Department of Psychiatry, Amsterdam Public Health Research Institute, Amsterdam UMC Location Vrije Universiteit Amsterdam, Boelelaan 1117, Amsterdam, The Netherlands.
Department of Developmental Psychopathology, Behavioral Science Institute, Radboud University Nijmegen, Nijmegen, The Netherlands.
Soc Psychiatry Psychiatr Epidemiol. 2023 Aug;58(8):1213-1226. doi: 10.1007/s00127-023-02432-0. Epub 2023 Feb 15.
Siblings of probands with depressive and anxiety disorders are at increased risk for psychopathology, but little is known about how risk factors operate within families to increase psychopathology for siblings. We examined the additional impact of psychosocial risk factors in probands-on top of or in combination with those in siblings-on depressive/anxious psychopathology in siblings.
The sample included 636 participants (M = 49.7; 62.4% female) from 256 families, each including a proband with lifetime depressive and/or anxiety disorders and their sibling(s) (N = 380 proband-sibling pairs). Sixteen psychosocial risk factors were tested. In siblings, depressive and anxiety disorders were determined with standardized psychiatric interviews; symptom severity was measured using self-report questionnaires. Analyses were performed with mixed-effects models accounting for familial structure.
In siblings, various psychosocial risk factors (female gender, low income, childhood trauma, poor parental bonding, being single, smoking, hazardous alcohol use) were associated with higher symptomatology and likelihood of disorder. The presence of the same risk factor in probands was independently associated (low income, being single) with higher symptomatology in siblings or moderated (low education, childhood trauma, hazardous alcohol use)-by reducing its strength-the association between the risk factor and symptomatology in siblings. There was no additional impact of risk factors in probands on likelihood of disorder in siblings.
Our findings demonstrate the importance of weighing psychosocial risk factors within a family context, as it may provide relevant information on the risk of affective psychopathology for individuals.
患者的兄弟姐妹患有抑郁和焦虑障碍的风险增加，但对于风险因素如何在家庭中运作以增加兄弟姐妹的精神病理学知之甚少。我们研究了在患者中存在的心理社会风险因素（除了兄弟姐妹中的风险因素之外或与兄弟姐妹中的风险因素结合使用）对兄弟姐妹的抑郁/焦虑精神病理学的额外影响。
该样本包括来自 256 个家庭的 636 名参与者（M=49.7；62.4%为女性），每个家庭都包括一名患有终生抑郁和/或焦虑障碍的患者及其兄弟姐妹（N=380 名患者-兄弟姐妹对）。测试了 16 种心理社会风险因素。在兄弟姐妹中，使用标准化的精神科访谈确定抑郁和焦虑障碍；使用自我报告问卷测量症状严重程度。使用混合效应模型进行分析，该模型考虑了家庭结构。
在兄弟姐妹中，各种心理社会风险因素（女性、低收入、童年创伤、不良父母关系、单身、吸烟、危险饮酒）与更高的症状和发病可能性相关。患者中存在相同的风险因素（低收入、单身）与兄弟姐妹的更高症状相关，或调节（低教育、童年创伤、危险饮酒）-通过降低其强度-与兄弟姐妹中风险因素与症状之间的关联。患者中风险因素对兄弟姐妹发病可能性没有额外影响。
我们的发现表明，在家庭环境中权衡心理社会风险因素非常重要，因为它可以为个体的情感精神病理学风险提供相关信息。
