Disorders In First-degree Relatives Research Articles

FAMILY HISTORY OF PSYCHOLOGICAL DISORDERS MODERATES THE ASSOCIATION BETWEEN PRENATAL MATERNAL STRESS AND RISK OF AUTISM

The increase in number of cases with autism spectrum disorder (ASD) requires further investigation to the etiology of it, which is not fully understood. It is suggested that children who are vulnerable to psychological disorders more likely to develop ASD when experience prenatally stress than children who do not. The researcher sought to conduct a natural experiment by collecting data from a sample derived from population lived in a region that experienced number of the worst civil wars in Libya. The sample consisted of 38 parents of children with ASD and 40 parents of typical children living in south Tripoli. These children were in utero during the civil wars that happened in 2011, 2014, and 2019. A case-control study was carried out comparing the two groups in terms of family history of psychological disorders. The child’s sex, parents’ age, and birth complications were controlled. Conditional logistic regression models were utilized to examine whether family history of psychological disorders predicted ASD. Findings from this study indicated that: children with ASD were more likely to have relatives with psychological disorders than those without ASD; the proportion of relatives with psychological disorders was significantly higher among children with ASD than those without ASD; there was significant associations between ASD and parents’, grandparents’, uncles’, aunts’ psychological disorders, having a first-degree relative suffers from a psychological disorder was associated with increase in odds of ASD. ,having second-degree relatives with a psychological disorder was significantly associated with increase odds of ASD, psychological disorders in first degree relatives and second degree relatives had comparable effect on the risk of ASD, when first degree relatives and second degree relatives affected the risk of ASD did not increase compared to the presence of a psychological disorder in either relatives

Risks and familial coaggregation of death by suicide, accidental death and major psychiatric disorders in first-degree relatives of individuals who died by suicide.

Evidence suggests a familial coaggregation of major psychiatric disorders, including schizophrenia, bipolar disorder, major depression (MDD), autism spectrum disorder (ASD) and attention-deficit hyperactivity disorder (ADHD). Those disorders are further related to suicide and accidental death. However, whether death by suicide may coaggregate with accidental death and major psychiatric disorders within families remains unclear. To clarify the familial coaggregation of deaths by suicide with accidental death and five major psychiatric disorders. Using a database linked to the entire Taiwanese population, 68 214 first-degree relatives of individuals who died by suicide between 2003 and 2017 and 272 856 age- and gender-matched controls were assessed for the risks of death by suicide, accidental death and major psychiatric disorders. A Poisson regression model showed that the first-degree relatives of individuals who died by suicide were more likely to die by suicide (relative risk RR = 4.61, 95% CI 4.02-5.29) or accident (RR = 1.62, 95% CI 1.43-1.84) or to be diagnosed with schizophrenia (RR = 1.53, 95% CI 1.40-1.66), bipolar disorder (RR = 1.99, 95% CI 1.83-2.16), MDD (RR = 1.98, 95% CI 1.89-2.08) or ADHD (RR = 1.34, 95% CI 1.24-1.44). Our findings identified a familial coaggregation of death by suicide with accidental death, schizophrenia, major affective disorders and ADHD. Further studies would be required to elucidate the pathological mechanisms underlying this coaggregation.

Early-Life and Family Risk Factors for Tic Disorder Persistence into Adulthood.

