罗斯康芒家族研究。I. 方法、先证者的诊断以及亲属患精神分裂症的风险。

The Roscommon Family Study. I. Methods, diagnosis of probands, and risk of schizophrenia in relatives.

作者信息

Kendler K S, McGuire M, Gruenberg A M, O'Hare A, Spellman M, Walsh D

机构信息

Department of Psychiatry, Medical College of Virginia, Virginia Commonwealth University, Richmond.

出版信息

Arch Gen Psychiatry. 1993 Jul;50(7):527-40. doi: 10.1001/archpsyc.1993.01820190029004.

DOI:10.1001/archpsyc.1993.01820190029004

PMID:8317947

Abstract

OBJECTIVES

We sought to examine, in a rural county in the West of Ireland, the degree of familial relationship between schizophrenia and other nonaffective psychoses and affective illness (AI).

DESIGN

A case-controlled epidemiologic family study using DSM-III-R criteria.

PARTICIPANTS

This study included three proband groups: (1) all cases with a clinical diagnosis of schizophrenia from the Roscommon County Case Register born from 1930 onward (n = 285); (2) a random sample of cases from the register with a clinical diagnosis of severe AI (n = 99); and (3) a matched, random sample of Roscommon residents ascertained from the electoral register (n = 150). Face-to-face structured interviews were conducted with 86% of traceable, living relatives (n = 1, 753) and 88% of traceable, living probands (n = 415).

RESULTS

In interviewed relatives, the lifetime risks (+/- SE) for schizophrenia, as a function of the "blind" proband diagnosis, were as follows: schizophrenia, 6.5% +/- 1.6%; schizoaffective disorder, 6.8% +/- 2.5%; schizotypal personality disorder, 6.9% +/- 3.9%; other nonaffective psychoses, 5.1% +/- 2.4%; psychotic AI, 2.8% +/- 1.2%; nonpsychotic AI, 0.6% +/- 0.6%; and control, 0.5% +/- 0.3%. Individuals with schizophrenia reproduced at a rate about one quarter that of controls and the risk for schizophrenia in parents of probands was much less than that found in siblings.

CONCLUSIONS

These results support the following hypotheses: (1) in the West of Ireland, as in other populations, schizophrenia is a strongly familial disorder; (2) schizophrenia shares a familial predisposition with a spectrum of clinical syndromes that includes schizoaffective disorder, other nonaffective psychoses, schizotypal personality disorder, and probably psychotic AI, but not nonpsychotic AI; and (3) the diminished reproductive rates associated with schizophrenia have a large impact on the pattern of risk of illness in relatives.

摘要

目的

我们试图在爱尔兰西部的一个乡村县，研究精神分裂症与其他非情感性精神病和情感性疾病（AI）之间的家族关系程度。

设计

一项采用《精神疾病诊断与统计手册》第三版修订版（DSM-III-R）标准的病例对照流行病学家族研究。

参与者

本研究包括三个先证者组：（1）罗斯康芒县病例登记册中自1930年起临床诊断为精神分裂症的所有病例（n = 285）；（2）登记册中临床诊断为重度AI的病例的随机样本（n = 99）；（3）从选民登记册中确定的罗斯康芒居民的匹配随机样本（n = 150）。对86%可追踪的在世亲属（n = 1753）和88%可追踪的在世先证者（n = 415）进行了面对面的结构化访谈。

结果

在接受访谈的亲属中，根据“盲法”先证者诊断，精神分裂症的终生风险（±标准误）如下：精神分裂症，6.5%±1.6%；分裂情感性障碍，6.8%±2.5%；分裂型人格障碍，6.9%±3.9%；其他非情感性精神病，5.1%±2.4%；伴有精神病性症状的情感性疾病，2.8%±1.2%；不伴有精神病性症状的情感性疾病，0.6%±0.6%；以及对照组，0.5%±0.3%。精神分裂症患者的生育率约为对照组的四分之一，先证者父母患精神分裂症的风险远低于其兄弟姐妹。

结论

这些结果支持以下假设：（1）在爱尔兰西部，与其他人群一样，精神分裂症是一种家族性很强的疾病；（2）精神分裂症与一系列临床综合征具有家族易感性，这些综合征包括分裂情感性障碍、其他非情感性精神病、分裂型人格障碍，可能还包括伴有精神病性症状的情感性疾病，但不包括不伴有精神病性症状的情感性疾病；（3）与精神分裂症相关的生育率下降对亲属的患病风险模式有很大影响。