长沙市中学生抑郁伴/不伴焦虑的调查及青少年重性抑郁障碍特定基因—基因、基因—环境交互作用研究
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摘要
第二章长沙市中学生抑郁伴／不伴焦虑的调查
目的：了解长沙市中学生抑郁检出率及性别差异、随年龄变化趋势。探讨青少年抑郁伴／不伴焦虑临床特征、社会心理学影响因素的差别。
方法：采取整群抽样法抽取长沙10所中学3965名研究对象(11-18岁),完成自评及父母评情绪和感受问卷(MFQ-C、MFQ-P),儿童焦虑性情绪障碍筛查量表(SCARED)、青少年自评生活事件量表(ASLEC)、儿童青少年社会支持评定量表(SSRS-CA)、养育关系问卷(PBI)、行为抑制量表(BIS)、家庭功能评定(FAD)、心理弹性量表(RS)、儿童认知偏差问卷(CCDQ)、儿童青少年精神发育及健康状况筛查工具—长处和困难问卷(SDQ)、抑郁自评量表(SDS)、了解个人、家庭及教养方式的基本情况。将MFQ-C=18分者视为抑郁症状者,其中MFQ-C=18分,且SCARED>25分者视为抑郁伴焦虑组,而MFQ-C=18分,且SCARED<25分者视为抑郁不伴焦虑组。
结果：(1)以MFQ-C总分18分为划界分确定的抑郁症状者,总检出率为30.70%,男性检出率为26.8%,女性为34.6%,女性检出率较男性高(P<0.05)。青春早期(11-12岁)检出率为18%,青春中期(13-15岁)为30.9%,青春晚期(16-18岁)为36.5%。青春中期较青春早期检出率显著上升(LRx2=40.70,P=0.000),青春晚期较青春中期检出率进一步上升(LRx2=11.41,P=0.001)。
(2)抑郁伴焦虑者占总抑郁症状人数的55.3%,抑郁不伴焦虑者占44.7%。抑郁伴焦虑的发生率高于抑郁不伴焦虑(LRx2=73.64,P=0.000)；存在抑郁的男生中有47%伴焦虑,而存在抑郁的女生有61.9%伴焦虑,女生抑郁伴焦虑的发生率高于男生(Pearsonx2=26.79,P=0.000)
(3)伴焦虑组学生SDQ情绪症状(t=14.33,P=0.000)、品行问题(f=3.2,P=0.001)、同伴交往问题(f=2.39,P=0.017)、多动注意缺陷问题(t=3.17,P=0.002)、总困难得分(t=10.51,P=0.000)均显著高于不伴焦虑组；伴焦虑组抑郁严重程度高于不伴焦虑组(t=13.42,P=0.000)；抑郁伴焦虑组认知偏差、应激性生活事件、主观支持评分显著高于不伴焦虑组(P<0.05)。
结论：(1)11-18岁中学生MFQ-C抑郁总检出率为30.70%,其中男性26.8%,女性34.6%,女性检出率较男性高。青春早期检出率为18%,青春中期为30.9%,青春晚期为36.5%,检出率呈现由青春早期至青春晚期逐渐上升的趋势。抑郁伴焦虑的发生率高于抑郁不伴焦虑,女生抑郁伴焦虑的发生率高于男生。
(2)与抑郁不伴焦虑的学生相比,抑郁伴焦虑的学生具有更高的抑郁水平、更多的品行问题、多动注意缺陷问题及同伴相处困难、更严重的认知偏差,经历更多的应激性生活事件,获得更多的主观支持。
第三章青少年重性抑郁障碍社会心理学因素病例对照研究
目的：探讨青少年重性抑郁障碍(Major Depressive Disorder,MDD)的社会心理学影响因素,并从中筛选出预测能力较强的变量。
方法：394名研究对象(病例173人,正常对照221人),学生完成MFQ-C、SCARED、自评BI、SDS、CCDQ、PBI、ASLEC、SSRS-CA、RS,家长完成学生个人、父母及家庭基本情况表、FAD、父母评BI、MFQ-P。进行病例组和对照组个人、父母、家庭环境、养育方式及其它社会心理学因素的比较；将有差别的因素纳入二分类Logistic回归,筛选出预测能力较强的变量。
结果：MDD患者组和对照组学生父母文化程度、家庭类型、家庭关系、父亲管教方式、父母管教态度一致性与否、重大疾病史、目前健康状况、RS、CCDQ、ASLEC、FAD、PBI父母关心及保护总分、自评BI、SSRS-CA得分均具有显著的差别(所有P<0.05)。其中,PBI母亲关怀总分、ASLEC、RS进入二分类回归方程。
结论：父母文化程度、家庭类型、家庭关系、父亲管教方式、父母管教态度一致性与否、重大疾病史、目前健康状况、心理弹性、认知偏差、应激性生活事件、家庭功能、PBI父母关怀及保护总分、自评行为抑制、社会支持是青少年MDD的影响因素。其中,PBI母亲关怀总分、应激性生活事件、心理弹性是对青少年MDD预测能力较强的变量。
第四章青少年重性抑郁障碍特定基因-基因、基因-环境交互作用
目的：探讨中国汉族青少年MDD与二等位基因5-HTTLPR(即5-HTTLPR)多态性、三等位基因5-HTTLPR (5-HTTLPR+rs25531)多态性及MAOA-u VNTR多态性与青少年MDD之间的关系；探讨二等位基因5-HTTLPR多态性／三等位基因5-HTTLPR多态性与MAOA-u VNTR多态性之间的交互作用与青少年MDD之间的关系；探讨二等位基因5-HTTLPR多态性／三等位基因5-HTTLPR多态性/MAOA-u VNTR多态性和SLEs间的交互作用与青少年MDD之间的关系。