Many children with tic disorders outgrow their tics, but little is known about the proportion of individuals who will continue to require specialist services in adulthood and which variables are associated with tic persistence. The aims were to estimate the proportion of individuals first diagnosed with tic disorders in childhood who continued to receive tic disorder diagnoses after age 18 years and to identify risk factors for persistence. In this Swedish nationwide cohort study including 3761 individuals diagnosed with tic disorders in childhood, we calculated the proportion of individuals whose diagnoses persisted into adulthood. Minimally adjusted logistic regression models examined the associations between sociodemographic, clinical, and family variables and tic disorder persistence. A multivariable model was then fitted, including only variables that were statistically significant in the minimally adjusted models. Seven hundred and fifty-four (20%) children with tic disorders received a diagnosis of a chronic tic disorder in adulthood. Psychiatric comorbidity in childhood (particularly attention-deficit hyperactivity disorder, obsessive-compulsive disorder, pervasive developmental disorders, and anxiety disorders) and psychiatric disorders in first-degree relatives (particularly tic and anxiety disorders) were the strongest risk factors for persistence. We did not observe statistically significant associations with socioeconomic variables, perinatal complications, comorbid autoimmune diseases, or family history of autoimmune diseases. All statistically significant variables combined explained approximately 10% of the variance in tic disorder persistence (P < 0.0001). Childhood psychiatric comorbidities and family history of psychiatric disorders were the strongest risk factors associated with tic disorder persistence into adulthood. © 2023 The Authors. Movement Disorders published by Wiley Periodicals LLC on behalf of International Parkinson and Movement Disorder Society.

Psychogenic non-epileptic seizures in youth: Individual and family psychiatric characteristics.

Youth with psychogenic non-epileptic seizures (PNES) are an understudied group associated with significant medical and psychiatric morbidity. Several studies have examined characteristics associated with youth's development of this disorder, though the exploration of family factors including psychiatric illness, has been lacking. This study sought to establish the need for a more comprehensive future study. A retrospective chart review was conducted on patients who had been admitted and diagnosed with PNES at the epilepsy monitoring unit at Children's Hospitals and Clinics of Minnesota. A total of 62 patients were included. All patients were evaluated by an epileptologist and psychologist during their diagnostic admission. "Spells" in question were captured via video EEG monitoring. PNES youth and family risk factors were assessed. Mean age of PNES symptom onset was 13.9 years. Patients (73%) were diagnosed within 6 months of onset of symptoms. Histories of other impairing somatic complaints were present in the youth (54%), with 67% having prior psychiatric diagnoses. Experiencing suicidal ideation or thoughts of self-harm occurred in 47% of this sample. Family members were unaware of the history of these symptoms with 12% of the parent's reporting awareness. Family history of psychiatric disorders (first-degree relatives of patient) was present in 54% of the sample, with anxiety, depression and conversion disorder being the most commonly endorsed diagnoses. Youth with PNES present with comorbid psychiatric disorders, though prior assessment and treatment for these disorders was not common. Youth with PNES have history of suicidal ideation and thoughts of self-harm, though parental awareness of these co-occurring symptoms is limited. Family risk factors, such as history of psychiatric disorder in first degree relatives, was high. The impact of these family risk factors is understudied and should be further evaluated to better understand the impact on development and maintenance of this disorder in youth.

Findings of a Multidisciplinary Assessment of Children Referred for Possible Neurodevelopmental Disorders: Insights from a Retrospective Chart Review Study.

Children with ASD have a wide spectrum of functional deficits in multiple neurodevelopmental domains. A multidisciplinary team assessment (MDT) is required to assess those deficits to help construct a multimodal intervention plan. This is a retrospective chart review of the assessment for children who were referred for an assessment of potential neurodevelopmental disorders. We reviewed 221 participants' charts from January 2019 to January 2020. The mean age of the children was 7.95 ± 3.69, while the mean age of the fathers and mothers was 37.31 ± 8.57 and 31.95 ± 6.93, respectively. Consanguinity was as high as 37.9% for the referred children with developmental delay who were first-degree related, and 13.2% of the parents were second-degree relatives. Approximately 26.6% of children had a family history of mental illness in first-degree relatives. ASD was the most commonly reported diagnosis post-assessment, and ADHD was the most common reported comorbidity at 64.3% and 88.5%, respectively. The MDT findings showed that 58% of children required moderate or higher assistance with toileting, 79.2% were unable to answer yes/no questions, and 86.8% were unable to understand "wh" questions. Only 26% of the nonverbal children had average IQ testing results, and 31% of verbal children did. In conclusion, the mean age of the children when assessed was above that recommended for early screening and intervention. An increased paternal and maternal age was noticeable. Consanguinity and a family history of mental disorders in first-degree relatives were high, attesting to a possible genetic risk.

