High concordance of bipolar I disorder in a nationwide sample of twins
High concordance of bipolar I disorder in a nationwide sample of twins
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DOI：
10.1176/appi.ajp.161.10.1814
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发表时间：
2004-10-01
影响因子：
17.7
通讯作者：
Lönnqvist, J
中科院分区：
文献类型：
--
作者：
Kieseppä, T;Partonen, T;Lönnqvist, J
目的：关于双胞胎双相I型障碍的少数研究一直强调遗传因素对疾病易感性的影响。作者报道了第一个关于双相I型障碍的双胞胎研究，涉及基于人群的双胞胎样本，通过结构化的个人访谈进行诊断。方法：所有出生于1940-1957年的芬兰同性双胞胎(N=19,124)在1969-1991年间被筛查为双相I型障碍的诊断，或在1975、1981和1990年的芬兰双胞胎队列调查中自我报告。因此确定了38对，并邀请他们参与研究；参与率为68%。终生诊断通过使用DSM-IV的结构化临床访谈进行。结果：同卵双生子的概率符合率为0.43(95%CI=0.10~0.82)，异卵双生子的概率符合率为0.06(95%CI=0.00~0.27)。责任相关系数分别为0.85和0.41。无家族遗传的模型被拒绝。最适合的模型是遗传和特定环境因素解释易感性差异的模型，遗传度估计为0.93(95%CI=0.69到1.00)。结论：通过结构化个人访谈评估的全国人群双生子样本证实了双相情感障碍的高遗传度。
Objective: The few studies of bipolar I disorder in twins have consistently emphasized the genetic contribution to disease liability. The authors report what appears to be the first twin study of bipolar I disorder involving a population-based twin sample, in which the diagnoses were made by using structured, personal interviews.Method: All Finnish same-sex twins (N= 19,124) born from 1940 to 1957 were screened for a diagnosis of bipolar I disorder as recorded in the National Hospital Discharge Register between 1969 and 1991 or self-reported in surveys of the Finnish Twin Cohort in 1975, 1981, and 1990. Thirty-eight pairs were thereby identified and invited to participate in the study; the participation rate was 68%. Lifetime diagnoses were made by using the Structured Clinical Interview for DSM-IV. The authors calculated probandwise and pairwise concordances and correlations in liability and applied biometrical model fitting.Results: The probandwise concordance rates were 0.43 (95% CI=0.10 to 0.82) for monozygotic twins and 0.06 (95% CI=0.00 to 0.27) for dizygotic twins. The correlations in liability were 0.85 and 0.41, respectively. The model with no familial transmission was rejected. The best-fitting model was the one in which genetic and specific environmental factors explained the variance in liability, with a heritability estimate of 0.93 (95% CI=0.69 to 1.00).Conclusions: The high heritability of bipolar disorder was demonstrated in a nationwide population-based twin sample assessed with structured personal interviews.