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Psychiatric ‘diseases’ versus behavioral disorders and degree of genetic influence

  • O. J. Bienvenu (a1), D. S. Davydow (a2) and K. S. Kendler (a3)
Abstract
Background

Psychiatric conditions in which symptoms arise involuntarily (‘diseases’) might be assumed to be more heritable than those in which choices are essential (behavioral disorders). We sought to determine whether psychiatric ‘diseases’ (Alzheimer's disease, schizophrenia, and mood and anxiety disorders) are more heritable than behavioral disorders (substance use disorders and anorexia nervosa).

Method

We reviewed the literature for recent quantitative summaries of heritabilities. When these were unavailable, we calculated weighted mean heritabilities from twin studies meeting modern methological standards.

Results

Heritability summary estimates were as follows: bipolar disorder (85%), schizophrenia (81%), Alzheimer's disease (75%), cocaine use disorder (72%), anorexia nervosa (60%), alcohol dependence (56%), sedative use disorder (51%), cannabis use disorder (48%), panic disorder (43%), stimulant use disorder (40%), major depressive disorder (37%), and generalized anxiety disorder (28%).

Conclusions

No systematic relationship exists between the disease-like character of a psychiatric disorder and its heritability; many behavioral disorders seem to be more heritable than conditions commonly construed as diseases. These results suggest an error in ‘common-sense’ assumptions about the etiology of psychiatric disorders. That is, among psychiatric disorders, there is no close relationship between the strength of genetic influences and the etiologic importance of volitional processes.

Copyright
Corresponding author
*Address for correspondence: Dr O. J. Bienvenu, Johns Hopkins University, 600 N. Wolfe St., Meyer 115, Baltimore, MD21287, USA. (Email: jbienven@jhmi.edu)
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This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

A Agrawal , KC Jacobson , CA Prescott , KS Kendler (2004). A twin study of personality and illicit drug use and abuse/dependence. Twin Research 7, 7281.

ALM Bergem , K Engedal , E Kringlen (1997). The role of heredity in late-onset Alzheimer disease and vascular dementia. Archives of General Psychiatry 54, 264270.

OJ Bienvenu , JF Samuels , PT Costa , IM Reti , WW Eaton , G Nestadt (2004). Anxiety and depressive disorders and the five-factor model of personality: a higher- and lower-order personality trait investigation in a community sample. Depression and Anxiety 20, 9297.

OJ Bienvenu , MB Stein , JF Samuels , CU Onyike , WW Eaton , G Nestadt (2009). Personality disorder traits as predictors of subsequent first-onset panic disorder or agoraphobia. Comprehensive Psychiatry 50, 209214.

JCS Breitner , KA Welsh , BA Gau , WM McDonald , DC Steffens , AM Saunders , KM Magruder , MJ Helms , BL Plassman , MF Folstein , J Brandt , CD Robinette , WF Page (1995). Alzheimer's disease in the National Academy of Sciences-National Research Council Registry of Aging Twin Veterans. III. Detection of cases, longitudinal results, and observations on twin concordance. Archives of Neurology 52, 763771.

CM Bulik , PF Sullivan , F Tozzi , H Furberg , P Lichtenstein , NL Pedersen (2006). Prevalence, heritability, and prospective risk factors for anorexia nervosa. Archives of General Psychiatry 63, 305312.

AG Cardno , EJ Marshall , B Coid , AM Macdonald , TR Ribchester , NJ Davies , P Venturi , LA Jones , SW Lewis , PC Sham , II Gottesman , AE Farmer , P McGuffin , AM Reveley , RM Murray (1999). Heritability estimates for psychotic disorders: the Maudsley twin psychosis series. Archives of General Psychiatry 56, 162168.

M Farrell , G Lewis (1990). Discrimination on the grounds of diagnosis. British Journal of Addiction 85, 883890.

