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转诊偏倚会影响焦虑症高危后代的研究结果吗?一项对患有惊恐障碍/广场恐惧症和重度抑郁症的未转诊父母的高危儿童进行的对照研究。

Does referral bias impact findings in high-risk offspring for anxiety disorders? A controlled study of high-risk children of non-referred parents with panic disorder/agoraphobia and major depression.

作者信息

Biederman Joseph, Monuteaux Michael C, Faraone Stephen V, Hirshfeld-Becker Dina R, Henin Aude, Gilbert Jennifer, Rosenbaum Jerrold F

机构信息

Pediatric Psychopharmacology Program and the Department of Psychiatry, Massachusetts General Hospital, Warren 705, 15 Parkman St., Boston, MA 02114, USA.

出版信息

J Affect Disord. 2004 Oct 15;82(2):209-16. doi: 10.1016/j.jad.2003.12.015.

Abstract

BACKGROUND

Previous findings in referred samples documented significant diagnostic specificity in patterns of transmission between parents with panic disorder (PD) and parents with major depression (MD) and their offspring. This study evaluated whether these patterns of transmission between parents and high-risk offspring are moderated by referral bias.

METHODS

Parental PD/agoraphobia (AG) and parental MD were used to predict rates of offspring psychiatric disorders and functional outcomes using data from an opportunistic sample of parents (n = 991) and offspring (n = 734) ascertained from case-control family genetic studies of youth with and without attention-deficit hyperactivity disorder. Subjects were comprehensively assessed with structured diagnostic interview methodology to evaluate psychiatric disorders in parents and offspring.

RESULTS

Parental PD/AG increased the risk for anxiety disorders in offspring, independently of parental MD while parental MD increased the risk for mood and disruptive behavior disorders in offspring, independently of parental PD/AG. Parental psychopathology was also associated with functional impairment in offspring.

LIMITATIONS

The use of a sample ascertained by ADHD and control probands, and parent psychiatric diagnostic reports for children under 12.

CONCLUSIONS

These results extend to non-referred samples previous findings from referred samples documenting diagnostic specificity in the familial transmission of PD/AG and MD from parents to offspring, suggesting that these patterns of transmission are not due to referral bias. These results could inform and enhance community programs aimed at screening for and treating pediatric psychopathology.

摘要

背景

先前针对转诊样本的研究结果表明,惊恐障碍(PD)患者父母、重度抑郁症(MD)患者父母与其后代之间的传播模式具有显著的诊断特异性。本研究评估了父母与高危后代之间的这些传播模式是否受到转诊偏倚的影响。

方法

利用来自有注意缺陷多动障碍和无注意缺陷多动障碍青少年病例对照家庭遗传研究中机会性抽样的父母(n = 991)及其后代(n = 734)的数据,使用父母的PD/广场恐惧症(AG)和父母的MD来预测后代精神障碍的发生率和功能结局。采用结构化诊断访谈方法对受试者进行全面评估,以评估父母和后代的精神障碍。

结果

父母的PD/AG增加了后代患焦虑症的风险,与父母的MD无关;而父母的MD增加了后代患情绪和破坏性行为障碍的风险,与父母的PD/AG无关。父母的精神病理学也与后代的功能损害有关。

局限性

使用了由注意力缺陷多动障碍和对照先证者确定的样本,以及针对12岁以下儿童的父母精神科诊断报告。

结论

这些结果将转诊样本中的先前发现扩展至非转诊样本,这些发现记录了PD/AG和MD从父母到后代的家族性传播中的诊断特异性,表明这些传播模式并非由转诊偏倚所致。这些结果可为旨在筛查和治疗儿童精神病理学的社区项目提供信息并加以改进。

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