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Am J Psychiatry 1996; 153:892-899
Copyright © 1996 by American Psychiatric Association
Depression spectrum disease, I: The role of gene-environment interaction
RJ Cadoret, G Winokur, D Langbehn, E Troughton, WR Yates and MA Stewart
Department of Psychiatry, University of Iowa College of Medicine, Iowa City 52242, USA.
OBJECTIVE: This study used an adoption study design to separate genetic
from environmental factors in the etiology of depression spectrum disease,
a type of major depression characterized by families in which male
relatives are alcoholic and females are depressed. The genetic etiology
hypothesis of depression spectrum disease proposes that an alcoholic
genetic diathesis predisposes to depression in females but alcoholism, not
depression, in males. METHOD: The study examined 197 adult offspring (95
male and 102 female) of alcoholic biological parents and used logistic
regression models to determine the contribution to major depression in male
and female adoptees that could be explained by the genetic alcoholic
diathesis combined with an environmental factor that was characterized by
psychiatrically or behaviorally disturbed adoptive parents. RESULTS: Major
depression in females was predicted by an alcoholic diathesis only when
combined with the disturbed adoptive parent variable. The same regression
model failed to predict depression in males. Other possible environmental
confounding factors contributing to an increased chance of depression were
found in females: fetal alcohol exposure, age at the time of adoption, and
a family with an adopted sibling who had a psychiatric problem. These
variables did not diminish the significance of the prediction of depression
with the alcohol genetic diathesis and disturbed parent model. CONCLUSIONS:
The results show that a genetic factor is present for which alcoholism is
at least a marker, and which exerts its effect in women as a
gene-environment interaction leading to major depression. This finding
suggests that an important etiologic factor in depression spectrum disease
is gene-environment interaction.
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