Tienari P J, Wynne L C
Department of Psychiatry, University of Oulu, Finland.
Ann Med. 1994 Aug;26(4):233-7. doi: 10.3109/07853899409147896.
The understanding and treatment of schizophrenia have been greatly hampered by uncertainty about etiological factors and controversy about diagnostic boundaries. Adoption studies have helped clarify both of these problems. First, the adoptees study method, the index offspring of adopting-away schizophrenic biological parents are compared with control adoptees whose adopting-away parents were non-schizophrenic. Earlier studies have found increased illness in the index adoptees, thus supporting a genetic hypothesis. Additionally, in this approach the comparison of index versus control adoptive rearing families permits the assessment of environmental joint or interaction effects. An on-going Finnish study appears to provide evidence supporting both genetic and environmental main effects, as well as joint effects. Secondly, in the adoptees' relatives method, the biological relatives of schizophrenic index adoptees are compared with the biological relatives of non-schizophrenic control adoptees. A Danish study found that the relatives not only have more frequent typical, narrowly defined schizophrenia but also have more 'latent', non-psychotic forms of the illness. Thus, the adoption studies of schizophrenia are proving valuable in establishing the significance of both genetic and environmental contributions to the illness and in clarifying the diagnostic criteria for a genetically relevant syndrome.
精神分裂症的病因因素存在不确定性,诊断界限也存在争议,这极大地阻碍了对其的理解和治疗。收养研究有助于厘清这两个问题。首先,在被收养者研究方法中,将患有精神分裂症的亲生父母的被收养子女(索引子代)与亲生父母未患精神分裂症的对照被收养者进行比较。早期研究发现索引被收养者的患病几率增加,从而支持了遗传假说。此外,通过这种方法,对索引被收养者与对照被收养者的收养抚养家庭进行比较,可以评估环境的联合或交互作用。一项正在进行的芬兰研究似乎提供了支持遗传和环境主效应以及联合效应的证据。其次,在被收养者亲属研究方法中,将患有精神分裂症的索引被收养者的生物学亲属与未患精神分裂症的对照被收养者的生物学亲属进行比较。一项丹麦研究发现,这些亲属不仅更频繁地患有典型的、狭义定义的精神分裂症,还患有更多“潜在的”、非精神病性形式的疾病。因此,精神分裂症的收养研究在确定遗传和环境因素对该疾病的影响以及厘清与遗传相关综合征的诊断标准方面具有重要价值。