Differential Etiology of Posttraumatic Stress Disorder with Conduct Disorder and Major Depression in Male Veterans

• Published in: Biological psychiatry (1969) Vol. 62; no. 10; pp. 1088 - 1094
• Main Authors: Fu, Qiang, Koenen, Karestan C, Miller, Mark W, Heath, Andrew C, Bucholz, Kathleen K, Lyons, Michael J, Eisen, Seth A, True, William R, Goldberg, Jack, Tsuang, Ming T
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 15-11-2007; Elsevier Science
• Subjects: Adult and adolescent clinical studies; Aged; Anxiety disorders. Neuroses; Biological and medical sciences; Conduct disorder; Conduct Disorder - complications; Conduct Disorder - epidemiology; Confidence Intervals; Depression; Depressive Disorder, Major - complications; Depressive Disorder, Major - epidemiology; Diseases in Twins - epidemiology; Diseases in Twins - psychology; Humans; major depression; Male; Medical sciences; Middle Aged; Models, Statistical; Mood disorders; Post-traumatic stress disorder; posttraumatic stress disorder; Prevalence; Psychiatry; Psychology. Psychoanalysis. Psychiatry; Psychopathology. Psychiatry; Stress Disorders, Post-Traumatic - complications; Stress Disorders, Post-Traumatic - epidemiology; Stress Disorders, Post-Traumatic - etiology; Twin Studies as Topic; Veterans - statistics & numerical data; Conduct disorder; major depression; posttraumatic stress disorder; Mood disorder; Human; Posttraumatic syndrome; Anxiety disorder; Depression; Male; Posttraumatic stress disorder; Stress; Etiology; Veteran; Social behavior disorder
• ISSN: 0006-3223; 1873-2402
• DOI: 10.1016/j.biopsych.2007.04.036

Background Epidemiologic studies reveal that posttraumatic stress disorder (PTSD) is highly comorbid with both conduct disorder and major depression in men. The genetic and environmental etiology of this comorbidity has not been examined. Methods Data were analyzed from 6744 middle-aged male-male monozygotic and dizygotic twins from the Vietnam Era Twin Registry. Conduct disorder, major depression, and PTSD were assessed via telephone interview using the Diagnostic Interview Schedule for the DSM-III-R in 1992. Structural equation modeling was used to estimate additive genetic, shared environmental, and individual-specific environmental effects common and specific to conduct disorder, major depression, and PTSD. Results The association between conduct disorder and PTSD was explained primarily by common shared environmental influences; these explained 10% (95% confidence interval: 6%–17%) of the variance in PTSD. The association between major depression and PTSD was largely explained by common genetic influences; these explained 19% (95% confidence interval: 11%–26%) of the variance in PTSD. Conclusions Our findings suggest that different etiologic mechanisms explain the association of conduct disorder and major depression with PTSD in male veterans. If replicated in other populations, results suggest research aimed at identifying specific genetic and environmental factors that influence PTSD may benefit from starting with those that have been more consistently and strongly associated with major depression and conduct disorder.