Metabolic Disorders in First-Degree Relatives of Patients With Type 2 Diabetes in a Southern Coastal Region in Iran

Background: Diabetes mellitus is a global health challenge. Metabolic disorders in first-degree relatives (FDRs) of patients with type 2 diabetes mellitus (T2DM) have been linked to a family history of diabetes. Objectives: This study aimed to investigate the frequency of metabolic syndrome (MetS), diabetes, and prediabetes in FDRs of patients with T2DM. Methods: This descriptive study included FDRs of patients with T2DM referred to the diabetes clinic of Shahid Mohammadi Hospital, Bandar Abbas, Iran in 2017. Waist circumference (WC) and blood pressure were measured for each participant. Fasting plasma glucose was measured in venous blood samples after 8-hour fasting. Two-hour plasma glucose was measured after a 75-g oral glucose tolerance test. Triglyceride and high-density lipoprotein were measured in venous blood samples after 12-hour fasting. The Adult Treatment Panel III (ATP III) and the International Diabetes Federation (IDF) criteria were used to diagnose MetS. Iranian-specific WC cutoffs from different studies were also used as alternatives for WC cutoffs in IDF criteria to form Iranian-specific MetS criteria. Results: This study included 300 FDRs (male: 33.7% vs. female: 66.3%) of patients with T2DM, with a mean age of 33.56±10.64 years. Among the participants, 19.7% had prediabetes and 8% had diabetes. MetS was diagnosed in 8.3% and 15% of the FDRs based on the ATP III and IDF criteria, respectively. The frequency of MetS ranged from 6.7% to 11.7% based on six different Iranian-specific WC cutoffs. Conclusion: The frequency of MetS, diabetes, and prediabetes was quite high in the FDRs of patients with T2DM. Screening for these metabolic disorders can help prevent future cardiovascular events in this specific group.

Associations of a family history of lupus with the risks of lupus and major psychiatric disorders in first-degree relatives.

Genetic factors link psychiatric disorders, particularly major depressive disorder (MDD), bipolar disorder, and obsessive-compulsive disorder (OCD), with systemic lupus erythematosus (SLE). Additionally, maternal SLE is a risk factor for long-term developmental problems, particularly learning disabilities, attention disorders, autism spectrum disorder (ASD) and speech disorders, in children. We aimed to determine whether first-degree relatives (FDRs) of patients with SLE have increased risks of SLE and major psychiatric disorders. Using the Taiwan National Health Insurance Research Database, we recruited 40 462 FDRs of patients with SLE as well as 161 848 matched controls. The risks of major psychiatric disorders, including schizophrenia, bipolar disorder, OCD, MDD, ASD and attention-deficit/hyperactivity disorder (ADHD), were assessed. The FDRs of patients with SLE had higher risks of SLE (reported as the adjusted relative risk and 95% confidence interval: 14.54; 12.19-17.34), MDD (1.23; 1.12-1.34), ADHD (1.60; 1.55-1.65), OCD (1.41; 1.14-1.74) and bipolar disorder (1.18; 1.01-1.38) compared with controls. Specifically, male FDRs of patients with SLE had higher risks of SLE and bipolar disorder, whereas female FDRs of patients with SLE had higher risks of MDD and OCD. Differences in the familial relationship (i.e. parents, children, siblings and twins) were consistently associated with higher risks of these disorders compared with controls. The FDRs of patients with SLE had higher risks of SLE, MDD, ADHD, OCD and bipolar disorder than the controls.

Using big data of genetics, health claims, and brain imaging to challenge the categorical classification in mental illness.

