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精神分裂症患者及对照先证者亲属患精神障碍的风险:三项独立研究的比较

The risk for psychiatric disorders in relatives of schizophrenic and control probands: a comparison of three independent studies.

作者信息

Kendler K S, Gardner C O

机构信息

Virginia Institute for Psychiatric and Behavioural Genetics, Medical College of Virginia/Virginia Commonwealth University, Richmond, USA.

出版信息

Psychol Med. 1997 Mar;27(2):411-9. doi: 10.1017/s003329179600445x.

Abstract

BACKGROUND

Although replication is the heart of science, psychiatric geneticists rarely have the opportunity to replicate findings, especially more than once.

METHODS

This article reviews results from three independent family studies of schizophrenia on which one of us conducted diagnostic reviews: the Danish Adoption Study (DAS), the Iowa 500 non-500 family study (IFS), and the Roscommon Family Study (RFS). We utilized DSM-III or DSM-III-R criteria and meta-analysis techniques.

RESULTS

The odds ratios (OR) in personally interviewed, first degree biological relatives of schizophrenic and matched control probands for schizophrenia, other non-affective psychoses (ONAP), schizotypal personality disorder (SPD), unipolar affective illness (UPAI), bipolar affective illness (BPAI), and anxiety disorders were homogeneous across studies. For alcoholism, ORs were significantly heterogeneous. Schizophrenia, SPD and ONAP strongly aggregated in relatives of schizophrenic probands with decreasing common OR estimates of 16.2, 5.0 and 4.0, respectively. The common OR for anxiety disorders was 1.1, indicating no familial co-aggregation. For UPAI and BPAI, the common ORs exceeded unity (1.3 and 1.9, respectively), although only the former was statistically significant.

CONCLUSIONS

Schizophrenia strongly aggregates in families and shares familial factors with SPD and ONAP but not anxiety disorders. The familial factors of aetiological importance for schizophrenia and affective illness may be weakly related. With the exception of alcoholism, the patterns of psychiatric disorders in relatives of schizophrenic and control probands in these three studies were sufficiently similar that, despite their methodological differences, they can probably be viewed as replications of one another.

摘要

背景

尽管重复性是科学的核心,但精神病遗传学家很少有机会重复研究结果,尤其是多次重复。

方法

本文回顾了三项关于精神分裂症的独立家系研究结果,其中一项研究由我们中的一人进行诊断评估:丹麦收养研究(DAS)、爱荷华500非500家系研究(IFS)和罗斯康芒家系研究(RFS)。我们采用了《精神疾病诊断与统计手册》第三版(DSM-III)或第三版修订本(DSM-III-R)标准以及荟萃分析技术。

结果

在这三项研究中,对精神分裂症患者及其匹配的对照先证者的一级生物学亲属进行面对面访谈后得出的精神分裂症、其他非情感性精神病(ONAP)、分裂型人格障碍(SPD)、单相情感障碍(UPAI)、双相情感障碍(BPAI)和焦虑症的优势比(OR)是一致的。对于酒精中毒,OR值存在显著异质性。精神分裂症、SPD和ONAP在精神分裂症先证者的亲属中高度聚集,共同OR估计值分别降至16.2、5.0和4.0。焦虑症的共同OR为1.1,表明不存在家族共聚集现象。对于UPAI和BPAI,共同OR超过了1(分别为1.3和1.9),尽管只有前者具有统计学意义。

结论

精神分裂症在家族中高度聚集,与SPD和ONAP共享家族因素,但与焦虑症无关。对精神分裂症和情感障碍具有病因学重要性的家族因素可能关系较弱。除酒精中毒外,这三项研究中精神分裂症先证者和对照先证者亲属的精神障碍模式足够相似,尽管它们在方法上存在差异,但可能可以被视为彼此的重复研究。

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