Maoz Hagai, Goldstein Tina, Goldstein Benjamin I, Axelson David A, Fan Jieyu, Hickey Mary Beth, Monk Kelly, Sakolsky Dara, Diler Rasim S, Brent David, Kupfer David J, Birmaher Boris
Western Psychiatric Institute and Clinic, University of Pittsburgh School of Medicine, Pennsylvania.
Sunnybrook Health Sciences Centre, University of Toronto, Canada.
J Am Acad Child Adolesc Psychiatry. 2014 Oct;53(10):1111-22.e5. doi: 10.1016/j.jaac.2014.07.005. Epub 2014 Aug 6.
In this study, we aimed to assess whether current mood state (depressed or manic/hypomanic) among parents with a mood disorder would affect their reports of their offspring's psychopathology.
Sixty-five parents with current depression, 42 parents with current mania/hypomania, 181 parents with mood disorder in remission, and their offspring (n = 479, aged 6-18 years) completed assessments of offspring psychopathology as part of the Pittsburgh Bipolar Offspring Study (BIOS). We compared rates of offspring psychopathology assessed using the following: a clinician-administered semi-structured interview with parent and child using the Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS); parent-reported Child Behavior Checklist (CBCL); offspring self-reported Youth Self Reports (YSR) for those 11 years and older (n = 250); and teachers' reports when available (n = 209).
There were no between-group differences in rates of psychopathology yielded from the K-SADS, except for more depressive disorders in offspring of parents with current mania/hypomania compared to offspring of parents in remission. Conversely, using the CBCL and comparing with parents who were in remission, parents with current depression reported significantly more externalizing psychopathology in offspring, whereas parents with current mania/hypomania reported more externalizing and internalizing psychopathology in their offspring. On the YSR, offspring of parents with current mania/hypomania had more internalizing psychopathology compared to offspring of parents in remission. Teacher's reports showed no between-group differences in rates of any psychopathology.
Parental active mood symptomatology, especially during a manic/hypomanic episode, significantly affects their reports of their offspring's psychopathology. Trained interviewers reduce potential report bias. Clinicians and studies assessing children's psychopathology should take into account parental current mood state.
在本研究中,我们旨在评估患有情绪障碍的父母当前的情绪状态(抑郁或躁狂/轻躁狂)是否会影响他们对其子女精神病理学的报告。
65名患有当前抑郁症的父母、42名患有当前躁狂/轻躁狂的父母、181名处于缓解期的情绪障碍父母及其子女(n = 479,年龄6至18岁)完成了对子女精神病理学的评估,这是匹兹堡双相情感障碍后代研究(BIOS)的一部分。我们比较了使用以下方法评估的子女精神病理学发生率:使用学龄儿童情感障碍和精神分裂症检查表(K-SADS)对父母和孩子进行临床医生管理的半结构化访谈;父母报告的儿童行为检查表(CBCL);11岁及以上子女自我报告的青少年自我报告(YSR)(n = 250);以及如有可用的教师报告(n = 209)。
除了与处于缓解期的父母的子女相比,患有当前躁狂/轻躁狂的父母的子女中有更多的抑郁症外,K-SADS得出的精神病理学发生率在组间没有差异。相反,使用CBCL并与处于缓解期的父母进行比较,患有当前抑郁症的父母报告其子女有明显更多的外化精神病理学问题,而患有当前躁狂/轻躁狂的父母报告其子女有更多的外化和内化精神病理学问题。在YSR上,患有当前躁狂/轻躁狂的父母的子女与处于缓解期的父母的子女相比,有更多的内化精神病理学问题。教师报告显示,任何精神病理学发生率在组间没有差异。
父母当前的情绪症状,特别是在躁狂/轻躁狂发作期间,会显著影响他们对其子女精神病理学的报告。训练有素的访谈者可减少潜在的报告偏差。评估儿童精神病理学的临床医生和研究应考虑父母当前的情绪状态。