Pilowsky Daniel J, Wickramaratne Priya, Nomura Yoko, Weissman Myrna M
Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York, USA.
J Am Acad Child Adolesc Psychiatry. 2006 Apr;45(4):452-60. doi: 10.1097/01.chi.0000198592.23078.8d.
To determine the independent effects of parental depression and family discord on offspring psychopathology among children at high and low risk of depression.
Family discord factors were assessed when subjects were approximately 17 years old, and offspring diagnoses were assessed about 20 years later. Parental and offspring psychopathology was assessed by interviewers blind to parents' clinical status. The following dimensions of family discord were assessed: poor marital adjustment, parent child discord, low family cohesion, affectionless control, and parental divorce.
Most family discord factors were associated with parental depression. Among children of depressed parents, none of the measures of family discord had a statistically significant association with offspring major depressive disorder or anxiety disorders. Among children of nondepressed parents, parental affectionless control was associated with an almost fivefold increased risk of major depressive disorder (odds ratio [OR] = 4.8; p < or = .05) and with more than a 14-fold increased risk of substance use disorders (OR = 14.3; p < or = .01).
Parental depression is associated with family discord and is a consistent risk factor for offspring major depressive disorder and anxiety disorders, as shown over a 20-year follow-up of offspring of depressed and nondepressed parents. Family discord factors may be a risk factor for major depressive disorder and substance use disorders in offspring of nondepressed parents.
确定父母抑郁和家庭不和对抑郁高风险和低风险儿童后代精神病理学的独立影响。
在受试者约17岁时评估家庭不和因素，约20年后评估后代诊断情况。由对父母临床状况不知情的访谈者评估父母和后代的精神病理学情况。评估了家庭不和的以下几个方面：婚姻适应不良、亲子不和、家庭凝聚力低、缺乏温情的控制以及父母离异。
大多数家庭不和因素与父母抑郁有关。在抑郁父母的子女中，没有一项家庭不和指标与后代重度抑郁症或焦虑症有统计学上的显著关联。在非抑郁父母的子女中，父母缺乏温情的控制与重度抑郁症风险几乎增加五倍（优势比[OR]=4.8；p≤0.05）以及物质使用障碍风险增加超过14倍（OR=14.3；p≤0.01）有关。
如对抑郁和非抑郁父母的后代进行的20年随访所示，父母抑郁与家庭不和有关，并且是后代重度抑郁症和焦虑症的一致风险因素。家庭不和因素可能是非抑郁父母后代重度抑郁症和物质使用障碍的一个风险因素。
