Kendler K S, Gardner C O, Prescott C A
Virginia Institute for Psychiatric and Behavioral Genetics and the Department of Psychiatry, Medical College of Virginia of Virginia Commonwealth University, Richmond 23298-0126, USA.
Psychol Med. 2001 Aug;31(6):989-1000. doi: 10.1017/s0033291701004226.
The risk for panic disorder (PD) is substantially increased in relatives of probands with PD. Prior literature provides only limited information about the degree to which this increase is due to genetic factors or family environment.
In personal interviews with both members of 3194 twin pairs, we assessed the lifetime history of lifetime panic attacks and PD. Twin resemblance was assessed by tetrachoric correlation and single and multiple threshold biometrical model fitting.
As fully syndromal PD, by DSM-III-R criteria, was too rare to analyse usefully we examined four other dichotomous definitions of increasing stringency: panic probe and very broad, broad and intermediate PD. For all four definitions and for the multiple threshold analyses, the best-fit model indicated that twin resemblance was due solely to genetic factors with a moderate heritability (33-43%). For the broad and intermediate dichotomous definitions of PD, however, a model with twin resemblance due to familial-environmental factors fit nearly as well. No gender effects were seen on the genetic risk factors for these PD-like syndromes.
Even with large epidemiological samples of twins, studying disorders as uncommon as PD is problematical. Despite these difficulties, our results suggest that: (i) narrowly and broadly defined PD are probably on the same continuum of liability; (ii) twin resemblance for these PD-like syndromes is likely due largely to genetic factors with a moderate level of heritability although a contribution of familial-environmental factors cannot be excluded, and, (iii) the same familial risk factors impact. to a similar degree, on the liability to PD in males and females.
恐慌症（PD）患者的亲属患恐慌症的风险大幅增加。先前的文献仅提供了有限的信息，说明这种增加在多大程度上是由于遗传因素或家庭环境。
在对3194对双胞胎的双方进行个人访谈时，我们评估了终生恐慌发作和恐慌症的病史。通过四分相关以及单阈值和多阈值生物统计学模型拟合来评估双胞胎的相似性。
根据《精神疾病诊断与统计手册第三版修订本》（DSM-III-R）标准，完全综合征性恐慌症极为罕见，无法进行有效分析，因此我们研究了另外四种严格程度递增的二分法定义：恐慌探查和非常宽泛、宽泛和中度恐慌症。对于所有这四种定义以及多阈值分析，最佳拟合模型表明双胞胎的相似性完全归因于遗传因素，遗传度中等（33%-43%）。然而，对于宽泛和中度二分法定义的恐慌症，一个因家族环境因素导致双胞胎相似性的模型拟合效果几乎相同。在这些类恐慌症综合征的遗传风险因素上未发现性别效应。
即使有大量双胞胎的流行病学样本，研究像恐慌症这样不常见的疾病也存在问题。尽管有这些困难，我们的结果表明：（i）狭义和广义定义的恐慌症可能处于相同的易感性连续体上；（ii）这些类恐慌症综合征的双胞胎相似性可能主要归因于遗传因素，遗传度中等，尽管不能排除家族环境因素的作用；（iii）相同的家族风险因素对男性和女性患恐慌症的易感性影响程度相似。
