Reich T, Cloninger C R, Van Eerdewegh P, Rice J P, Mullaney J
Department of Psychiatry, Jewish Hospital of St. Louis, Missouri 63110.
Alcohol Clin Exp Res. 1988 Aug;12(4):458-64. doi: 10.1111/j.1530-0277.1988.tb00227.x.
This is a study of the familial transmission of alcoholism in the families of 60 female and 240 male alcoholics ascertained in four psychiatric hospital units and in a local parole office. Eight hundred and thirty-one interviewed first-degree relatives and 125 spouses are included. The lifetime population prevalences of alcoholism in white males and females based on the Epidemiological Catchment Area Study in St. Louis were compared with the family rates. A semistructured comprehensive interview schedule (Home Environment and Lifetime Psychiatric Evaluation Record) was used and diagnoses made according to Feighner criteria for alcoholism. The methods of Survival Analysis established the presence of strong secular trends in the age-of-onset and lifetime prevalence of alcoholism in these families and in the general population. Accordingly, new methods for the analysis of family data that incorporate secular variation were developed. The Multifactorial Model of Disease Transmission was used to estimate familial correlations and these were parameterized by the "Tau" model of Familial Transmission. The model does not assume that all familial resemblance is due to genetic factors, but also includes the possibility of nongenetic transmission. Our analyses confirmed that more recently born cohorts of individuals had increased expected lifetime prevalences of alcoholism and decreased ages of onset, when compared with older cohorts. Separate age-of-onset distributions were required for males and females and the secular trends in age-of-onset were greatest in females. The differences between males and females were least in more recently born cohorts suggesting that sex-specific differences in the family and population distribution of alcoholism are decreasing.(ABSTRACT TRUNCATED AT 250 WORDS)
这是一项关于酗酒家族传播的研究，研究对象为在四个精神病院科室及当地假释办公室确诊的60名女性和240名男性酗酒者的家庭。研究纳入了831名接受访谈的一级亲属和125名配偶。将基于圣路易斯流行病学集水区研究得出的白人男性和女性酗酒的终生人群患病率与家庭患病率进行了比较。使用了半结构化综合访谈日程表（家庭环境与终生精神病学评估记录），并根据费格纳酗酒标准进行诊断。生存分析方法确定了这些家庭以及普通人群中酗酒发病年龄和终生患病率存在强烈的长期趋势。因此，开发了纳入长期变化的家庭数据新分析方法。使用疾病传播多因素模型来估计家族相关性，并通过家族传播的“Tau”模型对这些相关性进行参数化。该模型并不假定所有家族相似性都归因于遗传因素，还包括非遗传传播的可能性。我们的分析证实，与年龄较大的队列相比，最近出生的个体队列酗酒的预期终生患病率增加，发病年龄降低。男性和女性需要分别的发病年龄分布，且女性发病年龄的长期趋势最为明显。在最近出生的队列中，男性和女性之间的差异最小，这表明酗酒在家庭和人群分布中的性别特异性差异正在减小。（摘要截选至250词）
