Hostname: page-component-cd9895bd7-fscjk Total loading time: 0 Render date: 2024-12-26T21:05:39.583Z Has data issue: false hasContentIssue false
  • English
  • Français

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

Published online by Cambridge University Press:  12 May 2010

O. J. Bienvenu ,
D. S. Davydow  and
K. S. Kendler
O. J. Bienvenu*
Affiliation:
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA
D. S. Davydow
Affiliation:
Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, WA, USA
K. S. Kendler
Affiliation:
Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
*
*Address for correspondence: Dr O. J. Bienvenu, Johns Hopkins University, 600 N. Wolfe St., Meyer 115, Baltimore, MD 21287, USA. (Email: jbienven@jhmi.edu)
Get access Rights & Permissions [Opens in a new window]

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.

Keywords

Behaviordiseasegenetic epidemiologygenetics
Type
Review Article
Information
Psychological Medicine , Volume 41 , Issue 1 , January 2011 , pp. 33 - 40
Copyright
Copyright © Cambridge University Press 2010

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

Agrawal, A, Jacobson, KC, Prescott, CA, Kendler, KS (2004). A twin study of personality and illicit drug use and abuse/dependence. Twin Research 7, 72–81.CrossRefGoogle Scholar
Bergem, ALM, Engedal, K, Kringlen, E (1997). The role of heredity in late-onset Alzheimer disease and vascular dementia. Archives of General Psychiatry 54, 264–270.Google Scholar
Bienvenu, OJ, Samuels, JF, Costa, PT, Reti, IM, Eaton, WW, Nestadt, G (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, 92–97.Google Scholar
Bienvenu, OJ, Stein, MB, Samuels, JF, Onyike, CU, Eaton, WW, Nestadt, G (2009). Personality disorder traits as predictors of subsequent first-onset panic disorder or agoraphobia. Comprehensive Psychiatry 50, 209–214.Google Scholar
Breitner, JCS, Welsh, KA, Gau, BA, McDonald, WM, Steffens, DC, Saunders, AM, Magruder, KM, Helms, MJ, Plassman, BL, Folstein, MF, Brandt, J, Robinette, CD, Page, WF (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, 763–771.Google Scholar
Bulik, CM, Sullivan, PF, Tozzi, F, Furberg, H, Lichtenstein, P, Pedersen, NL (2006). Prevalence, heritability, and prospective risk factors for anorexia nervosa. Archives of General Psychiatry 63, 305–312.CrossRefGoogle Scholar
Cardno, AG, Marshall, EJ, Coid, B, Macdonald, AM, Ribchester, TR, Davies, NJ, Venturi, P, Jones, LA, Lewis, SW, Sham, PC, Gottesman, II, Farmer, AE, McGuffin, P, Reveley, AM, Murray, RM (1999). Heritability estimates for psychotic disorders: the Maudsley twin psychosis series. Archives of General Psychiatry 56, 162–168.Google Scholar
Farrell, M, Lewis, G (1990). Discrimination on the grounds of diagnosis. British Journal of Addiction 85, 883–890.Google Scholar
Foley, DL, Neale, MC, Kendler, KS (1998). Reliability of a lifetime history of major depression: implications for heritability and co-morbidity. Psychological Medicine 28, 857–870.Google Scholar
Gatz, M, Fratiglioni, L, Johansson, B, Berg, S, Mortimer, JA, Reynolds, CA, Fiske, A, Pedersen, N (2005). Complete ascertainment of dementia in the Swedish Twin Registry: the HARMONY study. Neurobiology of Aging 26, 439–447.Google Scholar
Gatz, M, Pedersen, NL, Berg, S, Johansson, B, Johansson, K, Mortimer, JA, Posner, SF, Viitanen, M, Winblad, B, Ahlbom, A (1997). Heritability for Alzheimer's disease: the study of dementia in Swedish twins. Journals of Gerontology. Series A, Biological Sciences and Medical Sciences 52, M117–M125.Google Scholar
Gatz, M, Reynolds, CA, Fratiglioni, L, Johansson, B, Mortimer, JA, Berg, S, Fiske, A, Pedersen, NL (2006). Role of genes and environments for explaining Alzheimer disease. Archives of General Psychiatry 63, 168–174.Google Scholar
Ghaemi, SN (2003). The Concepts of Psychiatry. Johns Hopkins University Press: Baltimore, MD.Google Scholar
Goldman, D, Oroszi, G, Ducci, F (2005). The genetics of addictions: uncovering the genes. Nature Reviews Genetics 6, 521–532.Google Scholar
