为了澄清,使用扩展的采用设计,焦虑障碍(AD)及其主要亚型的亲代传播来源及其与重度抑郁症(MD)的家族跨代关系。
后代(生于1960-1992年)和他们的父母,来自六种家庭类型(完好无损,没有和亲生父亲或母亲一起生活,和继父或继母住在一起,和收养),是从瑞典国家样本中确定的。诊断来自国家医疗登记册。我们评估了亲子关系的三个来源:基因加上养育,只有基因,只饲养。为了测试共病影响,单一诊断根据频率和最近情况分为共病病例.
对于AD到AD的父子传输,三种亲子关系基因加上饲养的最佳估计四度相关性,只有基因,仅饲养等于+0.16(95%CI=0.16,0.16),+0.12(95%CI=0.10,0.13),和+0.06(95%CI=0.04,0.07),分别,MD到MD传输的结果大致相似。交叉障碍交叉世代相关性适度降低,AD和MD的遗传和饲养相关性估计为+0.83(95%CI=0.76,0.90)和+0.83(95%CI=0.69,0.96),分别。对恐慌症和广泛性焦虑症(GAD)的分析产生了可比的发现,与MD的遗传相关性在广泛性焦虑症中略高于恐慌症。将诊断层次结构应用于共病病例会导致交叉障碍交叉世代传播的减少,估计的遗传相关性等于0.46(95%CI=0.30,0.62)。
对于AD及其主要子形式,跨代传播包括遗传效应和饲养效应。在传统分析中,AD和MD表现出高度相关的遗传和饲养效应。应用诊断层次结构时,遗传相关性减弱。
To clarify, using an extended adoption design, the sources of parent-offspring transmission for anxiety disorder (AD) and its major subforms and their familial cross-generational relationship with major depression (MD).
Offspring (born 1960-1992) and their parents, from six family types (intact, not-lived-with biological father or mother, lived-with step-father or step-mother, and adoptive), were ascertained from Swedish national samples. Diagnoses were obtained from national medical registers. We assessed three sources of parent-child resemblance: genes plus rearing, genes only, and rearing only. To test comorbidity effects, single diagnoses were assigned in comorbid cases based on frequency and recency.
For AD to AD parent-child transmission, best-estimate tetrachoric correlations for the three types of parent-offspring relationships genes plus rearing, genes only, and rearing only-equaled +0.16 (95% CI=0.16, 0.16), +0.12 (95% CI=0.10, 0.13), and +0.06 (95% CI=0.04, 0.07), respectively, with broadly similar results for MD to MD transmission. Cross-disorder cross-generation correlations were modestly lower, with genetic and rearing correlations for AD and MD estimated at +0.83 (95% CI=0.76, 0.90) and +0.83 (95% CI=0.69, 0.96), respectively. Analyses for panic disorder and generalized anxiety disorder (GAD) produced comparable findings, with the genetic correlation with MD modestly higher for generalized anxiety disorder than panic disorder. Applying a diagnostic hierarchy to comorbid cases resulted in a decline in cross-disorder cross-generation transmission with the estimated genetic correlation equaling +0.46 (95% CI=0.30, 0.62).
For AD and its major subforms, cross-generational transmission includes both genetic and rearing effects. In traditional analyses, AD and MD demonstrate highly correlated genetic and rearing effects. The genetic correlation weakened when applying a diagnostic hierarchy.