attitudes varying across age, gender, and behavioral experience. Those who were older, male, and had the specific behavioral experience were more likely to label it as having had sex. Behaviorally specific assessments of the various anal behaviors as part of the sexual repertoire is critical to more accurate evaluation of sexual histories and assessment of risks to sexual health.
Asunto(s)
Heterosexualidad/psicología , Conducta Sexual/psicología , Adolescente , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Estados Unidos , Adulto JovenRESUMEN
BACKGROUND: It is not known whether smoking is a risk factor for mental disorders. AIMS: To investigate the prospective associations between cigarette smoking in pregnant women and a range of psychiatric hospital diagnoses. METHOD: Using data from the Copenhagen Perinatal Cohort, we followed a cohort of 7926 young women from 1959-61 to 2007, linking data on cigarette smoking with psychiatric admission diagnoses obtained from the Danish Psychiatric Central Register. The women were interviewed by a physician in 1959-61 when data was obtained on smoking and other health related variables. With adjustment for age, social class and psychopharmacological treatment at baseline, the effects of smoking on the risk of (hierarchically ordered) major categories of mental disorders were examined. RESULTS: Significant positive associations were observed between number of cigarettes smoked and schizophrenia spectrum disorder, substance use-related disorder, a broad category of other non-psychotic disorders, and any psychiatric registration. For affective spectrum disorders, there was a significant, but non-linear association. CONCLUSION: Number of cigarettes smoked in young adulthood significantly predicted a range of psychiatric admission diagnoses and, for most diagnostic categories, evidence of a dose-response relationship was observed.
Asunto(s)
Hospitalización/estadística & datos numéricos , Enfermos Mentales/estadística & datos numéricos , Trastornos del Humor/etiología , Esquizofrenia/etiología , Fumar , Trastornos Relacionados con Sustancias/etiología , Femenino , Hospitales Psiquiátricos , Humanos , Entrevistas como Asunto , Trastornos del Humor/epidemiología , Embarazo , Estudios Prospectivos , Sistema de Registros , Factores de Riesgo , Esquizofrenia/epidemiología , Fumar/efectos adversos , Fumar/epidemiología , Factores Socioeconómicos , Trastornos Relacionados con Sustancias/epidemiologíaRESUMEN
The aim of the present study was to investigate the relationship between age of neuromotor milestone attainment and risk of adult schizophrenia. 5765 mothers of the Copenhagen Perinatal Cohort recorded 12 developmental milestones during the child's first year of life. Cohort members were followed until they were 46-48 years old through record linkage with the Danish Psychiatric Central Research Register. The age at which milestones were met in the 92 individuals who later developed schizophrenia was compared with milestone attainment in the 691 individuals who developed other psychiatric disorders and in the 4982 cohort controls who were never admitted to a psychiatric department. Group comparisons were adjusted for gender, mother's age, father's age, parental social status, breadwinner's education, single mother status and parity. Individuals who developed schizophrenia reached all developmental milestones later than controls and differed significantly from the controls with respect to the mean age of reaching the 12 milestones. Five developmental milestones in particular (smiling, lifting head, sitting, crawling, and walking) differed significantly. Individuals who later developed psychiatric disorders other than schizophrenia reached most developmental milestones earlier than those who developed schizophrenia, but later than the controls. The two psychiatric groups only differed significantly with respect to age of walking without support. The findings corroborate and methodologically extend previous research from prospective longitudinal cohort studies suggesting developmental delays observable as early as within the first year of life. These early developmental delays may not only characterize schizophrenia, but may be associated with a range of psychiatric disorders.
