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双相情感障碍与父母精神病理学

Bipolar disorder and parental psychopathology.

作者信息

Sucksdorff Dan, Chudal Roshan, Suominen Auli, Jokiranta Elina, Brown Alan S, Sourander Andre

机构信息

Department of Child Psychiatry, Faculty of Medicine, Research Centre for Child Psychiatry, Institute of Clinical Medicine, University of Turku, Lemminkäisenkatu 3/Teutori (3rd floor), 20014, Turku, Finland,

出版信息

Soc Psychiatry Psychiatr Epidemiol. 2014 Dec;49(12):1973-84. doi: 10.1007/s00127-014-0885-1. Epub 2014 May 3.

Abstract

PURPOSE

Few population-based studies have examined the association between parental psychopathology and bipolar disorder (BPD) in offspring. One limitation is lack of control for potential confounding by indicators of parental socio-economic status or maternal smoking during pregnancy. Furthermore, none of them included analyses restricted to parental diagnoses received prior to the birth of the offspring. Associations could not be affected by child-related factors affecting the parent in such analyses. This study explores associations between those parental psychiatric disorders diagnosed at any point of time as well as those diagnosed before offspring birth, and BPD in offspring.

METHODS

In this nested case-control study, we identified 1,861 cases, age up to 25 years, 3,643 matched controls, and their parents from Finnish national registers. The associations were examined using conditional logistic regression, calculating odds ratios (OR) and adjusting for region of birth, parental age and education and mother's smoking during pregnancy.

RESULTS

Anytime diagnosed parental disorders associating with BPD in offspring (95% confidence interval) were BPD [OR (maternal) 5.2 (2.52-10.62); OR (paternal) 8.1 (3.77-17.26)], schizophrenia and related psychoses [OR (maternal) 3.1 (1.69-5.84); OR (paternal) 4.5 (1.97-10.27)], other affective disorders [OR (maternal) 3.0 (2.08-4.21); OR (paternal) 3.0 (1.97-4.47)] and maternal anxiety disorders OR 2.6 (1.08-6.42). Statistically significant associations were also found for parental schizophrenia and related psychoses, and other affective disorders, diagnosed before offspring birth.

CONCLUSIONS

BPD is associated with many parental psychiatric disorders, particularly BPD and schizophrenia and related psychoses. The associations must be partially due to child-independent factors. Covariate adjustments had only a minor impact on the associations.

摘要

目的

很少有基于人群的研究探讨父母精神病理学与后代双相情感障碍(BPD)之间的关联。一个局限性是缺乏对父母社会经济地位指标或孕期母亲吸烟等潜在混杂因素的控制。此外,这些研究均未纳入仅限于后代出生前父母所获诊断的分析。在此类分析中,关联可能不受影响父母的儿童相关因素的影响。本研究探讨在任何时间点诊断的父母精神障碍以及在后代出生前诊断的父母精神障碍与后代BPD之间的关联。

方法

在这项巢式病例对照研究中,我们从芬兰国家登记册中确定了1861例年龄在25岁及以下的病例、3643例匹配对照及其父母。使用条件逻辑回归检验关联,计算比值比(OR),并对出生地区、父母年龄和教育程度以及孕期母亲吸烟情况进行校正。

结果

与后代BPD相关的任何时间诊断的父母障碍(95%置信区间)为BPD[OR(母亲)5.2(2.52 - 10.62);OR(父亲)8.1(3.77 - 17.26)]、精神分裂症及相关精神病性障碍[OR(母亲)3.1(1.69 - 5.84);OR(父亲)4.5(1.97 - 10.27)]、其他情感障碍[OR(母亲)3.0(2.08 - 4.21);OR(父亲)3.0(1.97 - 4.47)]以及母亲焦虑障碍OR 2.6(1.08 - 6.42)。对于后代出生前诊断的父母精神分裂症及相关精神病性障碍和其他情感障碍,也发现了具有统计学意义的关联。

结论

BPD与多种父母精神障碍相关,尤其是BPD以及精神分裂症及相关精神病性障碍。这些关联必定部分归因于与儿童无关的因素。协变量调整对这些关联的影响较小。

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