OBSTETRIC COMPLICATIONS AND PATHOLOGY IN BIPOLAR ILLNESS

描述（申请人摘要）：本补助金的长期目标 是为了提高对产科并发症病因作用的认识， (OCs)，以及它们与脑和神经心理异常的关系， 躁郁症 如果业主立案法团确实是重要的病因，它可以 具有重要的健康影响，因为最佳产科护理的目标是 双相情感障碍高风险的个体将提供一个有吸引力的 对疾病的一级预防。 具体目标是 调查是否有可能（a）不仅重复最近研究， 双相情感障碍患者中OC显著过量的发现， 与正常对照组或患者自己的兄弟姐妹相比， (b)在双相情感障碍患者中， 与MRI（磁共振成像）上观察到的脑部异常相关 在神经心理测试中表现不佳。 研究设计和方法包括获得出生的OC数据， （a）40例首次入院的双相情感障碍先证者的妊娠 年龄18-50岁，（B）40名精神病学正常对照先证者， 年龄、性别、种族和惯用手，沿着（c）大约120名 双相和对照先证者各自的兄弟姐妹。 诊断将使用 DSM-IV标准，基于结构化诊断访谈（SCID）， 辅以图表审查。 OC评分总结将通过以下方式获得： 将已公布的评级量表应用于OC数据，这些数据是从以下人员的访谈中获得的 受试者的母亲 OC、诊断、MRI和神经心理学评估 会盲目地相互尊重。 拟定研究 成本效益高，因为它将把收集到的业主立案法团数据“捎带”到 更大的研究已经获得资助，以收集诊断，MRI和 双相和对照先证者的神经心理学测试数据。 统计 适用于获得的OC数据分布将用于测试 假设双相先证者具有较高的（即，更差）OC评分 无论是正常对照还是双相先证者自己的兄弟姐妹， 较高的OC分数将与（a）结构性脑异常相关 在MRI扫描上观察到，（B）神经心理学测试较差 性能

DESCRIPTION (Applicant's abstract): The long-term objective of this grant is to advance understanding of the etiologic role of obstetric complications (OCs), and their relation to brain and neuropsychological abnormalities in bipolar disorder. If OCs are indeed etiologically significant, it could have important health implications, as optimal obstetric care targeted on individuals at high risk for bipolar disorder would then offer an attractive approach to primary prevention of the disorder. The specific aims are to investigate whether it is possible (a) not only to replicate recent study findings of a significant excess of OCs in patients with bipolar disorder, compared with either normal controls or the patients' own siblings, but also (b) to pioneer investigation of whether, in bipolar patients, OCs may be associated with brain abnormalities seen on MRI (magnetic resonance imaging) scans and with poor performance on neuropsychological tests. The research design and methods involve obtaining OC data on the births and pregnancies of (a) 40 first-admission patient probands with bipolar disorder aged 18-50 and (b) 40 psychiatrically normal control probands similar in age, gender, ethnicity, and handedness, along with (c) approximately 120 of the bipolar and control probands' respective siblings. Diagnoses will use DSM-IV criteria, based on structured diagnostic interviews (SCID), supplemented by chart review. Summary OC scores will be obtained by applying published rating scales to OC data obtained from interviews with subjects' mothers. OC, diagnostic, MRI, and neuropsychological assessments will be made blindly with respect to each other. The proposed study is highly cost-effective, as it will "piggyback" collection of OC data onto a larger study already funded to collect diagnostic, MRI and neuropsychological test data on bipolar and control probands. Statistics appropriate to obtained OC data distributions will be used to test the hypotheses that bipolar probands have higher (i.e., worse) OC scores than either normal controls or the bipolar probands' own siblings, and that higher OC scores will be associated (a) with structural brain abnormalities observed on MRI scans and (b) with poorer neuropsychological test performance.