الگوهای خانواده آسیب شناسی روانی در اختلالات روانی

Objective Familial loading and crucial outcomes of family history of psychopathology in psychiatric disorders have long been recognized. There has been ample literature providing convincing evidence for the importance of family psychopathology in development of emotional disturbances in children as well as worse outcomes in the course of psychiatric disorders. More often, maternal psychopathology seems to have been an issue of interest rather than paternal psychopathology while effects of second-degree familiality have received almost no attention. In this study, we addressed the relations between affected first- and second-degree relatives of probands and categories of psychiatric disorders. Method Subjects were 350 hospitalized psychiatric inpatients, consecutively admitted to psychiatry clinics in Van, Turkey. Mean age was 34.16 (SD ± 12) and 51.4% of the sample consisted of male patients. Assessment of psychopathology in psychiatric probands was conducted based on DSM-IV TR. Familial loading of psychiatric disorders amongst first- and second-degree relatives of patients were initially noted primarily relying on patients' retrospective reports, and confirmed by both phone call and following official health records via the Medical Knowledge System. We analyzed the data using latent class analysis approach. Results We found four patterns of familial psychopathology. Latent homogeneous subsets of patients due to familial characteristics were as paternal kinship psychopathology with schizophrenia, paternal kinship psychopathology with mood disorders, maternal kinship psychopathology and core family psychopathology. Conclusion Family patterns were critical to exerting variation in psychiatric disorders of probands and affected relatives. Probands with a core family pattern of psychopathology exhibited the most colorful clinical presentations in terms of variation in psychopathology. We observed a specificity of intergenerational transmission of psychiatric disorders when family patterns of psychopathology were taken into consideration, even second-degree relatives of psychiatric probands.

There has been a vast body of evidence that psychiatric disorders in parents are substantially associated with a rise in affect regulation problems in a wide range from mild to severe disturbances in children. Almost half of children of parents suffering from psychiatric disorders develop affective problems that persist into adulthood, particularly bipolar disorders and substance misuse [1]. An extensive parental psychopathology research has generally focused on possible influences of maternal emotional difficulties on child development, whilst paternal psychiatric disorders have been demonstrated to exert crucial direct and indirect adverse influences on child's psychological development, even though data concerning the effects of paternal pathology on the offspring relatively lag behind maternal investigations [2]. In a prospective longitudinal community study of parental major depression as a risk factor of psychopathology in offspring, Lieb et al [3] tied parental psychiatric disorders to an increased risk of affected offspring in which odds ratios were virtually in parallel with Birmaher et al. [4] and differences in estimated risks of maternal and paternal psychopathology for intergenerational transmission to the offspring were not substantial.