Psychiatric disorders in first-degree relatives (FDRs) often differ from the index patient's diagnosis, suggesting that there is genetic contribution to psychiatric disorders in which related cases do not all map to the same diagnosis as the index case. Our aim is to look for psychiatric comorbidities across major mental illnesses using three approaches, genetics, clinical diagnosis, and brain imaging to address common associations and pathology among mental illnesses. Genome-wide association studies from the Psychiatric Genomics Consortium showed single gene polymorphisms are common across 5 major psychiatric disorders, including schizophrenia (SZ), bipolar disorder (BD), major depressive disorder (MDD), autism spectrum disorder (ASD), and attention deficit hyperactivity disorder (ADHD). Clinically, results of Taiwan's nationwide population studies showed that other major psychiatric disorders were more likely to coaggregate in families with an index case of an individual with a psychiatric disorder, compared to control families. Finally, resting functional connectivity (FC) magnetic resonance imaging (MRI) and whole-brain connectomic analysis of SZ, BD I, BD II, MDD, and healthy controls revealed that the four groups of patients shared similar patterns of abnormal neural substrate in the brain that differed from controls. In conclusion, using big data from genetics, administrative health claims, and brain imaging, we identified concordance, indicating dimensional coherence of genetic heritability, clinical mutual associations, and common neurobiological substrates across major psychiatric disorders. These results will challenge the current diagnostic classification system and possibly move psychiatry beyond descriptive syndromes towards a nosology informed by disease cause.

P.041 First Degree Movement Disorders Cases and Research

Background: While researchers pursue the etiology, pathophysiology and treatment of movement disorders, presently there is no biological marker for the two most common disorders – essential tremor (ET), and Parkinson’s disease and variants (Parkinson syndrome, or PS). The diagnosis of each remains clinical, but definitive diagnosis is made on brain pathology. Population epidemiological studies are hampered by a lack of diagnostic precision. Twins with the same disorder are scarce, and the next best option is studies of well-documented first-degree family members. Methods: Patients were seen at the Saskatchewan Movement Disorders Program (SMDP). All autopsied cases with known clinicopathological diagnosis of a movement disorder between 1970 and 2019 were reviewed. Only those with a first-degree family member – parent, child, and/or sibling - with a movement disorder were included. Results: 671 cases with movement disorders seen at SMDP have been autopsied. 29 cases including probands were found and thirteen first-degree families were identified; eight families were multiple (2 or more) siblings and five families included one parent/one child. In seven families, the diagnosis was concordant. Conclusions: Movement disorders in first degree relatives with autopsied verified diagnosis are dissimilar in nearly half the cases. Such small intensively studied groups offer unique research opportunities.

Study Family History of Psychiatry Disorders in Schizophrenia Patients

Background: Schizophrenia is a chronic heterogeneous mental disorder that often has debilitating long-term outcomes. Our aim in this study is to survey history of psychiatric disorders in first-degree relatives of schizophrenia patients and its association with the disease clinical and demographic profile. Methods: In this retrospective study the hospital records of all schizophrenia patients that had been admitted in Ibn Sina Psychiatric Hospital from March 2018 to March 2019 were surveyed. Histories of any psychiatry disorders in the first-degree relatives of the schizophrenia patients were searched. The patients with positive family history were compared with those with negative family history in regard to age of onset, sex, negative symptoms, substance abuse and education level. Results: Of 250 files that were studied, 62 (24.2%) patients had family history of psychiatry disorders. Schizophrenia (10.8%), schizoaffective disorder (7.2%) and bipolar disorder (4.2%) were the most common psychiatry disorders in first-degree relatives of schizophrenia patients. Male sex, lower age at onset, substance abuse, negative symptoms, and lower education were more frequently observed in schizophrenia patients with positive family history. Conclusions: Our study demonstrated that family histories of schizophrenia, schizoaffective and bipolar disorder were higher in family history of schizophrenia patients than normal population. Furthermore, positive family history for psychiatric disorder is associated with worse prognosis in schizophrenia patients. J Neurol Res. 2020;10(6):231-234 doi: https://doi.org/10.14740/jnr631

Familial coaggregation of major psychiatric disorders in first-degree relatives of individuals with autism spectrum disorder: a nationwide population-based study.

