Adoption study demonstrating two genetic pathways to drug abuse.
Adoption study demonstrating two genetic pathways to drug abuse.
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DOI：
10.1001/archpsyc.1995.03950130042005
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发表时间：
1995
影响因子：
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通讯作者：
R. Cadoret;William R. Yates;E. Troughton;G. Woodworth;Mark A. Stewart
中科院分区：
文献类型：
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作者：
R. Cadoret;William R. Yates;E. Troughton;G. Woodworth;Mark A. Stewart
背景：对被收养者的研究表明，有两种遗传因素导致酒精滥用和/或依赖（滥用/依赖）。此外，在收养家庭中发现的环境因素也能独立预测酒精滥用/依赖。一项研究发现，有证据表明，药物滥用涉及两种遗传因素和独立的收养家庭因素的类似模式。本研究旨在验证以下假设：由亲生父母的酒精滥用/依赖和反社会人格障碍定义的遗传因素是药物滥用/依赖的病因，而养父母的精神问题是与药物滥用/依赖相关的另一个因素。方法对95名出生时就与亲生父母分离的男性被收养者成年后进行随访，以确定他们的精神疾病诊断和药物使用/滥用情况，采用结构化访谈方式，对亲生父母的诊断进行盲查。采用高风险病例对照设计，其中一半被收养者的亲生父母已知有酗酒者/依赖者和/或有反社会人格（根据医院或监狱记录诊断）。这些被收养者在年龄、性别和收养机构方面与另一组被收养者相匹配，这些被收养者的亲生父母在医院和监狱记录检索中没有找到。采用结构化访谈对收养家庭环境进行评估，包括对养父母双方的精神病学评估。结果采用对数线性模型对数据进行分析，发现药物滥用/依赖存在两种遗传途径。一条途径是直接从亲生父母的酗酒到药物滥用/依赖。第二条路径更为迂回，从亲生父母的反社会人格障碍开始，经过被收养人的攻击性、行为障碍、反社会人格障碍等干预变量，最终以药物滥用/依赖告终。由收养家庭精神状况界定的环境因素独立预测被收养者反社会人格障碍的增加。由酗酒母亲所生的被收养者显示出胎儿酒精综合症的证据，但控制这一点并没有减少酗酒的亲生父母与后代滥用药物/依赖之间直接遗传影响的证据。结论：本研究证实了两个独立的遗传因素参与药物滥用/依赖的模型和先前的研究结果，即不安的养父母与被养父母的药物滥用/依赖有关。
BACKGROUND Studies of adoptees have demonstrated that there are two genetic factors leading to alcohol abuse and/or dependence (abuse/dependence). In addition, environmental factors found in the adoptive family also predict alcohol abuse/dependency independently. One study has found evidence that a similar model of two genetic factors and independent adoptive family factors were involved in drug abuse. Our study was designed to test the hypothesis that genetic factors defined by alcohol abuse/dependency and anti-social personality disorder in biologic parents were etiologic in drug abuse/dependency and that psychiatric problems in adoptive parents were an additional factor associated with drug abuse/dependence. METHODS A sample of 95 male adoptees, separated at birth from their biologic parents, were followed up as adults to determine their psychiatric diagnosis and their substance use/abuse in a structured interview administered blind to biologic parent diagnoses. A high-risk, case-control design was used wherein half of the adoptees came from biologic parents known to be alcohol abuser/dependent and/or have antisocial personalities (diagnoses from hospital or prison records). These adoptees were matched for age, sex, and adoption agency to a control group of adoptees whose biologic parents were not found in the hospital and prison record search. Adoptive home environment was assessed by structured interviews, including psychiatric assessment of both adoptive parents. RESULTS Data were analyzed by log-linear modeling, which showed evidence of two genetic pathways to drug abuse/dependency. One pathway went directly from a biologic parent's alcoholism to drug abuse/dependency. The second pathway was more circuitous, and started with anti-social personality disorder in the biologic parent and proceeded through intervening variables of adoptee aggressivity, conduct disorder, antisocial personality disorder, and, eventually, ended in drug abuse/dependency. Environmental factors defined by psychiatric conditions in adoptive families independently predicted increased antisocial personality disorder in the adoptee. Adoptees born of alcohol-abusing mothers showed evidence of fetal alcohol syndrome, but controlling for this did not diminish the evidence for the direct genetic effect between an alcohol-abusing biologic parent and drug abuse/dependency in offspring. CONCLUSIONS This study confirms the model of two independent genetic factors involved in drug abuse/dependence and previous findings that disturbed adoptive parents are associated with adoptee drug abuse/dependency.