Adolescents at High Risk for Familial Bipolar Disorder

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1%的一般人群。发病年龄通常在青少年后期或成年早期。关于影响这种疾病发病率和发病年龄的特定风险因素知之甚少。1988年，NIMH建立了一个双相情感障碍遗传学倡议，目标是识别易感基因;这项合作已经确定了数百个双相情感障碍家庭的多个病例。作为最初的3个合作地点（印第安纳州大学、约翰霍普金斯大学和华盛顿大学圣刘易斯），我们现在建议评估和随访这些家庭中12 - 18岁的青少年。这将包括子女和侄女和侄子。这个“风险”组将与一组匹配的社区比较受试者进行比较。将使用针对青少年和父母（DIGS）的既定诊断工具（KSADS-PL）对300名研究受试者和300名对照者进行研究。将采用其他工具来评估行为、气质、家庭环境和物质使用。数据将存储在数据库中，该数据库旨在促进临床变量的纵向研究。分析将比较高风险组和对照组之间的潜在风险因素。高风险组的年度随访将在研究的第二年开始。假设将确定3组：1）表现为早发性双相情感障碍的行为症状或障碍青少年; 2）表现为迟发性双相情感障碍的焦虑症状或障碍青少年; 3）表现为迟发性单相或双相情感障碍的轻微情绪症状或障碍青少年。这项研究的伦理含义将通过检查参与的影响和由于高风险状态对自尊的影响来研究。

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 3 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 families. This will include offspring and nieces and nephews. This "at risk" group will be compared to a matched set of community comparison subjects. 300 study subjects and 300 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. 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. Annual follow-up of the high- risk group will begin in the second year of the study. It is hypothesized that 3 groups will be identified: 1) adolescents with behavioral symptoms or disorders who manifest early-onset bipolar disorder; 2) adolescents with anxiety symptoms or disorders who manifest later-onset bipolar disorder; and 3) adolescents with minor mood symptoms or disorders who manifest later-onset unipolar or bipolar disorder. The ethical implications of this research will be studied by examining the effects of participation and the effect on self-esteem due to high- risk status.