方法：404名研究对象(病例187人,正常对照217人)使用SNaPshot系统进行基因分型,ASLEC评估受访者近一年的负性生活事件。
结果：二等位基因5-HTTLPR、三等位基因5-HTTLPR, MAOA-u VNTR与青少年MDD患病与否、抑郁严重程度、是否共病焦虑、是否伴自杀行为／观念／企图无关联；二等位基因5-HTTLPR、三等位基因5-HTTLPR、MAOA-u VNTR和SLEs之间均不存在与青少年MDD患病相关联的交互作用；尚不能认为三等位基因5-HTTLPR与MAOA-u VNTR间存在与青少年MDD患病相关联的基因-基因交互作用,二等位基因5-HTTLPR L/S等位基因型与MAOA-u VNTR S/L基因型间可能存在与青少年MDD相关的交互作用(Waldx2=3.89, P=0.049)。
结论：尚不能认为二等位基因5-HTTLPR、三等位基因5-HTTLPR、MAOA-u VNTR与青少年MDD存在关联；二等位基因5-HTTLPR、三等位基因5-HTTLPR、MAOA-u VNTR和SLEs之间均不存在与青少年MDD患病相关联的交互作用；尚不能认为三等位基因5-HTTLPR与MAOA-u VNTR间存在与青少年MDD患病相关联的交互作用,二等位基因5-HTTLPR L/S等位基因型与MAOA-uVNTR S/L基因型间可能存在与青少年MDD相关联的基因-基因交互作用。
Chapter 2:An Anxious and Non-anxious Survey among Middle School Students in Changsha
Objective:To describe the prevalence characteristics of depression in middle school students, including rate, difference of rate between sexes and among different age groups. To explore the clinical characteristics and related factors of anxious and non-anxious adolescent Major Depressive Disorder (MDD).
Methods:A sample of 10 middle schools,3965 students (ages 11-18 years) in Changsha were screened using cluster sampling. Child or the parent Mood and Feelings Questionnaire (MFQ-C、MFQ-P), Child Anxiety Related Emotional Disorders (SCARED), Adolescent Self-rating Life Event Checklist (ASLEC), Social Support Rating Scale for Children and Adolescents (SSRS-CA), Parental Bonding Instrument (PBI), Behavioral Inhibition Scale (BIS), Family Assessment Device (FAD), Resilience Scale (RS), Children Cognitive Distortions Questionnaire (CCDQ), strength and difficulty questionnaire (SDQ), Self-Rating Depression Scale (SDS), fundamental information of students, their parents and the parenting style were filled out by students and their parents. Individuals whose MFQ-C score=18 (cut-off) were viewed as potential depressive students. Individuals whose MFQ-C=18 and SCARED>25 were viewed as anxious depressive students; Individuals whose MFQ-C=18 and SCARED<25 were viewed as non-anxious depressive students.
