Within-Family Environmental Transmission of Drug Abuse
Within-Family Environmental Transmission of Drug Abuse
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DOI：
10.1001/jamapsychiatry.2013.276
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发表时间：
2013-02-01
期刊：
影响因子：
25.8
通讯作者：
Sundquist, Jan
中科院分区：
文献类型：
--
作者：
Kendler, Kenneth S.;Ohlsson, Henrik;Sundquist, Jan
背景：药物滥用（DA）在家庭中非常普遍。这是遗传因素造成的，还是家庭环境造成的？目的：确定家庭环境对DA风险的影响。设计：在9个公共数据库中进行随访（1961-2009）在兄弟姐妹和配偶中。设置：瑞典。参与者：总共137 199对兄弟姐妹和7561对配偶，其中包含DA先证者和匹配的对照先证者。主要结果测量：药物滥用记录在医疗、法律的或药房登记记录中。结果：在最佳拟合模型中，其中包含显着的线性，二次和三次效应，在包含DA先证者的完整兄弟姐妹对中，兄弟姐妹中DA的相对风险从2年内出生的兄弟姐妹超过6.0下降到10年出生时小于4.5。在控制了全同胞对的年龄差异后，当受影响的先证者年龄较大时，其同胞患DA的风险率为1.42（95%CI，1.31-1.54）。在最佳拟合模型中，包含显著的线性、二次和三次效应，在包含DA先证者的配偶对中，配偶DA的相对风险从先证者DA登记1年内的25.0以上下降到5年后的6.0。通过仅检查全同胞来控制遗传效应，在年龄上较近的对中，DA风险的同胞相似性显著高于较远的对。年长的兄弟姐妹更强烈地将DA的风险传递给他们的弟弟妹妹，反之亦然。在一方配偶登记为DA后，另一方配偶的DA风险会短暂增加。这些结果支持强大的家庭环境影响DA在不同的生命阶段。要全面了解DA的家族传播，需要了解遗传和家族环境风险因素如何在发育过程中起作用和相互作用。JAMA精神病学杂志2013;70（2）：235-242. 2012年12月10日在线发布。doi：10.1001/jamapsychiatry.2013.276
Context: Drug abuse (DA) strongly runs in families. Does this result solely from genetic factors or does the family environment contribute?Objective: To determine the familial environmental contribution to the risk for DA.Design: Follow-up in 9 public databases (1961-2009) in siblings and spouses.Setting: Sweden.Participants: A total of 137 199 sibling pairs and 7561 spousal pairs containing a proband with DA and matched control probands.Main Outcome Measures: Drug abuse recorded in medical, legal, or pharmacy registry records.Results: In the best-fit model, which contained significant linear, quadratic, and cubic effects, among full sibling pairs containing a proband with DA, the relative risk for DA in the sibling declined from more than 6.0 for siblings born within 2 years of each other to less than 4.5 when born 10 years apart. Controlling for age differences in full sibling pairs, the hazard rate for DA in a sibling when the affected proband was older vs younger was 1.42 (95% CI, 1.31-1.54). In the best-fit model, which contained significant linear, quadratic, and cubic effects, among spousal pairs containing a proband with DA, the relative risk for DA in the spouse declined from more than 25.0 within 1 year of proband DA registration to 6.0 after 5 years.Conclusions: Controlling for genetic effects by examining only full siblings, sibling resemblance for the risk for DA was significantly greater in pairs closer vs more distant in age. Older siblings more strongly transmitted the risk for DA to their younger siblings than vice versa. After one spouse is registered for DA, the other spouse has a large short-lived increase in DA risk. These results support strong familial environmental influences on DA at various life stages. A complete understanding of the familial transmission of DA will require knowledge of how genetic and familial environmental risk factors act and interact over development. JAMA Psychiatry. 2013;70(2):235-242. Published online December 10, 2012. doi:10.1001/jamapsychiatry.2013.276