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TREATMENT OF BIPOLAR DISORDER IN CHILDREN AND ADOLESCENTS - PART 7

Thêm bằng chứng cho thấy một phân nhóm của đĩa CD có liên quan đến rối loạn lưỡng cực có thể được xác định xuất phát từ thí điểm phân tích nguy cơ gia đình (Biederman, Faraone, Wozniak & Monuteaux, 2000; Wozniak, Biederman, Faraone, Blier & Monuteaux, 2001). | Treatment Implications 245 Evidence from Family Genetic Studies Further evidence that a subtype of CD linked to bipolar disorder could be identified derives from pilot familial-risk analyses Biederman Faraone Wozniak Monuteaux 2000 Wozniak Biederman Faraone Blier Monuteaux 2001 . These results showed that relatives of probands with bipolar disorder had an increased risk for bipolar disorder but not CD whereas relatives of probands with CD had an increased risk for CD but not for bipolar disorder relatives of probands with CD plus bipolar disorder had an elevated risk for both disorders Wozniak et al. 2001 . Among relatives in this latter group bipolar disorder and antisocial disorders showed significant cosegregation that is relatives with one disorder were highly likely to have the other. As a result of this cosegregation CD plus bipolar disorder was significantly elevated among relatives of probands with CD plus bipolar disorder but was rare among the relatives of the other proband groups. Probands with the combined condition of CD and bipolar disorder also had high rates of conduct or antisocial disorders without bipolar disorder among the relatives suggesting a genetic loading with two subtypes of CD with and without bipolar disorder. The family study results support the concept of heterogeneity of bipolar disorder and CD. Whereas the rates of bipolar disorder in relatives were identical in both bipolar disorder proband groups the relatives of probands with CD plus bipolar disorder had almost exclusively the comorbid type of bipolar disorder CD antisocial personality disorder plus bipolar disorder and relatives of the probands with bipolar disorder had higher rates of bipolar disorder without CD antisocial personality disorder Wozniak et al. 2001 . These results provide compelling evidence that subtypes of CD and of bipolar disorder can be identified based on patterns of comorbidity with the other disorder. Notably both CD and bipolar disorder show both a .