Results:(1) Prevalence rate of subjects over MFQ-C cut-off point is 30.70%,26.8%in males and 34.6%in females, prevalence in females is higher than that in males. The prevalence rate is 18%in early adolescence (11-12 years),30.9%in middle adolescence (13-15 years),36.5%in late adolescence (16-18 years). Prevalence in middle adolescence is higher than early adolescence (LRx2=40.70, P=0.000), and prevalence in late adolescence is even higher (LR x2=11.41, P=0.001)。
(2) 55.3%of potential depressive students are anxious-depression, and 44.7%are non-anxious depression. The prevalence of anxious depression is higher than non-anxious depression (Fisher's exact P =0.000), with females higher than males.
(3) Anxious depressive students scored higher than non-anxious depressive students on SDQ emotional symptoms (t=14.33, P =0.000),conduct problems (t=3.17, P=0.002), peer relationship problems (t=2.39, P=0.017), attention deficit and hyperactivity problems (t=3.17, P=0.002), total difficulty score (t=10.51, P =0.000); Anxious depressive students scored higher than non-anxious depressive students on MFQ-C, cognitive distortion, subjective social support and stressful life events (P< 0.05).
Conclusion:(1) Prevalence rate of depression in 11-to-18 year-old adolescents is 30.70%,26.8%in males and 34.6%in females, prevalence in females is higher than that in males. The prevalence rate is 18%in early adolescence,30.9%in middle adolescence,36.5%in late adolescence. There is an increase trend from early adolescence to late adolescence. The prevalence rate of anxious depression is higher than non-anxious depression, with females higher than males.
(2) Anxious depressive students have higher depressive scores, more behavioral problems, more attention deficit and hyperactivity problems, more peer relationship problems, more cognitive distortion and experienced more stressful life events.
Chapter 3:A Case-control Study on the Related Socio-psychological Factors of Adolescent Major Depressive Disorder
Objective:To explore the related socio-psychological factors of adolescent MDD and try to identify the strongest predictors of adolescent MDD.
Methods:394 subjects (173 MDD patients,221 normal controls) were recruited to the study. MFQ-C、SCARED、self-report BI、SDS、CCDQ、PBI、ASLEC、SSRS-CA、RS were filled out by patients and FAD, parents-report BIS, MFQ-P, and fundamental information about patients, their parents, home environment and parenting were filled out or evaluated by their parents. Means of all these socio-psychological factors were compared between adolescent MDD group and normal control group. Variables which were identified to be related to adolescent MDD were used as independent variables in binary logistic regression to screen the strongest predictors of adolescent MDD.
Results:Parental education level, family structure, family relationship, paternal parenting, consistency in parenting, current physical health conditions, past history of severe physical illness, RS, CCDQ, ASLEC, FAD, PBI parental care and protection scores, self-report BI, SSRS-CA are statistically different between cases and controls (all P<0.05). PBI maternal care, ASLEC, RS are the variables in the binary logistic regression model.
Conclusion:Parental educational level, family structure, family relationship, paternal parenting, consistency in parenting, current physical health conditions, past history of severe physical illness, resilience, cognitive distortion, stressful life events, family function, PBI parental care and protection scores, self-report behavioral inhibition, social support are related factors of adolescent MDD. Among these factors, PBI maternal care, stressful life events, resilience are the strongest predictors of adolescent MDD.