Family coaggregation of attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), bipolar disorder (BD), major depressive disorder (MDD) and schizophrenia have been presented in previous studies. The shared genetic and environmental factors among psychiatric disorders remain elusive. This nationwide population-based study examined familial coaggregation of major psychiatric disorders in first-degree relatives (FDRs) of individuals with ASD. Taiwan's National Health Insurance Research Database was used to identify 26 667 individuals with ASD and 67 998 FDRs of individuals with ASD. The cohort was matched in 1:4 ratio to 271 992 controls. The relative risks (RRs) and 95% confidence intervals (CI) of ADHD, ASD, BD, MDD and schizophrenia were assessed among FDRs of individuals with ASD and ASD with intellectual disability (ASD-ID). FDRs of individuals with ASD have higher RRs of major psychiatric disorders compared with controls: ASD 17.46 (CI 15.50-19.67), ADHD 3.94 (CI 3.72-4.17), schizophrenia 3.05 (CI 2.74-3.40), BD 2.22 (CI 1.98-2.48) and MDD 1.88 (CI 1.76-2.00). Higher RRs of schizophrenia (4.47, CI 3.95-5.06) and ASD (18.54, CI 16.18-21.23) were observed in FDRs of individuals with both ASD-ID, compared with ASD only. The risk for major psychiatric disorders was consistently elevated across all types of FDRs of individuals with ASD. FDRs of individuals with ASD-ID are at further higher risk for ASD and schizophrenia. Our results provide leads for future investigation of shared etiologic pathways of ASD, ID and major psychiatric disorders and highlight the importance of mental health care delivered to at-risk families for early diagnoses and interventions.

Characteristics of Puberty Period in Adolescent Girls and Major Risk Factors of Menstrual Function Disorders Against the Background of Endemic Goiter

Disorders of menstrual function are often the result of thyroid dysfunction and disorders of the neuroendocrine regulation, initiated by iodine deficiency, and are the most destructive in puberty period.&#x0D; The objective of the study was to clarify the peculiarities of establishment of menstrual function and the degree of interaction between the hypothalamic-pituitary-ovarian system and thyroid gland against the background of iodine deficiency in adolescence.&#x0D; Materials and methods of research. Analytical analysis of medical records and sociomedical audit were carried out by interviewing 490 girls of puberty age, the purpose of which was to estimate the prevalence of thyroid dysfunction and possible factors of development of menstrual disorders.&#x0D; Results of the study and their discussion. The proportion of thyroid dysfunction in adolescent girls is quite significant; hypofunction was diagnosed 3.4 times more frequent than its increased activity. Less than half of the studied had regular menstrual cycle, while girls with thyroid dysfunction suffered much more often from menstrual dysfunction in the form of hypomenstrual syndrome (1.5-fold, p&lt;0.05), algodismenorrhea (1.6-fold, p&lt;0.05) and amenorrhea (1.4-fold, p&lt;0.05), premenstrual syndrome and anovulatory conditions associated with polycystic ovary syndrome. Such somatic diseases as neuro-vegetative dysfunction, diseases of the gastrointestinal tract, chronic tonsillitis, frequent lacunar angina and acute respiratory viral diseases are common. Clinical manifestations included symptoms of thyroid hypofunction, androgen-associated dermopathy, hirsutism syndrome, and concomitant endocrine-associated pathology of the mammary glands (mastalgia, mastopathy, and galactorrhea).&#x0D; Conclusions. The burden of perinatal history, the presence of thyroid pathology and other manifestations of metabolic and endocrine disorders in first-degree relatives are unfavourable prognostic factors of disorders of the menstrual cycle against the background of thyroid dysfunction. The findings obtained allow us to determine the leading risk factors for problematic menstruation establishment and menstrual disorders, especially when combined with thyroid dysfunction. Hypomenstrual syndrome and algodysmenorrhea, as well as manifestations of premenstrual syndrome and anovulatory cycles, belong to major disorders of the menstrual cycle in case of thyroid gland dysfunction.

