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首页> 外文期刊>The journal of clinical psychiatry >A prospective study of the offspring of bipolar parents responsive and nonresponsive to lithium treatment.
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A prospective study of the offspring of bipolar parents responsive and nonresponsive to lithium treatment.

机译：对双极型父母对锂治疗有反应和无反应的后代的前瞻性研究。

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BACKGROUND: The descriptions of clinical course among bipolar youths vary significantly and differ markedly from the findings described in classical studies of bipolar adults. This difference may in part reflect genetic heterogeneity. Response to lithium monotherapy identifies a homogeneous subgroup of bipolar adults. The aim of this study was to prospectively characterize the clinical course, including antecedent and comorbid conditions, among the offspring of 2 groups of bipolar parents divided on the basis of response to lithium. METHOD: Parents were identified from families participating in ongoing molecular genetic studies and selected from specialty affective disorder clinics. For each child, 1 parent met Research Diagnostic Criteria/DSM-IV criteria for bipolar I disorder and either response or nonresponse to lithium prophylaxis. The other parent had no lifetime history of a major psychiatric illness. Blind to family affiliation and lithium response, all eligible offspring aged 10 to 25 years were interviewed using the Schedule for Affective Disorders and Schizophrenia for School-Aged Children-Present and Lifetime Version (K-SADS-PL), and best-estimate diagnoses were made by a panel of experts. Offspring were then reassessed over a 5-year period. RESULTS: Offspring of lithium responders (N = 34) had good premorbid functioning and manifested classical mood disorders with an episodic course. Comorbid conditions in this group remitted prior to the mood disorder. In contrast, offspring of lithium nonresponders (N = 21) had poorer premorbid functioning and manifested mood disorders with a chronic course. Comorbid conditions continued alongside the mood disorder. Clinical course among affected offspring was predicted by the disease course of the parent. CONCLUSION: The pattern of clinical course, remitting or nonremitting, appears to be inherited. Among the offspring of lithium-responsive bipolar parents, an early-onset subgroup with a classical episodic clinical course can be identified.
机译：背景：双相青少年的临床过程描述差异很大，并且与双相成年人经典研究中描述的发现明显不同。这种差异可能部分反映了遗传异质性。对锂单药治疗的反应可确定双相成年人的同质亚组。这项研究的目的是前瞻性地表征两组根据对锂的反应而划分的双极父母的后代中的临床过程，包括前期和合并症。方法：从参与正在进行的分子遗传学研究的家庭中鉴定父母，并从专业的情感障碍诊所中选择父母。对于每个孩子，有1位父母符合针对双相I障碍以及对锂预防的反应或无反应的研究诊断标准/ DSM-IV标准。另一父母没有终生重大精神病史。盲目的家庭归属和锂反应，对所有年龄在10至25岁的合格后代进行了调查，使用了《情感障碍时间表和学龄前儿童精神分裂症及终生版》（K-SADS-PL），并进行了最佳估计诊断由专家小组制作。然后在5年内对后代进行重新评估。结果：锂反应者（N = 34）的后代具有良好的病前功能，并表现出典型的情绪障碍，并伴有发作过程。该组合并症在情绪障碍之前缓解。相比之下，锂无反应者（N = 21）的后代功能较差，并表现出慢性病的情绪障碍。合并症继续伴有情绪障碍。受影响的后代的临床病程由父母的疾病病程预测。结论：临床过程的模式，缓和或不缓和，似乎是遗传的。在对锂敏感的双极型父母的后代中，可以确定具有经典发作性临床病程的早发亚组。

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