Chapter 4
Specific G x G and G x E interactions on Adolescent MDD
Objective:To explore the association of biallelic 5-HTTLPR polymorphism, triallelic5-HTTLPR polymorphism (5-HTTLPR+ rs25531), MAOA gene-linked polymorphic region (MAOA-u VNTR/MAOA-LPR) and adolescent MDD. To test whether or not there are gene-gene interactions(biallelic5-HTTLPR×MAOA-uVNTR,triallelic 5-HTTLPR×MAOA-u VNTR) and gene-environment interactions (biallelic 5-HTTLPR×SLEs, triallelic 5-HTTLPR×SLEs, MAOA-u VNTR×SLEs) which related to adolescent MDD.
Methods:404 Chinese Han subjects, including 187 adolescent patients with MDD and 217 normal control students were recruited to the research.5-HTTLPR, rs25531 and MAOA-u VNTR were genotyped using SNaPshot SNP genotyping method. ASLEC were filled out to evaluate the stressful life events the subjects experienced in the past 1 year.
Results:Biallelic 5-HTTLPR polymorphism, triallelic 5-HTTLPR polymorphism, MAOA-u VNTR polymorphisms have no direct effect on adolescent MDD in terms of the occurrence, severity of MDD and with/without anxiety and suicidal behavior/ideation/attempt. There are no genexgene interactions related to adolescent MDD were found between biallelic 5-HTTLPR/triallelic 5-HTTLPR and MAOA-u VNTR. There were also no G×E interactions related to adolescent MDD were found between biallelic 5-HTTLPR/triallelic 5-HTTLPR/MAOA-u VNTR and SLEs. There is no evidence of triallelic 5-HTTLPR×MAOA-u VNTR interaction related to adolescent MDD; Biallelic 5-HTTLPR L/S×MAOA-u VNTR S/L interactions may be related to adolescent MDD.
Conclusion:Biallelic 5-HTTLPR polymorphism, triallelic 5-HTTLPR polymorphism, MAOA-u VNTR polymorphisms have no direct effect on adolescent MDD. There are no G×E interactions related to adolescent MDD were found between biallelic 5-HTTLPR/triallelic 5-HTTLPR/MAOA-u VNTR and SLEs. There is no evidence of triallelic 5-HTTLPR×MAOA-u VNTR interaction related to adolescent MDD; Biallelic 5-HTTLPR L/S×MAOA-u VNTR S/L interactions may be related to adolescent MDD.
目的：了解长沙市中学生抑郁检出率及性别差异、随年龄变化趋势。探讨青少年抑郁伴／不伴焦虑临床特征、社会心理学影响因素的差别。
方法：采取整群抽样法抽取长沙10所中学3965名研究对象(11-18岁),完成自评及父母评情绪和感受问卷(MFQ-C、MFQ-P),儿童焦虑性情绪障碍筛查量表(SCARED)、青少年自评生活事件量表(ASLEC)、儿童青少年社会支持评定量表(SSRS-CA)、养育关系问卷(PBI)、行为抑制量表(BIS)、家庭功能评定(FAD)、心理弹性量表(RS)、儿童认知偏差问卷(CCDQ)、儿童青少年精神发育及健康状况筛查工具—长处和困难问卷(SDQ)、抑郁自评量表(SDS)、了解个人、家庭及教养方式的基本情况。将MFQ-C=18分者视为抑郁症状者,其中MFQ-C=18分,且SCARED>25分者视为抑郁伴焦虑组,而MFQ-C=18分,且SCARED<25分者视为抑郁不伴焦虑组。
结果：(1)以MFQ-C总分18分为划界分确定的抑郁症状者,总检出率为30.70%,男性检出率为26.8%,女性为34.6%,女性检出率较男性高(P<0.05)。青春早期(11-12岁)检出率为18%,青春中期(13-15岁)为30.9%,青春晚期(16-18岁)为36.5%。青春中期较青春早期检出率显著上升(LRx2=40.70,P=0.000),青春晚期较青春中期检出率进一步上升(LRx2=11.41,P=0.001)。