Hettema, JM, Neale, MC, Kendler, KS (2001 a). A review and meta-analysis of the genetic epidemiology of anxiety disorders. American Journal of Psychiatry 158, 1568–1578.Google Scholar
Hettema, JM, Prescott, CA, Kendler, KS (2001 b). A population-based twin study of generalized anxiety disorder in men and women. Journal of Nervous and Mental Disease 189, 413–420.Google Scholar
Kendler, KS (2005). Psychiatric genetics: a methodologic critique. American Journal of Psychiatry 162, 3–11.Google Scholar
Kendler, KS, Aggen, SH, Tambs, K, Reichborn-Kjennerud, T (2006 a). Illicit psychoactive substance use, abuse and dependence in a population-based sample of Norwegian twins. Psychological Medicine 36, 955–962.Google Scholar
Kendler, KS, Gardner, CO, Prescott, CA (2001). Panic syndromes in a population-based sample of male and female twins. Psychological Medicine 31, 989–1000.Google Scholar
Kendler, KS, Gatz, M, Gardner, CO, Pedersen, NL (2006 b). A Swedish national twin study of lifetime major depression. American Journal of Psychiatry 163, 109–114.Google Scholar
Kendler, KS, Gatz, M, Gardner, CO, Pedersen, NL (2007). Clinical indices of familial depression in the Swedish Twin Registry. Acta Psychiatrica Scandinavica 115, 214–220.Google Scholar
Kendler, KS, Karkowski, LM, Neale, MC, Prescott, CA (2000). Illicit psychoactive substance use, heavy use, abuse, and dependence in a US population-based sample of male twins. Archives of General Psychiatry 57, 261–269.Google Scholar
Kendler, KS, Neale, MC, Kessler, RC, Heath, AC, Eaves, LJ (1994). The clinical characteristics of major depression as indices of the familial risk to illness. British Journal of Psychiatry 165, 66–72.Google Scholar
Kendler, KS, Pedersen, N, Johnson, L, Neale, MC, Mathe, AA (1993). A pilot twin study of affective illness, including hospital- and population-ascertained subsamples. Archives of General Psychiatry 50, 699–706.Google Scholar
Kendler, KS, Pedersen, NL, Neale, MC, Mathe, AA (1995). A pilot Swedish twin study of affective illness including hospital- and population-ascertained subsamples: results of model fitting. Behavior Genetics 25, 217–232.Google Scholar
Kendler, KS, Prescott, CA (1999). A population-based twin study of lifetime major depression in men and women. Archives of General Psychiatry 56, 39–44.Google Scholar
Kendler, KS, Prescott, CA, Myers, J, Neale, MC (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, 929–937.Google Scholar
Kieseppa, T, Partonen, T, Haukka, J, Kaprio, J, Lonnqvist, J (2004). High concordance of bipolar I disorder in a nationwide sample of twins. American Journal of Psychiatry 161, 1814–1821.Google Scholar
Klump, KL, Miller, KB, Keel, PK, McGue, M, Iacono, WG (2001). Genetic and environmental influences on anorexia nervosa syndromes in a population-based twin sample. Psychological Medicine 31, 737–740.CrossRefGoogle Scholar
Leckman, JF, Caruso, KA, Prusoff, BA, Weissman, MM, Merikangas, KR, Pauls, DL (1984 a). Appetite disturbance and excessive guilt in major depression: use of family study data to define depressive subtypes. Archives of General Psychiatry 41, 839–844.Google Scholar
Leckman, JF, Weissman, MM, Prusoff, BA, Caruso, KA, Merikangas, KR, Pauls, DL, Kidd, KK (1984 b). Subtypes of depression: family study perspective. Archives of General Psychiatry 41, 833–838.Google Scholar
Levinson, DF, Zubenko, GS, Crowe, RR, Depaulo, JR, Scheftner, WS, Weissman, MM, Holmans, P, Zubenko, WN, Boutelle, S, Murphy-Eberenz, K, MacKinnon, D, McInnis, MG, Marta, DH, Adams, P, Sassoon, S, Knowles, JA, Thomas, J, Chellis, J (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, 118–130.Google Scholar
Lyons, MJ, Toomey, R, Meyer, JM, Green, AI, Eisen, SA, Goldberg, J, True, WR, Tsuang, MT (1997). How do genes influence marijuana use? The role of subjective effects. Addiction 92, 409–417.Google Scholar
