Lavori P W, Keller M B, Endicott J
Department of Psychiatry, Massachusetts General Hospital, Boston 02114.
J Psychiatr Res. 1988;22(4):249-59. doi: 10.1016/0022-3956(88)90034-9.
Analysis of family history and family study diagnoses of major affective disorder in 4806 relatives of affectively ill probands from the NIMH Collaborative Study of the Psychobiology of Depression (Clinical) suggests that rates of disorder in uninterviewed relatives are greatly underestimated by family history. The implications of these underestimates for family and genetics analyses using the family history method are discussed, and other estimates are developed that have better statistical properties. Using the Model Based Direct Adjustment method, the rate of major affective disorder in all relatives (interviewed and uninterviewed) is estimated to be 32%, compared to 25% by the consensus (standard) method, which uses the Family History-RDC interview with one or more family members to make diagnoses on all uninterviewed relatives. This difference (over ten standard errors) is due to the much higher rate of illness estimated for the uninterviewed relatives (28% compared to 14%). Analysis of the sources of insensitivity of the FH-RDC is used to explain the difference between observed and imputed diagnosis rates.
对美国国立精神卫生研究所抑郁症心理生物学合作研究（临床）中情感障碍先证者的4806名亲属进行的家族史分析及家族研究诊断表明，家族史大大低估了未接受访谈亲属的障碍发生率。讨论了这些低估对使用家族史方法进行家族和遗传学分析的影响，并开发了具有更好统计特性的其他估计方法。使用基于模型的直接调整方法，估计所有亲属（接受访谈和未接受访谈）中重度情感障碍的发生率为32%，而使用家族史研究诊断标准访谈一名或多名家庭成员对所有未接受访谈亲属进行诊断的共识（标准）方法得出的发生率为25%。这种差异（超过十个标准误差）是由于未接受访谈亲属的疾病发生率估计要高得多（28%比14%）。对家族史研究诊断标准不敏感来源的分析用于解释观察到的诊断率与推断诊断率之间的差异。