Familial severe psychiatric history in bipolar disorder and correlation with disease severity and treatment response

BackgroundBipolar disorder is a heritable disorder, and we aimed to assess the impact of family history of mental disorders in first-degree relatives on the severity and course of bipolar disorder. MethodsThe Bipolar CHOICE (lithium versus quetiapine) and LiTMUS (optimized treatment with versus without lithium) comparative effectiveness studies were similar trials among bipolar disorder outpatients studying four different randomized treatment arms for 24 weeks. Patients self-reported on six severe mental disorders among first-degree relatives. We performed ANOVA and linear regression regarding disease severity measures, sociodemographic and cardiometabolic markers and mixed effects linear regression to evaluate treatment response. ResultsAmong 757 patients, 644 (85.1%) reported at least one first-degree relative with a severe mental disorder (mean=2.8; standard deviation=2.2; range=0-13). Depression (67.1%), alcohol abuse (51.0%) and bipolar disorder (47.0%) were the most frequently reported disorders. Familial psychiatric history correlated with several disease severity measures (hospitalizations, suicide attempts, and earlier onset) and sociodemographic markers (lower education and household income) but not with cardiometabolic markers (e.g. cholesterol or waist circumference) or cardiovascular risk scores, e.g. the Framingham risk score. Patients with familial psychiatric history tended to require more psychopharmacological treatment (p=0.054) but responded similarly (all p>0.1) to all four treatment arms. ConclusionsOur findings indicate that familial psychiatric history is common among outpatients with bipolar disorder and correlates with disease severity and sociodemographic measures. Patients with a greater familial psychiatric load required more intense treatment but achieved similar treatment responses compared to patients without familial psychiatric history.

Comparison of Effect of Bipolar I Disorder on Neurocognitive Functions between Full Biological Siblings of Patients from Simplex and Multiplex Families

Background: Cognitive deficits seem to be more prevalent in relatives of patients with bipolar disorder type I compared to relatives of BD type II patients. Assessment of cognitive performance in siblings of bipolar disorder from simplex (only one known case of bipolar disorder in first degree relatives) and multiplex (more than one known case of bipolar disorder in first degree relatives) families may provide some light to investigate the biological vulnerability in bipolar disorder. There is limited data pertaining to studies on siblings of patients with bipolar disorder and especially on comparison of effect of Bipolar I Disorder on neurocognitive functions between full biological siblings of patients from simplex and multiplex Families. Materials and Methods: This is a prospective, teaching hospital based, single point non-invasive study of 29 unaffected full biological siblings of patients diagnosed (as per DSM-IV-TR) as bipolar disorder I (BD-I) from Simplex and Multiplex families. Results: The siblings belonging to the multiplex group performed poorly on most domains of the Wisconsin Card Sorting Test (WCST). Comparison of the performance of the siblings belonging to the multiplex sub-group to those of simplex sub-group on the various domains of the Continuous Performance Test (CPT) and Spatial Working Memory Test (SWMT) did not show statistically significant difference. Conclusions: The performance in WCST is significantly affected in siblings from multiplex families than in simplex ones.

MODY2 diagnostic issues in adults

Approximately 90% of all cases of diabetes mellitus in adults involve type 2 diabetes, while the prevalence of maturity-onset diabetes of the young (MODY) remains undetermined leading to inappropriate treatment regimens. One of the most common monogenic forms of diabetes is a disease caused by a mutation in the glucokinase gene, MODY2. Knowledge of the clinical features of the disease allows the selection of patients with a high risk of mutation in the glucokinase gene and verification of diagnosis for molecular genetic research. This paper reflects the clinical features of MODY2 and the difficulties of diagnosis in adults. Furthermore, it presents a clinical case of a patient with MODY2 demonstrating all the features of this type of diabetes. A family member with a mutation in the gene allows to predict the nature of carbohydrate metabolism disorders in first degree relatives. A targeted study of only one part of the glucokinase gene in molecular genetic research is sufficient to confirm the diagnosis in relatives.

Compulsivity is measurable across distinct psychiatric symptom domains and is associated with familial risk and reward-related attentional capture.

