Kendler K S, Karkowski L, Prescott C A
Department of Psychiatry, Medical College of Virginia, Virginia Commonwealth University, Richmond, USA.
Acta Psychiatr Scand. 1999 May;99(5):368-76. doi: 10.1111/j.1600-0447.1999.tb07243.x.
Rates of illicit psychoactive substance use and abuse in women have increased substantially over the last 50 years. However, we understand little about the aetiology of these behaviors in women, and almost nothing about the role of familial-environmental and genetic factors.
We obtained, by means of blind telephone interviews with 1934 individual twins from female-female adult pairs ascertained through a population-based registry, including both members of 500 MZ and 326 DZ pairs, a history of lifetime illicit use, abuse and dependence, as defined by DSM-IV, of hallucinogens, opiates, sedatives and non-cocaine stimulants.
Lifetime prevalences for substance use ranged from 3.3% for opiates to 10.4% for hallucinogens. Rates of abuse (ranging from 0.7% for opiates to 3.2% for stimulants) and dependence (ranging from 0.2% for hallucinogens to 1.4% for stimulants) were substantially lower. Significant twin resemblance was found for hallucinogen use, opiate use, sedative use and stimulant use, abuse and symptoms of dependence. The results of twin-model fitting suggested that twin resemblance for hallucinogen and stimulant use was due to both genetic and familial environmental factors, while twin resemblance for opiate and sedative use as well as stimulant abuse and symptoms of dependence was solely the result of genetic factors. Heritability of liability ranged from 21% to 72%. Twin resemblance for substance use, abuse and dependence could not be explained by the similarity of the twins' environment in childhood, adolescence or adulthood.
Although limited by the rarity in women of these forms of substance use and misuse, our results none the less suggest that familial factors, which are at least in part genetic, strongly influence the vulnerability to hallucinogen, opiate, sedative and stimulant use and abuse in women.
在过去50年里,女性非法使用和滥用精神活性物质的比率大幅上升。然而,我们对女性这些行为的病因了解甚少,对家庭环境和遗传因素的作用几乎一无所知。
我们通过对1934名来自成年女性双胞胎对的个体进行盲态电话访谈来获取信息,这些双胞胎对是通过基于人群的登记系统确定的,包括500对同卵双胞胎和326对异卵双胞胎的两名成员,访谈内容为她们一生中按照《精神疾病诊断与统计手册》第四版(DSM-IV)定义的非法使用、滥用和依赖致幻剂、阿片类药物、镇静剂和非可卡因兴奋剂的病史。
物质使用的终生患病率从阿片类药物的3.3%到致幻剂的10.4%不等。滥用率(从阿片类药物的0.7%到兴奋剂的3.2%)和依赖率(从致幻剂的0.2%到兴奋剂的1.4%)则低得多。在致幻剂使用、阿片类药物使用、镇静剂使用以及兴奋剂使用、滥用和依赖症状方面发现了显著的双胞胎相似性。双胞胎模型拟合结果表明,致幻剂和兴奋剂使用的双胞胎相似性是遗传因素和家庭环境因素共同作用的结果,而阿片类药物和镇静剂使用以及兴奋剂滥用和依赖症状的双胞胎相似性则完全是遗传因素的结果。易感性的遗传度在21%至72%之间。双胞胎在物质使用、滥用和依赖方面的相似性无法用双胞胎在儿童期、青少年期或成年期环境的相似性来解释。
尽管这些形式的物质使用和滥用在女性中较为罕见,限制了本研究结果,但我们的结果仍然表明,至少部分为遗传因素的家庭因素强烈影响女性对致幻剂、阿片类药物、镇静剂和兴奋剂使用及滥用的易感性。