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首页> 外文期刊>Journal of affective disorders >Dose-response relationship between number of comorbid anxiety disorders in adolescent bipolar/unipolar disorders, and psychosis, suicidality, substance abuse and familiality.
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Dose-response relationship between number of comorbid anxiety disorders in adolescent bipolar/unipolar disorders, and psychosis, suicidality, substance abuse and familiality.

机译：青少年双相/单相障碍合并症焦虑症的数量与精神病，自杀，药物滥用和家族性之间的剂量反应关系。

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OBJECTIVES: To ascertain rates of panic, obsessive-compulsive (OCD) and social phobic disorders among adolescents with bipolar disorder (BP), unipolar major depressive disorder (MDD) and psychiatric comparison patients, to assess their relationships to suicidality, psychosis, comorbidity patterns and familiality. METHODS: The first author (SCD) interviewed 313 Latino adolescents using a structured interview based on the SCID. Family history was ascertained by live interview or interview by proxy. Patients were classified as BP, MDD, or non-affectively ill comparison controls (CC). Data regarding suicidality and psychosis were collected. Regression analysis was used to test associations and control for confounding effects. Positive likelihood ratios were used to measure the dose-response relationships between number of anxiety disorders and measures of severity of illness and familial loading for affective illness. RESULTS: Of the total sample, 36.7% were BP, 44.7% MDD and 18.5% CC. In BP vs. MDD the odds of panic disorder were 4.4, of OCD 5.1, and of social phobia 3.3. MDD, in turn, were more likely to have these disorders than CC. BP (but not MDD) with panic disorder and social phobia, were more likely to have suicidal ideation; among the anxiety disorders, only social phobia was associated with having greater odds of suicide attempts. Among BP and MDD, patients with all three anxiety disorders were more likely to be psychotic. Presence of any mood disorder among first-degree relatives substantially increased the odds of having panic disorder and social phobia. The presence of one comorbid anxiety disorder increased the odds of having another. Finally, there were dose-response relationships between number of anxiety disorders and measures of severity of illness and familial loading for affective illness. LIMITATIONS: Single interviewer using the SCID; cross sectional exploratory study. CONCLUSIONS: BP adolescents have a greater anxiety disorder burden than their MDD counterparts. The results are compatible with the hypothesis that heavy familial-genetic loading for affective illness in juveniles is associated with bipolarity, cumulative anxiety disorder comorbidity, suicidality and psychosis. These observations are in line with pioneering psychopathologic observation in the early 1900s by two French psychiatrists, Gilbert Ballet and Pierre Kahn, who saw common ground between what until then had been considered the distinct categories of the neuroses and cyclothymic (circular) psychoses. This perspective has much in common with current complex genetic models of anxious diatheses in bipolar disorder.
机译：目的：确定患有双相情感障碍（BP），单相严重抑郁症（MDD）和精神病比较患者的青少年中的恐慌，强迫症（OCD）和社交恐惧症的发生率，以评估其与自杀，精神病，合并症的关系和家庭。方法：第一作者（SCD）使用基于SCID的结构化访谈对313名拉丁裔青少年进行了访谈。家族史通过现场访谈或代理访谈来确定。将患者分类为BP，MDD或非情感疾病比较对照（CC）。收集有关自杀和精神病的数据。回归分析用于测试关联和控制的混杂效果。正似然比用于衡量焦虑症的数量与疾病严重程度和情感疾病的家族负担之间的剂量反应关系。结果：在总样本中，血压为36.7％，MDD为44.7％，CC为18.5％。在BP vs. MDD中，恐慌症的几率是4.4，强迫症5.1，社交恐惧症3.3。反过来，MDD较CC更可能患有这些疾病。患有恐慌症和社交恐惧症的BP（而非MDD）更容易自杀。在焦虑症中，只有社交恐惧症与自杀未遂的可能性更高。在BP和MDD中，患有这三种焦虑症的患者更容易患有精神病。一级亲属中存在任何情绪障碍的可能性大大增加了发生恐慌症和社交恐惧症的几率。一种合并症焦虑症的存在增加了另一种合并症的可能性。最后，焦虑症的数量与疾病严重程度和情感疾病的家族负担之间存在剂量反应关系。局限性：使用SCID的单身面试官;横断面探索性研究。结论：BP青少年的焦虑症负担比其MDD同行更大。该结果与以下假设相吻合：儿童情感疾病的家族遗传负担过重与躁郁症，累积性焦虑症合并症，自杀倾向和精神病有关。这些观察结果与1900年代初期两位法国精神科医生吉尔伯特·芭蕾和皮埃尔·卡恩（Pierre Kahn）进行的开创性精神病理学观察相一致，他们看到了之前被认为是神经病和环胸型（环状）精神病的不同类别之间的共同点。这种观点与当前双相情感障碍焦虑症的复杂遗传模型有很多共通之处。

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