Kosten T A, Anton S F, Rounsaville B J
Department of Psychiatry, Yale University School of Medicine, New Haven, CT 06520.
J Psychiatr Res. 1992 Apr;26(2):135-47. doi: 10.1016/0022-3956(92)90005-9.
Research investigating patterns of familial aggregation of psychiatric disorders has used the family history method in which a single family member reports on the psychiatric history of their relatives. This method is more efficient and less costly than the family study method, in which direct interviews are performed on as many family members as possible. The family history method has been shown to have good specificity, in family studies of depression, but sensitivity has been less acceptable. The present study is the first study to report on the sensitivity and specificity of five psychiatric diagnoses made in a substance abusing population using the family history method. Among substance abusers and their family members, substance abuse is the most accurately diagnosed disorder. However, among family members only, the accuracy of diagnosing substance abuse declines significantly. Spouses and offspring are better informants than parents or siblings, and female relatives are better informants than male relatives. When more than one informant is available and positive diagnoses are determined by any positive family report, sensitivity for most disorders increases significantly. The results are discussed in terms of increasing the accuracy of the family history method.
研究精神疾病家族聚集模式的研究采用了家族史方法，即由一名家庭成员报告其亲属的精神病史。这种方法比家族研究方法更高效、成本更低，后者需要对尽可能多的家庭成员进行直接访谈。家族史方法在抑郁症家族研究中已显示出良好的特异性，但敏感性却不太令人满意。本研究是第一项使用家族史方法报告在药物滥用人群中做出的五种精神疾病诊断的敏感性和特异性的研究。在药物滥用者及其家庭成员中，药物滥用是诊断最准确的疾病。然而，仅在家庭成员中，诊断药物滥用的准确性会显著下降。配偶和子女比父母或兄弟姐妹更适合提供信息，女性亲属比男性亲属更适合提供信息。当有不止一名信息提供者且任何阳性家族报告都能确定阳性诊断时，大多数疾病的敏感性会显著提高。将根据提高家族史方法的准确性来讨论这些结果。
