Hostname: page-component-7b7567c8c-wxvwp Total loading time: 0 Render date: 2026-11-15T01:57:57.251Z Has data issue: false hasContentIssue false
  • English
  • Français

Panic disorder in women: a population-based twin study

Published online by Cambridge University Press:  09 July 2009

Kenneth S. Kendler,
Michael C. Neale,
Ronald C. Kessler,
Andrew C. Heath and
Lindon J. Eaves
Kenneth S. Kendler*
Affiliation:
Department of Psychiatry and the Department of Human Genetics, Medical College of Virginia/Virginia Commonwealth University, Richmond, VA; the Institute for Social Research, University of Michigan, Ann Arbor, MI; Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
Michael C. Neale
Affiliation:
Department of Psychiatry and the Department of Human Genetics, Medical College of Virginia/Virginia Commonwealth University, Richmond, VA; the Institute for Social Research, University of Michigan, Ann Arbor, MI; Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
Ronald C. Kessler
Affiliation:
Department of Psychiatry and the Department of Human Genetics, Medical College of Virginia/Virginia Commonwealth University, Richmond, VA; the Institute for Social Research, University of Michigan, Ann Arbor, MI; Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
Andrew C. Heath
Affiliation:
Department of Psychiatry and the Department of Human Genetics, Medical College of Virginia/Virginia Commonwealth University, Richmond, VA; the Institute for Social Research, University of Michigan, Ann Arbor, MI; Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
Lindon J. Eaves
Affiliation:
Department of Psychiatry and the Department of Human Genetics, Medical College of Virginia/Virginia Commonwealth University, Richmond, VA; the Institute for Social Research, University of Michigan, Ann Arbor, MI; Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
*
1Address for correspondence: Dr Kenneth S. Kendler, Box 710, MCV Station, Richmond, VA 23298–0710, USA.
Get accessRights & Permissions [Opens in a new window]

Synopsis

Previous studies based on probands from clinical samples suggest that panic disorder aggregates strongly in families and may be due to a highly penetrant single major locus. In this study we examine panic disorder as assessed at blind, structured psychiatric interview in 2163 women from a population-based twin registry. DSM-III-R diagnoses were assigned at a narrow and at a broad level both by clinician review and by computer algorithm. The familial aggregation of panic disorder in this sample was only modest. The relatively small number of affected individuals prevented a definitive resolution of competing genetic and non-genetic models of familial transmission. Although there was some inconsistency across diagnostic approaches, most results suggested that the familial aggregation of panic disorder was due largely to genetic factors. Using a multifactorial-threshold model, the best estimates of the heritability of liability ranged from 30 to 40%. From a familial perspective, panic disorder with phobic avoidance appears to represent a more severe form of the syndrome than panic disorder without avoidance. Our results, which suggest that in the general population panic disorder is only a moderately heritable condition, are at variance with results from several previous investigations based on clinically ascertained samples.

Information

Type
Original Articles
Information
Psychological Medicine , Volume 23 , Issue 2 , May 1993, pp. 397 - 406
Copyright
Copyright © Cambridge University Press 1993

