Kendler K S, Neale M C, Sullivan P, Corey L A, Gardner C O, Prescott C A
Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Medical College of Virginia Commonwealth University, Richmond 23298-0126, USA.
Psychol Med. 1999 Mar;29(2):299-308. doi: 10.1017/s0033291798008022.
The development of drug dependence requires prior initiation. What is the relationship between the risk factors for initiation and dependence?
Using smoking as a model addiction, we assessed smoking initiation (SI) and nicotine dependence (ND) by personal interview in 1898 female twins from the population-based Virginia Twin Registry. We developed a twin structural equation model that estimates the correlation between the liability to SI and the liability to ND, given SI.
The liabilities to SI and ND were substantially correlated but not identical. Heritable factors played an important aetiological role in SI and in ND. While the majority of genetic risk factors for ND were shared with SI, a distinct set of familial factors, which were probably partly genetic, solely influenced the risk for ND. SI was associated with low levels of education and religiosity, high levels of neuroticism and extroversion and a history of a wide range of psychiatric disorders. ND was associated with low levels of education, extroversion, mastery, and self-esteem, high levels of neuroticism and dependency and a history of mood and alcohol use disorders.
The aetiological factors that influence SI and ND, while overlapping, are not perfectly correlated. One set of genetic factors plays a significant aetiological role in both SI and ND, while another set of familial factors, probably in part genetic, solely influences ND. Some risk factors for SI and ND impact similarly on both stages, some act at only one stage and others impact differently and even in opposite directions at the two stages. The pathway to substance dependence is complex and involves multiple genetic and environmental risk factors.
药物依赖的发展需要先前的起始阶段。起始阶段的风险因素与依赖之间的关系是什么？
以吸烟作为成瘾模型，我们通过对来自基于人群的弗吉尼亚双胞胎登记处的1898名女性双胞胎进行个人访谈，评估了吸烟起始（SI）和尼古丁依赖（ND）。我们建立了一个双胞胎结构方程模型，该模型在给定SI的情况下估计SI易感性与ND易感性之间的相关性。
SI和ND的易感性显著相关但并不完全相同。遗传因素在SI和ND中均起着重要的病因学作用。虽然ND的大多数遗传风险因素与SI相同，但一组独特的家族因素（可能部分是遗传因素）仅影响ND的风险。SI与低教育水平和宗教信仰、高神经质和外向性以及广泛的精神疾病史相关。ND与低教育水平、外向性、掌控感和自尊、高神经质和依赖性以及情绪和酒精使用障碍史相关。
影响SI和ND的病因学因素虽然有重叠，但并非完全相关。一组遗传因素在SI和ND中均起着重要的病因学作用，而另一组家族因素（可能部分是遗传因素）仅影响ND。SI和ND的一些风险因素在两个阶段的影响相似，一些仅在一个阶段起作用，而另一些在两个阶段的影响不同甚至相反。物质依赖的途径很复杂，涉及多种遗传和环境风险因素。
