Clark D B, Moss H B, Kirisci L, Mezzich A C, Miles R, Ott P
University of Pittsburgh, PA, USA.
J Am Acad Child Adolesc Psychiatry. 1997 Apr;36(4):495-502. doi: 10.1097/00004583-199704000-00012.
While preadolescent children of parents with substance use disorders (SUDs) are known to have more behavior problems, depression, and anxiety than expected, psychiatric disorders in these children and their relationships with parental disorders have not been systematically investigated. This study compares the psychiatric disorders of preadolescent boys of fathers with and without SUDs and examines the relationships between offspring and parental psychopathology.
Fathers (i.e., probands) of boys 10 through 12 years old were recruited to represent families of boys with paternal SUD (high risk or HR: n = 113) and boys without paternal SUD (low average risk or LAR: n = 170). These boys (i.e., index cases) and their biological parents participated in structured diagnostic interviews, and diagnoses were determined by the best-estimate method.
Disruptive behavior disorders and anxiety disorders were more prevalent in HR than in LAR index cases. Logistic regression analyses examining the relationships between parental and index case psychopathology indicated that parental childhood psychiatric disorders were more strongly predictive of index case psychiatric disorders than parental adulthood psychiatric disorders, including SUDs.
Inasmuch as HR boys had increased rates of disruptive behavior disorders and anxiety disorders, these disorders may be important targets for early intervention to prevent the development of SUD, as well as the morbidity associated with these disorders. Prevention efforts and studies of the transmission of liability for psychiatric disorders in children should carefully consider parental childhood characteristics.
虽然已知患有物质使用障碍（SUDs）的父母的青春期前儿童比预期有更多的行为问题、抑郁和焦虑，但这些儿童的精神障碍及其与父母障碍的关系尚未得到系统研究。本研究比较了有和没有SUDs的父亲的青春期前男孩的精神障碍，并探讨了后代与父母精神病理学之间的关系。
招募10至12岁男孩的父亲（即先证者），以代表有父亲SUD的男孩家庭（高风险或HR：n = 113）和没有父亲SUD的男孩家庭（低平均风险或LAR：n = 170）。这些男孩（即索引病例）及其亲生父母参加了结构化诊断访谈，并通过最佳估计方法确定诊断。
破坏性行为障碍和焦虑障碍在HR索引病例中比在LAR索引病例中更普遍。检验父母与索引病例精神病理学之间关系的逻辑回归分析表明，父母童年期精神障碍比父母成年期精神障碍（包括SUDs）更能强烈预测索引病例精神障碍。
鉴于HR男孩的破坏性行为障碍和焦虑障碍发生率增加，这些障碍可能是早期干预以预防SUD发展以及与这些障碍相关的发病率的重要目标。预防工作以及对儿童精神障碍易感性传播的研究应仔细考虑父母的童年特征。
