Vandeleur Caroline L, Strippoli Marie-Pierre F, Castelao Enrique, Gholam-Rezaee Mehdi, Ferrero François, Marquet Pierre, Aubry Jean-Michel, Preisig Martin
Department of Psychiatry, University Hospital of Lausanne, Site de Cery, Prilly, 1008, Lausanne, Switzerland.
Department of Mental Health and Psychiatry, University Hospital of Geneva, Geneva, Switzerland.
Soc Psychiatry Psychiatr Epidemiol. 2017 Aug;52(8):1041-1058. doi: 10.1007/s00127-017-1382-0. Epub 2017 Apr 10.
Studies focusing on the offspring of affected parents utilize the well-established familial aggregation of mood disorders as a powerful tool for the identification of risk factors, early clinical manifestations, and prodromes of mood disorders in these offspring. The major goals of the Lausanne-Geneva mood cohort study are to: (1) assess the familial aggregation of bipolar and unipolar mood disorders; (2) prospectively identify risk factors for mood disorders as well as their early signs and prodromes; (3) identify their endophenotypes including cognitive features, alterations in brain structure, HPA-axis dysregulation, and abnormalities of the circadian rhythm of activity.
Probands with bipolar disorders, major depressive disorder, and controls with at least one child aged from 4 to 17.9 years at study intake, their offspring, as well as their spouses are invited to take part in follow-up assessments at predetermined ages of the offspring. Direct semi-structured diagnostic interviews have been used for all participants. Probands, spouses, and adult offspring also undergo neurocognitive testing, anthropomorphic measures and biochemical exams, structural Magnetic Resonance Imaging, as well as objective assessments of physical activity using accelerometers in combination with ecological momentary assessments.
Currently, our study has up to seven follow-up assessments extending over a period of 20 years. There are 214 probands and 389 offspring with one direct interview before age 18 as well as a second assessment over follow-up. Data on 236 co-parents are also available from whom 55% have been directly interviewed. First publications support the specificity of the familial aggregation of BPD and the strong influence of an early onset of the parental BPD, which amplifies the risk of developing this disorder in offspring.
Information from clinical, biological, cognitive, and behavioral measures, based on contemporary knowledge, should further enhance our understanding of mood disorder psychopathology, its consequences, and underlying mechanisms.
聚焦于患病父母后代的研究，利用已得到充分证实的心境障碍家族聚集性，作为识别这些后代心境障碍的危险因素、早期临床表现及前驱症状的有力工具。洛桑-日内瓦心境队列研究的主要目标是：（1）评估双相和单相心境障碍的家族聚集性；（2）前瞻性地识别心境障碍的危险因素及其早期迹象和前驱症状；（3）识别其内表型，包括认知特征、脑结构改变、下丘脑-垂体-肾上腺（HPA）轴功能失调以及活动昼夜节律异常。
患有双相情感障碍、重度抑郁症的先证者，以及在研究纳入时至少有一个4至17.9岁孩子的对照者、他们的后代及其配偶，受邀在后代的预定年龄参加随访评估。所有参与者均采用直接半结构化诊断访谈。先证者、配偶和成年后代还需接受神经认知测试、人体测量和生化检查、结构磁共振成像，以及使用加速度计结合生态瞬时评估对身体活动进行客观评估。
目前，我们的研究有长达7次的随访评估，时间跨度为20年。有214名先证者和389名后代在18岁前接受了一次直接访谈，并在随访期间进行了第二次评估。还可获得236名共同父母的数据，其中55%接受了直接访谈。首批发表的文章支持双相情感障碍家族聚集性的特异性，以及父母双相情感障碍早发的强烈影响，这会增加后代患该疾病的风险。
基于当代知识，来自临床、生物学、认知和行为测量的信息应能进一步增强我们对心境障碍精神病理学、其后果及潜在机制的理解。
