Clinical, Demographic, and Familial Correlates of Bipolar Spectrum Disorders Among Offspring of Parents With Bipolar Disorder
Clinical, Demographic, and Familial Correlates of Bipolar Spectrum Disorders Among Offspring of Parents With Bipolar Disorder
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DOI：
10.1016/j.jaac.2010.01.009
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发表时间：
2010-04-01
影响因子：
13.3
通讯作者：
Birmaher, Boris
中科院分区：
文献类型：
--
作者：
Goldstein, Benjamin I.;Shamseddeen, Wael;Birmaher, Boris
目的：尽管双相情感障碍（BP）的父母的风险增加，但大多数后代并不表现出BP。识别后代中BP的危险因素可以改善预防和治疗策略。我们在匹兹堡双极后代研究（BIOS）中研究了这个主题。方法：受试者包括233名BP-I或BP-II父母的388名7-17岁子女（通过DSM-IV的结构化临床访谈）。使用学龄儿童情感障碍和精神分裂症量表，现在和终身版本（KSADS-PL）确定后代诊断。分析集中在41名被诊断为BP-I（N = 9）、BP-II（N = 5）或BP-NOS（N = 27）的后代。结果如下：与无BP后代的先证者父母相比，BP后代的先证者父母在出生时显着年轻，更有可能是女性，社会经济地位较低。父母的临床变量和产科变量与后代的BP无显著相关性。与无BP的后代相比，有身体和/或性虐待史、抗抑郁药暴露和兴奋剂暴露的后代明显更多。与无BP的后代相比，有BP的后代中注意力缺陷/多动障碍（ADHD）、焦虑症、对立违抗性障碍/行为障碍（ODD/CD）以及暴露于兴奋剂和抗抑郁药的患病率显著更高。回归分析中与子代血压显著相关的变量有：子代年龄较大、父母出生时年龄较小、子代焦虑障碍和ODD/CD、与血压相关的生物学因素。结论：焦虑和/或破坏性行为障碍的病史，以及父母高血压的存在，与后代双相谱系障碍的风险升高有关。如果前瞻性地重复，这些发现可能对BP后代精神病理学的诊断和治疗有意义。J. Am. Acad.儿童青少年。精神病学，2010;49（4）：388-396.
Objective: Despite increased risk, most offspring of parents with bipolar disorder (BP) do not manifest BP. The identification of risk factors for BP among offspring could improve preventive and treatment strategies. We examined this topic in the Pittsburgh Bipolar Offspring Study (BIOS). Method: Subjects included 388 offspring, ages 7-17 years, of 233 parents with BP-I or BP-II (via the Structured Clinical Interview for DSM-IV). Offspring diagnoses were determined using the Schedule for Affective Disorders and Schizophrenia for School-Aged Children, Present and Lifetime version (KSADS-PL). Analyses focused on the 41 offspring who were diagnosed with BP-I (N = 9), BP-II (N = 5), or BP-NOS (N = 27). Results: Offspring with BP had proband parents who were significantly younger at the time of their birth, were more likely to be female, and had lower socio-economic status, versus proband parents of offspring without BP. Parental clinical variables and obstetric variables were not significantly associated with BP among offspring. History of physical and/or sexual abuse, exposure to antidepressants, and exposure to stimulants was significantly greater among offspring with versus without BP. There was significantly greater prevalence of attention-deficit/hyperactivity disorder (ADHD), anxiety disorders, oppositional defiant disorder/conduct disorder (ODD/CD), and exposure to stimulants and antidepressants among offspring with versus without BP. Variables significantly associated with BP among offspring in regression analyses were as follows: older offspring age, younger parent age at birth, offspring anxiety disorders and ODD/CD, and biological coparent with BP. Conclusion: History of anxiety and/or disruptive behavior disorders, as well as presence of hi-lineal parental BP, is associated with elevated risk of bipolar spectrum disorders among offspring. If replicated prospectively, these findings could have implications for the diagnosis and treatment of psychopathology among BP offspring. J. Am. Acad. Child Adolesc. Psychiatry, 2010;49(4):388-396.