Virginia Institute for Psychiatric and Behavioral Genetics and Department of Psychiatry, Virginia Commonwealth University, Box 980126, Richmond, VA 23298-0126, USA.
Departments of Psychiatry and Internal Medicine, University of Groningen, University Medical Center Groningen, P.O. Box 30.001, 9700 RB Groningen, Netherlands.
Psychol Med. 2023 Jul;53(9):3879-3886. doi: 10.1017/S0033291722000526. Epub 2022 Mar 31.
Functional somatic disorders (FSD) feature medical symptoms of unclear etiology. Attempts to clarify their origin have been hampered by a lack of rigorous research designs. We sought to clarify the etiology of the FSD by examining the genetic risk patterns for FSD and other related disorders.
This study was performed in 5 829 186 individuals from Swedish national registers. We quantified familial genetic risk for FSD, internalizing disorders, and somatic disorders in cases of chronic fatigue syndrome (CFS), fibromyalgia (FM), and irritable bowel syndrome (IBS), using a novel method based on aggregate risk in first to fifth degree relatives, adjusting for cohabitation. We compared these profiles with those of a prototypic internalizing psychiatric - major depression (MD) - and a somatic/autoimmune disorder: rheumatoid arthritis (RA).
Patients with FM carry substantial genetic risks not only for FM, but also for pain syndromes and internalizing, autoimmune and sleep disorders. The genetic risk profiles for IBS and CFS are also widely distributed although with lower average risks. By contrast, genetic risk profiles of MD and RA are much more restricted to related conditions.
Patients with FM have a relatively unique family genetic risk score profile with elevated genetic risk across a range of disorders that differs markedly from the profiles of a classic autoimmune disorder (RA) and internalizing disorder (MD). A similar less marked pattern of genetic risks was seen for IBS and CFS. FSD arise from a distinctive pattern of genetic liability for a diversity of psychiatric, autoimmune, pain, sleep, and functional somatic disorders.
功能性躯体障碍(FSD)的特征是病因不明的医学症状。由于缺乏严格的研究设计,澄清其起源的尝试受到了阻碍。我们试图通过检查 FSD 及其他相关疾病的遗传风险模式来阐明 FSD 的病因。
本研究在瑞典国家登记处的 5829186 名个体中进行。我们使用一种基于第一至第五度亲属聚集风险的新方法,在调整同居因素后,量化了慢性疲劳综合征(CFS)、纤维肌痛(FM)和肠易激综合征(IBS)病例中 FSD、内化障碍和躯体障碍的家族遗传风险。我们将这些特征与典型的内化精神障碍(重度抑郁症(MD))和躯体/自身免疫障碍(类风湿关节炎(RA))的特征进行了比较。
FM 患者不仅携带 FM 的大量遗传风险,而且还携带疼痛综合征和内化、自身免疫和睡眠障碍的遗传风险。IBS 和 CFS 的遗传风险特征虽然平均风险较低,但分布也很广泛。相比之下,MD 和 RA 的遗传风险特征则更局限于相关疾病。
FM 患者的家族遗传风险评分特征相对独特,具有一系列不同的遗传风险,这些风险与经典自身免疫疾病(RA)和内化疾病(MD)的特征明显不同。IBS 和 CFS 也出现了类似的、但不那么明显的遗传风险模式。FSD 是由一系列不同的精神、自身免疫、疼痛、睡眠和功能性躯体障碍的遗传易感性所引起的。