Weissman M M, Fendrich M, Warner V, Wickramaratne P
College of Physicians and Surgeons, Columbia University, New York, NY.
J Am Acad Child Adolesc Psychiatry. 1992 Jul;31(4):640-8. doi: 10.1097/00004583-199207000-00010.
First onsets (incidence) of suicide attempts and DSM-III psychiatric disorders, including major depression, any anxiety disorder, conduct disorder, or substance abuse were determined in a 2-year longitudinal study of 174 offspring at high and low risk for major depression. All of the suicide attempts, the first onsets of major depression, and anxiety disorders were in offspring of depressed parents. Compared with asymptomatic offspring, offspring with subclinical manifestations of major depression, conduct disorder, and substance abuse at the initial interview were significantly more likely to become incident cases of the same disorder over the next 2 years. Either conduct disorder or substance abuse at initial interview were highly predictive of first onset of each other, but not of any other disorders 2 years later. Family risk factors (such as poor marital adjustment, parent-child discord, low cohesion, and affectionless control) at initial interview were associated with increased incidence of substance abuse, or conduct disorder, but not major depression or anxiety disorder. Combining both retrospective and prospective data, the overall suicide attempt rate was 7.8% in the offspring of depressed parents as compared with 1.4% in the offspring of nondepressed parents. By age 20, over 50% of the offspring of depressed patients reported a major depression.
在一项针对174名患重度抑郁症风险高低不同的后代进行的为期两年的纵向研究中，确定了自杀未遂以及《精神疾病诊断与统计手册》第三版（DSM-III）中的精神疾病首次发病情况（发病率），这些精神疾病包括重度抑郁症、任何焦虑症、品行障碍或物质滥用。所有自杀未遂案例、重度抑郁症首次发病案例以及焦虑症首次发病案例均出现在患有抑郁症的父母的后代中。与无症状的后代相比，在初次访谈时具有重度抑郁症、品行障碍和物质滥用亚临床症状的后代在接下来两年中更有可能成为同一种疾病的发病案例。初次访谈时出现的品行障碍或物质滥用对彼此的首次发病具有高度预测性，但对两年后的其他任何疾病则没有预测性。初次访谈时的家庭风险因素（如婚姻适应不良、亲子关系不和、凝聚力低以及缺乏温情的控制）与物质滥用或品行障碍的发病率增加有关，但与重度抑郁症或焦虑症无关。综合回顾性和前瞻性数据，患有抑郁症的父母的后代中总体自杀未遂率为7.8%，而未患抑郁症的父母的后代中这一比例为1.4%。到20岁时，超过50%的抑郁症患者后代报告患有重度抑郁症。
