新疆维吾尔族及汉族双相障碍患者冲动攻击行为基因与社会心理因素的交互研究

Bipolar disorder is a mood disorder characterized by impairing episodes of mania and depression. Bipolar disorder (BPD) is a common and serious mental disorder characterized by severe mood symptoms，including episodes of mania or hypomania and depression，occurring with a typically cyclical course. Lifetime prevalence for BPD has typically been reported to be approximately 0.5%～15% . Most Impulsive behavior of individuals with BPD experience violence, suicide, self-injury, or criminal behavior, etc.In recent years,at home and abroad,the relationship between the polymorphism of the 5-HT,COMT allele , the MAOA polymorphism and impulsive behavior was still in the primary exploratory stage. We have published more than 30 papers over the past six years and have made various discussion from the key point of social psychological perspective on aggression and violence.Found that suicide patients of depression were obviously associated with family violence.At present, Several of these genes have been associated with the characteristic of perpetrators ,sexual abuse in childhood(including 5-HTTLPR polymorphism of low-activity genotype, COMT-Vall58M polymorphisms heterozygous genotype and MAOA-uVNTR low-activity genotype).The familial aggregation phenomenon may reflect the role of a common home environment.The praverlence of BRD among Xinjiang uygur is high;In the study , based on the genetics principle, we will attempty to find HTR2B genes responsible for impulsive and aggressive behavior among Xinjian uyrur and the han people BPD , and analysis the correlation to environmental factors in patients.From the new point of view,we identifiey the high-risk groups of patients with impulsive and aggressive behavior;To explore the effect HTR2B or HTR2A,or MAOA gene on happen、progress、diagnosis and prognostic in bipolar disorder with impulsive and aggressive behavior.it is important to prevent the disorder,and with theoretical significance and practical value.

双相障碍是一种严重的精神疾病。有冲动攻击行为双相障碍患者易出现暴力行为、自杀、个人自伤，或犯罪行为等。近年来，国内外对5-HT多态性基因、COMT等位基因和MAOA多态性基因与冲动攻击行为关联仍处于初步探讨阶段。近6年我们发表论文30余篇，重点从社会心理等角度对暴力攻击行为作了探讨。初步研究已发现5-HTTLPR多态性低活性基因型、COMT-Vall58M多态性杂合子基因型和MAOA-uVNTR低活性基因型与冲动攻击行为个人内外倾性格、儿童期虐待明显关联。本研究拟根据遗传学的原理，对新疆维吾尔族、汉族双相障碍患者，筛查其冲动攻击行为基因HTR2B,HTR2A,COMT，MAOA.分析其与患者社会心理因素的交互作用。将从这个新视点，识别有冲动攻击行为患者高危人群，揭示以上4种基因多态性在有冲动攻击行为的双相障碍患者的发生、发展、诊断及预后中的作用。对防治该疾病有重要的理论意义和实际价值。

易激惹、愤怒及冲动攻击行为是双相障碍密切相关的症状。有冲动攻击行为双相障碍患者易出现暴力行为、自杀、个人自伤，或犯罪行为等。本课题主要筛查双相障碍患者有冲动攻击行为的相关“易感基因”以及社会心理因素，分析遗传和社会心理因素在双相障碍冲动攻击行为发生中的作用，为冲动攻击行为的预测和干预提供直接的理论依据。本课题双相障碍患者均来自新疆自治区人民医院临床心理科及新疆精神卫生中心，按其有无冲动攻击行为分为攻击组（296例）和无攻击组（572例）。采用PCR产物直接测序的方法检测新疆维吾尔族及汉族双相障碍患者各SNP位点的多态性分布。应用SPSS17.0分析基因多态性与冲动攻击行为的相关性，采用2×4叉生分析表进行基因与环境因素之间的交互作用分析。发现 新疆维吾尔族及汉族双相障碍患者冲动攻击行为与儿茶酚胺氧位甲基转移酶 (rs933271,rs740603位点)、5-羟色胺受体2A (rs6311位点)、单胺氧化酶A（uVNTR、rs5906893）、谷氨酸受体-6 (rs6922753、rs2227283) 基因多态性可能不具有关联性。汉族双相障碍患者冲动攻击行为与5-羟色胺受体1B(rs6296位点)基因基因多态性可能不具有关联性。维吾尔族及汉族双相障碍患者冲动攻击行为与单胺氧化酶A rs1137070基因多态性可能具有关联性。新疆维吾尔族双相障碍患者冲动攻击行为与5-羟色胺受体1B(rs6296位点)基因多态性可能具有关联性。 单胺氧化酶A rs1137070基因多态性与儿童期受虐是新疆汉族双相障碍患者冲动攻击行为发生的危险因素。 单胺氧化酶A rs1137070、5-羟色胺受体1B rs6296基因多态性与儿童期受虐是新疆维吾尔族双相障碍患者冲动攻击行为发生的危险因素。攻击组中儿童期多遭受躯体虐待，单胺氧化酶A rs1137070基因多态性与儿童期受虐之间存在正交互作用，5-羟色胺受体1B rs6296基因多态性与儿童期受虐之间存在负交互作用。父母亲养育方式中有过多的惩罚严厉及母亲过多的拒绝否认。儿童期受虐史和父母粗暴的教育方式可影响其成年后应对方式、社会支持。改变对暴力持“可以”的态度和减少消极应对方式、培养积极的应对方式对于早期干预双相II型障碍的冲动攻击行为有重要意义。本课题在识别双相障碍患者冲动攻击行为的高危人群及其防治策略上有重大的理论突破和实用价值。