Morgan Charity J, Coleman Michael J, Ulgen Ayse, Boling Lenore, Cole Jonathan O, Johnson Frederick V, Lerbinger Jan, Bodkin J Alexander, Holzman Philip S, Levy Deborah L
Department of Biostatistics, University of Alabama at Birmingham, Birmingham, AL, USA.
Psychology Research Laboratory, McLean Hospital, Belmont, MA, USA.
Schizophr Bull. 2017 May 1;43(3):523-535. doi: 10.1093/schbul/sbx016.
Thought disorder (TD) has long been associated with schizophrenia (SZ) and is now widely recognized as a symptom of mania and other psychotic disorders as well. Previous studies have suggested that the TD found in the clinically unaffected relatives of SZ, schizoaffective and bipolar probands is qualitatively similar to that found in the probands themselves. Here, we examine which quantitative measures of TD optimize the distinction between patients with diagnoses of SZ and bipolar disorder with psychotic features (BP) from nonpsychiatric controls (NC) and from each other. In addition, we investigate whether these same TD measures also distinguish their respective clinically unaffected relatives (RelSZ, RelBP) from controls as well as from each other. We find that deviant verbalizations are significantly associated with SZ and are co-familial in clinically unaffected RelSZ, but are dissociated from, and are not co-familial for, BP disorder. In contrast, combinatory thinking was nonspecifically associated with psychosis, but did not aggregate in either group of relatives. These results provide further support for the usefulness of TD for identifying potential non-penetrant carriers of SZ-risk genes, in turn enhancing the power of genetic analyses. These findings also suggest that further refinement of the TD phenotype may be needed in order to be suitable for use in genetic studies of bipolar disorder.
思维障碍（TD）长期以来一直与精神分裂症（SZ）相关联，现在也被广泛认为是躁狂症和其他精神障碍的一种症状。先前的研究表明，在SZ、分裂情感性障碍和双相情感障碍先证者的临床未受影响的亲属中发现的TD在性质上与在先证者自身中发现的相似。在此，我们研究哪些TD的定量测量方法能最优化区分诊断为SZ的患者和伴有精神病性特征的双相情感障碍（BP）患者与非精神科对照（NC）以及彼此之间的差异。此外，我们调查这些相同的TD测量方法是否也能区分各自临床未受影响的亲属（RelSZ、RelBP）与对照以及他们彼此之间的差异。我们发现异常言语与SZ显著相关，并且在临床未受影响的RelSZ中具有家族聚集性，但与BP障碍不相关且不具有家族聚集性。相比之下，组合思维与精神病非特异性相关，但在两组亲属中均未聚集。这些结果进一步支持了TD在识别SZ风险基因潜在非显性携带者方面的有用性，进而增强了基因分析的效力。这些发现还表明，可能需要进一步细化TD表型，以便适用于双相情感障碍的基因研究。
