Kendler K S, McGuire M, Gruenberg A M, O'Hare A, Spellman M, Walsh D
Department of Psychiatry, Medical College of Virginia/Virginia Commonwealth University, Richmond.
Arch Gen Psychiatry. 1993 Oct;50(10):781-8. doi: 10.1001/archpsyc.1993.01820220033004.
We sought to clarify the familial relationship between five putative schizophrenia-related personality disorders (schizotypal [SPD], paranoid, schizoid, avoidant, and borderline) and schizophrenia, other nonaffective psychoses, and affective illness.
A case-controlled epidemiologic family study using DSM-III-R criteria.
Five hundred thirty-four probands selected from a psychiatric case register or electoral register, of whom 415 were personally interviewed, and 2043 living and traceable relatives, of whom 1753 were personally interviewed.
Compared with relatives of unscreened controls, relatives of probands with schizophrenia had a highly significantly increased prevalence of SPD, and modest, but significant, increased prevalences of paranoid, schizoid, and avoidant personality disorders. Borderline personality disorder was rare, with a modest clustering of cases in relatives of affective disorder probands. The prevalence of SPD was also significantly elevated in relatives of probands with SPD and with other nonaffective psychoses but not in relatives of probands with psychotic or nonpsychotic affective illness. In contrast to the pattern seen for schizophrenia, the prevalence rate of SPD was substantially greater in parents than in siblings of schizophrenic probands.
Schizotypal personality disorder has a strong familial relationship with schizophrenia. Paranoid, schizoid, and avoidant, but not borderline, personality disorders may have a significant familial relationship with schizophrenia. Schizotypal personality disorder also reflects the familial liability to other psychotic disorders but probably not to affective illness. Fitness effects may substantially influence the pattern of schizophrenia-related personality disorders in relatives.
我们试图阐明五种假定的与精神分裂症相关的人格障碍（分裂型人格障碍[SPD]、偏执型、分裂样、回避型和边缘型）与精神分裂症、其他非情感性精神病及情感性疾病之间的家族关系。
一项采用《精神疾病诊断与统计手册第三版修订本》（DSM-III-R）标准的病例对照流行病学家族研究。
从精神病病例登记册或选民登记册中选取534名先证者，其中415人接受了个人访谈，以及2043名在世且可追踪的亲属，其中1753人接受了个人访谈。
与未筛查对照的亲属相比，精神分裂症先证者的亲属中SPD的患病率显著大幅增加，偏执型、分裂样和回避型人格障碍的患病率虽有所增加但幅度较小但具有统计学意义。边缘型人格障碍较为罕见，在情感性障碍先证者的亲属中有适度的病例聚集。SPD的患病率在SPD先证者以及其他非情感性精神病先证者的亲属中也显著升高，但在精神病性或非精神病性情感性疾病先证者的亲属中未升高。与精神分裂症所见模式不同，精神分裂症先证者的父母中SPD的患病率远高于其兄弟姐妹。
分裂型人格障碍与精神分裂症有很强的家族关系。偏执型、分裂样和回避型人格障碍（而非边缘型人格障碍）可能与精神分裂症有显著的家族关系。分裂型人格障碍也反映了对其他精神病性障碍的家族易感性，但可能与情感性疾病无关。健康效应可能会显著影响亲属中与精神分裂症相关的人格障碍模式。
