Potenza Marc N, Xian Hong, Shah Kamini, Scherrer Jeffrey F, Eisen Seth A
Department of Psychiatry, Yale University School of Medicine and Connecticut Mental Health Center, New Haven, CT 06519, USA.
Arch Gen Psychiatry. 2005 Sep;62(9):1015-21. doi: 10.1001/archpsyc.62.9.1015.
Although pathological gambling (PG) and major depression (MD) frequently co-occur, little is known regarding the relative contributions of environmental and genetic factors to the codevelopment of the disorders.
To estimate environmental and genetic contributions to PG and MD as defined in DSM-III-R and the lifetime co-occurrence of PG and MD.
Survey data from the Vietnam Era Twin Registry were examined in biometric models.
Telephone interview.
Of 10, 253 eligible participants, 7869 were successfully interviewed.
Estimated genetic, shared environmental, and unique environmental contributions to PG and MD and their lifetime co-occurrence in bivariate models.
Elevated odds ratios for MD were associated with those of PG (4.06; 95% confidence interval, 2.68-6.13), and the association remained significant following adjustment for sociodemographic and other psychiatric variables (odds ratio = 1.98; 95% confidence interval, 1.14-3.45). The best-fitting bivariate model indicated that 66% of the variance in PG and 41% of the variance in MD were owing to genetic factors, and 34% of the variance in PG and 59% of the variance in MD were owing to unique environmental factors. There was a substantial correlation between the genetic components of PG and MD (r(A) = 0.58), with 34% of the genetic variance for each disorder also contributing to that of the other. The best-fitting model estimated that 100% of the total overlap between PG and MD was genetic.
The correlation between PG and MD in middle-aged men appears to be largely influenced by overlapping genetic factors. Future research is needed to determine the extent to which these findings extend to other groups (eg, women), identify specific genes, and generate improved prevention and treatment strategies.
尽管病态赌博(PG)和重度抑郁症(MD)经常同时出现,但对于环境因素和遗传因素在这两种疾病共同发展过程中的相对作用,人们了解甚少。
评估环境因素和遗传因素对《精神疾病诊断与统计手册第三版修订本》(DSM-III-R)所定义的PG和MD的影响,以及PG和MD的终生共病情况。
在生物统计学模型中分析越南战争时期双胞胎登记处的调查数据。
电话访谈。
在10253名符合条件的参与者中,成功访谈了7869人。
在双变量模型中,评估遗传因素、共同环境因素和独特环境因素对PG和MD的影响,以及它们的终生共病情况。
MD的较高比值比与PG相关(4.06;95%置信区间,2.68 - 6.13),在对社会人口统计学和其他精神科变量进行调整后,这种关联仍然显著(比值比 = 1.98;95%置信区间,1.14 - 3.45)。拟合度最佳的双变量模型表明,PG变异的66%和MD变异的41%归因于遗传因素,PG变异的34%和MD变异的59%归因于独特环境因素。PG和MD的遗传成分之间存在显著相关性(r(A) = 0.58),每种疾病34%的遗传变异也对另一种疾病有贡献。拟合度最佳的模型估计,PG和MD之间的总重叠中有100%是由遗传因素导致的。
中年男性中PG和MD之间的相关性似乎在很大程度上受重叠遗传因素的影响。未来需要开展研究,以确定这些发现扩展到其他群体(如女性)的程度,识别特定基因,并制定更好的预防和治疗策略。