(2)抑郁伴焦虑者占总抑郁症状人数的55.3%,抑郁不伴焦虑者占44.7%。抑郁伴焦虑的发生率高于抑郁不伴焦虑(LRx2=73.64,P=0.000)；存在抑郁的男生中有47%伴焦虑,而存在抑郁的女生有61.9%伴焦虑,女生抑郁伴焦虑的发生率高于男生(Pearsonx2=26.79,P=0.000)
(3)伴焦虑组学生SDQ情绪症状(t=14.33,P=0.000)、品行问题(f=3.2,P=0.001)、同伴交往问题(f=2.39,P=0.017)、多动注意缺陷问题(t=3.17,P=0.002)、总困难得分(t=10.51,P=0.000)均显著高于不伴焦虑组；伴焦虑组抑郁严重程度高于不伴焦虑组(t=13.42,P=0.000)；抑郁伴焦虑组认知偏差、应激性生活事件、主观支持评分显著高于不伴焦虑组(P<0.05)。
结论：(1)11-18岁中学生MFQ-C抑郁总检出率为30.70%,其中男性26.8%,女性34.6%,女性检出率较男性高。青春早期检出率为18%,青春中期为30.9%,青春晚期为36.5%,检出率呈现由青春早期至青春晚期逐渐上升的趋势。抑郁伴焦虑的发生率高于抑郁不伴焦虑,女生抑郁伴焦虑的发生率高于男生。
(2)与抑郁不伴焦虑的学生相比,抑郁伴焦虑的学生具有更高的抑郁水平、更多的品行问题、多动注意缺陷问题及同伴相处困难、更严重的认知偏差,经历更多的应激性生活事件,获得更多的主观支持。
第三章青少年重性抑郁障碍社会心理学因素病例对照研究
目的：探讨青少年重性抑郁障碍(Major Depressive Disorder,MDD)的社会心理学影响因素,并从中筛选出预测能力较强的变量。
方法：394名研究对象(病例173人,正常对照221人),学生完成MFQ-C、SCARED、自评BI、SDS、CCDQ、PBI、ASLEC、SSRS-CA、RS,家长完成学生个人、父母及家庭基本情况表、FAD、父母评BI、MFQ-P。进行病例组和对照组个人、父母、家庭环境、养育方式及其它社会心理学因素的比较；将有差别的因素纳入二分类Logistic回归,筛选出预测能力较强的变量。
结果：MDD患者组和对照组学生父母文化程度、家庭类型、家庭关系、父亲管教方式、父母管教态度一致性与否、重大疾病史、目前健康状况、RS、CCDQ、ASLEC、FAD、PBI父母关心及保护总分、自评BI、SSRS-CA得分均具有显著的差别(所有P<0.05)。其中,PBI母亲关怀总分、ASLEC、RS进入二分类回归方程。
结论：父母文化程度、家庭类型、家庭关系、父亲管教方式、父母管教态度一致性与否、重大疾病史、目前健康状况、心理弹性、认知偏差、应激性生活事件、家庭功能、PBI父母关怀及保护总分、自评行为抑制、社会支持是青少年MDD的影响因素。其中,PBI母亲关怀总分、应激性生活事件、心理弹性是对青少年MDD预测能力较强的变量。
第四章青少年重性抑郁障碍特定基因-基因、基因-环境交互作用
目的：探讨中国汉族青少年MDD与二等位基因5-HTTLPR(即5-HTTLPR)多态性、三等位基因5-HTTLPR (5-HTTLPR+rs25531)多态性及MAOA-u VNTR多态性与青少年MDD之间的关系；探讨二等位基因5-HTTLPR多态性／三等位基因5-HTTLPR多态性与MAOA-u VNTR多态性之间的交互作用与青少年MDD之间的关系；探讨二等位基因5-HTTLPR多态性／三等位基因5-HTTLPR多态性/MAOA-u VNTR多态性和SLEs间的交互作用与青少年MDD之间的关系。
方法：404名研究对象(病例187人,正常对照217人)使用SNaPshot系统进行基因分型,ASLEC评估受访者近一年的负性生活事件。
结果：二等位基因5-HTTLPR、三等位基因5-HTTLPR, MAOA-u VNTR与青少年MDD患病与否、抑郁严重程度、是否共病焦虑、是否伴自杀行为／观念／企图无关联；二等位基因5-HTTLPR、三等位基因5-HTTLPR、MAOA-u VNTR和SLEs之间均不存在与青少年MDD患病相关联的交互作用；尚不能认为三等位基因5-HTTLPR与MAOA-u VNTR间存在与青少年MDD患病相关联的基因-基因交互作用,二等位基因5-HTTLPR L/S等位基因型与MAOA-u VNTR S/L基因型间可能存在与青少年MDD相关的交互作用(Waldx2=3.89, P=0.049)。
结论：尚不能认为二等位基因5-HTTLPR、三等位基因5-HTTLPR、MAOA-u VNTR与青少年MDD存在关联；二等位基因5-HTTLPR、三等位基因5-HTTLPR、MAOA-u VNTR和SLEs之间均不存在与青少年MDD患病相关联的交互作用；尚不能认为三等位基因5-HTTLPR与MAOA-u VNTR间存在与青少年MDD患病相关联的交互作用,二等位基因5-HTTLPR L/S等位基因型与MAOA-uVNTR S/L基因型间可能存在与青少年MDD相关联的基因-基因交互作用。
Chapter 2:An Anxious and Non-anxious Survey among Middle School Students in Changsha
Objective:To describe the prevalence characteristics of depression in middle school students, including rate, difference of rate between sexes and among different age groups. To explore the clinical characteristics and related factors of anxious and non-anxious adolescent Major Depressive Disorder (MDD).
