Crocq M A, Macher J P, Duval F
Centre Hospitalier Spécialisé, Rouffach.
Encephale. 1992 Jan;18 Spec No 1:31-4.
The latest classifications of mood disorders, such as DSM III and ICD 10, differ from previous ones by emphasizing the bipolar-unipolar distinction. This fairly recent distinction now enjoys a wide consensus. It is supported mainly by family studies. The first works originated from the school of Kleist and Leonhard and were quickly followed by reports by Perris and Angst (1966). Studies that followed the publication of DSM III confirm that the prevalence of bipolar mood disorders is twice as high among first-degree relatives of bipolar probands when compared with those of unipolar probands. Family studies suggest that unipolar and bipolar disorders are distinct but still share some degree of genetic overlap. Other genetic approaches such as twin and adoption studies are less conclusive. Recent linkage studies with genomic markers (RFLPs) cannot directly support the validity of the bipolar-unipolar distinction. They suggest the role of a major gene locus, notably in the Xq27-Xq28 region, only in a limited number of bipolar pedigrees. Most mood disorders might involve a polygenic environment; in this context, a more limited number of factors could be associated with the polarity of the disorder.
最新的心境障碍分类，如《精神疾病诊断与统计手册》第三版（DSM III）和《国际疾病分类》第十版（ICD 10），与之前的分类不同，它们强调双相情感障碍与单相情感障碍的区别。这种相当新的区别现在已得到广泛认可。它主要得到家族研究的支持。最早的研究源于克莱斯特学派和莱昂哈德学派，随后佩里斯和安格斯特（1966年）也发表了相关报告。在《精神疾病诊断与统计手册》第三版出版之后的研究证实，与单相情感障碍先证者的一级亲属相比，双相情感障碍先证者的一级亲属中双相情感障碍的患病率高出两倍。家族研究表明，单相情感障碍和双相情感障碍是不同的，但仍存在一定程度的遗传重叠。其他遗传研究方法，如同卵双生子研究和收养研究，结论性较差。最近利用基因组标记（限制性片段长度多态性，RFLPs）进行的连锁研究不能直接支持双相情感障碍与单相情感障碍区别的有效性。它们仅在少数双相情感障碍家系中表明了一个主要基因座的作用，尤其是在Xq27 - Xq28区域。大多数心境障碍可能涉及多基因环境；在这种情况下，较少数量的因素可能与障碍的极性有关。
