Predictive Value of Family History on Severity of Illness The Case for Depression, Anxiety, Alcohol Dependence, and Drug Dependence
Predictive Value of Family History on Severity of Illness The Case for Depression, Anxiety, Alcohol Dependence, and Drug Dependence
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DOI：
10.1001/archgenpsychiatry.2009.55
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发表时间：
2009-07-01
影响因子：
--
通讯作者：
Moffitt, Terrie E.
中科院分区：
文献类型：
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作者：
Milne, Barry J.;Caspi, Avshalom;Moffitt, Terrie E.
内容：如果家族史与被认为是疾病严重性指标的临床特征相关，这可以为临床医生预测患者预后和研究人员选择遗传研究病例提供信息。虽然抑郁症的家族史和临床特征之间的关联的测试很多，这样的测试是相对缺乏其他疾病。目的：检验家族史与疾病的4项临床指标相关的假设（复发、损害、服务使用和发病年龄）与4种精神疾病的关系（重性抑郁发作、焦虑症、酒精依赖和药物依赖）。设计：前瞻性纵向队列研究。地点：新西兰。参与者：共981名成员的1972年至1973年达尼丁研究出生cohort（96%的保留）。主要结果测量：对于每种疾病，家族史分数计算为受影响的家庭成员的比例，从数据的3代参与者的家庭。前瞻性地收集的数据在研究的重复评估（年龄11 - 32岁）被用来评估复发，损害，和发病年龄;收集的数据通过生活史日历在32岁时被用来评估service use.Results：家族史与所有4种疾病类型的存在。此外，家族史与所有4种疾病的复发率更高（但与抑郁症女性无显著性差异）、损伤更严重和更多的服务使用相关。家族史与发病时年龄较轻的任何disorder.Conclusions：家族史的疾病和先证者的临床特征之间的关联表明，一致的方向的影响，抑郁症，焦虑症，酒精依赖和药物依赖。对于这些疾病类型，家族史对于确定患者的临床预后和选择用于遗传研究的病例是有用的。
Context: If family history is associated with clinical features that are thought to index seriousness of disorder, this could inform clinicians predicting patients' prognosis and researchers selecting cases for genetic studies. Although tests of associations between family history and clinical features are numerous for depression, such tests are relatively lacking for other disorders.Objective: To test the hypothesis that family history is associated with 4 clinical indexes of disorder (recurrence, impairment, service use, and age at onset) in relation to 4 psychiatric disorders (major depressive episode, anxiety disorder, alcohol dependence, and drug dependence).Design: Prospective longitudinal cohort study.Setting: New Zealand.Participants: A total of 981 members of the 1972 to 1973 Dunedin Study birth cohort (96% retention).Main Outcome Measures: For each disorder, family history scores were calculated as the proportion of affected family members from data on 3 generations of the participants' families. Data collected prospectively at the study's repeated assessments (ages 11-32 years) were used to assess recurrence, impairment, and age at onset; data collected by means of a life history calendar at age 32 years were used to assess service use.Results: Family history was associated with the presence of all 4 disorder types. In addition, family history was associated with a more recurrent course for all 4 disorders (but not significantly for women with depression), worse impairment, and greater service use. Family history was not associated with younger age at onset for any disorder.Conclusions: Associations between family history of a disorder and clinical features of that disorder in probands showed consistent direction of effects across depression, anxiety disorder, alcohol dependence, and drug dependence. For these disorder types, family history is useful for determining patients' clinical prognosis and for selecting cases for genetic studies.