Psychiatric 'diseases' versus behavioral disorders and degree of genetic influence.
BACKGROUND
Psychiatric conditions in which symptoms arise involuntarily ('diseases') might be assumed to be more heritable than those in which choices are essential (behavioral disorders). We sought to determine whether psychiatric 'diseases' (Alzheimer's disease, schizophrenia, and mood and anxiety disorders) are more heritable than behavioral disorders (substance use disorders and anorexia nervosa).


METHODS
We reviewed the literature for recent quantitative summaries of heritabilities. When these were unavailable, we calculated weighted mean heritabilities from twin studies meeting modern methological standards.


RESULTS
Heritability summary estimates were as follows: bipolar disorder (85%), schizophrenia (81%), Alzheimer's disease (75%), cocaine use disorder (72%), anorexia nervosa (60%), alcohol dependence (56%), sedative use disorder (51%), cannabis use disorder (48%), panic disorder (43%), stimulant use disorder (40%), major depressive disorder (37%), and generalized anxiety disorder (28%).


CONCLUSIONS
No systematic relationship exists between the disease-like character of a psychiatric disorder and its heritability; many behavioral disorders seem to be more heritable than conditions commonly construed as diseases. These results suggest an error in 'common-sense' assumptions about the etiology of psychiatric disorders. That is, among psychiatric disorders, there is no close relationship between the strength of genetic influences and the etiologic importance of volitional processes.
Bienvenu
O J
OJ
Department of Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD 21287, USA. jbienven@jhmi.edu
Davydow
D S
DS
Kendler
K S
KS
D000544:Alzheimer Disease / Q000209:etiology / Q000235:genetics; D000856:Anorexia Nervosa / Q000209:etiology / Q000235:genetics; D006801:Humans; D001523:Mental Disorders / Q000209:etiology / Q000235:genetics*; D010641:Phenotype; D019966:Substance-Related Disorders / Q000209:etiology / Q000235:genetics
Am J Psychiatry. 2004 Oct;161(10):1814-21
15465978
Am J Med Genet B Neuropsychiatr Genet. 2003 May 15;119B(1):118-30
12707949
Arch Gen Psychiatry. 2003 Dec;60(12):1187-92
14662550
Arch Gen Psychiatry. 2003 Sep;60(9):929-37
12963675
Arch Gen Psychiatry. 2006 Feb;63(2):168-74
16461860
Psychol Med. 2001 Aug;31(6):989-1000
11513384
Psychol Med. 1995 Sep;25(5):1037-49
8588001
Arch Gen Psychiatry. 2003 May;60(5):497-502
12742871
Br J Addict. 1990 Jul;85(7):883-90
2397315
Addiction. 1997 Apr;92(4):409-17
9177062
Compr Psychiatry. 2009 May-Jun;50(3):209-14
19374963
Am J Psychiatry. 2000 Mar;157(3):469-71
10698830
Am J Psychiatry. 2000 Oct;157(10):1552-62
11007705
Nat Rev Genet. 2005 Jul;6(7):521-32
15995696
Am J Psychiatry. 2006 Jan;163(1):109-14
16390897
Psychosom Med. 2008 Feb;70(2):239-44
18158375
Arch Neurol. 1995 Aug;52(8):763-71
7639628
Arch Gen Psychiatry. 1984 Sep;41(9):833-8
6466042
J Gerontol A Biol Sci Med Sci. 1997 Mar;52(2):M117-25
9060980
Neurology. 2004 Jul 27;63(2):305-11
15277625
Arch Gen Psychiatry. 1986 May;43(5):430-4
3964021
Arch Gen Psychiatry. 2000 Mar;57(3):261-9
10711912
Arch Gen Psychiatry. 1996 Feb;53(2):129-36
8629888
Behav Genet. 1995 May;25(3):217-32
7598665
Arch Gen Psychiatry. 1997 Mar;54(3):264-70
9075467
Arch Gen Psychiatry. 1999 Jan;56(1):39-44
9892254
Am J Med Genet. 2001 Dec 8;105(8):724-8
11803520
Br J Psychiatry. 1972 Aug;121(561):147-61
5072240
Twin Res. 2004 Feb;7(1):72-81
15053856
Psychol Med. 2001 May;31(4):737-40
11352375
J Nerv Ment Dis. 2001 Jul;189(7):413-20
11504317
MedGenMed. 2006 Jan 04;8(1):2
16915132
J Affect Disord. 2001 Apr;64(1):1-18
11292515
Lancet. 1996 Mar 2;347(9001):573-8
8596319
Am J Psychiatry. 2001 Oct;158(10):1568-78
11578982
JAMA. 2005 May 25;293(20):2526-8
15914753
Psychol Med. 2006 Jul;36(7):955-62
16650346
Neurobiol Aging. 2005 Apr;26(4):439-47
15653172
Br J Psychiatry. 1994 Jul;165(1):66-72
7953060
Acta Psychiatr Scand. 2007 Mar;115(3):214-20
17302621
J Affect Disord. 2000 Jan-Mar;57(1-3):25-35
10708813
Drug Alcohol Depend. 2006 May 20;82(3):204-10
16225998
Am J Psychiatry. 2005 Jan;162(1):3-11
15625194
Depress Anxiety. 2004;20(2):92-7
15390211
Arch Gen Psychiatry. 2006 Mar;63(3):305-12
16520436
Arch Gen Psychiatry. 1984 Sep;41(9):839-44
6589979
Twin Res Hum Genet. 2006 Feb;9(1):30-7
16611465
Arch Gen Psychiatry. 1993 Sep;50(9):699-700
8357295
Psychol Med. 1998 Jul;28(4):857-70
9723141
Am J Med Genet. 1998 Feb 7;81(1):92-7
9514594
Arch Gen Psychiatry. 1999 Feb;56(2):162-8
10025441