Compulsivity can be seen across various mental health conditions and refers to a tendency toward repetitive habitual acts that are persistent and functionally impairing. Compulsivity involves dysfunctional reward-related circuitry and is thought to be significantly heritable. Despite this, its measurement from a transdiagnostic perspective has received only scant research attention. Here we examine both the psychometric properties of a recently developed compulsivity scale, as well as its relationship with compulsive symptoms, familial risk, and reward-related attentional capture. Two-hundred and sixty individuals participated in the study (mean age=36.0 [SD=10.8] years; 60.0% male) and completed the Cambridge-Chicago Compulsivity Trait Scale (CHI-T), along with measures of psychiatric symptoms and family history thereof. Participants also completed a task designed to measure reward-related attentional capture (n=177). CHI-T total scores had a normal distribution and acceptable Cronbach's alpha (0.84). CHI-T total scores correlated significantly and positively (all p<0.05, Bonferroni corrected) with Problematic Usage of the Internet, disordered gambling, obsessive-compulsive symptoms, alcohol misuse, and disordered eating. The scale was correlated significantly with history of addiction and obsessive-compulsive related disorders in first-degree relatives of participants and greater reward-related attentional capture. These findings suggest that the CHI-T is suitable for use in online studies and constitutes a transdiagnostic marker for a range of compulsive symptoms, their familial loading, and related cognitive markers. Future work should more extensively investigate the scale in normative and clinical cohorts, and the role of value-modulated attentional capture across compulsive disorders.

Coaggregation of Major Psychiatric Disorders in First-Degree Relatives of Individuals With Attention-Deficit/Hyperactivity Disorder: A Nationwide Population-Based Study.

Attention-deficit/hyperactivity disorder (ADHD) is a highly heritable mental illness that is easily passed from one generation to the next. Studies have shown that first-degree relatives (FDRs; ie, parents, offspring, and siblings) of individuals with ADHD had a higher risk of also having ADHD. However, the familial coaggregation of ADHD with other major psychiatric disorders, specifically schizophrenia (ICD-9-CM code 295), bipolar disorder (ICD-9-CM cods 296 except codes 296.2, 296.3, 296.9, and 296.82), major depressive disorder (ICD-9-CM codes 296.2 and 296.3), and autism spectrum disorder (ASD; ICD-9-CM code 299), remains unclear. Among the entire Taiwanese population in 2010, there were 220,966 parents of children with ADHD (ICD-9-CM code 314), 174,460 siblings of children with ADHD, and 5,875 children of parents with ADHD. Matched control individuals who did not have FDRs with ADHD (1:4) were selected based on age, sex, and their relation to family members. FDRs (parents, offspring, siblings, and twins) of ADHD-diagnosed individuals had higher relative risks (95% CI) of major psychiatric disorders than the controls: 1.69 (1.60-1.79) for schizophrenia, 2.21 (2.10-2.32) for bipolar disorder, 2.08 (2.02-2.13) for major depressive disorder, 4.14 (3.90-4.39) for ASD, and 6.87 (6.73-7.01) for ADHD. These results show that ADHD coaggregated with other major psychiatric disorders, specifically schizophrenia, bipolar disorder, major depressive disorder, and ASD, within families. The results suggest that public health officials and psychiatrists should closely monitor and follow the mental health of FDRs of ADHD-diagnosed individuals, such as parents and siblings of children with ADHD.

Familial Aggregation and Coaggregation of Suicide Attempts and Comorbid Mental Disorders in Adults

