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Comorbidity and co-transmission of alcoholism, anxiety and depression

  • K. R. Merikangas (a1), N. J. Risch (a1) and M. M. Weissman (a1)
Synopsis
Synopsis

This paper applies data from a family study of depression to assess patterns of comorbidity and co-transmission of alcoholism, anxiety disorders, and major depression. We found that all three disorders were strongly transmissible; however, alcoholism demonstrated the greatest degree of familial aggregation. The pairwise associations among depression, anxiety and alcoholism indicated that the traits are co-transmitted in families, especially depression and anxiety. Individual associations between traits (or comorbidity) were entirely explained by transmitted (perhaps genetic) agents, because the correlations between traits due to random environment were not significant. These findings have important implications for treatment, psychiatric nosology, and aetiological investigations of these conditions.

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Corresponding author
1Address for correspondence: Dr Kathleen R. Merikang; s, Genetic Epidemiology Research Unit, Yale University School of Medicine, 40 Temple Street, Lower Level, New Haven, Connectic at 06510–3223, USA.
References
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Angst J. (1966). Zur Aetiologie und Nosologie endogener depressiver Psychosen. In Monographien aus dein Gesantgebiete der Neurolog? und Psychiatrie pp. 1206. Springer-Verlag: Berlin.
Berkson J. (1946). Limitation of the application of the 4-fold table analysis to hospital data. Biometrics 2, 4753.
Bowen R. C., Cipywnyk D., D'Arcy C. & Keegan D. (1984). Alcoholism, anxiety disorders, and agoraphobia. Alcoholism, Clinical and Experimental Research 8, 4850.
Boyd J. H., Burke J. D., Gruenberg E., Holzer C. E. III, Ra D. S., George L. K., Karno M., Stoltzman R., McEvoy L., Nestadt G. (1984). Exclusion criteria of DSM-III: a study of a - occurrence of hierarchy-free syndromes. Archives of General Psychiatry 41, 983989.
Breier A., Charney D. S. & Heninger G. R. (1985). The diagnostic validity of anxiety disorders and their relationship to depressive illness. American Journal of Psychiatry 142, 787817.
Cadoret R. & Winokur G. (1974). Depression in alcoholism. Anne's of the New York Academy of Sciences 233, 3436.
Cadoret R. J., O'Gorman T. W., Heywood E. & Troughton I. (1985). Genetic and environmental factors in major depression. Journal of Affective Disorders 9, 155164.
Chambless D. L., Cherney J., Caputo G. C. & Rheinstein B. I. (1987). Anxiety disorders and alcoholism: a study with inpatie it alcoholics. Journal of Anxiety Disorders 1, 2940.
Cloninger C. R., Reich T. & Wetzel R. (1979). Alcoholism and affective disorders: familial association and genetic models. n Alcoholism and Affective Disorders: Clinical, Genetic, and Biochemical Studies (ed. Goodwin D. W. and Erickson C. K.), pp. 5786. S.P. Medical and Scientific Books: New York.
Cloninger C. R., Martin R. L., Clayton P. J. & Guze S. V. (1981). A blind follow-up and family study of anxiety neurosis: preliminary analysis of the St. Louis 500. In Anxiety: New Research and Changing Concepts (ed. Klein D. F. and Rabkin J.), pp. 137154. Raven Press: New York.
Cohen M. E., Badal D., Kilpatrick A., Read E. W. & White P. D. (1951). The high familial prevalence of neurocirculatory asthenia (anxiety neurosis, effort syndrome). American Journal of Human Genetics 3, 126158.
Coryell W., Endicott J., Andreasen N. C., Keller M. B., Clayton P. J., Hirschfeld R. M. A., Sheftner W. A. & Winokur G. (1988). Depression and panic attacks: the significance of overlap as reflected in follow-up and family study data. American Journal of Psychiatry 145, 293300.
Cowley D. S. (1992). Alcohol abuse, substance abuse, and panic disorder. American Journal of Medicine SuppllA, 4148.
Cox D. R. (1972). Regression models and life tables. Journal of Royal Statistical Society B, 34, 187220.
Falconer D. S. (1965). The inheritance of liability to certain diseases, estimated from the incidence among relatives. Annals of Human Genetics 29, 5176.
Feinstein A. R. (1970). The pre-therapeutic classification of comorbidity in chronic disease. Journal of Chronic Diseases 23, 455468.
Gershon E. S., Hamovit J. & Guroff J. J. (1982). A family study of schizoaffective, bipolar I, bipolar II, unipolar, and normal control probands. Archives of General Psychiatry 39, 11571167.
Harris E. L., Noyes R. Jr., Crowe R. R. & Chaudhry D. R. (1983). A family study of agoraphobia. Archives of General Psychiatry 40, 10611064.
Helzer J. E. & Pryzbeck T. R. (1988). The co-occurrence of alcoholism with other psychiatric disorders in the general population and its impact on treatment. Journal of Studies on Alcohol 49, 219224.
Hollingshead A. B. (1957). Two Factor Index of Social Position. Yale University Press: New Haven.
Kaplan E. B. & Elston R. B. (1972). A Subroutine Package for Maximum Likelihood Estimation (MAXLIK). Institute of Statistics Mimeoseries #823: Chapel Hill.
Kendler K. S., Heath A. & Martin N. G. (1986). Symptoms of anxiety and depression in a volunteer twin population. Archives of General Psychiatry 43, 213221.
Kushner M. G., Sher K. J. & Beitman B. D. (1990). The relations between alcohol problems and the anxiety disorders. American Journal of Psychiatry 147, 685695.
