Rasic Daniel, Hajek Tomas, Alda Martin, Uher Rudolf
*To whom correspondence should be addressed; Department of Psychiatry, Canada Research Chair in Early Intervention in Psychiatry, Dalhousie University, 5909 Veterans' Memorial Lane, Room 3089, Abbie J. Lane Memorial Building, Halifax, Nova Scotia B3H 2E2, Canada; fax: 902-473-4877, e-mail:
Schizophr Bull. 2014 Jan;40(1):28-38. doi: 10.1093/schbul/sbt114. Epub 2013 Aug 19.
Offspring of parents with severe mental illness (SMI; schizophrenia, bipolar disorder, major depressive disorder) are at an increased risk of developing mental illness. We aimed to quantify the risk of mental disorders in offspring and determine whether increased risk extends beyond the disorder present in the parent.
Meta-analyses of absolute and relative rates of mental disorders in offspring of parents with schizophrenia, bipolar disorder, or depression in family high-risk studies published by December 2012.
We included 33 studies with 3863 offspring of parents with SMI and 3158 control offspring. Offspring of parents with SMI had a 32% probability of developing SMI (95% CI: 24%-42%) by adulthood (age >20). This risk was more than twice that of control offspring (risk ratio [RR] 2.52; 95% CI 2.08-3.06, P < .001). High-risk offspring had a significantly increased rate of the disorder present in the parent (RR = 3.59; 95% CI: 2.57-5.02, P < .001) and of other types of SMI (RR = 1.92; 95% CI: 1.48-2.49, P < .001). The risk of mood disorders was significantly increased among offspring of parents with schizophrenia (RR = 1.62; 95% CI: 1.02-2.58; P = .042). The risk of schizophrenia was significantly increased in offspring of parents with bipolar disorder (RR = 6.42; 95% CI: 2.20-18.78, P < .001) but not among offspring of parents with depression (RR = 1.71; 95% CI: 0.19-15.16, P = .631).
Offspring of parents with SMI are at increased risk for a range of psychiatric disorders and one third of them may develop a SMI by early adulthood.
患有严重精神疾病（SMI；精神分裂症、双相情感障碍、重度抑郁症）的父母的后代患精神疾病的风险增加。我们旨在量化后代患精神障碍的风险，并确定增加的风险是否超出父母所患的疾病范围。
对2012年12月前发表的家庭高风险研究中，患有精神分裂症、双相情感障碍或抑郁症的父母的后代中精神障碍的绝对和相对发生率进行荟萃分析。
我们纳入了33项研究，其中有3863名患有严重精神疾病的父母的后代和3158名对照后代。患有严重精神疾病的父母的后代在成年期（年龄>20岁）患严重精神疾病的概率为32%（95%CI：24%-42%）。这一风险是对照后代的两倍多（风险比[RR]2.52；95%CI 2.08-3.06，P<.001）。高风险后代患父母所患疾病的发生率显著增加（RR = 3.59；95%CI：2.57-5.02，P<.001），患其他类型严重精神疾病的发生率也显著增加（RR = 1.92；95%CI：1.48-2.49，P<.001）。精神分裂症患者的后代患情绪障碍的风险显著增加（RR = 1.62；95%CI：1.02-2.58；P = .042）。双相情感障碍患者的后代患精神分裂症的风险显著增加（RR = 6.42；95%CI：2.20-18.78，P<.001），但抑郁症患者的后代中未增加（RR = 1.71；95%CI：0.19-15.16，P = .631）。
患有严重精神疾病的父母的后代患一系列精神疾病的风险增加，其中三分之一可能在成年早期患严重精神疾病。
