A comparison of recovered bipolar patients, healthy relatives of bipolar probands, and normal controls using the short TEMPS-A
A comparison of recovered bipolar patients, healthy relatives of bipolar probands, and normal controls using the short TEMPS-A
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DOI：
10.1016/j.jad.2004.01.012
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发表时间：
2005-03-01
影响因子：
6.6
通讯作者：
Akiskal, HS
中科院分区：
文献类型：
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作者：
Mendlowicz, MV;Jean-Louis, G;Akiskal, HS
目的：通过与临床康复的双相情感障碍患者 (BP) 和正常对照 (NC) 进行比较，调查双相情感障碍先证者 (RBP) 的健康亲属（RBP 是发生情绪障碍的高风险人群）是否存在气质失调。方法：最初招募了 52 名 RBP 和 23 名 BP 来进行双相情感障碍的多中心遗传学研究。 NC（n = 102）还通过报纸广告、广播和电视公告、传单、时事通讯或口碑招募。所有志愿者都被要求填写 TEMPS-A 量表，这是一份自我报告问卷，旨在测量精神病患者和健康志愿者的气质变化。在对音律进行评分时，我们依赖于 TEMPS-A 的简短验证版本 [J.影响。混乱。 (2004)]，其中负载 < 0.035 的性状已被删除。结果：为了检查三组之间气质维度的差异，使用诊断组构建了 MANCOVA 模型，将年龄和性别的固定因素（BP vs. RBP vs. NC）效应调整为协变量。 MANCOVA 显示了因变量的整体群体效应（Hotelling 的 F-(5,F-175) = 6.64，p < 0.001）。四个因变量（心境恶劣、循环性、易怒和焦虑气质）显示出显着的组间差异。 RBP 的环性气质得分低于 BP，但高于 NC。 BP和RBP表现出比NC更高的焦虑气质得分。北卡罗来纳州的情绪高涨得分明显最高。局限性：鉴于细胞尺寸较小，无法进行双极 I 与双极 II 子分析。结论：本分析的方法学优势在于 BP 组已临床康复，我们在本分析中使用经过验证的 TEMPS-A 简短版本。我们的研究结果表明，双相情感障碍先证者的一些临床健康亲属表现出亚临床循环不稳定，包括情绪、兴趣、自信心、睡眠和/或精力以及焦虑倾向，而这在正常对照中未观察到。这些特征可能代表脆弱性标记，并且可能用于识别患有双相谱系障碍或该谱系内的特定临床亚型（例如双相 I、双相 II）的高风险个体。这是一个概念性的观点，有许多悬而未决的问题。这些问题的解决需要将表型的创新定义纳入不同人群气质分量表的分析中。气质子量表本身需要适当校准，以找出最有前途的特征或特定组合。在本期的其他地方报道了在更大范围的样本中对这些气质进行更广泛和复杂的数量性状分析[J.影响。混乱。 （2004）]。 (c) 2004 Elsevier B.V. 保留所有权利。
Objective: To investigate the presence of temperament dysregulation in healthy relatives of bipolar probands (RBP), a population at high risk for developing mood disorders, by comparing them with clinically recovered bipolar patients (BP) and normal controls (NC). Method: 52 RBP and 23 BP were originally recruited for a multicenter genetic study in bipolar disorders. NC (n = 102) were also recruited by newspaper advertisement, radio and television announcements, flyers, newsletters, or word of mouth. All Volunteers were asked to complete the TEMPS-A Scale, a self-report questionnaire designed to measure temperamental variations in psychiatric patients and healthy volunteers. In scoring temperaments, we relied upon the short validated version of the TEMPS-A [J. Affect. Disord. (2004)], from which traits with loadings < 0.035 had been deleted. Results: To examine differences in temperament dimensions among the three groups, a MANCOVA model was constructed using diagnostic group as the fixed factor (BP vs. RBP vs. NC) effects of age and gender were adjusted as covariates. MANCOVA showed overall group effect on the dependent variables (Hotelling's F-(5,F-175) = 6.64, p < 0.001). Four dependent variables (dysthymic, cyclothymic, irritable, and anxious temperaments) showed significant between-group differences. RBP showed lower cyclothymic temperament scores than BP, but higher scores than NC. BP and RBP showed higher anxious temperament scores than NC. Hyperthymic scores were significantly highest in the NC. Limitation: In view of the small cell sizes, bipolar I vs. bipolar II subanalyses could not be conducted. Conclusions: Methodologic strengths of the present analyses is that the BP group had clinically recovered, and we used the validated short version of the TEMPS-A for the present analyses. Our findings suggest that some clinically healthy relatives of bipolar probands exhibit a subclinical cyclothymic instability ill mood, interest, self-confidence, sleep, and/or energy as well as anxiety proneness that is not observed among normal controls. These traits may represent vulnerability markers and could presumably be used to identify individuals at high risk for developing bipolar spectrum disorders, or specific clinical subtypes (e.g., bipolar I, bipolar II) within this spectrum. This is a conceptual perspective with many unanswered questions. Resolution of these questions will require innovative definitions of phenotypes to be included in the analyses of the temperament subscales in different populations. The temperament subscales themselves need to be calibrated properly, to find out which traits or specific combinations of trains are most promising. More extensive and complex quantitative trait analyses of these temperaments in a much expanded sample are reported elsewhere in this issue [J. Affect. Disord. (2004)]. (c) 2004 Elsevier B.V. All rights reserved.