Cadoret R J, Yates W R, Troughton E, Woodworth G, Stewart M A
Department of Psychiatry, University of Iowa, Iowa City.
Arch Gen Psychiatry. 1995 Jan;52(1):42-52. doi: 10.1001/archpsyc.1995.03950130042005.
Studies of adoptees have demonstrated that there are two genetic factors leading to alcohol abuse and/or dependence (abuse/dependence). In addition, environmental factors found in the adoptive family also predict alcohol abuse/dependency independently. One study has found evidence that a similar model of two genetic factors and independent adoptive family factors were involved in drug abuse. Our study was designed to test the hypothesis that genetic factors defined by alcohol abuse/dependency and anti-social personality disorder in biologic parents were etiologic in drug abuse/dependency and that psychiatric problems in adoptive parents were an additional factor associated with drug abuse/dependence.
A sample of 95 male adoptees, separated at birth from their biologic parents, were followed up as adults to determine their psychiatric diagnosis and their substance use/abuse in a structured interview administered blind to biologic parent diagnoses. A high-risk, case-control design was used wherein half of the adoptees came from biologic parents known to be alcohol abuser/dependent and/or have antisocial personalities (diagnoses from hospital or prison records). These adoptees were matched for age, sex, and adoption agency to a control group of adoptees whose biologic parents were not found in the hospital and prison record search. Adoptive home environment was assessed by structured interviews, including psychiatric assessment of both adoptive parents.
Data were analyzed by log-linear modeling, which showed evidence of two genetic pathways to drug abuse/dependency. One pathway went directly from a biologic parent's alcoholism to drug abuse/dependency. The second pathway was more circuitous, and started with anti-social personality disorder in the biologic parent and proceeded through intervening variables of adoptee aggressivity, conduct disorder, antisocial personality disorder, and, eventually, ended in drug abuse/dependency. Environmental factors defined by psychiatric conditions in adoptive families independently predicted increased antisocial personality disorder in the adoptee. Adoptees born of alcohol-abusing mothers showed evidence of fetal alcohol syndrome, but controlling for this did not diminish the evidence for the direct genetic effect between an alcohol-abusing biologic parent and drug abuse/dependency in offspring.
This study confirms the model of two independent genetic factors involved in drug abuse/dependence and previous findings that disturbed adoptive parents are associated with adoptee drug abuse/dependency.
对领养者的研究表明，有两个遗传因素会导致酒精滥用和/或依赖（滥用/依赖）。此外，在领养家庭中发现的环境因素也能独立预测酒精滥用/依赖情况。一项研究发现，有证据表明类似的由两个遗传因素和独立的领养家庭因素构成的模型也与药物滥用有关。我们的研究旨在检验以下假设：生物学父母的酒精滥用/依赖及反社会人格障碍所定义的遗传因素是药物滥用/依赖的病因，且领养父母的精神问题是与药物滥用/依赖相关的另一个因素。
选取95名在出生时即与生物学父母分离的男性领养者作为样本，在他们成年后进行随访，通过对生物学父母诊断不知情的结构化访谈来确定他们的精神诊断以及物质使用/滥用情况。采用高风险病例对照设计，其中一半领养者的生物学父母已知存在酒精滥用/依赖和/或患有反社会人格（根据医院或监狱记录诊断）。这些领养者在年龄、性别和领养机构方面与另一组领养者对照组进行匹配，该对照组领养者的生物学父母在医院和监狱记录搜索中未被发现。通过结构化访谈评估领养家庭环境，包括对领养父母双方的精神评估。
采用对数线性模型分析数据，结果显示存在两条导致药物滥用/依赖的遗传途径。一条途径直接从生物学父母的酗酒发展到药物滥用/依赖。第二条途径更为迂回，始于生物学父母的反社会人格障碍，经过领养者攻击性、品行障碍、反社会人格障碍等中间变量，最终导致药物滥用/依赖。领养家庭中由精神状况所定义的环境因素能独立预测领养者反社会人格障碍的增加。母亲酗酒的领养者表现出胎儿酒精综合征的迹象，但对此进行控制并未削弱生物学父母酗酒与后代药物滥用/依赖之间直接遗传效应的证据。
本研究证实了参与药物滥用/依赖的两个独立遗传因素模型以及先前的研究结果，即领养父母精神紊乱与领养者药物滥用/依赖有关。
