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父母精神病理学与子女抽动秽语综合征/慢性抽动障碍:全国病例对照研究。

Parental Psychopathology and Tourette Syndrome/Chronic Tic Disorder in Offspring: A Nationwide Case-Control Study.

机构信息

University of Turku and Turku University Hospital, Turku, Finland; Child Neurology, Helsinki University Hospital and University of Helsinki, Finland.

Center for Human Genetics Research, Massachusetts General Hospital, and Harvard Medical School, Boston.

出版信息

J Am Acad Child Adolesc Psychiatry. 2017 Apr;56(4):297-303.e4. doi: 10.1016/j.jaac.2017.01.009. Epub 2017 Feb 2.

Abstract

OBJECTIVE

To determine the associations between maternal and paternal psychiatric diagnoses and Tourette syndrome (TS)/chronic tic disorder (CT) in a nationwide study.

METHOD

This nested case-control study linked data derived from three national registers. All singletons born and diagnosed with TS/CT in Finland between January 1991 and December 2010 were identified (n = 1,120) and matched to four controls (n = 4,299). Conditional logistic regression was used to examine the associations between parental psychopathology and TS/CT.

RESULTS

Altogether, 24.9% of patients with TS/CT and 12.0% of controls had a mother with a psychiatric diagnosis. Similarly, 17.9% and 12.9% had a father with a psychiatric diagnosis. Any maternal and any paternal psychiatric diagnosis was associated with offspring TS/CT (odds ratio [OR] 2.3; 95% CI 1.9-2.7 and OR 1.2; 95% CI 1.01-1.5, respectively). The association between maternal psychiatric diagnosis and TS/CT was stronger than that between paternal psychiatric diagnosis and TS/CT (p < .001). Maternal personality disorders (OR 3.1, 95% CI 1.9-5.1), anxiety disorders (OR 2.6, 95% CI 1.9-3.5), affective disorders (OR 2.3, 95% CI 1.8-2.9), psychotic disorders (OR 2.0, 95% CI 1.2-3.3), and addiction disorders (OR 1.8, 95% CI 1.1-2.8) were associated with TS/CT. Paternal OCD (OR 6.5, 95% CI 1.1-39.5) and anxiety disorders (OR 1.5, 95% CI 1.1-2.3) were associated with TS/CT.

CONCLUSION

Parental psychiatric diagnoses (especially in the mother) are associated with diagnosed offspring TS/CT. Further studies are required before the results can be generalized to all children with TS/CT. The associations between maternal psychiatric disorders and TS may reflect both maternal specific environmental and/or genetic influences.

摘要

目的

在一项全国性研究中,确定父母的精神科诊断与妥瑞氏症(TS)/慢性抽动障碍(CT)之间的关联。

方法

这项嵌套病例对照研究将来自三个国家登记处的数据联系起来。在芬兰,1991 年 1 月至 2010 年 12 月期间,每确诊一例 TS/CT 患者,就匹配四名对照(n=4299)。使用条件逻辑回归来检验父母精神病理学与 TS/CT 之间的关联。

结果

共有 24.9%的 TS/CT 患者和 12.0%的对照者的母亲被诊断患有精神疾病。同样,17.9%和 12.9%的患者的父亲被诊断患有精神疾病。任何母亲和任何父亲的精神科诊断都与子女 TS/CT 相关(优势比[OR]2.3;95%CI1.9-2.7 和 OR1.2;95%CI1.01-1.5)。母亲的精神科诊断与 TS/CT 的关联强于父亲的精神科诊断与 TS/CT 的关联(p<.001)。母亲的人格障碍(OR3.1,95%CI1.9-5.1)、焦虑障碍(OR2.6,95%CI1.9-3.5)、情感障碍(OR2.3,95%CI1.8-2.9)、精神病性障碍(OR2.0,95%CI1.2-3.3)和成瘾障碍(OR1.8,95%CI1.1-2.8)与 TS/CT 相关。父亲的强迫症(OR6.5,95%CI1.1-39.5)和焦虑障碍(OR1.5,95%CI1.1-2.3)与 TS/CT 相关。

结论

父母的精神科诊断(尤其是母亲)与确诊的子女 TS/CT 相关。在将结果推广到所有患有 TS/CT 的儿童之前,需要进一步的研究。母亲精神障碍与 TS 之间的关联可能反映了母亲特定的环境和/或遗传影响。

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