Apter Gisèle, Bobin Anne, Genet Marie-Camille, Gratier Maya, Devouche Emmanuel
Erasme Hospital, Psychiatry and Psychopathology Research Institute, 143 Avenue Armand Guillebaud, 92160, Antony, France.
EA 3456 - LABORATOIRE ETHOLOGIE COGNITION DEVELOPPEMENT (LECD), Paris Ouest Nanterre University, 200 avenue de la République, 92001, Nanterre Cedex, France.
Curr Psychiatry Rep. 2017 Aug 23;19(10):72. doi: 10.1007/s11920-017-0820-8.
This paper highlights the most recent publications, in the field of psychiatry, on offspring of patients with psychiatric illnesses such as schizophrenia and bipolar disorder, and then summarizes what we know about the progeny of adults with mood disorders, the most prevalent of parental disorders. Studies examining personality disorders and contextual factors such as stress and trauma are examined with a focus on the crucial question of development and attachment status in children. Findings converge to reveal that offspring of parents (generally mothers) with most major psychiatric disorders present a higher risk for all mental disorders, and a wide range of disorders are also found in children, adolescent, and finally adult offspring of mothers with mood and anxiety disorders. Developmental psychopathology and infant and child psychiatry have focused on early relationship formation through social interaction and attachment patterns as pathways affected by vulnerability or resilience factors. First year of life longitudinal studies following mothers and infants has shown that maternal psychopathology is positively correlated with higher risk of attachment issues. It would seem that pathology appears when adaptation to real-life contexts becomes difficult in association with an accumulation of negative individual characteristics and environmental circumstances. We suggest that in order to move forward psychiatry should embrace a developmental cascade model, which posits a cumulative pathway for the emergence of psychopathology in the developing child. We propose that we have sufficient knowledge today to start implementing multilevel approaches to enhance the health and mental health of the next generation.
本文重点介绍了精神病学领域中关于精神疾病患者后代（如精神分裂症和双相情感障碍患者的后代）的最新出版物，然后总结了我们对患有情绪障碍的成年人（最常见的父母疾病类型）后代的了解。对人格障碍以及压力和创伤等背景因素的研究进行了审视，重点关注儿童的发育和依恋状况这一关键问题。研究结果一致表明，患有大多数主要精神疾病的父母（通常是母亲）的后代患所有精神疾病的风险更高，而且患有情绪和焦虑障碍的母亲的儿童、青少年及成年后代中也发现了广泛的疾病。发展心理病理学以及婴幼儿精神病学一直将通过社会互动和依恋模式形成早期关系作为受脆弱性或复原力因素影响的途径。对母婴进行的为期一年的纵向研究表明，母亲的精神病理学与依恋问题的较高风险呈正相关。似乎当与负面个体特征和环境状况的积累相关联，适应现实生活情境变得困难时，病理现象就会出现。我们建议，为了取得进展，精神病学应采用一种发展级联模型，该模型假定了发育中的儿童出现精神病理学的累积途径。我们提议，我们如今已有足够的知识来开始实施多层次方法，以增进下一代的健康和心理健康。
