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精神疾病诊断和单相抑郁症的家族史:一项基于丹麦国家登记册的队列研究。

Parental history of psychiatric diagnoses and unipolar depression: a Danish National Register-based cohort study.

作者信息

Musliner K L, Trabjerg B B, Waltoft B L, Laursen T M, Mortensen P B, Zandi P P, Munk-Olsen T

机构信息

Department of Mental Health,Johns Hopkins Bloomberg School of Public Health,Baltimore,MD,USA.

National Centre for Register-based Research,University of Aarhus,Aarhus,Denmark and The Lundbeck Foundation Initiative for Integrative Psychiatric Research,iPSYCH,Denmark.

出版信息

Psychol Med. 2015 Oct;45(13):2781-91. doi: 10.1017/S0033291715000744. Epub 2015 Apr 29.

Abstract

BACKGROUND

Depression is known to run in families, but the effects of parental history of other psychiatric diagnoses on depression rates are less well studied. Few studies have examined the impact of parental psychopathology on depression rates in older age groups.

METHOD

We established a population-based cohort including all individuals born in Denmark after 1954 and alive on their 10th birthday (N = 29 76 264). Exposure variables were maternal and paternal history of schizophrenia, bipolar disorder, depression, anxiety or 'other' psychiatric diagnoses. Incidence rate ratios (IRRs) were estimated using Poisson regressions.

RESULTS

Parental history of any psychiatric diagnosis increased incidence rates of outpatient (maternal: IRR 1.88, p < 0.0001; paternal: IRR 1.68, p < 0.0001) and inpatient (maternal: IRR 1.99, p < 0.0001; paternal: IRR 1.83, p < 0.0001) depression relative to no parental history. IRRs for parental history of non-affective disorders remained relatively stable across age groups, while IRRs for parental affective disorders (unipolar or bipolar) decreased with age from 2.29-3.96 in the youngest age group to 1.53-1.90 in the oldest group. IRR estimates for all parental diagnoses were similar among individuals aged ⩾41 years (IRR range 1.51-1.90).

CONCLUSIONS

Parental history of any psychiatric diagnosis is associated with increased incidence rates of unipolar depression. In younger age groups, parental history of affective diagnoses is more strongly associated with rates of unipolar depression than non-affective diagnoses; however, this distinction disappears after age 40, suggesting that parental psychopathology in general, rather than any one disorder, confers risk for depression in middle life.

摘要

背景

抑郁症具有家族遗传性,但父母有其他精神疾病诊断史对抑郁症发病率的影响研究较少。很少有研究考察父母精神病理学对老年人群抑郁症发病率的影响。

方法

我们建立了一个基于人群的队列,包括1954年后在丹麦出生且10岁时仍存活的所有个体(N = 2976264)。暴露变量为母亲和父亲的精神分裂症、双相情感障碍、抑郁症、焦虑症或“其他”精神疾病诊断史。发病率比(IRR)采用泊松回归估计。

结果

与无父母精神疾病诊断史相比,父母有任何精神疾病诊断史都会增加门诊抑郁症(母亲:IRR 1.88,p < 0.0001;父亲:IRR 1.68,p < 0.0001)和住院抑郁症(母亲:IRR 1.99,p < 0.0001;父亲:IRR 1.83,p < 0.0001)的发病率。非情感性障碍的父母诊断史的IRR在各年龄组中相对稳定,而父母情感性障碍(单相或双相)的IRR随年龄增长而下降,从最年轻年龄组的2.29 - 3.96降至最年长组的1.53 - 1.90。在年龄≥41岁的个体中,所有父母诊断的IRR估计值相似(IRR范围为1.51 - 1.90)。

结论

父母有任何精神疾病诊断史与单相抑郁症发病率增加有关。在较年轻年龄组中,父母情感性疾病诊断史与单相抑郁症发病率的关联比非情感性疾病诊断史更强;然而,这种差异在40岁以后消失,这表明一般而言,父母的精神病理学而非任何一种特定疾病会增加中年患抑郁症的风险。

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