Clarification of the joint influence of familial patterns of suicide attempts and comorbid mental disorders can enhance the understanding and prevention of suicide attempts. To investigate the familial patterns of suicide attempts and comorbid mental disorders and their associations in a 2-site family study of mood and anxiety disorders. Data were obtained from 2 parallel community-based family studies conducted in the United States (National Institute of Mental Health [NIMH] study) and in Lausanne, Switzerland (PsyCoLaus study), on the comorbidity of mood and anxiety disorders. The study sample comprised 1119 adult probands and 5355 first-degree relatives. Data were collected and analyzed from October 2004 to December 2016. Lifetime suicide attempt and mental disorders in first-degree relatives, obtained through direct interviews or family history reports. The study included 1119 adult probands (675 female [60.3%] and a mean [SD] age of 50 [12.0] years) and 5355 first-degree relatives (2752 female [51.4%] and a mean [SD] age of 52 [1.5] years). Of these participants, 90 (8.0%) of 1119 probands and 199 (3.7%) of 5355 relatives had a lifetime history of suicide attempt. Those with such a history had higher rates of all mental disorders, a greater number of disorders, and statistically significantly poorer current and lifetime global functioning. After adjustment for age and sex, a statistically significant association between suicide attempts in probands and in relatives was found at the NIMH site (OR, 2.6; 95% CI, 1.5-4.7), at the Lausanne site (OR, 3.1; 95% CI, 1.6-6.0), and in the combined data (OR, 2.9; 95% CI, 1.9-4.5). All mood disorder subtypes and substance use disorders were statistically significantly associated with suicide attempts. The familial association between lifetime suicide attempts in probands and relatives was not statistically significant for the combined sample (OR, 1.6; 95% CI, 1.0-2.7) after adjustment for comorbid conditions in probands and relatives. Social anxiety disorder in probands was associated with suicide attempts in relatives (OR, 2.4; 95% CI, 1.7-3.5) after controlling for comorbid mood, anxiety, and substance use disorders. Familiality of suicide attempts appears to be explained by a history of mental disorders among those with suicide attempts; the novel finding of a common familial diathesis for suicide attempts and social anxiety, particularly in combination with mood disorders, has heuristic value for future research and may be a risk marker that can inform prevention efforts.

Postpartum depression and affecting factors in primary care.

The aim of this study was to determine the frequency and affecting factors of postpartum depression (PPD) in Edirne city center. This cross-sectional study was conducted among 111 pregnant women in their third trimester in Family Health Centers in Edirne, Turkey. The participants filled out a questionnaire on sociodemographic factors developed by the researchers along with the Beck Depression Inventory for Primary Care (BDI-PC) before childbirth. Women with a probability of depression, determined with the BDI-PC, were excluded, and the remaining 100 participants were applied the Edinburgh postpartum depression scale (EPDS) in the first and second months after childbirth. The frequency of PPD was 14% (n = 14) in the first month and 17% (n = 17) in the second month of delivery. Thus, 24 different mothers out of 100 were determined to have PPD in the first two months after childbirth. The probability of PPD, measured with EPDS, was significantly higher among younger mothers, mothers with unemployed husbands, mothers with lower income, mothers with a health problem of the child, and mothers who do not breastfeed. There was no significant relationship between PPD and mother's education status, marriage age, the age of first labor, PPD after previous childbirth, psychiatric disorders in first-degree relatives, higher number of children, method of delivery, and unwanted pregnancies. PPD is an important community problem. Thus, it is useful to monitor the risky mothers in primary care and screen them with the practical EPDS in order to prevent the negative effects on the baby and the mother.

Associations between risk factors for schizophrenia and concordance in four monozygotic twin samples.

Concordance for schizophrenia is high in monozygotic twins but the extent to which concordance varies according to the presence of other schizophrenia risk factors is not well established. We aimed to investigate this in systematically ascertained twin samples. DSM-III-R/DSM-IV diagnoses were made from original data or published case histories from four systematically ascertained monozygotic twin samples. Probandwise concordance for schizophrenia was calculated according to the presence of psychotic disorder in first-degree relatives, birth order, gender, and age-at-onset. Logistic regression analysis was also performed to adjust for potential confounders. Psychotic disorder in parents and earlier age-at-onset were significantly associated with higher probandwise concordance for schizophrenia, including after adjustment for potential confounders. For example, when no parents had a psychotic disorder concordance was 34/88 (38.6%) versus 10/16 (62.5%) when one parent was affected; and for age-at-onset <23 years concordance was 25/46 (54.3%), declining to 13/44 (29.5%) for age-at-onset >30 years. These results are consistent with psychotic disorder in parents and age-at-onset being markers of the level of familial liability to schizophrenia and these factors may be useful in genetic counseling of monozygotic twins and in identifying and managing those at particularly high risk, if these findings are further replicated.