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Article purchase

Temporarily unavailable

References

Akaike, H. (1987). Factor analysis and AIC. Psychometrika 52, 317–332.Google Scholar
American Psychiatric Association (1968). Diagnostic and Statistical Manual of Mental Disorders, 2nd edn.American Psychiatric Association: Washington, DC.Google Scholar
American Psychiatric Association (1980). Diagnostic and Statistical Manual of Mental Disorders, 3rd edn.American Psychiatric Association: Washington, DC.Google Scholar
American Psychiatric Association (1987). Diagnostic and Statistical Manual of Mental Disorders, Revised 3rd edn. American Psychiatric Association: Washington, DC.Google Scholar
Argyle, N. & Roth, M. (1989). The definition of panic attacks, Part I. Psychiatric Developments 3, 175–186.Google Scholar
Barlow, D. H. (1988). Anxiety and Its Disorders. Guilford Press: New York.Google Scholar
Breier, A., Charney, D. S. & Heninger, G. R. (1985). The diagnostic validity of anxiety disorders and their relationship to depressive illness. American Journal of Psychiatry 142, 787–797.Google Scholar
Cohen, J. (1960). A coefficient of agreement for nominal scales. Educational and Psychological Measurement 20, 37–46.Google Scholar
Crowe, R. R. (1990). Panic disorder: genetic considerations. Journal of Psychiatric Research 24 (Suppl. 2), 129–134.CrossRefGoogle ScholarPubMed
Crowe, R. R., Noyes, R., Pauls, D. & Slymen, D. (1983). A family study of panic disorder. Archives of General Psychiatry 40, 1065–1069.Google Scholar
Crowe, R. R., Noyes, R. Jr., Wilson, A. F., Elston, R. C. & Ward, L. J. (1987). A linkage study of panic disorder. Archives of General Psychiatry 44, 933–937.CrossRefGoogle ScholarPubMed
Crowe, R. R., Noyes, R. Jr., Persico, T., Wilson, A. F. & Elston, R. C. (1988). Genetic studies of panic disorder and related conditions. In Relatives at Risk for Mental Disorder (ed. Dunner, D. L., Gershon, E. S. and Barret, J. E.), pp. 73–85. Raven Press: New York.Google Scholar
Crowe, R. R., Noyes, R. Jr., Samuelson, S., Wesner, R. & Wilson, R. (1990). Close linkage between panic disorder and alpha-hapto-globin excluded in 10 families. Archives of General Psychiatry 47, 377–380.CrossRefGoogle ScholarPubMed
Eaton, W. W., Dryman, A. & Weissman, M. M. (1991). Panic and phobia. In Psychiatric Disorders in America: The Epidemiologic Catchment Area Study (ed. Robins, L. N. and Regier, D. A.), pp. 155–179. The Free Press: New York.Google Scholar
Eaves, L. J., Eysenck, H. J., Martin, N. G., Jardine, R., Heath, A. C., Feingold, L., Young, P. A. & Kendler, K. S. (1989). Genes, Culture and Personality: An Empirical Approach. Oxford University Press: London.Google Scholar
Falconer, D. S. (1965). The inheritance of liability to certain diseases, estimated from the incidence among relatives. Annals of Human Genetics 29, 51–76.CrossRefGoogle Scholar
Heath, A. C., Neale, M. C., Hewitt, J. K., Eaves, L. J. & Fulker, D. W. (1989). Testing structural equation models for twin data using LISREL. Behavior Genetics 19, 9–35.CrossRefGoogle ScholarPubMed
Hopper, J. L., Judd, F. K., Derrick, P. L. & Burrows, G. D. (1987). A family study of panic disorder. Genetic Epidemiology 4, 33–41.CrossRefGoogle ScholarPubMed
James, J. W. (1971). Frequency in relatives for an all-or-none trait. Annals of Human Genetics, London 35, 47–49.Google Scholar
Jöreskog, K. G. & Sörbom, D. (1988). PRELIS: A Preprocessor for LISREL. Scientific Software: Mooresville, IN.Google Scholar
Jöreskog, K. G. & Sörbom, D. (1989). LISREL 7: A Guide to the Program and Applications, 2nd edn.SPSS, Inc.: Chicago, IL.Google Scholar
Joyce, P. R., Bushnell, J. A., Oakley-Browne, M. A., Wells, J. E. & Hornblow, A. F. (1989). The epidemiology of panic symptomatology and agoraphobic avoidance. Comprehensive Psychiatry 30, 303–312.Google Scholar
Kendler, K. S. (1983). Overview: a current perspective on twin studies of schizophrenia. American Journal of Psychiatry 140, 1413–1425.Google ScholarPubMed
Kendler, K. S. & Kidd, K. K. (1986). Recurrence risks in an oligogenic threshold model: the effect of alterations in allele frequency. Annals of Human Genetics 50, 83–91.CrossRefGoogle Scholar
