Kendler K S, Myers J
Virginia Institute of Psychiatric and Behavioral Genetics, Virginia Commonwealth University School of Medicine, Richmond, VA, USA.
Psychol Med. 2014 Feb;44(3):647-55. doi: 10.1017/S0033291713000585. Epub 2013 Apr 11.
The distribution and co-morbidity of common psychiatric disorders can be largely explained as manifestations of two broad psychopathological spectra of internalizing and externalizing disorders. Twin studies suggest that these spectra arise from genetic factors.
Structural equation twin modeling was applied to interview and questionnaire data on personality traits and lifetime psychiatric disorders on more than 5300 members of male-male (MM) and female-female (FF) twin pairs.
The best-fitting models for both the externalizing and internalizing spectra differed significantly in males and females. In males, the externalizing genetic common factor was best indexed by four disorders in the following order: antisocial personality disorder (ASPD), drug abuse/dependence (DAD), alcohol abuse dependence (AAD) and conduct disorder (CD). In females, the four disorders most closely related to the externalizing common factor were, in order: DAD, AAD, nicotine dependence (ND) and ASPD. Personality traits of novelty seeking (NS) and extraversion (E) better indexed the genetic externalizing spectrum in females than in males. In both males and females, major depression (MD) and generalized anxiety disorder (GAD) best indexed the genetic internalizing common factor. Panic disorder (PD) and agoraphobia (AgP) better reflected the internalizing genetic common factor in women, and neuroticism (N) in men. Genetic correlations between the two spectra were estimated at + 0.53 in males and + 0.52 in females.
The disorders that optimally index the genetic liability to externalizing and internalizing disorders in the general population differ meaningfully in men and women. In both sexes, these genetic spectra are better assessed by psychiatric disorders than by personality traits.
常见精神障碍的分布及共病情况在很大程度上可解释为内化性和外化性障碍这两种广泛精神病理学谱系的表现。双生子研究表明，这些谱系源于遗传因素。
采用结构方程双生子模型，对5300多名男性同性（MM）和女性同性（FF）双生子的人格特质及终生精神障碍访谈和问卷数据进行分析。
外化性和内化性谱系的最佳拟合模型在男性和女性中存在显著差异。在男性中，外化性遗传共同因素的最佳指标依次为四种障碍：反社会人格障碍（ASPD）、药物滥用/依赖（DAD）、酒精滥用/依赖（AAD）和品行障碍（CD）。在女性中，与外化性共同因素最密切相关的四种障碍依次为：DAD、AAD、尼古丁依赖（ND）和ASPD。与男性相比，寻求新奇（NS）和外向性（E）的人格特质在女性中能更好地反映遗传外化谱系。在男性和女性中，重度抑郁症（MD）和广泛性焦虑障碍（GAD）最能反映遗传内化共同因素。惊恐障碍（PD）和广场恐惧症（AgP）在女性中能更好地反映内化性遗传共同因素，在男性中则是神经质（N）。两种谱系之间的遗传相关性在男性中估计为+0.53，在女性中为+0.52。
在一般人群中，最能体现外化性和内化性障碍遗传易感性的障碍在男性和女性中存在显著差异。在两性中，这些遗传谱系通过精神障碍比通过人格特质能得到更好的评估。
