Althoff Robert R, Rettew David C, Faraone Stephen V, Boomsma Dorret I, Hudziak James J
Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts, USA.
Biol Psychiatry. 2006 Nov 1;60(9):903-11. doi: 10.1016/j.biopsych.2006.02.025. Epub 2006 May 2.
The Child Behavior Checklist (CBCL) has been used to provide a quantitative description of childhood bipolar disorder (BPAD). Many have reported that children in the clinical range on the Attention Problems (AP), Aggressive Behavior (AGG), and Anxious-Depressed (A/D) syndromes simultaneously are more likely to meet the criteria for childhood BPAD. The purpose of this study was to determine if Latent Class Analysis (LCA) could identify heritable phenotypes representing the CBCL-Juvenile Bipolar (CBCL-JBD) profile and whether this phenotype demonstrates increased frequency of suicidal endorsement.
The CBCL data were received by survey of mothers of twins in two large twin samples, the Netherlands Twin Registry. The setting for the study was the general community twin sample. Participants included 6246 10-year-old Dutch twins from the Netherlands Twin Registry. The main outcome measure consisted of the LCA on the items comprising the AP, AGG, and A/D subscales and means from the suicidal items #18 and #91 within classes.
A 7 class model fit best for girls and an 8 class fit best for boys. The most common class for boys or girls was one with no symptoms. The CBCL-JBD phenotype was the least common--about 4%-5% of the boys and girls. This class was the only one that had significant elevations on the suicidal items of the CBCL. Gender differences were present across latent classes with girls showing no aggression without the CBCL-JBD phenotype and rarely showing attention problems in isolation. Evidence of high heritability of these latent classes was found with odds ratios.
In a general population sample, LCA identifies a CBCL-JBD phenotype latent class that is associated with high rates of suicidality, is highly heritable, and speaks to the comorbidity between attention problems, aggressive behavior, and anxious/depression in children.
儿童行为量表（CBCL）已被用于对儿童双相情感障碍（BPAD）进行定量描述。许多人报告称，在注意力问题（AP）、攻击行为（AGG）和焦虑抑郁（A/D）综合征临床范围内的儿童同时更有可能符合儿童BPAD的标准。本研究的目的是确定潜在类别分析（LCA）是否能够识别代表CBCL-青少年双相情感障碍（CBCL-JBD）概况的遗传表型，以及这种表型是否显示出自杀性认可频率增加。
通过对两个大型双胞胎样本（荷兰双胞胎登记处）中双胞胎母亲的调查获得CBCL数据。研究背景为一般社区双胞胎样本。参与者包括来自荷兰双胞胎登记处的6246名10岁荷兰双胞胎。主要结局指标包括对构成AP、AGG和A/D子量表的项目进行LCA，以及各类别中自杀项目#18和#91的均值。
7类模型最适合女孩，8类模型最适合男孩。男孩或女孩最常见的类别是无症状类别。CBCL-JBD表型最不常见，约占男孩和女孩的4%-5%。该类别是唯一在CBCL自杀项目上有显著升高的类别。潜在类别之间存在性别差异，没有CBCL-JBD表型的女孩不表现出攻击行为，且很少单独出现注意力问题。通过优势比发现了这些潜在类别的高遗传性证据。
在一般人群样本中，LCA识别出一种CBCL-JBD表型潜在类别，其与高自杀率相关，具有高度遗传性，并说明了儿童注意力问题、攻击行为和焦虑/抑郁之间的共病情况。
