Goetz Michal, Novak Tomas, Viktorinova Michaela, Ptacek Radek, Mohaplova Marketa, Sebela Antonin
Second Faculty of Medicine, Charles University Prague, Praha, Czechia.
Department of Child Psychiatry, Motol University Hospital, Praha, Czechia.
Front Psychiatry. 2019 Apr 9;10:198. doi: 10.3389/fpsyt.2019.00198. eCollection 2019.
Although a positive family history is the strongest predictor for bipolar disorder (BD), most offspring of BD parents (BO) will not develop the disorder. Identification of vulnerability markers for BD is essential for specific individual risk estimation. Impairments in cognitive functioning and the presence of specific temperament traits are considered promising candidates. Sixty-three BO (48% female; 11.8 ± 3.3 years) and 54 control offspring (CO; 44% female; 12.3 ± 3.2 years) comparable in sex ( = 0.4) and age ( = 0.4) were enrolled. Detection of current sub/threshold mood symptoms by the Kiddie Schedule for Affective Disorders and Schizophrenia and General Behavior Inventory was applied to separate BO into ultrahigh-risk (UHR) and high-risk (HR) subgroups. Cognitive functions were tested by the Developmental Neuropsychological Assessment II test battery, d2 Test of Attention, and Amsterdam Neuropsychological Tasks. Temperament was assessed by the Temperament in Middle Childhood and Early Adolescent Temperament Questionnaires. The BO sample consisted of 5 BD, 17 UHR, and 41 HR participants. We did not observe any significant differences between the BO and CO groups or between the UHR, HR, and CO subgroups (Hedges' = 0.21-0.39) in cognitive functioning. The BO differed significantly in some temperament traits from the CO ( = 0.42-0.61), while the UHR subgroup exhibited lower effortful control and attention focusing than both HR and CO participants ( = 0.92-1.19). The cross-sectional design and wide age range of the sample limited our findings. Neuropsychological impairment does not seem to be a trait marker of BD in the premorbid stage. Temperament with low effortful control and low attention focusing might be associated with the development of mood disorders in BO.
尽管家族病史呈阳性是双相情感障碍(BD)最强的预测指标,但大多数双相情感障碍患者的后代(BO)不会患上这种疾病。识别双相情感障碍的易感性标志物对于特定个体风险评估至关重要。认知功能受损和特定气质特征的存在被认为是有希望的候选因素。招募了63名双相情感障碍患者的后代(48%为女性;11.8±3.3岁)和54名对照后代(CO;44%为女性;12.3±3.2岁),他们在性别(=0.4)和年龄(=0.4)上具有可比性。应用儿童情感障碍和精神分裂症的儿童版量表以及一般行为量表来检测当前的亚阈值/阈值情绪症状,以将双相情感障碍患者的后代分为超高风险(UHR)和高风险(HR)亚组。通过发育神经心理评估II测试电池、注意力的d2测试和阿姆斯特丹神经心理任务来测试认知功能。通过童年中期气质问卷和青少年早期气质问卷来评估气质。双相情感障碍患者的后代样本包括5名双相情感障碍患者、17名超高风险者和41名高风险参与者。我们没有观察到双相情感障碍患者的后代组与对照后代组之间或超高风险、高风险和对照后代亚组之间在认知功能上有任何显著差异(Hedges'=0.21 - 0.39)。双相情感障碍患者的后代在某些气质特征上与对照后代有显著差异(=0.42 - 0.61),而超高风险亚组在努力控制和注意力集中方面比高风险和对照后代参与者更低(=0.92 - 1.19)。样本的横断面设计和较宽的年龄范围限制了我们的研究结果。神经心理损伤似乎不是双相情感障碍病前阶段的特征标志物。努力控制低和注意力集中低的气质可能与双相情感障碍患者的后代情绪障碍的发展有关。