Taylor M A, Berenbaum S A, Jampala V C, Cloninger C R
Department of Psychiatry and Behavioral Sciences, University of Health Sciences/The Chicago Medical School, IL 60064-3095.
Am J Psychiatry. 1993 Feb;150(2):278-85. doi: 10.1176/ajp.150.2.278.
Most investigators presume that schizophrenia and affective disorder are separate diseases. Others have proposed alternatives to this Kraepelinian view. These alternatives were addressed by preliminary analyses of data from a family study of psychopathology.
The authors identified 1,895 first-degree relatives of 166 patients with DSM-III schizophrenia, 71 patients with affective disorder, and 85 medical comparison probands; 949 relatives were blindly diagnosed.
The risks for schizophrenia and affective disorder (unipolar melancholia and bipolar disorder combined) were significantly higher in the relatives of the schizophrenic probands and the relatives of the probands with affective disorder than in the relatives of the comparison probands. The morbid risk for nonmelancholic depressions was not significantly higher. Among the relatives of the schizophrenic probands, the risk for affective disorder was highest among the relatives of the patients with "core" schizophrenia, who were younger at illness onset, had chronic illness, had severe emotional blunting, and showed few affective features.
Despite limitations, these preliminary analyses, consistent with other studies, suggest some familial relationship between schizophrenia and severe forms of affective disorder.
大多数研究者假定精神分裂症和情感障碍是两种不同的疾病。其他一些人则对这种克雷佩林学派的观点提出了不同看法。这些不同看法通过一项精神病理学家族研究的数据初步分析得以探讨。
作者确定了166例符合《精神疾病诊断与统计手册》第三版(DSM-III)精神分裂症患者、71例情感障碍患者以及85例医学对照先证者的1895名一级亲属;对949名亲属进行了盲法诊断。
精神分裂症先证者的亲属以及情感障碍先证者的亲属中,精神分裂症和情感障碍(单相抑郁和双相障碍合并)的患病风险显著高于对照先证者的亲属。非抑郁性抑郁症的患病风险没有显著升高。在精神分裂症先证者的亲属中,情感障碍的患病风险在“核心”精神分裂症患者的亲属中最高,这些患者起病年龄较小、患有慢性疾病、有严重的情感迟钝且几乎没有情感特征。
尽管存在局限性,但这些初步分析与其他研究一致,表明精神分裂症与严重形式的情感障碍之间存在某种家族关系。