Tienari Pekka, Wynne Lyman C, Sorri Anneli, Lahti Ilpo, Läksy Kristian, Moring Juha, Naarala Mikko, Nieminen Pentti, Wahlberg Karl-Erik
Department of Psychiatry, University of Oulu, Finland. University of Rochester, USA. Department of Psychiatry, University of Oulu, Finland.
Br J Psychiatry. 2004 Mar;184:216-22. doi: 10.1192/bjp.184.3.216.
Earlier adoption studies have convincingly confirmed the importance of a genetic contribution to schizophrenia. The designs, however, did not incorporate observations of the rearing-family environment.
To test the hypothesis that genetic factors moderate susceptibility to environmentally mediated risks associated with rearing-family functioning.
A Finnish national sample of adopted-away offspring of mothers with schizophrenia-spectrum disorders was compared blindly with adoptees without this genetic risk. Adoptive rearing was assessed using family rating scales based upon extended family observations at initial assessment. Adoptees were independently re-diagnosed after a median interval of 12 years, with register follow-up after 21 years.
In adoptees at high genetic risk of schizophrenia, but not in those at low genetic risk, adoptive-family ratings were a significant predictor of schizophrenia-spectrum disorders in adoptees at long-term follow-up.
Adoptees at high genetic risk are significantly more sensitive to adverse v. 'healthy' rearing patterns in adoptive families than are adoptees at low genetic risk.
早期的收养研究令人信服地证实了遗传因素对精神分裂症的重要影响。然而，这些研究设计并未纳入对养育家庭环境的观察。
检验遗传因素调节对与养育家庭功能相关的环境介导风险易感性的假设。
将芬兰全国范围内患有精神分裂症谱系障碍母亲的被收养子女样本与无此遗传风险的被收养者进行盲法比较。在初次评估时，基于大家庭观察，使用家庭评定量表对收养养育情况进行评估。被收养者在中位间隔12年后进行独立重新诊断，21年后进行登记随访。
在精神分裂症遗传风险高的被收养者中，而非遗传风险低的被收养者中，收养家庭评定是长期随访中被收养者精神分裂症谱系障碍的显著预测因素。
与遗传风险低的被收养者相比，遗传风险高的被收养者对收养家庭中不良与“健康”养育模式的敏感性显著更高。
