The rearing environment and the risk for alcohol use disorder: a Swedish national high-risk home-reared v. adopted co-sibling control study.
The rearing environment and the risk for alcohol use disorder: a Swedish national high-risk home-reared v. adopted co-sibling control study.
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DOI：
10.1017/s0033291720000963
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发表时间：
2021-10
影响因子：
6.9
通讯作者：
Sundquist K
中科院分区：
文献类型：
--
作者：
Kendler KS;Ohlsson H;Sundquist J;Sundquist K
虽然酒精使用障碍（AUD）在家庭中很常见，但研究养育环境的影响，不受遗传效应的影响，是罕见的，迄今为止，矛盾的。在这里，我们试图进行这样的研究，采用一个过继共同胞对照设计。我们将高风险定义为有101名亲生父母患有外化综合症（澳元、吸毒或犯罪），并确定了1316个高风险全同胞和4623个高风险半同胞，其中至少有一名成员是家庭抚养的，另一名成员是家庭抚养的。被收养。在瑞典，收养家庭经过仔细筛选，为被收养者提供高质量的养育环境。从国家医疗、刑事和药房登记处评估AUD。控制性别、父母出生时的年龄，以及对于同父异母的兄弟姐妹，控制非共同父母的情感状态，匹配的收养与家庭抚养的全同胞和半同胞的AUD风险比（± 95%CI）分别为0.76（0.65-0.89）和0.77（0.70-0.84）。收养对AUD风险的保护作用在具有非常高的家庭责任（两个高风险父母）的全兄弟姐妹和半兄弟姐妹对中更强，当收养家庭因死亡或离婚或包含高风险养父母而破裂时，保护作用显着减弱。在全同胞和半同胞对中，我们发现证据表明养育环境对AUD风险有很大影响。高质量的养育环境可以显著降低AUD的风险，特别是在那些高家族风险的人群中。
Although alcohol use disorder (AUD) runs strongly within families, studies examining the impact of rearing environment, unconfounded by genetic effects, are rare and, to date, contradictory. We here seek to conduct such a study using an adoptive co-sib control design. Defining high-risk as having ⩾1 biological parent with an externalizing syndrome (AUD, drug abuse or crime), we identified 1316 high-risk full-sibships and 4623 high-risk half-sibships containing at least one member who was home-reared and one who was adopted-away. Adoptive families are carefully screened in Sweden to provide high-quality rearing environment for adoptees. AUD was assessed from national medical, criminal and pharmacy registries. Controlling for sex, parental age at birth, and, for half-siblings, affection status of the non-shared parent, hazard ratios (±95% CI) for AUD in the matched adopted v. home-reared full- and half-siblings were, respectively, 0.76 (0.65–0.89) and 0.77 (0.70–0.84). The protective effect of adoption on AUD risk was stronger in the full- and half-sibling pairs with very high familial liability (two high-risk parents) and significantly weaker when the adoptive family was broken by death or divorce or contained a high-risk adoptive parent. In both full- and half-sibling pairs, we found evidence that the rearing environment substantially impacts on the risk for AUD. High-quality rearing environments can meaningfully reduce the risk for AUD, especially in those at high familial risk.