Risk of Psychiatric and Neurodevelopmental Disorders Among Siblings of Probands With Autism Spectrum Disorders
Risk of Psychiatric and Neurodevelopmental Disorders Among Siblings of Probands With Autism Spectrum Disorders
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DOI：
10.1001/jamapsychiatry.2016.0495
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发表时间：
2016-06-01
期刊：
影响因子：
25.8
通讯作者：
Sourander, Andre
中科院分区：
文献类型：
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作者：
Jokiranta-Olkoniemi, Elina;Cheslack-Postava, Keely;Sourander, Andre
以前的研究集中在检查精神分裂症，双相情感障碍和自闭症谱系障碍（ASD）的家族聚集性。很少有人知道其他精神和神经发育障碍的人与ASD的同胞兄弟姐妹之间的集群。目的是检查与ASD的先证者的同胞兄弟姐妹之间的精神和神经发育障碍的风险。设计，设置，和参与者芬兰自闭症和自闭症谱系障碍的产前研究使用了一个基于人群的队列，包括从1987年1月1日出生的儿童，12月31日，2005年，他在2007年12月31日之前被诊断为ASD。每个病例与4名对照参与者按性别、出生日期和地点单独匹配。病例和对照的兄弟姐妹出生于1977年1月1日至2005年12月31日，并于1987年1月1日至2009年12月31日接受诊断。这项巢式病例对照研究包括3578例ASD患者和6022名全同胞，11775名对照组和22127名来自芬兰国家登记册的同胞。分析2014年3月6日至2016年2月12日的数据。主要结局和指标ASD先证者的兄弟姐妹与匹配对照的兄弟姐妹之间精神和神经发育障碍的校正风险比（RR）。对ASD亚组单独进行了额外的分析，包括儿童自闭症，Bogger综合征和未另行说明的广泛性发育障碍。对3578例ASD先证者按性别和智力残疾进行分层分析（2841名男孩[79.4%]）和11775名对照（9 345名男孩[79.4%]），1319例（36.9%）和2052例对照（17.4%）至少有1个兄弟姐妹被诊断患有任何精神或神经发育障碍（校正RR，2.5; 95% CI，2.3-2.6）。最大的关联是儿童期发病的疾病（1061例病例[29.7%] vs 1362例对照[11.6%];校正RR，3.0; 95% CI，2.8-3.3），包括ASD（374例病例[10.5%] vs 125例对照[1.1%];校正RR，11.8; 95% CI，9.4-14.7），抽动障碍（28例病例[0.8%] vs 24例对照[0.2%];校正RR，4.3; 95% CI，2.3-8.2），注意缺陷/多动障碍（189例病例[5.3%] vs 180例对照[1.5%];校正RR，3.7; 95%CI，2.9-4.7），学习和协调障碍（563例病例[15.7%] vs 697例对照[5.9%];校正RR，3.2; 95%CI，2.8-3.6），智力残疾（104例病例[2.9%] vs 137例对照[1.2%];校正RR，3.1; 95% CI，2.3-4.2），行为和对立障碍（180例[5.0%] vs 221例对照[1.9%];校正RR，2.8; 95%CI，2.2-3.5），以及儿童期发作的情绪障碍（126例[3.5%] vs 157例对照[1.3%];校正RR，2.6; 95%CI，1.9-3.4）。孤独症谱系障碍也与精神分裂症谱系障碍，情感障碍，焦虑症，和其他神经症和人格障碍之间的siblings.CONCLUSIONS和相关性精神和神经发育障碍簇先证者与ASD的兄弟姐妹。对于病因学研究，这些发现提供了进一步的证据，表明几种精神和神经发育障碍有共同的危险因素。
IMPORTANCE Previous research has focused on examining the familial clustering of schizophrenia, bipolar disorder, and autism spectrum disorders (ASD). Little is known about the clustering of other psychiatric and neurodevelopmental disorders among siblings of persons with ASD.OBJECTIVE To examine the risk for psychiatric and neurodevelopmental disorders among full siblings of probands with ASD.DESIGN, SETTING, AND PARTICIPANTS The Finnish Prenatal Study of Autism and Autism Spectrum Disorders used a population-based cohort that included children born from January 1, 1987, to December 31, 2005, who received a diagnosis of ASD by December 31, 2007. Each case was individually matched to 4 control participants by sex and date and place of birth. The siblings of the cases and controls were born from January 1, 1977, to December 31, 2005, and received a diagnosis from January 1, 1987, to December 31, 2009. This nested case-control study included 3578 cases with ASD with 6022 full siblings and 11 775 controls with 22 127 siblings from Finnish national registers. Data were analyzed from March 6, 2014, to February 12, 2016.MAIN OUTCOMES AND MEASURES The adjusted risk ratio (RR) for psychiatric and neurodevelopmental disorders among siblings of probands with ASD vs siblings of matched controls. Additional analyses were conducted separately for ASD subgroups, including childhood autism, Asperger syndrome, and pervasive developmental disorders not otherwise specified. Analyses were further stratified by sex and intellectual disability among the probands.RESULTS Among the 3578 cases with ASD (2841 boys [79.4%]) and 11 775 controls (9345 boys [79.4%]), 1319 cases (36.9%) and 2052 controls (17.4%) had at least 1 sibling diagnosed with any psychiatric or neurodevelopmental disorder (adjusted RR, 2.5; 95% CI, 2.3-2.6). The largest associations were observed for childhood-onset disorders (1061 cases [29.7%] vs 1362 controls [11.6%]; adjusted RR, 3.0; 95% CI, 2.8-3.3), including ASD (374 cases [10.5%] vs 125 controls [1.1%]; adjusted RR, 11.8; 95% CI, 9.4-14.7), tic disorders (28 cases [0.8%] vs 24 controls [0.2%]; adjusted RR, 4.3; 95% CI, 2.3-8.2), attention-deficit/hyperactivity disorder (189 cases [5.3%] vs 180 controls [1.5%]; adjusted RR, 3.7; 95% CI, 2.9-4.7), learning and coordination disorders (563 cases [15.7%] vs 697 controls [5.9%]; adjusted RR, 3.2; 95% CI, 2.8-3.6), intellectual disability (104 cases [2.9%] vs 137 controls [1.2%]; adjusted RR, 3.1; 95% CI, 2.3-4.2), conduct and oppositional disorders (180 cases [5.0%] vs 221 controls [1.9%]; adjusted RR, 2.8; 95% CI, 2.2-3.5), and emotional disorders with onset specific to childhood (126 cases [3.5%] vs 157 controls [1.3%]; adjusted RR, 2.6; 95% CI, 1.9-3.4). Autism spectrum disorders were also associated with schizophrenia spectrum disorders, affective disorders, anxiety disorders, and other neurotic and personality disorders among siblings.CONCLUSIONS AND RELEVANCE Psychiatric and neurodevelopmental disorders cluster among siblings of probands with ASD. For etiologic research, these findings provide further evidence that several psychiatric and neurodevelopmental disorders have common risk factors.