The Roscommon Family Study. I. Methods, diagnosis of probands, and risk of schizophrenia in relatives.
The Roscommon Family Study. I. Methods, diagnosis of probands, and risk of schizophrenia in relatives.
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DOI：
10.1001/archpsyc.1993.01820190029004
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发表时间：
1993-07
影响因子：
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通讯作者：
K. Kendler;M. McGuire;A. Gruenberg;A. O’Hare;Mary Spellman;D. Walsh
中科院分区：
文献类型：
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作者：
K. Kendler;M. McGuire;A. Gruenberg;A. O’Hare;Mary Spellman;D. Walsh
目的在爱尔兰西部的一个乡村，研究精神分裂症与其他非情感性精神病和情感性疾病(AI)的家庭关系程度。设计采用DSM-III-R标准的病例对照流行病学家系研究。研究对象本研究包括三个先证组：(1)罗斯康姆县病例登记处自1930年起出生的所有临床诊断为精神分裂症的病例(n=285)；(2)从登记处随机抽取临床诊断为严重禽流感的病例(n=99)；(3)从选民登记册中确定的匹配的随机居民样本(n=150)。对86%的可追踪的在世亲属(n=1753)和88%的可追踪的在世先证者(n=415)进行了面对面的结构化访谈。结果在受访亲属中，精神分裂症的终生危险度(+/-SE)为：精神分裂症，6.5%+/-1.6%；分裂情感性障碍，6.8%+/-2.5%；分裂型人格障碍，6.9%+/-3.9%；其他非情感性精神病，5.1%+/-2.4%；精神病性AI，2.8%+/-1.2%；非精神病性AI，0.6%+/-0.6%；对照为0.5%+/-0.3%。精神分裂症患者的繁殖率约为对照组的四分之一，先证者的父母患精神分裂症的风险比兄弟姐妹低得多。结论这些结果支持以下假设：(1)在爱尔兰西部，像在其他人群中一样，精神分裂症是一种强烈的家族性障碍；(2)精神分裂症具有家族易感性，并有一系列临床症状，包括分裂性情感障碍、其他非情感性精神病、分裂型人格障碍，可能是精神病性AI，但不是非精神病性AI；(3)与精神分裂症相关的生育率下降对亲属的患病风险模式有很大影响。
OBJECTIVES We sought to examine, in a rural county in the West of Ireland, the degree of familial relationship between schizophrenia and other nonaffective psychoses and affective illness (AI). DESIGN A case-controlled epidemiologic family study using DSM-III-R criteria. PARTICIPANTS This study included three proband groups: (1) all cases with a clinical diagnosis of schizophrenia from the Roscommon County Case Register born from 1930 onward (n = 285); (2) a random sample of cases from the register with a clinical diagnosis of severe AI (n = 99); and (3) a matched, random sample of Roscommon residents ascertained from the electoral register (n = 150). Face-to-face structured interviews were conducted with 86% of traceable, living relatives (n = 1, 753) and 88% of traceable, living probands (n = 415). RESULTS In interviewed relatives, the lifetime risks (+/- SE) for schizophrenia, as a function of the "blind" proband diagnosis, were as follows: schizophrenia, 6.5% +/- 1.6%; schizoaffective disorder, 6.8% +/- 2.5%; schizotypal personality disorder, 6.9% +/- 3.9%; other nonaffective psychoses, 5.1% +/- 2.4%; psychotic AI, 2.8% +/- 1.2%; nonpsychotic AI, 0.6% +/- 0.6%; and control, 0.5% +/- 0.3%. Individuals with schizophrenia reproduced at a rate about one quarter that of controls and the risk for schizophrenia in parents of probands was much less than that found in siblings. CONCLUSIONS These results support the following hypotheses: (1) in the West of Ireland, as in other populations, schizophrenia is a strongly familial disorder; (2) schizophrenia shares a familial predisposition with a spectrum of clinical syndromes that includes schizoaffective disorder, other nonaffective psychoses, schizotypal personality disorder, and probably psychotic AI, but not nonpsychotic AI; and (3) the diminished reproductive rates associated with schizophrenia have a large impact on the pattern of risk of illness in relatives.