Kendler, K. S., Heath, A. C., Martin, N. G. & Eaves, L. J. (1986). Symptoms of anxiety and depression in a volunteer twin population: the etiologic role of genetic and environmental factors. Archives of General Psychiatry 43, 213–221.CrossRefGoogle Scholar
Kendler, K. S., MacLean, C. J., Neale, M. C., Kessler, R. C., Heath, A. C. & Eaves, L. J. (1991). The genetic epidemiology of bulimia nervosa. American Journal of Psychiatry 148, 1627–1637.Google ScholarPubMed
Kendler, K. S., Neale, M. C., Kessler, R. C., Health, A. C. & Eaves, L. J. (1992). A population-based twin study of major depression in women: the impact of varying definitions of illness. Archives of General Psychiatry 49, 257–266.Google Scholar
Klerman, G. L., Weissman, M. M., Ouellette, R., Johnson, J. & Greenwald, S. (1991). Panic attacks in the community: social morbidity and health care utilization. Journal of the American Medical Association 265, 742–746.Google Scholar
Loehlin, J. C. & Nichols, R. C. (1976). Heredity, Environment and Personality: A Study of 850 Sets of Twins. University of Texas Press: Austin.Google Scholar
McGuffin, P. & Katz, R. (1989). The genetics of depression and manic-depressive illness. British Journal of Psychiatry 155, 294–304.CrossRefGoogle Scholar
Mannuzza, S., Fyer, A. J., Martin, L. Y., Gallops, M. S., Endicott, J., Gorman, J., Liebowitz, M. R. & Klein, D. F. (1989). Reliability of anxiety assessment. I. Diagnostic agreement. Archives of General Psychiatry 46, 1093–1101.CrossRefGoogle ScholarPubMed
Marks, I. M. (1987). Fears, Phobias, and Rituals. Oxford University Press: New York.Google Scholar
Martin, N. G., Eaves, L. J., Kearsey, M. J. & Davies, P. (1978). The power of the classical twin study. Heredity 40, 97–116.Google Scholar
Mutchler, K., Crowe, R. R., Noyes, R. Jr. & Wesner, R. W. (1990). Exclusion of the tyrosine hydroxylase gene in 14 panic disorder pedigrees. American Journal of Psychiatry 147, 1367–1369.Google Scholar
Neale, M. C., Heath, A. C., Hewitt, J. K., Eaves, L. J. & Fulker, D. W. (1989). Fitting genetic models with LISREL: hypothesis testing. Behavior Genetics 19, 37–49.CrossRefGoogle ScholarPubMed
Noyes, R., Crowe, R. R., Harris, E. L., Hamra, B. J., McChesney, C. M. & Chaudhry, D. R. (1986). Relationship between panic disorder and agoraphobia. Archives of General Psychiatry 43, 227–232.Google Scholar
Pauls, D. L., Bucher, K. D., Crowe, R. R. & Noyes, R. (1980). A genetic study of panic disorder pedigrees. American Journal of Human Genetics 32, 639–644.Google ScholarPubMed
Pearson, K. (1901). Mathematical contributions to the theory of evolution. VIII. On the correlation of characters not quantitatively measureable. Proceedings of the Royal Society 66, 241–244.Google Scholar
Reich, T., James, J. W. & Morris, C. A. (1972). The use of multiple thresholds in determining the mode of transmission of semi-continuous traits. Annals of Human Genetics 36, 163–184.Google Scholar
Robins, L. N. (1989). Diagnostic grammar and assessment: translating criteria into questions. Psychological Medicine 19, 57–68.Google Scholar
SAS Institute (1990). SAS/STAT. User's Guide, Version 6, 4th edn, vol. 2. SAS Institute: Cary, NC.Google Scholar
Spence, J. E., Corey, L. A., Nance, W. E., Marazita, M. L., Kendler, K. S. & Schieken, R. M. (1988). Molecular analysis of twin zygosity using VNTR DNA probes. American Journal of Human Genetics 43, A159.Google Scholar
Spitzer, R. L., Williams, J. B. & Gibbon, M. (1987). Structured Clinical Interview for DSM-III-R. Biometrics Research Dept., New York State Psychiatric Institute: New York.Google Scholar
Suarez, B. K., Fishman, P. M. & Reich, T. (1977). Estimating the parameters of the incompletely penetrant single locus model using multiple populations. Human Heredity 27, 336–351.CrossRefGoogle ScholarPubMed
Torgersen, S. (1983). Genetic factors in anxiety disorders. Archives of General Psychiatry 40, 1085–1089.CrossRefGoogle ScholarPubMed
Walters, E. E., Neale, M. C., Eaves, L. J., Heath, A. C., Kessler, R. C. & Kendler, K. S. (1992). Bulimia nervosa and major depression: a study of common genetic and environmental factors. Psychological Medicine 22, 617–622.Google Scholar
Zitrin, C. M., Woerner, M. G. & Klein, D. F. (1981). Differentiation of panic anxiety from anticipatory anxiety and avoidance behavior. In Anxiety: New Research and Changing Concepts (ed. Klein, D. F. and Rabkin, J.), pp. 27–46. Raven Press: New York.Google Scholar