Depression and genetic causal attribution of epilepsy in multiplex epilepsy families.
Depression and genetic causal attribution of epilepsy in multiplex epilepsy families.
复制标题
作者：
Sorge ST;Hesdorffer DC;Phelan JC;Winawer MR;Shostak S;Goldsmith J;Chung WK;Ottman R
基因研究的快速发展和基因检测的使用增加了对癫痫患者遭遇的遗传原因的重视。对其他疾病的研究表明，遗传因果归因可以影响患者的心理反应和应对策略，但目前对癫痫患者及其亲属如何应对癫痫的遗传归因知之甚少。我们调查了抑郁症（癫痫中最常见的精神共病）可能与包含多名癫痫患者的家庭成员认为癫痫具有遗传原因有关的可能性。一个自我管理的调查完成了417个人在104个家庭，平均每个家庭有4个癫痫患者。用PHQ-9测量电流抑制。通过三个问题来评估遗传因果归因：感知癫痫相关突变的可能性，感知遗传学在家族中引起癫痫的作用，以及（癫痫患者）感知遗传学在引起个体癫痫中的影响。没有癫痫的亲属被问及他们认为未来患癫痫的机会，与普通人相比。在182名癫痫患者中，当前抑郁症的患病率为14.8%，在184名无癫痫的生物学亲属中为6.5%，在51名已婚个体中为3.9%。在癫痫患者中，抑郁症与遗传归因无关。然而，在没有癫痫的生物学亲属中，抑郁症的患病率随着癫痫相关突变的感知机会增加而增加（p=0.02）。这种关联并不介导的未来癫痫风险的亲属无癫痫。抑郁症与携带癫痫相关突变的可能性有关，这些突变在包含多个受影响个体的家庭中的无癫痫个体中存在。在处理这些家庭的心理健康问题时，应考虑这种关联。
Rapid advances in genetic research and increased use of genetic testing have increased the emphasis on genetic causes of epilepsy in patient encounters. Research in other disorders suggests that genetic causal attributions can influence patients’ psychological responses and coping strategies, but little is currently known about how epilepsy patients and their relatives will respond to genetic attributions of epilepsy. We investigated the possibility that depression, the most frequent psychiatric comorbidity in the epilepsies, might be related to the perception that epilepsy has a genetic cause among members of families containing multiple individuals with epilepsy. A self-administered survey was completed by 417 individuals in 104 families averaging four individuals with epilepsy per family. Current depression was measured with the PHQ-9. Genetic causal attribution was assessed by three questions addressing: perceived likelihood of having an epilepsy-related mutation, perceived role of genetics in causing epilepsy in the family, and (in individuals with epilepsy) perceived influence of genetics in causing the individual’s epilepsy. Relatives without epilepsy were asked about their perceived chance of developing epilepsy in the future, compared with the average person. Prevalence of current depression was 14.8% in 182 individuals with epilepsy, 6.5% in 184 biological relatives without epilepsy, and 3.9% in 51 married-in individuals. Among individuals with epilepsy, depression was unrelated to genetic attribution. Among biological relatives without epilepsy, however, prevalence of depression increased with increasing perceived chance of having an epilepsy-related mutation (p=0.02). This association was not mediated by perceived future epilepsy risk among relatives without epilepsy. Depression is associated with perceived likelihood of carrying an epilepsy-related mutation among individuals without epilepsy in families containing multiple affected individuals. This association should be considered when addressing mental health issues in such families.
登录
查看更多内容
DOI：
10.1016/s1474-4422(15)00199-4
发表时间：
2015-12
期刊：
The Lancet. Neurology
影响因子：
--
作者：
EpiPM Consortium
通讯作者：
EpiPM Consortium
影响因子：
5.6
作者：
Heiman GA;Kamberakis K;Gill R;Kalachikov S;Pedley TA;Hauser WA;Ottman R
通讯作者：
Ottman R
影响因子：
3.8
作者：
Phelan, JC;Yang, LH;Cruz-Rojas, R
通讯作者：
Cruz-Rojas, R
影响因子：
5.6
作者：
Ottman, R;Berenson, K;Barker-Cummings, C
通讯作者：
Barker-Cummings, C
影响因子：
4.7
作者：
Rief, W;Nanke, A;Zech, T
通讯作者：
Zech, T