Piven J, Palmer P
Department of Psychiatry, University of Iowa College of Medicine, Iowa City 52242-1000, USA.
Am J Psychiatry. 1999 Apr;156(4):557-63. doi: 10.1176/ajp.156.4.557.
Several studies have shown familial aggregation of some axis I psychiatric disorders in families ascertained through a single autistic proband. In this study the authors examined the rate of axis I psychiatric disorders in nonautistic relatives from multiple-incidence autism families and the possible relationship of these disorders to the broad autism phenotype.
The rates of axis I psychiatric disorders, assessed by using semistructured and family history interviews, were compared in parents, grandparents, and aunts and uncles ascertained through 25 families of multiple-incidence autism probands and 30 families of probands with Down's syndrome. The possible association between selected psychiatric disorders and the broad autism phenotype, assessed directly through semistructured interviews and observational rating measures, was also examined in the two groups of parents.
The parents of the autistic probands had significantly higher rates of major depressive disorder and social phobia than the parents of the Down's syndrome probands. The high rate of depression in the parents of the autistic probands was consistent with the high rates of depression and anxiety detected in the grandparents and aunts and uncles in the autism families by family history. There was no evidence of an association, within individuals, between either depression or social phobia and the broad autism phenotype.
Relatives of autistic individuals have high rates of major depression and social phobia that are not associated with the broad autism phenotype and cannot be explained by the increased stress associated with raising an autistic child. Alternative mechanisms and the scientific and clinical implications of these findings are discussed.
多项研究表明,在通过单一自闭症先证者确定的家庭中,一些轴I精神障碍存在家族聚集性。在本研究中,作者调查了多发型自闭症家庭中非自闭症亲属的轴I精神障碍发生率,以及这些障碍与广泛自闭症表型之间的可能关系。
通过对25个多发型自闭症先证者家庭和30个唐氏综合征先证者家庭的父母、祖父母以及叔伯姑姨进行半结构化访谈和家族史访谈,比较轴I精神障碍的发生率。还通过半结构化访谈和观察评分量表直接评估了两组父母中选定的精神障碍与广泛自闭症表型之间的可能关联。
自闭症先证者的父母患重度抑郁症和社交恐惧症的比率显著高于唐氏综合征先证者的父母。自闭症先证者父母的高抑郁症发生率与自闭症家庭中祖父母及叔伯姑姨通过家族史检测出的高抑郁症和焦虑症发生率一致。在个体层面,抑郁症或社交恐惧症与广泛自闭症表型之间均无关联证据。
自闭症个体的亲属患重度抑郁症和社交恐惧症的比率较高,这些与广泛自闭症表型无关,也不能用养育自闭症儿童带来的压力增加来解释。本文讨论了这些发现的其他机制以及科学和临床意义。