Pediatric Psychopharmacology Program, Division of Child Psychiatry, Massachusetts General Hospital, Boston, MA, USA.
Department of Psychiatry, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA.
Acta Psychiatr Scand. 2019 Apr;139(4):361-368. doi: 10.1111/acps.13013. Epub 2019 Mar 18.
To investigate the association between pediatric bipolar I (BP-I) disorder and conduct disorder (CD) using familial risk analysis.
We compared diagnoses in relatives of youth in four proband groups defined by the presence or absence of BP-I and CD: (1) probands with neither CD nor BP-I (probands: N = 550; relatives: N = 1656), (2) probands with CD and without BP-I (probands: N = 40; relatives: N = 127), (3) probands with BP-I and without CD (probands: N = 197; relatives: N = 579), and (4) probands with both CD and BP-I (probands: N = 176; relatives: N = 488). All subjects were evaluated with structured diagnostic interviews, and diagnoses of relatives were made blind to the diagnoses of probands.
Relatives of probands with BP-I disorder had high rates of BP-I, and relatives of probands with CD had high rates of CD irrespective of the comorbidity with the other disorder. Relatives of probands with the combined condition of CD and BP-I had high rates of the combined condition.
The finding of cosegregation between BP-I disorder and CD is consistent with the hypothesis that the combined condition represents a distinct subtype of either disorder.
通过家族风险分析研究儿童双相 I 障碍（BP-I）与品行障碍（CD）之间的关联。
我们比较了四个先证者组的亲属中的诊断，这些先证者组是根据是否存在 CD 和 BP-I 来定义的：（1）既无 CD 也无 BP-I 的先证者（先证者：N=550；亲属：N=1656）；（2）有 CD 而无 BP-I 的先证者（先证者：N=40；亲属：N=127）；（3）有 BP-I 而无 CD 的先证者（先证者：N=197；亲属：N=579）；（4）有 CD 和 BP-I 的先证者（先证者：N=176；亲属：N=488）。所有受试者均接受了结构化诊断访谈评估，且亲属的诊断是在不了解先证者诊断的情况下做出的。
BP-I 障碍先证者的亲属中 BP-I 障碍的发生率很高，而 CD 先证者的亲属中 CD 的发生率也很高，无论其是否与另一种障碍共病。同时患有 CD 和 BP-I 的先证者的亲属中同时患有这两种疾病的比例很高。
BP-I 障碍与 CD 之间的共分离发现与以下假说一致，即联合疾病代表了这两种疾病的一个不同亚型。
