Hostname: page-component-cd9895bd7-mkpzs Total loading time: 0 Render date: 2024-12-26T06:47:09.550Z Has data issue: false hasContentIssue false
  • English
  • Français

Comorbidity and co-transmission of alcoholism, anxiety and depression

Published online by Cambridge University Press:  09 July 2009

K. R. Merikangas ,
N. J. Risch  and
M. M. Weissman
K. R. Merikangas*
Affiliation:
Departments of Psychiatry, Epidemiology and Public Health, and Human Genetics, Yale University School of Medicine, New Haven, Connecticut; and Department of Psychiatry, College of Physicians and Surgeons, Columbia University and New York State Psychiatric Institute, New York, USA
N. J. Risch
Affiliation:
Departments of Psychiatry, Epidemiology and Public Health, and Human Genetics, Yale University School of Medicine, New Haven, Connecticut; and Department of Psychiatry, College of Physicians and Surgeons, Columbia University and New York State Psychiatric Institute, New York, USA
M. M. Weissman
Affiliation:
Departments of Psychiatry, Epidemiology and Public Health, and Human Genetics, Yale University School of Medicine, New Haven, Connecticut; and Department of Psychiatry, College of Physicians and Surgeons, Columbia University and New York State Psychiatric Institute, New York, USA
*
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.
Get access Rights & Permissions [Opens in a new window]

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.

Type
Original Articles
Information
Psychological Medicine , Volume 24 , Issue 1 , February 1994 , pp. 69 - 80
Copyright
Copyright © Cambridge University Press 1994