Asunto(s)
Discapacidades del Desarrollo/psicología , Relaciones Padres-Hijo , Esquizofrenia/etiología , Psicología del Esquizofrénico , Adulto , Niño , Estudios de Cohortes , Dinamarca/epidemiología , Femenino , Humanos , Masculino , Embarazo , Factores de Riesgo , Esquizofrenia/epidemiología , Autoimagen , Adulto JovenRESUMEN
Recent research suggests that prenatal exposure to nonviral infection may be associated with increased risk of schizophrenia, and we hypothesized an association between maternal bacterial infection during pregnancy and elevated offspring risk of schizophrenia. Data on maternal infections from the Copenhagen Perinatal Cohort were linked with the Danish National Psychiatric Register. Offspring cases of narrowly defined schizophrenia (International Classification of Diseases, Eighth Revision [ICD-8]) and more broadly defined schizophrenia (ICD-8 and ICD-10) were identified before the ages of 32-34 and 45-47 years, respectively. The effect of prenatal exposure to bacterial infections was adjusted for prenatal exposure to analgesics and parental social status. In a risk set of 7941 individuals, 85 cases (1.1%) of ICD-8 schizophrenia were identified by the age of 32-34 years and 153 cases (1.9%) of more broadly defined schizophrenia by the age of 45-47 years. First-trimester exposure conferred an elevated risk of ICD-8 schizophrenia (odds ratio 2.53; 95% confidence interval [CI] 1.07-5.96) and also of broadly defined schizophrenia (odds ratio 2.14; 95% CI 1.06-4.31). Second-trimester exposure also conferred a significantly elevated risk of schizophrenia but only in unadjusted analyses. These findings suggest a relationship between maternal bacterial infection in pregnancy and offspring risk of schizophrenia, and this effect was somewhat stronger for ICD-8 schizophrenia with earlier onset. Post hoc analyses showed that upper respiratory tract and gonococcal infections were associated with elevated risk of the disease. An association between risk of schizophrenia and prenatal exposure to bacterial infections might be mediated through transplacental passage of maternally produced cytokines in response to bacterial infections.
Asunto(s)
Infecciones Bacterianas/epidemiología , Complicaciones Infecciosas del Embarazo/epidemiología , Efectos Tardíos de la Exposición Prenatal/epidemiología , Esquizofrenia/epidemiología , Adulto , Analgésicos/administración & dosificación , Analgésicos/efectos adversos , Infecciones Bacterianas/etiología , Estudios de Cohortes , Dinamarca , Femenino , Humanos , Recién Nacido , Masculino , Persona de Mediana Edad , Embarazo , Complicaciones Infecciosas del Embarazo/etiología , Efectos Tardíos de la Exposición Prenatal/etiología , Riesgo , Esquizofrenia/etiología , Estadística como AsuntoRESUMEN
The risk of schizophrenia has been linked with a family history of schizophrenia and less strongly with other psychiatric disorders in family members. Using data from the Copenhagen Perinatal Cohort and from the Danish Psychiatric Case Register, we studied the relationship between offspring risk of schizophrenia and a range of psychotic and non-psychotic psychiatric diagnoses in parents. Psychiatric admission data after 1969 were available for 7047 cohort members born between 1959 and 1961, and for 7006 mothers and 6993 fathers. Univariate analysis showed that neurosis, alcohol and substance dependence in both parents were associated with elevated risk of offspring schizophrenia; in addition, maternal schizophrenia, affective disorder and personality disorder were associated with elevated risk. Controlling for parental age, parental social status, and parental psychiatric co-diagnosis, offspring risk of schizophrenia was associated with maternal schizophrenia (OR = 15.41 with 95% CI 5.96-39.81) and, independently, with paternal hospitalisation with neurosis (OR = 5.90 with 95% CI 2.23-15.62). The risk of schizophrenia associated with paternal neurosis remained significant after excluding offspring of parents with non-affective psychosis from the sample. These findings suggest that genetic and family studies should not only focus on parental history of schizophrenia since the simple distinction between positive and negative family history could not accurately describe offspring risk in this sample.