Methods:A sample of 10 middle schools,3965 students (ages 11-18 years) in Changsha were screened using cluster sampling. Child or the parent Mood and Feelings Questionnaire (MFQ-C、MFQ-P), Child Anxiety Related Emotional Disorders (SCARED), Adolescent Self-rating Life Event Checklist (ASLEC), Social Support Rating Scale for Children and Adolescents (SSRS-CA), Parental Bonding Instrument (PBI), Behavioral Inhibition Scale (BIS), Family Assessment Device (FAD), Resilience Scale (RS), Children Cognitive Distortions Questionnaire (CCDQ), strength and difficulty questionnaire (SDQ), Self-Rating Depression Scale (SDS), fundamental information of students, their parents and the parenting style were filled out by students and their parents. Individuals whose MFQ-C score=18 (cut-off) were viewed as potential depressive students. Individuals whose MFQ-C=18 and SCARED>25 were viewed as anxious depressive students; Individuals whose MFQ-C=18 and SCARED<25 were viewed as non-anxious depressive students.
Results:(1) Prevalence rate of subjects over MFQ-C cut-off point is 30.70%,26.8%in males and 34.6%in females, prevalence in females is higher than that in males. The prevalence rate is 18%in early adolescence (11-12 years),30.9%in middle adolescence (13-15 years),36.5%in late adolescence (16-18 years). Prevalence in middle adolescence is higher than early adolescence (LRx2=40.70, P=0.000), and prevalence in late adolescence is even higher (LR x2=11.41, P=0.001)。
(2) 55.3%of potential depressive students are anxious-depression, and 44.7%are non-anxious depression. The prevalence of anxious depression is higher than non-anxious depression (Fisher's exact P =0.000), with females higher than males.
(3) Anxious depressive students scored higher than non-anxious depressive students on SDQ emotional symptoms (t=14.33, P =0.000),conduct problems (t=3.17, P=0.002), peer relationship problems (t=2.39, P=0.017), attention deficit and hyperactivity problems (t=3.17, P=0.002), total difficulty score (t=10.51, P =0.000); Anxious depressive students scored higher than non-anxious depressive students on MFQ-C, cognitive distortion, subjective social support and stressful life events (P< 0.05).
Conclusion:(1) Prevalence rate of depression in 11-to-18 year-old adolescents is 30.70%,26.8%in males and 34.6%in females, prevalence in females is higher than that in males. The prevalence rate is 18%in early adolescence,30.9%in middle adolescence,36.5%in late adolescence. There is an increase trend from early adolescence to late adolescence. The prevalence rate of anxious depression is higher than non-anxious depression, with females higher than males.
(2) Anxious depressive students have higher depressive scores, more behavioral problems, more attention deficit and hyperactivity problems, more peer relationship problems, more cognitive distortion and experienced more stressful life events.
