BIPOLAR DISORDER AND PRE- AND PERINATAL COMPLICATIONS

这项研究的长期目标是促进对 双相情感障碍产前和围产期并发症的病因学作用。 如果这种并发症在病因学上确实意义重大，它可能会 重要的健康影响，因为改善产科保健的目标是 然后，双相情感障碍的高危人群会提供一个 对初级预防采取有吸引力的方法。 具体目的是调查是否有可能确认和 通过新的更大的样本和改进的方法来扩展试点 产科并发症(OCS)增多的研究结果 患有双相情感障碍的先证者与他们自己的精神障碍患者的比较 正常的兄弟姐妹。 研究设计和方法将涉及到获取医疗记录 60例老年双相情感障碍患者的出生和妊娠情况 25-35岁和所有同龄可用兄弟姐妹，包括至少60岁 精神上正常的兄弟姐妹。使用DSM-III-R标准的诊断将是 基于结构化的诊断性访谈(SCID补充 关于情绪障碍症状的其他问题)和对 相关的医疗记录。使用公布的量表汇总OC分数 在以前的OCS和OCS研究中被几组调查人员应用 精神障碍，将根据仔细审查获得 产科记录。补充分数将包括报告的OCS 采访先证者的母亲。对业主立案法团和精神病患者的评分 诊断将被设置为相互之间的盲区。 一个更大的样本，由大约80个双相先证者及其 兄弟姐妹，将进行研究，以确保至少60个兄弟姐妹可以 从先证者的详细产科记录和 至少有一个正常的兄弟姐妹，先证者和兄弟姐妹的群体是 在平均年龄、出生顺序和性别上相似。样本大小已选定 基于使用Effect的功率分析，提供良好的统计功率 与我们的初步研究中发现的尺寸相似。非参数 将使用统计程序对我们的顺序OC分数数据进行测试 双相先证者有显著更高的OC分数的假设 而不是他们正常的兄弟姐妹。探索性分析将检查相关的 问题，例如特定类型的业主立案法团是否最强烈 与双相情感障碍有关。

The study's long-term objective is to advance understanding of the etiologic role of pre- and perinatal complications in Bipolar Disorder. If such complications are indeed etiologically significant, it could have important health implications, since improved obstetric care targeted on individuals at high risk for Bipolar Disorder would then offer an attractive approach to primary prevention. The specific aim is to investigate whether it is possible to confirm and extend, with a new and larger sample, and improved methodology, pilot study findings of an excess of obstetrical complications (OCs) in probands with Bipolar Disorder, compared to their own psychiatrically normal sibs. The research design and methods will involve obtaining medical records on the births and pregnancies of 60 subjects with Bipolar Disorder aged 25-35 and all available sibs of the same age, including at least 60 psychiatrically normal sibs. Diagnoses using DSM-III-R criteria will be made based on structured diagnostic interviews (SCID supplemented by additional questions on symptoms of mood disorders) and by a review of pertinent medical records. Summary OC scores, using published scales applied by several groups of investigators in previous studies of OCs and psychiatric disorders, will be obtained based on careful review of obstetrical records. A supplementary score will include OCs reported in interviews with probands' mothers. Ratings of OCs and psychiatric diagnoses will be made blind with respect to each other. A larger sample, composed of approximately 80 bipolar probands and their siblings, will be studied to insure that at least 60 sibships can be obtained with detailed obstetrical records on both the proband and at least one normal sibling, and that groups of probands and sibs are similar in mean age, birth order, and sex. Sample sizes have been chosen to provide good statistical power, based on a power analysis using effect sizes similar to those found in our pilot study. Nonparametric statistical procedures will be used on our ordinal OC score data to test the hypothesis that bipolar probands have significantly higher OC scores than their normal sibs. Exploratory analyses will examine related questions, such as whether specific types of OCs are most strongly associated with Bipolar Disorder.