The rearing environment and risk for drug abuse: a Swedish national high-risk adopted and not adopted co-sibling control study
The rearing environment and risk for drug abuse: a Swedish national high-risk adopted and not adopted co-sibling control study
复制标题
DOI：
10.1017/s0033291715002858
复制
发表时间：
2016-05-01
影响因子：
6.9
通讯作者：
Sundquist, J.
中科院分区：
文献类型：
--
作者：
Kendler, K. S.;Ohlsson, H.;Sundquist, J.
背景资料。虽然药物滥用(DA)具有很强的家族性，具有重要的遗传影响，但我们需要更多地了解养育环境在DA风险中的作用。为了解决这个问题，我们采用了高风险的采用和未采用的共同同胞对照设计。高危子女有一个或多个亲生父母登记患有DA、酒精使用障碍或犯罪行为。使用瑞典登记处，我们确定了1161个高风险全同胞和3085个高风险半同胞，其中至少有一名成员被收养，另一名成员未被收养。DA的登记是通过国家刑事、医疗和药房登记进行的。在瑞典，对领养家庭进行筛查，为领养人提供高质量的抚养环境。控制出生时的父母年龄和性别(以及，在同父异母的兄弟姐妹中，另一方的高危状态)，被收养的全兄弟姐妹和同父异母的兄弟姐妹患DA的风险显著较低[危险比和95%可信区间分别为0.55(0.45-0.69)和0.55(95%可信区间0.48-0.63)]。收养对DA风险的保护作用在具有很高家庭责任的全亲和同父异母(两个高危父母)中显著增强，而当收养家庭因死亡或离婚而破裂或包含高危父母时显著减弱。在全同胞和同父异母的兄弟姐妹中，我们发现了重复的证据，即养育环境对DA的风险有很大影响。在遗传风险较高的人群中，高质量的养育环境可以大大降低DA的风险。
Background. Although drug abuse (DA) is strongly familial, with important genetic influences, we need to know more about the role of rearing environment in the risk for DA. To address this question, we utilized a high-risk adopted and non-adopted co-sibling control design.Method. High-risk offspring had one or more biological parents registered for DA, alcohol use disorders or criminal behavior. Using Swedish registries, we identified 1161 high-risk full-sibships and 3085 high-risk half-sibships containing at least one member who was adopted-away and one member who was not. Registration for DA was via national criminal, medical and pharmacy registers. In Sweden, adoptive families are screened to provide high-quality rearing environment for adoptees.Results. Controlling for parental age at birth and gender (and, in half-siblings, high-risk status of the other parent), risk for DA was substantially lower in the full-and half-siblings who were adopted v. not adopted [hazard ratios and 95% confidence intervals: 0.55 (0.45-0.69) and 0.55 (95% CI 0.48-0.63), respectively]. The protective effect of adoption on risk for DA was significantly stronger in the full-and half-sibling pairs with very high familial liability (two high-risk parents) and significantly weaker when the adoptive family was broken by death or divorce, or contained a high-risk parent.Conclusions. In both full-and half-sibling pairs, we found replicated evidence that rearing environment strongly impacts on risk for DA. High-quality rearing environments can substantively reduce risk for DA in those at high genetic risk.