抑郁症自杀行为遗传流行病学对照研究

A study on genetic epidemiology of suicidal behaviors in major depression

目的 探讨遗传因素在抑郁症自杀行为中的作用。方法 采用病例对照研究方法对 10 3例抑郁症自杀行为先证者和 10 3例对照的亲属资料进行遗传流行病学研究。结果 2 4 2 7%的先证者的Ⅰ级亲属有自杀行为 ;Ⅰ级亲属、Ⅱ级亲属发生率依次为 4 5 6 %、1 6 0 % ,显著高于对照组Ⅰ级亲属发生率 0 2 6 4 % (P <0 0 1) ,其OR值及95 %可信区间分别为 18 0 7(4 33～ 75 4 0 )、6 16 (1 4 3～ 2 6 6 3) ,且Ⅰ级亲属自杀行为发生率 >Ⅱ级亲属 >Ⅲ级亲属>群体自杀行为发生率。采用Li mantel Gart法得分离比及 95 %可信区间为 0 12 88(0 0 991～ 0 15 85 )。多基因阈值模型估计 ,抑郁症自杀行为先证者Ⅰ、Ⅱ、Ⅲ级亲属的遗传度分别为 71 5 2± 11 0 2 %、4 1 92± 11 81%、31 0 9±13 2 9% ,三者加权平均遗传度为 4 9 38± 3 99%。结论 抑郁症自杀行为具有多基因遗传的特点 ,遗传因素在决定抑郁症自杀行为的易患性上起到重要的作用。

Objective To explore the significance of genetic factor in thepathogenesis of suicidal behaviors (SB) in major depression (MD). Methods A case control study of 103 MD with SB and 103 conlrols was performed to analyze the effect of genetic factor on the liability of SB. Falconer's method was used to estimate the effect of heritability. Results 25 (24 27%) of 103 probands had one or more first degree relatives suffered from SB. Prevalence rates of SB in first degree relatives and second degree felatives in proband group were 4 56%、1 60%, respectively. which were significantly higher than that in control group (0 264%) ( P <0 001). Futhermore, the odd ratio (OR) and its 95% confidence interval (95% CI) were 18 07 (4 33～75 40)、 6 16 (1 43～26 63), respectively. The descending order of prevalence rates was as follows: first degree relatives>second degree relatives>third degree relatives>control relatives. A ratio of apart and its 95% confidence interval (95% CI) was 0 1288 (0 0991～0 1585). Heritability of SB was 71 52±11 02% in the first degree relatives, 41 92±11 81% in the second degree relatives, and 31 09±13 29% in the third degree relatives. The weighted mean heritability was 49 38±3 99%. Conclusions SB in MD has characteristics of polygenic disease. Genetic factar might play an important role in the liability of SB in MD.