Duffy A, Alda M, Kutcher S, Fusee C, Grof P
Affective Disorders Service, Royal Ottawa Hospital, Ont., Canada.
Am J Psychiatry. 1998 Mar;155(3):431-3. doi: 10.1176/ajp.155.3.431.
The purpose of this pilot study was to describe the initial course of psychiatric illness in the adolescent children of parents with bipolar disorder who were divided into two groups on the basis of their response to long-term lithium monotherapy.
Proband parents met Research Diagnostic Criteria for bipolar illness and predetermined criteria for a clear response or nonresponse to lithium prophylaxis. All adolescent offspring were interviewed by a blinded interviewer using the Schedule for Affective Disorders and Schizophrenia for School-Age Children, and final diagnosis was made by blinded consensus.
Psychiatrically ill children of lithium-responsive parents tended to have affective disorders that remitted and followed a recurrent course. Psychiatrically ill children of lithium-nonresponsive parents, however, manifested a broad range of psychopathology, had high rates of comorbid illnesses, and experienced nonremitting affective illnesses.
These results suggest that family history and course of illness are important factors to consider in the diagnosis and pharmacological treatment of affective disorders.
本初步研究的目的是描述双相情感障碍患者青春期子女的精神疾病初始病程，这些子女根据其对长期单一锂盐治疗的反应被分为两组。
先证者父母符合双相情感障碍的研究诊断标准以及对锂盐预防性治疗有明确反应或无反应的预定标准。所有青春期后代均由一名盲法访谈者使用儿童情感障碍和精神分裂症访谈量表进行访谈，最终诊断由盲法达成共识做出。
锂盐反应性父母的患精神疾病子女倾向于患有缓解且呈复发病程的情感障碍。然而，锂盐无反应性父母的患精神疾病子女表现出广泛的精神病理学症状，共病率高，且患有不缓解的情感疾病。
这些结果表明，家族史和病程是情感障碍诊断和药物治疗中需要考虑的重要因素。
