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Major depression and phobias: the genetic and environmental sources of comorbidity

  • Kenneth S. Kendler (a1), Michael C. Neale (a1), Ronald C. Kessler (a1), Andrew C. Heath (a1) and Lindon J. Eaves (a1)
  • DOI:
  • Published online: 01 July 2009

In a population based sample of 2163 personally interviewed female twins, substantial comorbidity was observed between DSM-III-R defined major depression (MD) and 4 subtypes of phobia: agoraphobia, social phobia, animal phobia and situational phobia. However, the level of comorbidity of MD with agoraphobia was much greater than that found with the other phobic subtypes. We conducted bivariate twin analyses to decompose the genetic and environmental sources of comorbidity between MD and the phobias. Our results suggest that a modest proportion of the genetic vulnerability to MD also influences the risk for all phobic subtypes, with the possible exception of situational phobias. Furthermore, the magnitude of comorbidity resulting from this shared genetic vulnerability is similar across the phobic subtypes. By contrast, the non-familial environmental experiences which predispose to depression substantially increase the vulnerability to agoraphobia, have a modest impact on the risk for social and situational phobias and no effect on the risk for animal phobias. The increased comorbidity between MD and agoraphobia results, nearly entirely, from individual-specific environmental risk factors for MD which also increase the risk for agoraphobia but not for other phobias.

Corresponding author
1Address for correspondence: Dr Kenneth S. Kendler, Department of Psychiatry, Medical College of Virginia, Box 710, Richmond, VA 23298–0710, USA.
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H. Akaike (1987). Factor analysis and AIC. Psychometrika 52, 317332.

D. H. Barlow , P. A. DiNardo , B. B. Vermilyea , J. Vermilyea & E. B. Blanchard (1986). Co-morbidity and depression among the anxiety disorders: issues in diagnosis and classification. Journal of Nervous and Mental Disease 174, 6372.

J. H. Boyd , J. D. Burke , E. Gruenberg , C. E. Holzer III, D. S. Rae , L. K. George , M. Karno , R. Stoltzman , L. McEvoy & G. Nestadt (1984). Exclusion criteria of DSM-III: a study of co-occurrence of hierarchy-free syndromes. Archives of General Psychiatry 41, 983989.

G. J. Canino , H. R. Bird , P. E. Shrout , M. Rubio-Stipec , M. Bravo , R. Martinez , M. Sesman & L. M. Guevara (1987). The prevalence of specific psychiatric disorders in Puerto Rico. Archives of General Psychiatry 44, 727735.

J. Cohen (1960). A coefficient of agreement for nominal scales. Educational and Psychological Measurement 20, 3746.

L. J. Eaves , H. J. Eysenck , N. G. Martin , R. Jardine , A. C. Heath , L. Feingold , P. A. Young & K. S. Kendler (1989). Genes, Culture and Personality: An Empirical Approach. Oxford University Press: London.

A. C. Heath , M. C. Neale , J. K. Hewitt , L. J. Eaves & D. W. Fulker (1989). Testing structural equation models for twin data using LISREL. Behavior Genetics 19, 935.

K. S. Kendler , M. C. Neale , R. C. Kessler , A. C. Heath & L. J. Eaves (1992 a). A population-based twin study of major depression in women: the impact of varying definitions of illness. Archives of General Psychiatry 49, 257266.

K. S. Kendler , M. C. Neale , R. C. Kessler , A. C. Heath & L. J. Eaves (1992 b). The genetic epidemiology of phobias in women: the inter-relationship of agoraphobia, social phobia, situational phobia and simple phobia. Archives of General Psychiatry 49, 273281.

K. S. Kendler , M. C. Neale , R. C. Kessler , A. C. Heath & L. J. Eaves (1992 c). Generalized anxiety disorder in women: a population-based twin study. Archives of General Psychiatry 49, 267272.

G. L. Klerman , P. W. Lavori , J. Rice , T. Reich , J. Endicott & N. C. Andreasen (1985). Birth-cohort trends in rates of major depressive disorder among relatives of patients with affective disorder. Archives of General Psychiatry 42, 689693.

K. Koehler , D. Vartzopoulos & H. Ebel (1986). Agoraphobia and depression: relationships and severity in hospitalized women. Comprehensive Psychiatry 27, 533539.

M. C. Neale & L. R. Cardon (1992). Methodology for Genetic Studies of Twins and Families. Kluwer Academic Publishers B.V.: Dordrecht, The Netherlands.

M. C. Neale & D. W. Fulker (1984). A bivariate path analysis of fear data on twins and their parents. Acta Geneticae Medicae et Gemellologiae 33, 273286.

M. C. Neale , A. C. Heath , J. K. Hewitt , L. J. Eaves & D. W. Fulker (1989). Fitting genetic models with LISREL: hypothesis testing. Behavior Genetics 19, 3749.

K. Philips , D. W. Fulker & R. J. Rose (1987). Path analysis of seven fear factors in adult twin and sibling pairs and their parents. Genetic Epidemiology 4, 345355.

L. N. Robins & D. A. Regier , eds. (1991). Psychiatric Disorders in America. The Free Press: New York.

L. N. Robins , J. E. Helzer , M. M. Weissman , H. Orvaschel , E. Gruenberg , J. D. Burke & D. A. Regier (1984). Lifetime prevalence of specific psychiatric disorders in three sites. Archives of General Psychiatry 41, 949958.

B. Rorsman , A. Grasbeck , O. Hagnell , J. Lanke , R. Ohman , L. Ojesjo & L. Otterbeck (1990). A prospective study of first-incidence depression: the Lundby study, 1957–1972. British Journal of Psychiatry 156, 336342.

R. J. Rose & W. B. Ditto (1983). A developmental-genetic analysis of common fears from early adolescence to early adulthood. Child Development 54, 361368.

W. C. Sanderson , P. A. DiNardo , R. M. Rapee & D. H. Barlow (1990). Syndrome comorbidity in patients diagnosed with a DSM-III-R anxiety disorder. Journal of Abnormal Psychology 99, 308312.

A. H. Thompson , R. C. Bland & H. T. Orn (1989). Relationship and chronology of depression, agoraphobia, and panic disorder in the general population. Journal of Nervous and Mental Disease 177, 456463.

S. Torgersen (1979). The nature and origin of common phobic fears. British Journal of Psychiatry 134, 343351.

M. M. Weissman & J. K. Myers (1978). Affective disorders in a US urban community: the use of Research Diagnostic Criteria in an epidemiological survey. Archives of General Psychiatry 35, 13041311.

J. S. Wells , J. A. Bushnell , A. R. Hornblow , P. R. Joyce & M. A. Oakley-Browne (1989). Christchurch psychiatric epidemiology study. Part I. Methodology and lifetime prevalence for specific psychiatric disorders. Australian and New Zealand Journal of Psychiatry 23, 315326.

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