Wilens Timothy E, Yule Amy, Martelon MaryKate, Zulauf Courtney, Faraone Stephen V
Clinical and Research Programs in Pediatric Psychopharmacology, Adult ADHD Massachusetts General Hospital, Boston, Massachusetts; Department of Psychiatry, Harvard Medical School, Boston, Massachusetts.
Am J Addict. 2014 Sep-Oct;23(5):440-6. doi: 10.1111/j.1521-0391.2014.12125.x. Epub 2014 Mar 15.
Adolescents with bipolar disorder (BPD) have been previously shown to be at very high risk for substance use disorders (SUD). We now examine the influence of a parental history of substance use disorders on SUD risk in offspring with and without BPD.
We studied 190 parents ascertained through 104 adolescent BPD probands and 189 parents ascertained through 98 control probands using structured interviews. We compared the prevalence of SUD using logistic regression.
While adjusting for BPD in our combined sample, probands with a parental history of SUD were more likely to have an alcohol use disorder compared to probands without a parental history. Probands with a parental history of SUD were not more likely to have a drug use disorder or overall SUD compared to probands without a parental history. BPD in the offspring did not pose any additional risk between parental history of SUD and offspring SUD.
Alcohol use disorders were more common in the offspring of parents with a SUD history compared to parents without SUD and the risk was not influenced by offspring BPD.
Clarifying the mechanisms linking parental SUD to offspring SUD, particularly in children and adolescents with BPD, would help clinicians to educate and monitor high-risk families, which would facilitate strategies to mitigate risks associated with parental substance abuse.
先前研究表明,双相情感障碍(BPD)青少年患物质使用障碍(SUD)的风险极高。我们现在研究有物质使用障碍家族史对患或未患BPD后代SUD风险的影响。
我们通过对104名青少年BPD先证者确定的190名父母以及通过98名对照先证者确定的189名父母进行结构化访谈来开展研究。我们使用逻辑回归比较SUD的患病率。
在对我们的合并样本中的BPD进行校正后,有物质使用障碍家族史的先证者与无家族史的先证者相比,更有可能患有酒精使用障碍。与无家族史的先证者相比,有物质使用障碍家族史的先证者患药物使用障碍或总体SUD的可能性并不更高。后代患BPD在物质使用障碍家族史和后代SUD之间未造成任何额外风险。
与无物质使用障碍家族史的父母相比,有物质使用障碍家族史的父母的后代中酒精使用障碍更为常见,且该风险不受后代患BPD的影响。
阐明父母物质使用障碍与后代物质使用障碍之间的联系机制,尤其是在患有BPD的儿童和青少年中,将有助于临床医生对高危家庭进行教育和监测,这将有助于制定减轻与父母药物滥用相关风险的策略。