DL Foley , MC Neale , KS Kendler (1998). Reliability of a lifetime history of major depression: implications for heritability and co-morbidity. Psychological Medicine 28, 857870.

M Gatz , L Fratiglioni , B Johansson , S Berg , JA Mortimer , CA Reynolds , A Fiske , N Pedersen (2005). Complete ascertainment of dementia in the Swedish Twin Registry: the HARMONY study. Neurobiology of Aging 26, 439447.

M Gatz , CA Reynolds , L Fratiglioni , B Johansson , JA Mortimer , S Berg , A Fiske , NL Pedersen (2006). Role of genes and environments for explaining Alzheimer disease. Archives of General Psychiatry 63, 168174.

D Goldman , G Oroszi , F Ducci (2005). The genetics of addictions: uncovering the genes. Nature Reviews Genetics 6, 521532.

JM Hettema , MC Neale , KS Kendler (2001 a). A review and meta-analysis of the genetic epidemiology of anxiety disorders. American Journal of Psychiatry 158, 15681578.

JM Hettema , CA Prescott , KS Kendler (2001 b). A population-based twin study of generalized anxiety disorder in men and women. Journal of Nervous and Mental Disease 189, 413420.

KS Kendler (2005). Psychiatric genetics: a methodologic critique. American Journal of Psychiatry 162, 3–11.

KS Kendler , CO Gardner , CA Prescott (2001). Panic syndromes in a population-based sample of male and female twins. Psychological Medicine 31, 989–1000.

KS Kendler , M Gatz , CO Gardner , NL Pedersen (2006 b). A Swedish national twin study of lifetime major depression. American Journal of Psychiatry 163, 109114.

KS Kendler , M Gatz , CO Gardner , NL Pedersen (2007). Clinical indices of familial depression in the Swedish Twin Registry. Acta Psychiatrica Scandinavica 115, 214220.

KS Kendler , LM Karkowski , MC Neale , CA Prescott (2000). Illicit psychoactive substance use, heavy use, abuse, and dependence in a US population-based sample of male twins. Archives of General Psychiatry 57, 261269.

KS Kendler , MC Neale , RC Kessler , AC Heath , LJ Eaves (1994). The clinical characteristics of major depression as indices of the familial risk to illness. British Journal of Psychiatry 165, 6672.

KS Kendler , N Pedersen , L Johnson , MC Neale , AA Mathe (1993). A pilot twin study of affective illness, including hospital- and population-ascertained subsamples. Archives of General Psychiatry 50, 699706.

KS Kendler , NL Pedersen , MC Neale , AA Mathe (1995). A pilot Swedish twin study of affective illness including hospital- and population-ascertained subsamples: results of model fitting. Behavior Genetics 25, 217232.

KS Kendler , CA Prescott (1999). A population-based twin study of lifetime major depression in men and women. Archives of General Psychiatry 56, 3944.

KS Kendler , CA Prescott , J Myers , MC Neale (2003). The structure of genetic and environmental risk factors for common psychiatric and substance use disorders in men and women. Archives of General Psychiatry 60, 929937.

T Kieseppa , T Partonen , J Haukka , J Kaprio , J Lonnqvist (2004). High concordance of bipolar I disorder in a nationwide sample of twins. American Journal of Psychiatry 161, 18141821.


JF Leckman , KA Caruso , BA Prusoff , MM Weissman , KR Merikangas , DL Pauls (1984 a). Appetite disturbance and excessive guilt in major depression: use of family study data to define depressive subtypes. Archives of General Psychiatry 41, 839844.

JF Leckman , MM Weissman , BA Prusoff , KA Caruso , KR Merikangas , DL Pauls , KK Kidd (1984 b). Subtypes of depression: family study perspective. Archives of General Psychiatry 41, 833838.