Lader M. (1972). The nature of anxiety. British Journal of Psychiatry 121, 481491.
Leckman J. F., Weissman M. M., Merikangas K. R., Pauls D. L. & Prusoff B. A. (1993). Panic disorder and major depression: increased risk of depression, alcoholism, panic, and phobic disorders in families of depressed probands with panic disorder. Archives of General Psychiatry 40, 10551060.
Lee E. (1980). Statistical Methods for Survival Data Analysis. Wadsworth Publishing Co.: Belmont.
Maier W., Buller R. & Hallmayer J. (1988). Comorbidity of panic disorder and major depression: results from a family study. In Panic and Phobias: Treatments and Variables Affecting Course Outcome(ed. Hand I. and Wittchen H. U.), pp. 180185. Springer-Verlag: Berlin.
Marks I. & Lader M. (1973). Anxiety states (anxiety neurosis): a review. Journal of Nervous and Mental Disease 156, 318.
Maser J. D. & Cloninger C. R. (1990). Comorbidity of Anxiety and Mood Disorders. American Psychiatric Press, Inc.: Washington, DC.
Merikangas K. R. (1990). Co-morbidity for anxiety and depression: review of family and genetic studies. In Comorbidity of Mood and Anxiety Disorders (ed. Maser J. D. and Cloninger C. R.), pp. 331348. American Psychiatric Press, Inc: Washington, DC.
Merikangas K. R. & Gelernter C. S. (1990). Co-morbidity for alcoholism and depression. Psychiatric Clinics of North America 13, 613632.
Merikangas K. R., Leckman J. F., Prusoff B. A., Pauls D. L. & Weissman M. M. (1985). Familial transmission of depression and alcoholism. Archives of General Psychiatry 42, 367372.
Merikangas K. R., Risch N. J., Merikangas J. R., Weissman M. M. & Kidd K. K. (1988). Migraine and depression: association and familial transmission. Journal of Psychiatric Research 22, 119129.
Mullan M. J., Gurling H. M. D., Oppenheim B. E. & Murray R. M. (1986). The relationship between alcoholism and neurosis: evidence from a twin study. British Journal of Psychiatry 148, 435441.
Mullaney J. A. & Trippett C. J. (1979). Alcohol dependence and phobias: clinical description and relevance. British Journal of Psychiatry 135, 565573.
Munjack D. J. & Moss H. B. (1981). Affective disorder and alcoholism in families of agoraphobics. Archives of General Psychiatry 38, 869871.
Murphy J., Sobol A., Neff R., Olivier D. C. & Leighton A. H. (1984). Stability of prevalence. Archives of General Psychiatry 41, 990997.
Noyes R. Jr., Clancy J., Crowe R. R., Hoenk P. R. & Slymen D. J. (1978). The family prevalence of anxiety neurosis. Archives of General Psychiatry 35, 10571059.
Osler W. (1904). Aequanimitas, pp. 130. P. Blakiston's Son & Co.: Philadelphia.
Regier D. A., Farmer M., Rae D., Locke B., Keith S., Judd L. & Goodwin F. (1990). Comorbidity of mental disorders with alcohol and drug abuse. Journal of the American Medical Association 240, 25112518.
Reich T., Rice J., Cloninger C. R., Wette R. & James J. (1979). The use of multiple thresholds and segregation analysis in analyzing the phenotypic heterogeneity of multifactorial traits. Annals of Human Genetics 42, 371389.
Reinhardt P. (1980). SAS Supplemental Library User's Guide. SAS Institute: Cary, NC.
Smail P., Stockwell T., Canter S. & Hodgson R. (1984). Alcohol dependence and phobic anxiety states. I. A prevalence study. British Journal of Psychiatry 144, 5357.
Smith C. (1976). Statistical resolution of genetic heterogeneity in familial disease. Annals of Human Genetics 39, 281290.
Stavrakaki C. & Vargo B. (1986). The relationship of anxiety and depression: a review of the literature. British Journal of Psychiatry 149, 716.
Stockwell T., Smail P., Hodgson R. & Canter S. (1984). Alcohol dependence and phobic anxiety states. II. A retrospective study. British Journal of Psychiatry 144, 5863.
Torgersen S. (1985). Hereditary differentiation of anxiety and affective neuroses. British Journal of Psychiatry 146, 530534.
Van Valkenburg C., Akiskal H. S., Puzantian V. & Rosenthal T. (1984). Anxious depressions: clinical family history and naturalistic outcome – comparisons with panic and major depressive disorders. Journal of Affective Disorders 6, 6782.
Weiss K. J. & Rosenburg D. J. (1985). Prevalence of anxiety disorder among alcoholics. Journal of Clinical Psychiatry 46, 35.
Weissman M. M. & Myers J. K. (1980). Clinical depression in alcoholism. American Journal of Psychiatry 137, 372373.
Weissman M. M., Kidd K. K. & Prusoff B. A. (1982). Variability in rates of affective disorders in relatives of depressed and normal probands. Archives of General Psychiatry 39, 13971403.
Weissman M. M., Merikangas K. R., Wickramaratne P. J., Kidd K. K., Prusoff B. A., Leckman J. F. & Pauls D. L. (1986). Understanding the clinical heterogeneity of major depression using family data. Archives of General Psychiatry 43, 430434.
Wesner R. B. (1990). Alcohol use and abuse secondary to anxiety. Psychiatric Clinics of North America, 13, 699713.
Woodruff R. A. Jr., Guze S. B. & Clayton P. J. (1979). Alcoholism and depression. In Alcoholism and Affective Disorders (ed. Goodwin D. W. and Erickson C. K.), pp. 3948. SP Medical and Scientific Books: New York.
Woodruff R. H., Guze S. B. & Clayton P. J. (1972). Anxiety neurosis among psychiatric outpatients. Comprehensive Psychiatry 13, 165170.
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Psychological Medicine
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