Ruzickova Martina, Turecki Gustavo, Alda Martin
Department of Psychiatry, Dalhousie University, Halifax, Canada.
Am J Med Genet C Semin Med Genet. 2003 Nov 15;123C(1):18-25. doi: 10.1002/ajmg.c.20010.
Bipolar disorder is a severe psychiatric disease characterized by varying treatment response among individual patients. Effects of certain treatments, for instance, lithium, can be predicted from clinical characteristics of patients and their family histories. This led to a suggestion that a treatment response could identify subtypes of bipolar disorder particularly suited for gene-mapping studies. In this paper we review family and molecular studies of bipolar disorder responsive to lithium, as well as studies aiming to identify polymorphisms associated with the treatment response itself. While molecular genetic research and gene expression studies promise to bring new insights into the pathophysiology of the illness and the nature of treatment response, and thus provide new information for better treatment of bipolar disorder in the future, results from family studies and studies of clinical correlates of treatment response may already be utilized in the management of bipolar disorder.
双相情感障碍是一种严重的精神疾病,其特征是个体患者之间的治疗反应各不相同。某些治疗方法的效果,例如锂盐治疗,可以根据患者的临床特征及其家族病史进行预测。这引发了一种观点,即治疗反应可以识别出特别适合基因图谱研究的双相情感障碍亚型。在本文中,我们回顾了对锂盐治疗有反应的双相情感障碍的家族和分子研究,以及旨在识别与治疗反应本身相关的多态性的研究。虽然分子遗传学研究和基因表达研究有望为该疾病的病理生理学和治疗反应的本质带来新的见解,从而为未来更好地治疗双相情感障碍提供新信息,但家族研究和治疗反应临床相关性研究的结果可能已经在双相情感障碍的管理中得到应用。