DF Levinson , GS Zubenko , RR Crowe , JR Depaulo , WS Scheftner , MM Weissman , P Holmans , WN Zubenko , S Boutelle , K Murphy-Eberenz , D MacKinnon , MG McInnis , DH Marta , P Adams , S Sassoon , JA Knowles , J Thomas , J Chellis (2003). Genetics of recurrent early-onset depression (GenRED): design and preliminary clinical characteristics of a repository sample for genetic linkage studies. American Journal of Medical Genetics. Part B, Neuropsychiatric Genetics 119B, 118130.

MJ Lyons , R Toomey , JM Meyer , AI Green , SA Eisen , J Goldberg , WR True , MT Tsuang (1997). How do genes influence marijuana use? The role of subjective effects. Addiction 92, 409417.


P McGuffin , R Katz , S Watkins , J Rutherford (1996). A hospital-based twin register of the heritability of DSM-IV unipolar depression. Archives of General Psychiatry 53, 129136.

P McGuffin , F Rijsdijk , M Andrew , P Sham , R Katz , A Cardno (2003). The heritability of bipolar affective disorder and the genetic relationship to unipolar depression. Archives of General Psychiatry 60, 497502.

PR McHugh (2005). Striving for coherence: psychiatry's efforts over classification. Journal of the American Medical Association 293, 25262528.

JM Meyer , JCS Breitner (1998). Multiple threshold model for the onset of Alzheimer's disease in the NAS-NRC Twin Panel. American Journal of Medical Genetics 81, 9297.

NL Pedersen , SF Posner , M Gatz (2001). Multiple-threshold models for genetic influences on age of onset for Alzheimer's disease: findings in Swedish twins. American Journal of Medical Genetics 105, 724728.

I Raiha , J Kaprio , M Koskenvuo , T Rajala , L Sourander (1996). Alzheimer's disease in Finnish twins. Lancet 347, 573578.

M Roth (2001). Unitary or binary nature of classification of depressive illness and its implications for the scope of manic depressive disorder. Journal of Affective Disorders 64, 118.

M Roth , C Gurney , RF Garside , TA Kerr (1972). Studies in the classification of affective disorders: the relationship between anxiety states and depressive illnesses: I. British Journal of Psychiatry 121, 147161.


JF Scherrer , WR True , H Xian , MJ Lyons , SA Eisen , J Goldberg , N Lin , MT Tsuang (2000). Evidence for genetic influences common and specific to symptoms of generalized anxiety and panic. Journal of Affective Disorders 57, 2535.

G Schomerus , H Matschinger , MC Angermeyer (2006). Alcoholism: illness beliefs and resource allocation preferences of the public. Drug and Alcohol Dependence 82, 204210.

PF Sullivan , KS Kendler , MC Neale (2003). Schizophrenia as a complex trait: evidence from a meta-analysis of twin studies. Archives of General Psychiatry 60, 11871192.

PF Sullivan , MC Neale , KS Kendler (2000). Genetic epidemiology of major depression: review and meta-analysis. American Journal of Psychiatry 157, 15521562.

TD Wade , CM Bulik , M Neale , KS Kendler (2000). Anorexia nervosa and major depression: shared genetic and environmental risk factors. American Journal of Psychiatry 157, 469471.

TD Wade , M Tiggemann , CM Bulik , CG Fairburn , NR Wray , NG Martin (2008). Shared temperament risk factors for anorexia nervosa: a twin study. Psychosomatic Medicine 70, 239244.

MM Weissman , KR Merikangas , P Wickramaratne , KK Kidd , BA Prusoff , JF Leckman , DL Pauls (1986). Understanding the clinical heterogeneity of major depression using family data. Archives of General Psychiatry 43, 430434.

K Wirdefeldt , M Gatz , M Schalling , NL Pedersen (2004). No evidence for heritability of Parkinson disease in Swedish twins. Neurology 63, 305311.

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Psychological Medicine
  • ISSN: 0033-2917
  • EISSN: 1469-8978
  • URL: /core/journals/psychological-medicine
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