Lin P-C, Liang C-S, Tsai C-K, Tsai S-J, Chen T-J, Bai Y-M, Chen M-H
From the Beitou Branch, Department of Psychiatry, Tri-Service General Hospital, National Defense Medical Center, No. 60, Xinmin Rd., Beitou Dist., Taipei City 11243, Taiwan.
Department of Neurology, Tri-Service General Hospital, National Defense Medical Center, No. 325, Sec. 2, Chenggong Rd., Neihu Dist., Taipei City 11490, Taiwan.
QJM. 2022 Dec 12;115(12):813-821. doi: 10.1093/qjmed/hcac153.
Genetic factors link psychiatric disorders, particularly major depressive disorder (MDD), bipolar disorder, and obsessive-compulsive disorder (OCD), with systemic lupus erythematosus (SLE). Additionally, maternal SLE is a risk factor for long-term developmental problems, particularly learning disabilities, attention disorders, autism spectrum disorder (ASD) and speech disorders, in children.
We aimed to determine whether first-degree relatives (FDRs) of patients with SLE have increased risks of SLE and major psychiatric disorders.
Using the Taiwan National Health Insurance Research Database, we recruited 40 462 FDRs of patients with SLE as well as 161 848 matched controls. The risks of major psychiatric disorders, including schizophrenia, bipolar disorder, OCD, MDD, ASD and attention-deficit/hyperactivity disorder (ADHD), were assessed.
The FDRs of patients with SLE had higher risks of SLE (reported as the adjusted relative risk and 95% confidence interval: 14.54; 12.19-17.34), MDD (1.23; 1.12-1.34), ADHD (1.60; 1.55-1.65), OCD (1.41; 1.14-1.74) and bipolar disorder (1.18; 1.01-1.38) compared with controls. Specifically, male FDRs of patients with SLE had higher risks of SLE and bipolar disorder, whereas female FDRs of patients with SLE had higher risks of MDD and OCD. Differences in the familial relationship (i.e. parents, children, siblings and twins) were consistently associated with higher risks of these disorders compared with controls.
The FDRs of patients with SLE had higher risks of SLE, MDD, ADHD, OCD and bipolar disorder than the controls.
遗传因素将精神疾病，尤其是重度抑郁症（MDD）、双相情感障碍和强迫症（OCD），与系统性红斑狼疮（SLE）联系起来。此外，母亲患SLE是儿童长期发育问题的一个风险因素，尤其是学习障碍、注意力障碍、自闭症谱系障碍（ASD）和言语障碍。
我们旨在确定SLE患者的一级亲属（FDR）患SLE和主要精神疾病的风险是否增加。
利用台湾国民健康保险研究数据库，我们招募了40462名SLE患者的FDR以及161848名匹配的对照。评估了包括精神分裂症、双相情感障碍、OCD、MDD、ASD和注意力缺陷多动障碍（ADHD）在内的主要精神疾病的风险。
与对照组相比，SLE患者的FDR患SLE（报告为调整后的相对风险和95%置信区间：14.54；12.19 - 17.34）、MDD（1.23；1.12 - 1.34）、ADHD（1.60；1.55 - 1.65）、OCD（1.41；1.14 - 1.74）和双相情感障碍（1.18；1.01 - 1.38）的风险更高。具体而言，SLE患者的男性FDR患SLE和双相情感障碍的风险更高，而SLE患者的女性FDR患MDD和OCD的风险更高。与对照组相比，家族关系（即父母、子女、兄弟姐妹和双胞胎）的差异始终与这些疾病的较高风险相关。
与对照组相比，SLE患者的FDR患SLE、MDD、ADHD、OCD和双相情感障碍的风险更高。