Asunto(s)
Hijo de Padres Discapacitados/psicología , Trastornos Mentales/genética , Trastornos Mentales/psicología , Esquizofrenia/genética , Psicología del Esquizofrénico , Adulto , Alcoholismo/epidemiología , Alcoholismo/genética , Alcoholismo/psicología , Niño , Estudios de Cohortes , Comorbilidad , Estudios Transversales , Dinamarca , Femenino , Predisposición Genética a la Enfermedad/genética , Humanos , Incidencia , Estudios Longitudinales , Masculino , Trastornos del Humor/epidemiología , Trastornos del Humor/genética , Trastornos del Humor/psicología , Trastornos Neuróticos/epidemiología , Trastornos Neuróticos/genética , Trastornos Neuróticos/psicología , Oportunidad Relativa , Trastornos de la Personalidad/epidemiología , Trastornos de la Personalidad/genética , Trastornos de la Personalidad/psicología , Trastornos Psicóticos/epidemiología , Trastornos Psicóticos/genética , Trastornos Psicóticos/psicología , Sistema de Registros , Riesgo , Esquizofrenia/epidemiología , Factores Sexuales , Trastornos Relacionados con Sustancias/epidemiología , Trastornos Relacionados con Sustancias/genética , Trastornos Relacionados con Sustancias/psicologíaRESUMEN
OBJECTIVE: This study attempted to determine whether lack of breast-feeding or a short duration of breast-feeding during infancy is associated with an elevated risk of hospitalization with alcohol-related diagnoses in adult life. METHOD: The study was a prospective longitudinal birth cohort design conducted in a sample of 6,562 men and women, all of whom were born in Copenhagen, Denmark, between October 1959 and December 1961. The sample was divided into two categories based on duration of breast-feeding, as assessed by a physician interview with mothers at a 1-year examination. Psychiatric hospitalizations with alcohol-related diagnoses according to ICD-8 or ICD-10 were identified in the Danish Psychiatric Central Register in 1999. Nine potential confounders were included as covariates: gender of the cohort member, maternal age, parental social status, maternal prenatal smoking, unwanted pregnancy, maternal and paternal psychiatric hospitalization with alcohol-related diagnosis, and maternal and paternal psychiatric hospitalization with other diagnosis. RESULTS: Alcohol-related diagnoses were more frequent in men, but the results were comparable for men and women. The adjusted predictive effect of early weaning was 1.47. Elevated relative risks were also associated with maternal smoking during pregnancy (1.52) and unwanted pregnancy status (1.59). Other independent predictors were male gender, maternal psychiatric hospitalization with alcohol-related diagnosis, and low parental social status. CONCLUSIONS: Independent of a number of other risk factors for alcoholism, a significant association between early weaning and elevated risk of hospitalization with alcohol-related diagnoses was observed.
Asunto(s)
Trastornos Relacionados con Alcohol/epidemiología , Hospitalización/estadística & datos numéricos , Destete , Adulto , Trastornos Relacionados con Alcohol/diagnóstico , Estudios de Cohortes , Dinamarca/epidemiología , Salud de la Familia , Femenino , Humanos , Lactante , Recién Nacido , Estudios Longitudinales , Masculino , Embarazo , Complicaciones del Embarazo/epidemiología , Embarazo no Deseado , Estudios Prospectivos , Factores de Riesgo , Factores Sexuales , Fumar/epidemiología , Clase Social , Factores de TiempoRESUMEN
CONTEXT: Congenital adrenal hyperplasia (CAH) is a disorder with a wide spectrum of severity. OBJECTIVE: The objective of this study was to investigate cognitive function in CAH women. DESIGN: This was a case-control study. SETTING: This study was conducted at a tertiary center for pediatric endocrinology at the University Hospital of Copenhagen. PARTICIPANTS: Thirty-five Danish CAH women (age 17-51 yr) were included, and participation rate was 84%. Control women were recruited through the Danish Civil Registration System and matched on age and education. MAIN OUTCOME MEASURES: An abbreviated form of the Wechsler Adult Intelligence Scale was used, i.e. full-scale intelligence quotient (IQ; five of 11 subtests), which included three of six verbal IQ subtests and two of five performance IQ subtests. RESULTS: A significantly lower IQ was found in CAH patients compared with controls with respect to mean full-scale IQ (84.5 vs. 99.1; P < 0.001), mean verbal IQ (86.6 vs. 97.3; P < 0.001), and mean performance IQ (85.7 vs. 101.3; P < 0.001). The salt-wasting CAH group had lower IQ scores than the simple-virilizing CAH group, which reached significance for mean total IQ (81.2 vs. 92.8, P = 0.04) and mean verbal IQ (84.7 vs. 95.5, P = 0.05), and additionally, lower scores than the late-onset CAH group, which reached significance for performance IQ (mean 81.5 vs. 96.2, P = 0.02). CONCLUSIONS: Impaired cognitive function was observed in patients with CAH, especially in salt-wasting CAH. These intriguing findings may reflect adverse effects of hyponatremic episodes, suboptimal postnatal hormone replacement therapy or prenatal adrenal androgen excess, and the potential psychosocial consequences of the disorder.
