主要精神和物质使用障碍的结果作为遗传风险和遗传异质性的指标。

IF 5.5 2区 医学 Q1 PSYCHIATRY
Kenneth S Kendler, Henrik Ohlsson, Jan Sundquist, Kristina Sundquist
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引用次数: 0

摘要

背景:我们调查了瑞典国家登记的六种主要精神和物质障碍——药物使用障碍(DUD)、酒精使用障碍(AUD)、重度抑郁症(MD)、双相情感障碍(BD)、焦虑症(AD)和精神分裂症(SZ)——的社会和精神结局是否反映了每种疾病的主要遗传风险和遗传异质性水平。方法:我们利用遗传风险比——定义为继发性疾病的遗传风险与原发性疾病的遗传风险之比——从家庭遗传风险评分中得出。社会结果差是由领取社会福利、病假、提前退休养老金、社会贫困地区居住等4个变量共同决定的。精神病预后定义为精神病住院天数。结果:随着社会结果的恶化,除SZ外,所有疾病的主要遗传风险都大幅上升,DUD、AUD和注意缺陷多动障碍的次要遗传风险也大幅上升。由于只有双相障碍和SZ的精神预后较差,原发性遗传风险急剧增加。总体而言,MD、AD和BD的社会结果越差,其遗传异质性就越强,而AUD、DUD和SZ的异质性增加则较为温和。相比之下,精神病学结果较差的患者,SZ的遗传风险在遗传上更加均匀,而bd的趋势类似,但不那么明显。结论:尽管我们的主要疾病之间存在重要差异,但社会和精神病学结果通常是遗传风险的有力指标,可以反映遗传异质性的水平。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
The outcome of major psychiatric and substance use disorders as an index of genetic risk and genetic heterogeneity.

Background: We investigate whether, in Swedish national registers, social and psychiatric outcomes for six major psychiatric and substance disorders - drug use disorder (DUD), alcohol use disorder (AUD), major depression (MD), bipolar disorder (BD), anxiety disorder (AD), and schizophrenia (SZ) - reflect the primary genetic risk for each disorder and the level of genetic heterogeneity.

Methods: We utilize Genetic Risk Ratios - defined as the ratio of the genetic risk for secondary disorders to the genetic risk for the primary disorder - derived from Family Genetic Risk Scores. Poor social outcome was defined by a common factor of four variables: receipt of social welfare, sick leave, early retirement pension, and residence in a socially deprived area. Psychiatric outcome was defined as days of inpatient psychiatric hospitalization.

Results: With poorer social outcomes, the primary genetic risks rose robustly for all disorders except SZ, as did the secondary genetic risks for DUD, AUD, and attention-deficit hyperactivity disorder. With poorer psychiatric outcomes, available only for BD and SZ, the primary genetic risks increased sharply. Overall, MD, AD, and BD became substantially more genetically heterogenous as their social outcomes became poorer, while for AUD, DUD, and SZ, the increase in heterogeneity was more modest. By contrast, with poorer psychiatric outcome, genetic risks for SZ became substantially more genetically homogeneous, with a similar but less robust trend seen for BD.

Conclusions: Despite important differences between our primary disorders, social and psychiatric outcomes are often robust indices of genetic risk and can reflect the levels of genetic heterogeneity.

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来源期刊
Psychological Medicine
Psychological Medicine 医学-精神病学
CiteScore
11.30
自引率
4.30%
发文量
711
审稿时长
3-6 weeks
期刊介绍: Now in its fifth decade of publication, Psychological Medicine is a leading international journal in the fields of psychiatry, related aspects of psychology and basic sciences. From 2014, there are 16 issues a year, each featuring original articles reporting key research being undertaken worldwide, together with shorter editorials by distinguished scholars and an important book review section. The journal''s success is clearly demonstrated by a consistently high impact factor.
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