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精神健康症状、社会和认知脆弱性以及人格方面的家族相似性:抑郁症和焦虑症患者及其兄弟姐妹的研究。

Familial resemblance in mental health symptoms, social and cognitive vulnerability, and personality: A study of patients with depressive and anxiety disorders and their siblings.

机构信息

Amsterdam UMC, Vrije Universiteit, Psychiatry, Amsterdam Public Health research institute, Amsterdam, The Netherlands.

Department of Developmental Psychopathology, Behavioral Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands.

出版信息

J Affect Disord. 2021 Nov 1;294:420-429. doi: 10.1016/j.jad.2021.06.072. Epub 2021 Jul 1.

Abstract

BACKGROUND

Investigating siblings of probands with affective disorders enables the identification of psychopathology-related risk features. Leveraging data from an older adult sample, as compared to most previous sibling studies, enabled us to study more definitive clinical profiling across the lifespan. We examined prevalence of depressive/anxiety disorders in siblings, proband-sibling resemblance in psychopathology-related features, and whether unaffected siblings showed higher levels of these features than healthy controls.

METHODS

The sample (N=929; M=50.6) consisted of 256 probands with lifetime depressive and/or anxiety disorders, their 380 siblings, and 293 healthy controls without affected relatives. Fifteen psychopathology-related features were investigated across four domains: mental health symptoms, social vulnerabilities, cognitive vulnerabilities, and personality.

RESULTS

Lifetime disorders were present in 50.3% of siblings. Prevalence was 2-3 times higher than Dutch population frequencies. We found small to medium probandsibling resemblance across psychopathology-related features (ρ=0.10-0.32). Unaffected siblings reported poorer interpersonal functioning and more negative life events, childhood trauma, and rumination than healthy controls.

LIMITATIONS

Due to the cross-sectional study design, the directionality of effects cannot be determined. No inferences can be made about potential differences in familial resemblance in psychopathology-related features between high- and low-risk families.

CONCLUSIONS

Siblings of probands with affective disorders are at higher risk for depressive/anxiety disorders. Even when unaffected, still show higher psychosocial vulnerability than healthy controls. Nevertheless, the only modest proband-sibling resemblance across psychopathology-related features suggests that individual mechanisms differentiate clinical trajectories across the lifespan. Identification of these mechanisms is crucial to improve resilience in subjects with familial risk.

摘要

背景

研究情感障碍患者的兄弟姐妹,可以确定与精神病理学相关的风险特征。与大多数以前的兄弟姐妹研究相比,利用来自老年样本的数据,使我们能够在整个生命周期中研究更明确的临床特征。我们检查了兄弟姐妹中抑郁/焦虑障碍的患病率、与精神病理学相关特征的患者-兄弟姐妹相似性,以及未受影响的兄弟姐妹是否表现出比健康对照组更高水平的这些特征。

方法

该样本(N=929;M=50.6)包括 256 名有终生抑郁和/或焦虑障碍的患者、他们的 380 名兄弟姐妹和 293 名无患病亲属的健康对照者。调查了四个领域的 15 个与精神病理学相关的特征:心理健康症状、社会脆弱性、认知脆弱性和人格。

结果

有 50.3%的兄弟姐妹患有终生障碍。其患病率是荷兰人群频率的 2-3 倍。我们发现患者与兄弟姐妹之间在与精神病理学相关的特征上存在小到中等程度的相似性(ρ=0.10-0.32)。未受影响的兄弟姐妹报告人际关系较差,生活事件、儿童期创伤和反刍更多,比健康对照组更消极。

局限性

由于横断面研究设计,无法确定效应的方向性。不能对高风险和低风险家庭之间与精神病理学相关特征的潜在家族相似性差异做出推断。

结论

情感障碍患者的兄弟姐妹患抑郁/焦虑障碍的风险较高。即使未受影响,与健康对照组相比,他们仍表现出更高的社会心理脆弱性。然而,与精神病理学相关特征的患者-兄弟姐妹相似性只有适度,这表明个体机制在整个生命周期中区分了临床轨迹。识别这些机制对于提高有家族风险的个体的适应能力至关重要。

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