ArticleThe Lancet regional health. Western Pacific2025
Sex-differences in the intergenerational transmission of mental disorders among schizophrenia probands: familial risk and protective factors in a population-based study.
Article in The Lancet regional health. Western Pacific, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT07005245 (The Demand for Psychological and Social Services Related to COVID-19 Pandemic in Families of Patients With Severe Mental Disorders), which is not on this map. Not yet cited in PubMed.
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The Demand for Psychological and Social Services Related to COVID-19 Pandemic in Families of Patients With Severe Mental Disorders
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29 authors.
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Abstract
Background: Parental schizophrenia confers intergenerational mental health risks. The sex-specific transmission patterns remain poorly quantified. This study examined parent-reported transmission rate and familial risk factors among Chinese offspring of schizophrenia probands. Methods: In this cross-sectional study, we enrolled 27,315 schizophrenia probands and 35,772 offspring. Psychiatric disorder diagnoses of offspring were parent-reported and subsequently verified via the medical management system. Age- and sex-standardized rate referenced China's 2020 census. Robust Poisson regression generated adjusted rate ratios (aRR). Multivariable logistic models were used to identify risk factors for young offspring. This study was registered with ClinicalTrials (NCT07005245). Findings: The parent-reported transmission rate in offspring was 2.68% (95% CI, 2.52%-2.85%), dominated by schizophrenia spectrum disorders (1.42%). Standardized rates reached 2.53% (95% CI, 2.01%-3.05%) after demographic standardization. Offspring risk increased by 86.0% when conception occurred post-parental illness onset. Firstborn status (aRR = 1.67), low-income household (aRR = 1.43), and being a male child (aRR = 1.14) were significantly associated with elevated risk. Sex-specific parental age effects were also observed. In the subgroup analysis of underage (<17 years) offspring, maternal transmission was associated with post-parental-onset birth (OR = 2.48, Interpretation: Our findings highlighted critical interactions between familial aggregation, sex-differentiated perinatal exposures, and caregiving environments. Policy priorities should integrate sex-stratified genetic counselling, prenatal medication monitoring, and family support programs targeting caregiving inequalities. Funding: This study was supported by the National Natural Science Foundation of China (32070589).
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