A high risk twin study of combat-related PTSD comorbidity.
Combat-related posttraumatic stress disorder (PTSD) is highly comorbid with other mental disorders. However, the nature of the relationship between PTSD and other mental disorders remains unclear. A discordant high-risk twin design was used on data from a sub-sample of the male-male twin pair members of the Vietnam Era Twin Registry to examine whether patterns of comorbidity are consistent with a psychopathological response to combat exposure or reflect familial vulnerability to psychopathology. Mental disorders were assessed via the Mental Health Diagnostic Interview Schedule Version III - Revised. Discordant monozygotic within-pair comparisons revealed that PTSD probands had higher symptom counts and diagnostic prevalences of mood and anxiety disorders than their non-combat exposed co-twins. Monozygotic co-twins of PTSD probands had significantly more mood disorder symptoms than monozygotic co-twins of combat controls or dizygotic co-twins of veterans with PTSD. These findings suggest that a) major depression, generalized anxiety disorder and panic disorder are part of a post-combat response syndrome; b) a shared familial vulnerability also contributes to the association between PTSD and major depression, PTSD and dysthymia, and c) this shared vulnerability is mediated by genetic factors.
Koenen
Karestan C
KC
Women's Health Sciences Division (116B-3), National Center for PTSD, VA Boston Healthcare System, MA 02130, USA. Karestan.Koenen@bmc.org
Lyons
Michael J
MJ
Goldberg
Jack
J
Simpson
John
J
Williams
Wesley M
WM
Toomey
Rosemary
R
Eisen
Seth A
SA
True
William R
WR
Cloitre
Marylene
M
Wolfe
Jessica
J
Tsuang
Ming T
MT
D000328:Adult; D016009:Chi-Square Distribution; D003130:Combat Disorders / Q000235:genetics* / Q000523:psychology; D004200:Diseases in Twins / Q000235:genetics*; D006801:Humans; D008297:Male; D001523:Mental Disorders / Q000150:complications* / Q000235:genetics* / Q000523:psychology; D008875:Middle Aged; D011569:Psychiatric Status Rating Scales; D012042:Registries; D013313:Stress Disorders, Post-Traumatic / Q000150:complications* / Q000235:genetics* / Q000523:psychology; D014728:Veterans / Q000523:psychology*; D014744:Vietnam