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Child Psychiatrist /Adult Psychiatrist

Having Parents With AUD Increases Psychiatric, Substance Use Disorder Risk

Keypoint: Offspring of parents with AUD are at increased risk for ADHD.


When evaluating the familial vulnerability to and genetics of alcohol use disorder (AUD), investigators found that offspring of parents with AUD were at increased risk for AUD, drug use disorder, attention-deficit/hyperactivity disorder (ADHD), depression, and anxiety. These results were published in the American Journal of Psychiatry.


Disorder Risk

Although environmental factors play a significant role in the development of AUD, research has consistently demonstrated a strong genetic component. Previous studies have shown that individuals with a family history of AUD are at a higher risk of developing the disorder themselves compared to those without such a history. Moreover, the risk increases with the degree of genetic relatedness to an affected individual. However, relatively little is known about whether this risk for AUD – and additional psychiatric disorders – is elevated for the offspring of parents who both have AUD.


To explore this association, the investigators used data from multiple nationwide Swedish registers to cover all individuals born in Sweden from 1970 to 1990 and raised in intact families. A total of 1,244,516 offspring (51.4% boys/men) were followed from 10 years of age until time of diagnosis, conclusion of the study, death, or emigration. The outcomes of interest included the time to first diagnosis of AUD, drug use disorder, ADHD, major depression, and anxiety disorder in the offspring of parents with AUD.


Offspring of parents with AUD demonstrated increased hazard ratios (HRs) for AUD (HR, 2.36; 95% CI, 2.28-2.44), drug use disorder (HR, 2.04; 95% CI, 1.97-2.11), and ADHD (HR, 1.82; 95% CI, 1.74-1.90), with smaller but still elevated risks for major depression (HR, 1.43; 95% CI, 1.41-1.46) and anxiety disorder (HR, 1.43; 95% CI, 1.40-1.46).


The investigators also observed that this risk was similar across parental genders. The risk for AUD was similar for the offspring of mothers (HR, 2.36; 95% CI, 2.23-2.51) and fathers (HR, 2.35; 95% CI, 2.28-2.44) with AUD. Additionally, although daughters and sons of parents with AUD displayed comparable overall outcomes, sons showed elevated HRs for major depression and anxiety disorder in comparison to daughters.


Furthermore, an offspring’s risk for developing AUD was significantly higher when both parents had AUD (HR, 4.64; 95% CI, 4.26-5.05) relative to having just 1 parent with AUD (HR, 2.36; 95% CI, 2.28–2.44).


The investigators concluded, “[O]ur results suggested a decomposition of the familial risk for AUD into three components: a largely nonspecific risk that included both common internalizing and externalizing disorders, a moderately specific liability to externalizing disorders, and a specific risk of AUD.”


Study limitations include the reliance on diagnoses from Swedish registries – which may only detect more severe cases – and the confounding influence of parental or child comorbidity.


The investigators found that the overall prevalence of disorders among the population sample was 2.72% for AUD, 3.51% for drug use disorder, 2.09% for ADHD, 15.23% for major depression, and 14.90% for anxiety disorders.


Note: This article originally appeared on Psychiatry Advisor

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