早发型与晚发型抑郁症遗传效应比较

A comparison of genetic effects between the early and late onset unipolar depression

目的:了解早发型与晚发型单相抑郁症之间是否存在遗传效应的差异。方法:对符合中国精神障碍分类与诊断标准第3版抑郁发作诊断标准的115例单相抑郁症患者,以初发病年龄30岁为界,分为早发组47例和晚发组68例。对照组230名,无精神疾病,与患者组无血缘关系。对所得资料行单因素分析,用多基因阈值理论进行遗传率的估算。结果:早发组有精神疾病家族史者为55.3%(26/47),显著高于晚发组35.3%(24/68);早发组一级亲属心境障碍和单相抑郁症发生率分别为9.1%(23/252)和7.9%(20/252),显著高于晚发组一级亲属的4.8%(23/479)和3.6%(17/479);两组一级亲属单相抑郁症发生率均显著高于对照组一级亲属的0.2%。早发组加权平均遗传率及标准误(96.3±1.3)%高于晚发组(75.7±1.2)%,脑部CT器质性改变亦少于晚发组(P<0.05或P<0.01)。结论:早发型及晚发型单相抑郁症均有明显的遗传效应,但二者的遗传效应存在差异。

Objectlve：To explore the possible differences of genetic effects between the early onset and late onset unipolar depression. Method： 115 subjects who met CCMD-3 diagnostic criteria for depressive epi- sode were divided into the early onset and late onset subgroups （47 cases and 68 cases） according to cut-off point of age 30 years. The data were examined with the single factor analysis and the heritability was estimated with multiple gene threshold theory. Results：The number of early onset patients with family history of mental illness was found to be 55.3% （26/47）, which was larger comparing to 35.3% （24/68）found among the late onset patients. The risk rate of mood disorder in first-degree relatives of the early onset unipolar depression pa- tients was determined to be 9.1% （23/252）, again higher comparing to the rate of 4.8% （23/479） among the late onset. Prevalence rate of depression in first-degree relatives of early onset and late onset unipolar depression patients are 7.9% and 3.6% respectively, both being higher than that of the control group （0.2%）. Prevalence of depression was also significantly higher in first degree relatives of the early onset patients than in that of the late onset patients. The weighted mean with standard error of heritability of early onset unipolar depression was （ 96.3：1：1.3 ） % , higher than（75.7 ± 1.2 ） % of late onset unipolar depression. The brain pathological changes with CT scan in the early onset group were less than that in the late onset group, the differences were all statisti- cally significant （ P 〈 0.05 or P 〈 0.01 ）. Conclusion： There is significant genetic effects on unipolar depres- sion, and the effects are significantly different between the early onset and late onset unipolar depression.