Adolescents at High Risk for Familial Bipolar Disorder

青少年患家族性躁郁症的高风险

• 批准号: 7369867
• 负责人: MELVIN G MCINNIS
• 金额: $ 26.29万
• 依托单位: UNIVERSITY OF MICHIGAN AT ANN ARBOR
• 依托单位国家: 美国
• 财政年份: 2005
• 资助国家: 美国
• 起止时间: 2005-05-19 至 2010-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/7369867
• 关键词: Accounting; Adolescence; Adolescent; Affect; Affective Symptoms; Age; Age of Onset; Alcohol or Other Drugs use; Anxiety; Anxiety Disorders; Attention deficit hyperactivity disorder; Awareness; Behavior; Behavior Disorders; Behavioral; Behavioral Symptoms; Bipolar Disorder; Blood specimen; Cell Line; Characteristics; Child; Clinical; Clinical Data; Collaborations; Collection; Communities; Conduct Disorder; Consent; Control Groups; DNA; Data; Databases; Development; Diagnosis; Diagnostic; Dimensions; Disease; Doctor of Medicine; Dysthymic Disorder; Environment; Evaluation; Event; Family; Family Characteristics; Family member; Follow-Up Studies; Frequencies; Future; General Population; Genetic; Goals; Grant; Home environment; Incidence; Indiana; Individual; Interview; Knowledge; Life; Lifestyle-related condition; Longitudinal Studies; Major Depressive Disorder; Manic; Measures; Mental Depression; Mental disorders; Methods; Minor; Mood Disorders; Moods; National Institute of Mental Health; Numbers; Outcome; Panic Attack; Parents; Participant; Patient Self-Report; Perception; Population Study; Principal Investigator; Problem behavior; Psychopathology; Questionnaires; Range; Rate; Regression Analysis; Relative (related person); Reporting; Research; Research Personnel; Risk; Risk Factors; Sampling; Schedule; Score; Screening procedure; Site; Social support; Study Subject; Subgroup; Substance abuse problem; Susceptibility Gene; Symptoms; Temperament; Universities; Washington; aged; base; early onset; follow-up; genetic pedigree; instrument; outcome forecast; proband; programs; psychologic; repository; self esteem

DESCRIPTION (provided by applicant) Bipolar disorder is a severe heritable psychiatric illness affecting 1% of the general population. The age of onset is generally in the late teenage years or early adulthood. Very little is known about specific risk factors that influence the incidence and age of onset of this disorder. In 1988 the NIMH established a Genetics Initiative in bipolar disorder with the goal of identifying susceptibility genes; this collaboration has identified several hundred families with multiple cases of bipolar disorder. As three of the initial collaborating sites (Indiana University, Johns Hopkins University, and Washington University at St Louis) we are now proposing to assess and follow adolescents, ages 12 -18 years, in these and similar families. This "at risk" group will be compared to a matched set of community comparison subjects. Three hundred study subjects and three hundred controls will be studied using established diagnostic instruments (KSADS- PL) for the adolescents and the parents (DIGS). Other instruments to assess behavior, temperament, family environment, and substance use will be employed. DNA will also be collected. The data will be stored in a database developed to facilitate longitudinal studies of clinical variables. Analyses will compare potential risk factors among the high risk group and the controls. Follow-up of the high risk group will begin in the second year of the study. It is hypothesized that three groups will be identified: 1) adolescents with behavioral symptoms or disorders who will manifest early-onset bipolar disorder; 2) adolescents with anxiety symptoms or disorders who will manifest later-onset b polar disorder; and 3) adolescents with minor mood symptoms or disorders who will manifest later-onset unipolar or bipolar disorder. All subjects will be characterized on the three dimensions of behavioral, anxiety, and mood symptoms; intermediate outcomes and major mood diagnoses will be evaluated in relation to baseline dimensional ratings. The ethical implications of this research will be studied by examining the effects of participation and any effect on self-esteem due to high risk status as well as the implications of the collections and potential use of genetic data for prediction of risk within families. Clinical data and DNA will be shared with the scientific community.

描述（由申请人提供）双相情感障碍是一种严重的遗传性精神疾病，影响总人口的1%。发病年龄一般在青少年晚期或成年早期。对影响这种疾病的发病率和发病年龄的具体危险因素知之甚少。1988年，NIMH建立了双相情感障碍遗传学倡议，目标是确定易感基因；这项合作已经确定了数百个有双相情感障碍的家庭。作为最初的三个合作地点（印第安纳大学、约翰霍普金斯大学和圣路易斯华盛顿大学），我们现在提议评估和跟踪这些家庭和类似家庭中12 -18岁的青少年。这个“有风险”的群体将与一组匹配的社区比较对象进行比较。300名研究对象和300名对照者将使用已建立的青少年和家长诊断工具（KSADS- PL）进行研究。其他评估行为、性情、家庭环境和药物使用的工具也将被采用。DNA也将被收集。这些数据将储存在一个数据库中，该数据库是为了便于对临床变量进行纵向研究而开发的。分析将比较高危组和对照组的潜在危险因素。高风险组的随访将在研究的第二年开始。假设将确定三组：1)有行为症状或障碍的青少年将表现为早发性双相情感障碍；2)有焦虑症状或障碍的青少年将表现为晚发性躁郁症；3)有轻微情绪症状或障碍的青少年将表现为晚发性单极或双相障碍。所有受试者将在行为、焦虑和情绪症状三个维度上进行特征描述；中间结果和主要情绪诊断将根据基线维度评分进行评估。这项研究的伦理意义将通过检查参与的影响和由于高风险状况而对自尊的任何影响，以及收集和潜在使用遗传数据预测家庭风险的影响来研究。临床数据和DNA将与科学界共享。