Fu Qiang, Heath Andrew C, Bucholz Kathleen K, Nelson Elliot, Goldberg Jack, Lyons Michael J, True William R, Jacob Theodore, Tsuang Ming T, Eisen Seth A
Missouri Alcoholism Research Center at Washington University, Department of Psychiatry, Washington University School of Medicine, 40 N Kingshighway Blvd, Suite 2, St Louis, MO 63108, USA.
Arch Gen Psychiatry. 2002 Dec;59(12):1125-32. doi: 10.1001/archpsyc.59.12.1125.
Little is known about genetic factors that underlie the interrelationships among antisocial personality disorder (ASPD), major depression (MD), alcohol dependence (AD), and marijuana dependence (MJD). We examined the contribution of genetic effects associated with ASPD to the comorbidity of MD and substance use disorders.
The Vietnam Era Twin Registry is a general population registry of male veteran twins constructed from computerized Department of Defense files and other sources. A telephone diagnostic interview was administered to eligible twins from the Registry in 1992. Of 5150 twin pairs who served on active military duty during the Vietnam era, 3360 pairs (1868 monozygotic and 1492 dizygotic) in which both members completed the pertinent diagnostic interview sections were included. The main outcome measures were lifetime DSM-III-R ASPD, MD, AD, and MJD.
Structural equation modeling was performed to estimate additive genetic, shared environmental, and nonshared environmental effects common and specific to each disorder. The heritability estimates for lifetime ASPD, MD, AD, and MJD were 69%, 40%, 56%, and 50%, respectively. Genetic effects on ASPD accounted for 38%, 50%, and 58% of the total genetic variance in risk for MD, AD, and MJD, respectively. After controlling for genetic effects on ASPD, the partial genetic correlations of MD with AD and with MJD were no longer statistically significant. Genetic effects specific to MD and AD and familial effects specific to MJD remained statistically significant. Nonshared environmental contributions to the comorbidity in these disorders were small.
In this sample, the shared genetic risk between MD and both AD and MJD was largely explained by genetic effects on ASPD, which in turn was associated with increased risk of each of the other disorders.
关于反社会人格障碍（ASPD）、重度抑郁症（MD）、酒精依赖（AD）和大麻依赖（MJD）之间相互关系的遗传因素，我们所知甚少。我们研究了与ASPD相关的遗传效应在MD与物质使用障碍共病中的作用。
越南时代双胞胎登记处是一个由国防部计算机档案和其他来源构建的男性退伍军人双胞胎的普通人群登记处。1992年，对登记处符合条件的双胞胎进行了电话诊断访谈。在5150对在越南时代服现役的双胞胎中，有3360对（1868对同卵双胞胎和1492对异卵双胞胎）的双方都完成了相关诊断访谈部分，被纳入研究。主要结局指标为终生DSM-III-R的ASPD、MD、AD和MJD。
进行结构方程模型分析，以估计每种障碍共有的和特定的加性遗传、共享环境和非共享环境效应。终生ASPD、MD、AD和MJD的遗传度估计分别为69%、40%、56%和50%。对ASPD的遗传效应分别占MD、AD和MJD风险总遗传方差的38%、50%和58%。在控制了对ASPD的遗传效应后，MD与AD以及MD与MJD的部分遗传相关性不再具有统计学意义。MD和AD特有的遗传效应以及MJD特有的家族效应仍然具有统计学意义。非共享环境对这些障碍共病的影响较小。
在本样本中，MD与AD和MJD之间共享的遗传风险在很大程度上由对ASPD的遗传效应所解释，而ASPD又与其他每种障碍风险的增加相关。