Mackintosh, M-A, Gatz, M, Wetherell, JL, Pedersen, NL (2006). A twin study of lifetime generalized anxiety disorder (GAD) in older adults: genetic and environmental influences shared by neuroticism and GAD. Twin Research and Human Genetics 9, 30–37.Google Scholar
McGuffin, P, Katz, R, Watkins, S, Rutherford, J (1996). A hospital-based twin register of the heritability of DSM-IV unipolar depression. Archives of General Psychiatry 53, 129–136.Google Scholar
McGuffin, P, Rijsdijk, F, Andrew, M, Sham, P, Katz, R, Cardno, A (2003). The heritability of bipolar affective disorder and the genetic relationship to unipolar depression. Archives of General Psychiatry 60, 497–502.Google Scholar
McHugh, PR (2005). Striving for coherence: psychiatry's efforts over classification. Journal of the American Medical Association 293, 2526–2528.Google Scholar
McHugh, PR, Slavney, PR (1998). The Perspectives of Psychiatry. Johns Hopkins University Press: Baltimore, MD.CrossRefGoogle Scholar
Meyer, JM, Breitner, JCS (1998). Multiple threshold model for the onset of Alzheimer's disease in the NAS-NRC Twin Panel. American Journal of Medical Genetics 81, 92–97.Google Scholar
Pedersen, NL, Posner, SF, Gatz, M (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, 724–728.Google Scholar
Raiha, I, Kaprio, J, Koskenvuo, M, Rajala, T, Sourander, L (1996). Alzheimer's disease in Finnish twins. Lancet 347, 573–578.Google Scholar
Roth, M (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, 1–18.Google Scholar
Roth, M, Gurney, C, Garside, RF, Kerr, TA (1972). Studies in the classification of affective disorders: the relationship between anxiety states and depressive illnesses: I. British Journal of Psychiatry 121, 147–161.Google Scholar
Roy, M-A, Neale, MC, Pedersen, NL, Mathe, AA, Kendler, KS (1995). A twin study of generalized anxiety disorder and major depression. Psychological Medicine 25, 1037–1049.Google Scholar
Scherrer, JF, True, WR, Xian, H, Lyons, MJ, Eisen, SA, Goldberg, J, Lin, N, Tsuang, MT (2000). Evidence for genetic influences common and specific to symptoms of generalized anxiety and panic. Journal of Affective Disorders 57, 25–35.Google Scholar
Schomerus, G, Matschinger, H, Angermeyer, MC (2006). Alcoholism: illness beliefs and resource allocation preferences of the public. Drug and Alcohol Dependence 82, 204–210.Google Scholar
Sheehan, DV (1983). The Anxiety Disease. Bantam Books: New York.Google Scholar
Shorter, E (2009). Before Prozac: The Troubled History of Mood Disorders in Psychiatry. Oxford University Press: New York, NY.Google Scholar
Sullivan, PF, Kendler, KS, Neale, MC (2003). Schizophrenia as a complex trait: evidence from a meta-analysis of twin studies. Archives of General Psychiatry 60, 1187–1192.Google Scholar
Sullivan, PF, Neale, MC, Kendler, KS (2000). Genetic epidemiology of major depression: review and meta-analysis. American Journal of Psychiatry 157, 1552–1562.Google Scholar
Thomasson, HR, Li, TK (1993). How alcohol and aldehyde dehydrogenase genes modify alcohol drinking, alcohol flushing, and the risk for alcoholism. Alcohol Health and Research World 17, 167–172.Google Scholar
To, SE, Vega, CP (2006). Alcoholism and pathways to recovery: new survey results on views and treatment options. Medscape General Medicine 8, 2.Google Scholar
Wade, TD, Bulik, CM, Neale, M, Kendler, KS (2000). Anorexia nervosa and major depression: shared genetic and environmental risk factors. American Journal of Psychiatry 157, 469–471.Google Scholar
Wade, TD, Tiggemann, M, Bulik, CM, Fairburn, CG, Wray, NR, Martin, NG (2008). Shared temperament risk factors for anorexia nervosa: a twin study. Psychosomatic Medicine 70, 239–244.Google Scholar
Weissman, MM, Merikangas, KR, Wickramaratne, P, Kidd, KK, Prusoff, BA, Leckman, JF, Pauls, DL (1986). Understanding the clinical heterogeneity of major depression using family data. Archives of General Psychiatry 43, 430–434.Google Scholar
Wirdefeldt, K, Gatz, M, Schalling, M, Pedersen, NL (2004). No evidence for heritability of Parkinson disease in Swedish twins. Neurology 63, 305–311.Google Scholar