University of Oulu

Nietola, M., Huovinen, H., Heiskala, A. et al. Early childhood and adolescent risk factors for psychotic depression in a general population birth cohort sample. Soc Psychiatry Psychiatr Epidemiol 55, 1179–1186 (2020).

Early childhood and adolescent risk factors for psychotic depression in a general population birth cohort sample

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Author: Nietola, Miika1; Huovinen, Hanna2; Heiskala, Anni2;
Organizations: 1Psychiatric Department, University of Turku and the Hospital District of Southwest Finland, Kunnallissairaalantie 20, Building 9, 3. Floor, 20700 Turku, Finland
2Center for Life Course Health Research, University of Oulu, Oulu, Finland
3Medical Research Center Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
4Infrastructure for Population Studies, Faculty of Medicine, University of Oulu, Oulu, Finland
5Psychiatric Department, University of Turku and Satakunta Hospital District, Turku, Finland
6Department of Psychiatry, Oulu University Hospital, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.5 MB)
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Language: English
Published: Springer Nature, 2020
Publish Date: 2020-11-09


Background and purpose: In the group of severe mental disorders, psychotic depression (PD) is essentially under-researched. Knowledge about the risk factors is scarce and this applies especially to early risk factors. Our aim was to study early childhood and adolescent risk factors of PD in a representative birth cohort sample with a follow-up of up to 50 years.

Methods: The study was carried out using the Northern Finland Birth Cohort 1966 (NFBC 1966). We used non-psychotic depression (NPD) (n = 746), schizophrenia (SZ) (n = 195), psychotic bipolar disorder (PBD) (n = 27), other psychoses (PNOS) (n = 136) and healthy controls (HC) (n = 8200) as comparison groups for PD (n = 58). We analysed several potential early risk factors from time of birth until the age of 16 years.

Results: The main finding was that parents’ psychiatric illness [HR 3.59 (1.84–7.04)] was a risk factor and a high sports grade in school was a protective factor [HR 0.29 (0.11–0.73)] for PD also after adjusting for covariates in the multivariate Cox regression model. Parental psychotic illness was an especially strong risk factor for PD. The PD subjects had a parent with psychiatric illness significantly more often (p < 0.05) than NPD subjects. Differences between PD and other disorder groups were otherwise small.

Conclusions: A low sports grade in school may be a risk factor for PD. Psychiatric illnesses, especially psychoses, are common in the parents of PD subjects. A surprisingly low number of statistically significant risk factors may have resulted from the size of the PD sample and the underlying heterogeneity of the etiology of PD.

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Series: Social psychiatry and psychiatric epidemiology
ISSN: 0933-7954
ISSN-E: 1433-9285
ISSN-L: 0933-7954
Volume: 55
Issue: 9
Pages: 1179 - 1186
DOI: 10.1007/s00127-020-01835-7
Type of Publication: A1 Journal article – refereed
Field of Science: 3124 Neurology and psychiatry
Funding: Open access funding provided by University of Turku (UTU) including Turku University Central Hospital. This work was funded by Turku University Foundation (Grant Number: 10-2305).
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