Chapter 3:A Case-control Study on the Related Socio-psychological Factors of Adolescent Major Depressive Disorder
Objective:To explore the related socio-psychological factors of adolescent MDD and try to identify the strongest predictors of adolescent MDD.
Methods:394 subjects (173 MDD patients,221 normal controls) were recruited to the study. MFQ-C、SCARED、self-report BI、SDS、CCDQ、PBI、ASLEC、SSRS-CA、RS were filled out by patients and FAD, parents-report BIS, MFQ-P, and fundamental information about patients, their parents, home environment and parenting were filled out or evaluated by their parents. Means of all these socio-psychological factors were compared between adolescent MDD group and normal control group. Variables which were identified to be related to adolescent MDD were used as independent variables in binary logistic regression to screen the strongest predictors of adolescent MDD.
Results:Parental education level, family structure, family relationship, paternal parenting, consistency in parenting, current physical health conditions, past history of severe physical illness, RS, CCDQ, ASLEC, FAD, PBI parental care and protection scores, self-report BI, SSRS-CA are statistically different between cases and controls (all P<0.05). PBI maternal care, ASLEC, RS are the variables in the binary logistic regression model.
Conclusion:Parental educational level, family structure, family relationship, paternal parenting, consistency in parenting, current physical health conditions, past history of severe physical illness, resilience, cognitive distortion, stressful life events, family function, PBI parental care and protection scores, self-report behavioral inhibition, social support are related factors of adolescent MDD. Among these factors, PBI maternal care, stressful life events, resilience are the strongest predictors of adolescent MDD.
Chapter 4
Specific G x G and G x E interactions on Adolescent MDD
Objective:To explore the association of biallelic 5-HTTLPR polymorphism, triallelic5-HTTLPR polymorphism (5-HTTLPR+ rs25531), MAOA gene-linked polymorphic region (MAOA-u VNTR/MAOA-LPR) and adolescent MDD. To test whether or not there are gene-gene interactions(biallelic5-HTTLPR×MAOA-uVNTR,triallelic 5-HTTLPR×MAOA-u VNTR) and gene-environment interactions (biallelic 5-HTTLPR×SLEs, triallelic 5-HTTLPR×SLEs, MAOA-u VNTR×SLEs) which related to adolescent MDD.
Methods:404 Chinese Han subjects, including 187 adolescent patients with MDD and 217 normal control students were recruited to the research.5-HTTLPR, rs25531 and MAOA-u VNTR were genotyped using SNaPshot SNP genotyping method. ASLEC were filled out to evaluate the stressful life events the subjects experienced in the past 1 year.
Results:Biallelic 5-HTTLPR polymorphism, triallelic 5-HTTLPR polymorphism, MAOA-u VNTR polymorphisms have no direct effect on adolescent MDD in terms of the occurrence, severity of MDD and with/without anxiety and suicidal behavior/ideation/attempt. There are no genexgene interactions related to adolescent MDD were found between biallelic 5-HTTLPR/triallelic 5-HTTLPR and MAOA-u VNTR. There were also no G×E interactions related to adolescent MDD were found between biallelic 5-HTTLPR/triallelic 5-HTTLPR/MAOA-u VNTR and SLEs. There is no evidence of triallelic 5-HTTLPR×MAOA-u VNTR interaction related to adolescent MDD; Biallelic 5-HTTLPR L/S×MAOA-u VNTR S/L interactions may be related to adolescent MDD.
Conclusion:Biallelic 5-HTTLPR polymorphism, triallelic 5-HTTLPR polymorphism, MAOA-u VNTR polymorphisms have no direct effect on adolescent MDD. There are no G×E interactions related to adolescent MDD were found between biallelic 5-HTTLPR/triallelic 5-HTTLPR/MAOA-u VNTR and SLEs. There is no evidence of triallelic 5-HTTLPR×MAOA-u VNTR interaction related to adolescent MDD; Biallelic 5-HTTLPR L/S×MAOA-u VNTR S/L interactions may be related to adolescent MDD.
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