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頁籤選單縮合
題名 | Genetic Eqidemiology of Schizophrenia: Review and Reassessment=精神分裂病遺傳流行病學:回顧與再檢討 |
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作者 | 莊明哲; | 書刊名 | The Kaohsiung Journal of Medical Sciences |
卷期 | 14:7 1998.07[民87.07] |
頁次 | 頁405-412 |
專輯 | Schizophrenia-Basic Clinical Aspects |
分類號 | 415.983 |
關鍵詞 | 精神分裂病; 遺傳; Schizophrenia; Gene; Genetic epidemiology; |
語文 | 英文(English) |
中文摘要 | 近年來嚴謹的研究指出,精神分裂病具家族遺傳。雖然受到精神分裂病定義上之侷限,少數的研究發現精神分裂病患家屬的絕對病發率為較低外,其餘以應用對照研究方法所得的結果仍是一致的。上述發現並可由基因與環境遺傳理論證實;精神分裂病的同卵雙胞胎發病率要比異卵雙胞胎來得高。雖然如此,同卵雙胞胎研究中並非百分之百有上述結論,顯示精神分裂病病因中亦有其他重要的非基因因素存在。尤其甚之,領養研究為一很好控制基因與環境的實證研究法,應用上述研究方法亦證實精神分裂病有其基因因子的存在。雖然透過家族、雙胞胎與領養研究發現精神分裂病有明顯的基因因素,然而其遺傳方式仍未明確。應用數學模式原理之研究仍不能印證「單一基因」遺傳模式,而「多基因多因素」之遺傳模式又被否定;因此,精神分裂病之遺傳模式至今仍撲朔迷離。基因串聯分析法為目前一有效解釋遺傳機轉的方法,然而至今應用此研究法仍未對精神分裂病有一致性且重複印證的報告。目前,醫學界正針對精神分裂病特殊或不同的染色體基因的位置進行探討,上述研究的突破對將來臨床工作將會有極大的影響。 |
英文摘要 | When a rigorous methodological approach is utilized, a substantial majority of recent studies provide evidence for the familial transmission of schizophrenia. Although the absolute rates of schizophrenia among relatives of schizophrenics tend to be lower than those reported in the earlier studies due to the restrictiveness of contemporary definitions of schizophrenia, the risk to relatives compared to that of controls has remained quite consistent. This observation that relatives of schizophrenics have an elevated risk for schizophrenia compared to controls is consistent with theories of both genetic and environmental transmission. Twin studies of schizophrenia have consistently reported greater concordance rates for monozygotic than dizygotic twins. Although this indicates the importance of genetic factors, the less than 100% concordance for monozygotic twins observed in every study indicates that nongenetic factors also play a role in the etiology of schizophrenia. Further, adoption studies offer an opportunity to unconfound genes and environment. The findings of adoption studies confirm that there are genetic components for schizophrenia. Even though we have shown that family, twin, and adoption studies have provided strong evidence for the role of genetic factors in schizophrenia, the mode of transmission remains unclear. The results of mathematical modeling studies do not support the single gene model. There is somewhat more support for the multifactorial polygenic model, but the model has also been rejected in several studies. Thus, the pattern of inheritance of schizophrenia has eluded an unambiguous characterization. Genetic linkage analysis promised to clarify the mechanisms of transmission, but early positive reports were subsequently overturned and, to date, there are no consistently replicated positive linkage findings for schizophrenia. There is now a world-wide search for the location of the genes on specific chromosomes which are responsible for schizophrenia. The clinical implications of current work to the future of locating a schizophrenic gene or genes will be discussed. |
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