Maier W, Minges J, Lichtermann D
Department of Psychiatry, University of Mainz, F.R.G.
J Psychiatr Res. 1995 Sep-Oct;29(5):375-88. doi: 10.1016/0022-3956(95)00024-y.
This controlled family study explores (1) whether panic disorder and unipolar depression share familial factors, and (2) whether the co-occurrence of lifetime diagnoses of panic disorder and unipolar depression in individuals defines a distinct diagnostic subtype in terms of familial aggregation. To be most informative, the familial lifetime prevalence rates for panic disorder and unipolar depression have to be determined in a set of four proband groups: 78 patients with unipolar depression and panic disorder. 121 patients with unipolar depression alone (no panic disorder), 81 patients with panic disorder alone (no unipolar depression), and 109 control probands sampled in the general population were compared by lifetime prevalence rates for panic disorder and unipolar depression in their first-degree relatives. Altogether 1046 relatives were interviewed directly; family history information was available on another 346 subjects. Both disorders were aggregating in families. We found modest overlap of familial components; the relative risk of panic disorder only in relatives of patients with unipolar depression only was 2.3, and the relative risk of unipolar depression only in relatives of patients with panic disorder only was 1.8. The comorbid condition did not represent a distinct subtype in terms of familial aggregation. Excess comorbidity was observed in affected relatives independent of the diagnostic status of the index case. Thus, a sharing of familial factors of aetiological relevance between panic disorder and unipolar depression might explain a limited proportion of comorbid cases. However, the major proportion of comorbidity between panic disorder and unipolar depression may still be due to non-familial factors.
（1）惊恐障碍和单相抑郁症是否共享家族因素；（2）个体一生中惊恐障碍和单相抑郁症诊断的共现情况，就家族聚集性而言，是否定义了一种独特的诊断亚型。为了获得最丰富的信息，必须在四组先证者中确定惊恐障碍和单相抑郁症的家族终生患病率：78例患有单相抑郁症和惊恐障碍的患者；121例仅患有单相抑郁症（无惊恐障碍）的患者；81例仅患有惊恐障碍（无单相抑郁症）的患者；以及109名从普通人群中抽取的对照先证者，通过比较他们一级亲属中惊恐障碍和单相抑郁症的终生患病率进行研究。总共直接访谈了1046名亲属；另外346名受试者也提供了家族史信息。两种障碍在家族中都具有聚集性。我们发现家族成分有适度重叠；仅在仅患有单相抑郁症患者的亲属中，惊恐障碍的相对风险为2.3，而仅在仅患有惊恐障碍患者的亲属中，单相抑郁症的相对风险为1.8。就家族聚集性而言，共病情况并不代表一种独特的亚型。在受影响的亲属中观察到过多的共病情况，且与索引病例的诊断状态无关。因此，惊恐障碍和单相抑郁症之间病因相关的家族因素共享可能解释了有限比例的共病病例。然而，惊恐障碍和单相抑郁症之间共病的主要比例可能仍归因于非家族因素。
