双相障碍患者后代患精神障碍的风险较高。一项为期四年的前瞻性研究。

High risk for psychiatric disorders in bipolar offspring. A four years prospective study.

机构信息

Member of the Research Group in Psychiatry (GIPSI), Department of Psychiatry, Faculty of Medicine, University of Antioquia, Medellín, Colombia; Mood Disorder Program, Hospital San Vicente Foundation, Medellín, Colombia.

出版信息

Rev Colomb Psiquiatr (Engl Ed). 2021 Oct-Dec;50(4):273-284. doi: 10.1016/j.rcpeng.2020.01.005.

DOI:10.1016/j.rcpeng.2020.01.005

PMID:34815013

Abstract

UNLABELLED

Bipolar disorder (BD) has a large hereditary component. It is a disorder that begins in early adulthood, but about which it has been described a premorbid period preceding the onset of BD. During this herald expression psychiatric disorders and symptoms, such as depressive, manic, psychotic, anxious and others, may appear.

OBJECTIVE

To determine the psychopathological profile of a Bipolar Offspring (BO) group compared with the Community Control Offspring (CCO) group, and its evolution over time, including subthreshold symptoms and mental disorders.

METHODS

We conducted an observational mixed cohort study, with a prospective design. We included subjects from six to 30 years of age, from the region of Antioquia, Colombia. A total of 131 subjects from the risk group BO and 150 subjects from the CCO group were evaluated through validated psychiatric diagnostic interviews (K-SADS-PL and DIGS) at baseline and at 4 years follow up. All interviews were carried out by a staff blind to parent diagnoses. Follow-up assessment were complete in 72% of the offspring. Forty-two subjects were excluded as they surpassed the age of 30 years, and only 46 subjects were not followed (change of address or did not consent to participate).

RESULTS

Compared with the CCO group, the BO group had a higher frequency of affective disorder, psychotic disorder, externalizing disorders and use of the psychoactive substances during both assessments at time 1 and 2. The magnitude of the differences between the groups increased when they reach time 2. The BO group had a greater risk for presenting subthreshold symptoms and definitive psychiatric disorders, such as affective disorders, psychotic disorders and externalizing disorders. In addition, the BO group had a younger age of onset for psychoactive substances consumption.

CONCLUSION

During the follow-up period, the BO group had a higher risk of presenting mental disorders compared with the CCO group. The most relevant symptoms and disorders that could precede the onset of BD were depressive, bipolar not otherwise specified, psychotic and substance use.

摘要

未加标签

双相情感障碍（BD）具有较大的遗传成分。它是一种始于成年早期的疾病，但据描述，在 BD 发病前存在一个前驱期。在此前驱期表达中，可能会出现精神障碍和症状，如抑郁、躁狂、精神病、焦虑等。

目的

与社区对照后代（CCO）组相比，确定双相情感障碍后代（BO）组的精神病理学特征，及其随时间的演变，包括亚阈值症状和精神障碍。

方法

我们进行了一项观察性混合队列研究，采用前瞻性设计。我们纳入了来自哥伦比亚安蒂奥基亚地区的 6 至 30 岁的受试者。共有 131 名风险组 BO 受试者和 150 名 CCO 组受试者在基线和 4 年随访时接受了经过验证的精神病诊断访谈（K-SADS-PL 和 DIGS）。所有访谈均由一组对父母诊断不知情的工作人员进行。随访评估在 72%的后代中完成。42 名受试者因年龄超过 30 岁而被排除，只有 46 名受试者未被随访（地址变更或不同意参与）。

结果

与 CCO 组相比，BO 组在两次评估时（第 1 次和第 2 次）均更频繁地出现情感障碍、精神病性障碍、外化障碍和使用精神活性物质。当到达第 2 次评估时，两组之间的差异程度增大。BO 组发生亚阈值症状和明确精神障碍（如情感障碍、精神病性障碍和外化障碍）的风险更高。此外，BO 组开始使用精神活性物质的年龄更小。