The structure of genetic and environmental risk factors for common psychiatric and substance use disorders in men and women
The structure of genetic and environmental risk factors for common psychiatric and substance use disorders in men and women
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DOI：
10.1001/archpsyc.60.9.929
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发表时间：
2003-09-01
影响因子：
--
通讯作者：
Neale, MC
中科院分区：
文献类型：
--
作者：
Kendler, KS;Prescott, CA;Neale, MC
背景资料：合并症的模式表明，常见的精神和物质使用综合征可分为两大类的内化和外化障碍。我们不知道如何遗传和环境的危险因素有助于这种模式的合并症或这些群体的病因结构是否不同，在男性和women.Methods：终身诊断为10个精神病综合征的个人访谈中获得了超过5600名成员的男性-男性和女性-女性双胞胎对确定从人口为基础的登记。多变量双胞胎建模进行使用程序Mx.Results：我们首先适合模型以下7个综合征：抑郁症，广泛性焦虑症，恐惧症，酒精依赖，药物滥用/依赖，成人反社会行为，和行为障碍。完整的模型，这可能是限制在男性和女性受试者的平等，确定了2个遗传因素。第一组在酒精依赖、药物滥用/依赖、成人反社会行为和行为障碍方面的负荷最大，第二组在重度抑郁症、广泛性焦虑症和恐怖症方面的负荷最大。酒精依赖和药物滥用/依赖有大量的疾病特异性遗传危险因素。共同的环境因素在品行障碍和成人反社会行为中最为明显。没有明确的内部/外部结构被视为独特的环境共同因素。然后，我们拟合模型5内化综合征。完整的模型，这也可以被限制在男性和女性的平等，揭示了一个遗传因素加载最严重的抑郁症和广泛性焦虑症和另一个加载最强烈的动物和情境phobies.Conclusions：的基本结构的遗传和环境的危险因素的常见的精神疾病和药物滥用障碍的男性和女性是非常相似的。遗传风险因素易患两大类内在和外在疾病。在内化障碍中，有2个遗传因素易患焦虑-痛苦和恐惧为主的障碍。物质使用障碍具有疾病特异性遗传风险。行为障碍和成人反社会行为的外化障碍受共享环境的影响显著。常见精神疾病和物质使用障碍的终生共病模式主要来自遗传危险因素的影响。
Background: Patterns of comorbidity suggest that the common psychiatric and substance use syndromes may be divisible into 2 broad groups of internalizing and externalizing disorders. We do not know how genetic and environmental risk factors contribute to this pattern of comorbidity or whether the etiologic structure of these groups differ in men and women.Methods: Lifetime diagnoses for 10 psychiatric syndromes were obtained at a personal interview in more than 5600 members of male-male and female-female twin pairs ascertained from a population-based registry. Multivariate twin modeling was performed using the program Mx.Results: We first fit models to the following 7 syndromes: major depression, generalized anxiety disorder, phobia, alcohol dependence, drug abuse/dependence, adult antisocial behavior, and conduct disorder. The full model, which could be constrained to equality in male and female subjects, identified 2 genetic factors. The first had strongest loadings on alcohol dependence, drug abuse/dependence, adult antisocial behavior, and conduct disorder the second, on major depression, generalized anxiety disorder, and phobia. Alcohol dependence and drug abuse/dependence had substantial disorder-specific genetic risk factors. Shared environmental factors were most pronounced for conduct disorder and adult antisocial behavior. No clear internalizing/externalizing structure was seen for the unique environmental common factors. We then fit models to 5 internalizing syndromes. The full model, which could also be constrained to equality in men and women, revealed one genetic factor loading most heavily on major depression and generalized anxiety disorder and another loading most strongly on animal and situational phobia.Conclusions: The underlying structure of the genetic and environmental risk factors for the common psychiatric and drug abuse disorders in men and women is very similar. Genetic risk factors predispose to 2 broad groups of internalizing and externalizing disorders. Within the internalizing disorders, 2 genetic factors are seen that predispose to disorders dominated by anxious-misery and fear. Substance use disorders have disorder-specific genetic risks. The externalizing disorders of conduct disorder and adult antisocial behavior are significantly influenced by the shared environment. The pattern of lifetime comorbidity of common psychiatric and substance use disorders results largely from the effects of genetic risk factors.