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Angst, J. (1966). Zur Aetiologie und Nosologie endogener depressiver Psychosen. In Monographien aus dein Gesantgebiete der Neurolog? und Psychiatrie pp. 1–206. Springer-Verlag: Berlin.Google Scholar
Berkson, J. (1946). Limitation of the application of the 4-fold table analysis to hospital data. Biometrics 2, 47–53.CrossRefGoogle Scholar
Bowen, R. C., Cipywnyk, D., D'Arcy, C. & Keegan, D. (1984). Alcoholism, anxiety disorders, and agoraphobia. Alcoholism, Clinical and Experimental Research 8, 48–50.CrossRefGoogle ScholarPubMed
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, 983–989.CrossRefGoogle ScholarPubMed
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, 787–817.Google ScholarPubMed
Cadoret, R. & Winokur, G. (1974). Depression in alcoholism. Anne's of the New York Academy of Sciences 233, 34–36.CrossRefGoogle ScholarPubMed
Cadoret, R. J., O'Gorman, T. W., Heywood, E. & Troughton, I. (1985). Genetic and environmental factors in major depression. Journal of Affective Disorders 9, 155–164.CrossRefGoogle ScholarPubMed
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, 29–40.CrossRefGoogle Scholar
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. 57–86. S.P. Medical and Scientific Books: New York.Google Scholar
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. 137–154. Raven Press: New York.Google Scholar
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, 126–158.Google ScholarPubMed
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, 293–300.Google ScholarPubMed
Cowley, D. S. (1992). Alcohol abuse, substance abuse, and panic disorder. American Journal of Medicine SuppllA, 41–48.CrossRefGoogle Scholar
Cox, D. R. (1972). Regression models and life tables. Journal of Royal Statistical Society B, 34, 187–220.Google Scholar
Falconer, D. S. (1965). The inheritance of liability to certain diseases, estimated from the incidence among relatives. Annals of Human Genetics 29, 51–76.CrossRefGoogle Scholar
Feinstein, A. R. (1970). The pre-therapeutic classification of comorbidity in chronic disease. Journal of Chronic Diseases 23, 455–468.CrossRefGoogle ScholarPubMed
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, 1157–1167.CrossRefGoogle ScholarPubMed
Harris, E. L., Noyes, R. Jr., Crowe, R. R. & Chaudhry, D. R. (1983). A family study of agoraphobia. Archives of General Psychiatry 40, 1061–1064.CrossRefGoogle ScholarPubMed
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, 219–224.CrossRefGoogle ScholarPubMed
Hollingshead, A. B. (1957). Two Factor Index of Social Position. Yale University Press: New Haven.Google Scholar
Kaplan, E. B. & Elston, R. B. (1972). A Subroutine Package for Maximum Likelihood Estimation (MAXLIK). Institute of Statistics Mimeoseries #823: Chapel Hill.Google Scholar
Kendler, K. S., Heath, A. & Martin, N. G. (1986). Symptoms of anxiety and depression in a volunteer twin population. Archives of General Psychiatry 43, 213–221.CrossRefGoogle Scholar
Kushner, M. G., Sher, K. J. & Beitman, B. D. (1990). The relations between alcohol problems and the anxiety disorders. American Journal of Psychiatry 147, 685–695.Google ScholarPubMed
Lader, M. (1972). The nature of anxiety. British Journal of Psychiatry 121, 481–491.CrossRefGoogle ScholarPubMed
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, 1055–1060.CrossRefGoogle Scholar
Lee, E. (1980). Statistical Methods for Survival Data Analysis. Wadsworth Publishing Co.: Belmont.Google Scholar
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. 180–185. Springer-Verlag: Berlin.CrossRefGoogle Scholar
Marks, I. & Lader, M. (1973). Anxiety states (anxiety neurosis): a review. Journal of Nervous and Mental Disease 156, 3–18.CrossRefGoogle ScholarPubMed
Maser, J. D. & Cloninger, C. R. (1990). Comorbidity of Anxiety and Mood Disorders. American Psychiatric Press, Inc.: Washington, DC.Google Scholar
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. 331–348. American Psychiatric Press, Inc: Washington, DC.Google Scholar
Merikangas, K. R. & Gelernter, C. S. (1990). Co-morbidity for alcoholism and depression. Psychiatric Clinics of North America 13, 613–632.CrossRefGoogle Scholar
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, 367–372.CrossRefGoogle ScholarPubMed
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, 119–129.CrossRefGoogle ScholarPubMed
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, 435–441.CrossRefGoogle ScholarPubMed
Mullaney, J. A. & Trippett, C. J. (1979). Alcohol dependence and phobias: clinical description and relevance. British Journal of Psychiatry 135, 565–573.CrossRefGoogle ScholarPubMed
Munjack, D. J. & Moss, H. B. (1981). Affective disorder and alcoholism in families of agoraphobics. Archives of General Psychiatry 38, 869–871.CrossRefGoogle ScholarPubMed
Murphy, J., Sobol, A., Neff, R., Olivier, D. C. & Leighton, A. H. (1984). Stability of prevalence. Archives of General Psychiatry 41, 990–997.CrossRefGoogle ScholarPubMed
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, 1057–1059.CrossRefGoogle ScholarPubMed
Osler, W. (1904). Aequanimitas, pp. 130. P. Blakiston's Son & Co.: Philadelphia.Google Scholar
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, 2511–2518.CrossRefGoogle Scholar
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, 371–389.CrossRefGoogle ScholarPubMed
Reinhardt, P. (1980). SAS Supplemental Library User's Guide. SAS Institute: Cary, NC.Google Scholar
Smail, P., Stockwell, T., Canter, S. & Hodgson, R. (1984). Alcohol dependence and phobic anxiety states. I. A prevalence study. British Journal of Psychiatry 144, 53–57.CrossRefGoogle Scholar
Smith, C. (1976). Statistical resolution of genetic heterogeneity in familial disease. Annals of Human Genetics 39, 281–290.CrossRefGoogle ScholarPubMed
Stavrakaki, C. & Vargo, B. (1986). The relationship of anxiety and depression: a review of the literature. British Journal of Psychiatry 149, 7–16.CrossRefGoogle ScholarPubMed
Stockwell, T., Smail, P., Hodgson, R. & Canter, S. (1984). Alcohol dependence and phobic anxiety states. II. A retrospective study. British Journal of Psychiatry 144, 58–63.CrossRefGoogle ScholarPubMed
Torgersen, S. (1985). Hereditary differentiation of anxiety and affective neuroses. British Journal of Psychiatry 146, 530–534.CrossRefGoogle ScholarPubMed
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, 67–82.CrossRefGoogle ScholarPubMed
Weiss, K. J. & Rosenburg, D. J. (1985). Prevalence of anxiety disorder among alcoholics. Journal of Clinical Psychiatry 46, 3–5.Google ScholarPubMed
Weissman, M. M. & Myers, J. K. (1980). Clinical depression in alcoholism. American Journal of Psychiatry 137, 372–373.Google ScholarPubMed
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, 1397–1403.CrossRefGoogle ScholarPubMed
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, 430–434.CrossRefGoogle ScholarPubMed
Wesner, R. B. (1990). Alcohol use and abuse secondary to anxiety. Psychiatric Clinics of North America, 13, 699–713.CrossRefGoogle ScholarPubMed
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. 39–48. SP Medical and Scientific Books: New York.Google Scholar
Woodruff, R. H., Guze, S. B. & Clayton, P. J. (1972). Anxiety neurosis among psychiatric outpatients. Comprehensive Psychiatry 13, 165–170.CrossRefGoogle ScholarPubMed