Psychopathological precursors of the onset of mood disorders in offspring of parents with and without mood disorders: results of a 13-year prospective cohort high-risk study.
Psychopathological precursors of the onset of mood disorders in offspring of parents with and without mood disorders: results of a 13-year prospective cohort high-risk study.
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有或没有情绪障碍的父母的后代出现情绪障碍的精神病理学前兆：一项为期 13 年的前瞻性队列高风险研究的结果。
DOI：
10.1111/jcpp.13307
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发表时间：
2021
期刊：
影响因子：
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通讯作者：
Preisig,Martin
中科院分区：
文献类型：
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作者：
Rudaz,Dominique;Vandeleur,CarolineL;Gholam,Mehdi;Castelao,Enrique;Strippoli,Marie-PierreF;Marquet,Pierre;Aubry,Jean-Michel;Merikangas,KathleenR;Preisig,Martin
背景：关于可能在心境障碍发展早期出现的特定障碍的演变，前瞻性高风险研究的证据仍然有限。此外，很少有研究探讨了情绪障碍亚型的特异性父母的后代与两个主要亚型的情绪障碍和控制的基础上，从童年到成年的过渡期的前瞻性跟踪。我们的具体目标是：（a）确定与MDD相比，（轻）躁狂青年的精神病理学前兆模式的差异，（B）检查这些模式是否因父母情绪障碍的亚型而不同。（51%女性，研究开始时平均年龄10.1岁），88例BPD患者，71例MDD患者，30例物质使用障碍患者和60例医学对照患者。平均随访时间为13.2年，每三年进行一次评估。（风险比= 4.44; 95%CI：2.19-9.02），CD（HR = 3.31;1.55-7.07）和DUD（HR = 2.54; 1.15-5.59）预测（轻）躁狂发作的发生，而SAD预测后代的MDD（HR = 1.53; 1.09-2.15）、广泛性焦虑（HR = 2.56; 1.05-6.24）和惊恐障碍（HR = 3.13; 1.06-9.23）。在整个队列的早期预测（低）躁狂症也显着相关的发作（低）躁狂症的父母BPD.ConclusionsThe发病的情绪障碍的后代之间的可识别的抑郁发作和非情绪障碍。这些前体在后代中因情绪亚型而异。应密切监测具有这些前体的高风险后代，以防止MDD的进一步发展或转化为BPD。
BackgroundThere is still limited evidence from prospective high‐risk research on the evolution of specific disorders that may emerge early in the development of mood disorders. Moreover, few studies have examined the specificity of mood disorder subtypes among offspring of parents with both major subtypes of mood disorders and controls based on prospective tracking across the transition from childhood to adulthood. Our specific objectives were to (a) identify differences in patterns of psychopathological precursors among youth with (hypo)mania compared to MDD and (b) examine whether these patterns differ by subtypes of parental mood disorders.MethodsOur data stem from a prospective cohort study of 449 directly interviewed offspring (51% female, mean age 10.1 years at study intake) of 88 patients with BPD, 71 with MDD, 30 with substance use disorders and 60 medical controls. The mean duration of follow‐up was 13.2 years with evaluations conducted every three years.ResultsWithin the whole cohort of offspring, MDE (Hazard Ratio = 4.44; 95%CI: 2.19–9.02), CD (HR = 3.31;1.55–7.07) and DUD (HR = 2.54; 1.15–5.59) predicted the onset of (hypo)manic episodes, whereas MDD in offspring was predicted by SAD (HR = 1.53; 1.09–2.15), generalized anxiety (HR = 2.56; 1.05–6.24), and panic disorder (HR = 3.13; 1.06–9.23). The early predictors of (hypo)mania in the whole cohort were also significantly associated with the onset of (hypo)mania among the offspring of parents with BPD.ConclusionsThe onset of mood disorders is frequently preceded by identifiable depressive episodes and nonmood disorders. These precursors differed by mood subtype in offspring. High‐risk offspring with these precursors should be closely monitored to prevent the further development of MDD or conversion to BPD.