Association of FKBP5 polymorphisms and childhood abuse with risk of posttraumatic stress disorder symptoms in adults
Association of FKBP5 polymorphisms and childhood abuse with risk of posttraumatic stress disorder symptoms in adults
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DOI：
10.1001/jama.299.11.1291
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发表时间：
2008-03-19
影响因子：
120.7
通讯作者：
Ressler, Kerry J.
中科院分区：
文献类型：
--
作者：
Binder, Elisabeth B.;Bradley, Rebekah G.;Ressler, Kerry J.
背景
除了创伤暴露外，其他因素也会增加成年后患创伤后应激障碍（PTSD）的风险。遗传和环境因素都有影响，其中儿童虐待具有显著的风险责任。
目的
通过儿童虐待的基因×环境相互作用、非儿童虐待创伤暴露水平以及应激相关基因FKBP5的基因多态性，增进对遗传和环境风险因素及其在PTSD发展中相互作用的理解。
设计、地点和参与者
一项横断面研究，使用口头问卷调查结合单核苷酸多态性（SNP）基因分型，对900名非精神科门诊患者（所有基因型研究包括762名）进行遗传和心理风险因素检查，这些患者有显著程度的儿童期虐待以及非儿童虐待创伤。参与者主要是2005年至2007年在佐治亚州亚特兰大市一家城市公立医院的普通医疗和妇产科诊所寻求治疗的城市低收入黑人（>95%）男性和女性。
主要观察指标
使用改良的PTSD症状量表测量成人PTSD症状的严重程度，使用创伤事件量表测量非儿童虐待（主要是成人）创伤暴露和儿童虐待，以及跨越FKBP5基因座的8个SNP。
结果
儿童虐待程度和非儿童虐待创伤各自独立地预测成人PTSD症状的程度（均值[标准差]，无儿童虐待的PTSD症状量表得分为8.03[10.48]，而≥2种虐待的得分为20.93[14.32]；无
Context In addition to trauma exposure, other factors contribute to risk for development of posttraumatic stress disorder ( PTSD) in adulthood. Both genetic and environmental factors are contributory, with child abuse providing significant risk liability.Objective To increase understanding of genetic and environmental risk factors as well as their interaction in the development of PTSD by gene x environment interactions of child abuse, level of non - child abuse trauma exposure, and genetic polymorphisms at the stress- related gene FKBP5.Design, Setting, and Participants A cross- sectional study examining genetic and psychological risk factors in 900 nonpsychiatric clinic patients ( 762 included for all genotype studies) with significant levels of childhood abuse as well as non - child abuse trauma using a verbally presented survey combined with single- nucleotide polymorphism ( SNP) genotyping. Participants were primarily urban, low- income, black ( > 95%) men and women seeking care in the general medical care and obstetrics- gynecology clinics of an urban public hospital in Atlanta, Georgia, between 2005 and 2007.Main Outcome Measures Severity of adult PTSD symptomatology, measured with the modified PTSD Symptom Scale, non - child abuse (primarily adult) trauma exposure and child abuse measured using the traumatic events inventory and 8 SNPs spanning the FKBP5 locus.Results Level of child abuse and non - child abuse trauma each separately predicted level of adult PTSD symptomatology ( mean [ SD], PTSD Symptom Scale for no child abuse, 8.03 [ 10.48] vs >= 2 types of abuse, 20.93 [ 14.32]; and for no non - child abuse trauma, 3.58 [ 6.27] vs >= 4 types, 16.74 [ 12.90]; P