Asunto(s)
Hiperplasia Suprarrenal Congénita/complicaciones , Hiperplasia Suprarrenal Congénita/psicología , Trastornos del Conocimiento/etiología , Trastornos del Conocimiento/psicología , Corticoesteroides/uso terapéutico , Adulto , Educación , Femenino , Estudios de Seguimiento , Genotipo , Hospitalización , Humanos , Hipoglucemia/etiología , Hiponatremia/etiología , Pruebas de Inteligencia , Persona de Mediana Edad , Pruebas Neuropsicológicas , Calidad de Vida , Resultado del TratamientoRESUMEN
BACKGROUND: Disturbances in the central nervous system originating during foetal life may increase the risk of schizophrenia. AIMS: To illuminate the hypothesis that prenatal exposure to analgesics may affect foetal neurodevelopment, leading to increased risk of schizophrenia in adulthood. METHOD: Using data from the Copenhagen Perinatal Cohort and from the Danish Psychiatric Central Register, we studied the relationship between prenatal exposure to analgesics and the risk of schizophrenia. The effect of prenatal exposure was adjusted for parental history of schizophrenia, second-trimester viral infections, concomitant drug treatment during pregnancy, an index of pregnancy complications, parental social status and parental age. RESULTS: In a risk set of 7999 individuals, 116 cases of schizophrenia were found (1.5%). Prenatal exposure to analgesics in the second trimester was associated with an elevated risk (adjusted odds ratio 4.75, 95% CI1.9-12.0). Independent of the covariates, the effect remained statistically significant. CONCLUSIONS: Independent of a wide range of possible confounders, a significant association between second-trimester exposure to analgesics and increased risk of schizophrenia was observed.
Asunto(s)
Analgésicos , Esquizofrenia/etiología , Adulto , Estudios de Cohortes , Femenino , Humanos , Masculino , Oportunidad Relativa , Embarazo , Segundo Trimestre del Embarazo , Tercer Trimestre del Embarazo , Efectos Tardíos de la Exposición Prenatal , Factores de RiesgoRESUMEN
OBJECTIVE: Diuretics prescribed after the first trimester for treatment of hypertension in pregnant women may interfere with normal plasma volume expansion and cause volume depletion. The authors hypothesized that prenatal exposure to diuretics and maternal hypertension might disrupt fetal neurodevelopment and increase the risk of schizophrenia in offspring. METHOD: Using data from the Copenhagen Perinatal Cohort of individuals born between 1959 and 1961, the authors studied the relationship of maternal hypertension and diuretic treatment during pregnancy with the risk of schizophrenia (ICD-8 code 295) in the offspring. Prenatal medical information was linked to the Danish National Psychiatric Register. The effects of maternal hypertension and diuretic treatment were adjusted for the maternal history of schizophrenia, social status of the family breadwinner, mother's age, and concomitant drug treatment during pregnancy. RESULTS: In a risk set of 7,866 individuals, 84 cases of schizophrenia were found (1.1% prevalence). Logistic multiple regression analysis identified the following independent risk factors: maternal hypertension (odds ratio=1.69 [95% CI=1.02-2.80]), diuretic treatment in the third trimester (odds ratio=2.55 [95% CI=1.21-5.37]), and maternal schizophrenia (odds ratio=11.12 [95% CI=4.60-29.91]). Prenatal exposure to both hypertension and diuretic treatment in the third trimester conferred a 4.01-fold (95% CI=1.41-11.40) elevated risk. CONCLUSIONS: Children of mothers with hypertension in pregnancy plus diuretic treatment in the third trimester were at significantly increased risk of developing schizophrenia. In pregnancies complicated by hypertension, diuretics may interfere with aspects of fetal neurodevelopment and thus increase the vulnerability of offspring to the development of schizophrenia later in life.