Is response to prophylactic lithium a familial trait?
Is response to prophylactic lithium a familial trait?
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DOI：
10.4088/jcp.v63n1013
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发表时间：
2002-10-01
影响因子：
5.3
通讯作者：
Alda, M
中科院分区：
文献类型：
--
作者：
Grof, P;Duffy, A;Alda, M
背景：在情绪障碍的治疗中，根据亲属的治疗反应选择药物已被广泛接受。然而，这一建议尚未在文献中得到充分证实。我们测试的假设，长期锂治疗的反应是一个familial trait.Method：我们比较了双极锂反应者和双极对照的双极亲属长期锂治疗的反应。在106例锂盐反应性双相情感障碍患者的家庭中，确定了24名双相情感障碍亲属（使用情感障碍和精神分裂症量表-终身版[SADS-L]和研究诊断标准[RDC]确定）。在双相情感障碍诊所连续40例锂治疗患者（符合RDC和DSM-IV双相情感障碍标准）作为对照组。结果：亲属中明确反应的患病率为67%，而对照组的反应率为35%（chi（2）= 6.04，df = 1，p = 0.014）。结论：亲属和对照组之间反应的这种高度显着差异支持了这样一种观点，即对锂预防性治疗的反应在家庭中聚集。
Background: Selecting a drug according to the treatment response in a relative has been widely accepted advice in the management of mood disorders. However, this recommendation has not been adequately substantiated in the literature. We tested the hypothesis that response to long-term lithium treatment is a familial trait.Method: We compared response to long-term lithium treatment in bipolar relatives of bipolar lithium responders and bipolar controls. Twenty-four relatives with bipolar disorder (as determined using the Schedule for Affective Disorders and Schizophrenia-Lifetime version [SADS-L] and Research Diagnostic Criteria [RDC]) were identified in families of 106 patients with lithium-responsive bipolar disorder. A consecutive series of 40 lithium-treated patients in a bipolar clinic (meeting RDC and DSM-IV criteria for bipolar disorder) served as a comparison group. Lithium response was evaluated on a rating scale reflecting the quality and quantity of available data.Results: The prevalence of unequivocal response among the relatives was 67%, as compared with the response rate of 35% in the comparison group (chi(2) = 6.04, df = 1, p = .014).Conclusion: This highly significant difference in response between relatives and the control group supports the view that the response to lithium prophylaxis clusters in families.