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作用 如果这些并发症确实具有重要的病因学意义， 重要的健康影响，因为改善产科护理的目标是 双相情感障碍高危人群将提供 一级预防的吸引力。 具体目的是调查是否有可能确认和 扩大试点范围，采用新的更大的样本和改进的方法， 研究结果的产科并发症（OC）过多， 双相情感障碍的先证者，与他们自己的精神病学相比， 正常的同胞 研究设计和方法将涉及获得医疗记录 对60例双相情感障碍受试者的分娩和妊娠进行了研究， 25-35岁和所有同龄的兄弟姐妹，包括至少60岁 精神正常的同胞 使用DSM-III-R标准的诊断将 根据结构化诊断访谈（SCID补充， 关于情绪障碍症状的其他问题）， 相关的医疗记录 使用已发表量表总结OC评分 在以前的业主立案法团研究中， 精神疾病，将获得基于仔细审查 产科记录 补充评分将包括 先证者母亲访谈。 法团评级及精神科 将使诊断相对于彼此是盲目的。 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 获得详细的产科记录的先证者和在 至少一个正常同胞，先证者和同胞组是 在平均年龄、出生顺序和性别上相似。 样本量已选定 基于功效分析，使用效应提供良好的统计功效 与我们的试点研究中发现的尺寸相似。 非参数 统计程序将用于我们的有序OC评分数据，以检验 双相先证者OC评分显著较高的假设 比他们正常的兄弟姐妹。 探索性分析将检查相关 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.