Post Robert M, Leverich Gabriele S, Kupka Ralph, Keck Paul E, McElroy Susan L, Altshuler Lori L, Frye Mark A, Rowe Michael, Grunze Heinz, Suppes Trisha, Nolen Willem A
aBipolar Collaborative Network, Bethesda, Maryland bDepartment of Psychiatry and Behavioral Sciences, George Washington University, Washington, District of Columbia cDepartment of Psychiatry and Behavioral Neuroscience dDepartment of Psychiatry and Behavioral Neuroscience, Biological Psychiatry Program, University of Cincinnati Medical College, Cincinnati eLindner Center of HOPE, Mason, Ohio fDepartment of Psychiatry and Biobehavioral Sciences, David Geffen School of Medicine, University of California gDepartment of Psychiatry, VA Greater Los Angeles Healthcare System, West Los Angeles Healthcare Center, Los Angeles hDepartment of Psychiatry and Behavioral Sciences, Stanford University School of Medicine iV.A. Palo Alto HealthCare System, Palo Alto, California jDepartment of Psychiatry, Mayo Clinic, Rochester, Michigan, USA kDepartment of Psychiatry, VU University Medical Center, Amsterdam lDepartment of Psychiatry, University Medical Center, University of Groningen, Groningen, The Netherlands mDepartment of Psychiatry and Psychotherapy, Christian Doppler Klink, Paracelsus Medical University Salzburg, Austria.
Psychiatr Genet. 2015 Oct;25(5):194-200. doi: 10.1097/YPG.0000000000000093.
We previously found that compared with Europe more parents of the USA patients were positive for a mood disorder, and that this was associated with early onset bipolar disorder. Here we examine family history of psychiatric illness in more detail across several generations.
A total of 968 outpatients (average age 41) with bipolar disorder from four sites in the USA and three in the Netherlands and Germany (abbreviated as Europe) gave informed consent and provided detailed demographic and family history information on a patient questionnaire. Family history of psychiatric illness (bipolar disorder, unipolar depression, suicide attempt, alcohol abuse, substance abuse, and other illness) was collected for each parent, four grandparents, siblings, and children.
Parents of the probands with bipolar disorder from the USA compared with Europe had a significantly higher incidence of both unipolar and bipolar mood disorders, as well as each of the other psychiatric conditions listed above. With a few exceptions, this burden of psychiatric disorders was also significantly greater in the grandparents, siblings, and children of the USA versus European patients.
The increased complexity of psychiatric illness and its occurrence over several generations in the families of patients with bipolar disorder from the USA versus Europe could be contributing to the higher incidence of childhood onsets and greater virulence of illness in the USA compared with Europe. These data are convergent with others suggesting increased both genetic and environmental risk in the USA, but require replication in epidemiologically-derived populations with data based on interviews of the family members.
我们之前发现，与欧洲相比，美国患者的更多父母患有情绪障碍，且这与早发性双相情感障碍有关。在此，我们更详细地研究几代人中精神疾病的家族史。
来自美国四个地点以及荷兰和德国三个地点（简称为欧洲）的总共968名双相情感障碍门诊患者（平均年龄41岁）签署了知情同意书，并在患者问卷上提供了详细的人口统计学和家族史信息。收集了每位父母、四位祖父母、兄弟姐妹和子女的精神疾病家族史（双相情感障碍、单相抑郁症、自杀未遂、酒精滥用、药物滥用及其他疾病）。
与欧洲相比，来自美国的双相情感障碍先证者的父母患单相和双相情绪障碍以及上述其他每种精神疾病的发生率显著更高。除了少数例外情况，美国患者的祖父母、兄弟姐妹和子女的精神疾病负担也明显高于欧洲患者。
与欧洲相比，美国双相情感障碍患者家庭中精神疾病的复杂性增加及其在几代人中的发生，可能是导致美国儿童期发病发生率更高以及疾病严重性更高的原因。这些数据与其他研究结果一致，表明美国的遗传和环境风险均有所增加，但需要在基于家庭成员访谈数据的流行病学衍生人群中进行重复验证。
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