Abstract
There has been increasing attention to the subgroups of mood disorders and their boundaries with other mental disorders, particularly psychoses. The goals of the present paper were (1) to assess the familial aggregation and co-aggregation patterns of the full spectrum of mood disorders (that is, bipolar, schizoaffective (SAF), major depression) based on contemporary diagnostic criteria; and (2) to evaluate the familial specificity of the major subgroups of mood disorders, including psychotic, manic and major depressive episodes (MDEs). The sample included 293 patients with a lifetime diagnosis of SAF disorder, bipolar disorder and major depressive disorder (MDD), 110 orthopedic controls, and 1734 adult first-degree relatives. The diagnostic assignment was based on all available information, including direct diagnostic interviews, family history reports and medical records. Our findings revealed specificity of the familial aggregation of psychosis (odds ratio (OR)=2.9, confidence interval (CI): 1.1–7.7), mania (OR=6.4, CI: 2.2–18.7) and MDEs (OR=2.0, CI: 1.5–2.7) but not hypomania (OR=1.3, CI: 0.5–3.6). There was no evidence for cross-transmission of mania and MDEs (OR=.7, CI:.5–1.1), psychosis and mania (OR=1.0, CI:.4–2.7) or psychosis and MDEs (OR=1.0, CI:.7–1.4). The strong familial specificity of psychotic, manic and MDEs in this largest controlled contemporary family study challenges the growing assertion that the major types of mood disorders are manifestations of a common underlying diathesis.
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References
Berrettini W . Bipolar disorder and schizophrenia: convergent molecular data. Neuromol Med 2004; 5: 109–117.
Cross-Disorder Group of the Psychiatric Genomics C Smoller JW, Craddock N, Kendler K, Lee PH, Neale BM et al. Identification of risk loci with shared effects on five major psychiatric disorders: a genome-wide analysis. Lancet 2013; 381: 1371–1379.
Maier W, Lichtermann D, Minges J, Hallmayer J, Heun R, Benkert O et al. Continuity and discontinuity of affective disorders and schizophrenia. Results of a controlled family study. Arch Gen Psychiatry 1993; 50: 871–883.
Gershon ES, DeLisi LE, Hamovit J, Nurnberger JI Jr., Maxwell ME, Schreiber J et al. A controlled family study of chronic psychoses. Schizophrenia and schizoaffective disorder. Arch Gen Psychiatry 1988; 45: 328–336.
Kendler KS, McGuire M, Gruenberg AM, O'Hare A, Spellman M, Walsh D . The Roscommon Family Study. IV. Affective illness, anxiety disorders, and alcoholism in relatives. Arch Gen Psychiatry 1993; 50: 952–960.
Maier W, Lichtermann D, Franke P, Heun R, Falkai P, Rietschel M . The dichotomy of schizophrenia and affective disorders in extended pedigrees. Schizophr Res 2002; 57: 259–266.
Maier W, Lichtermann D, Minges J, Heun R, Hallmayer J, Benkert O . Schizoaffective disorder and affective disorders with mood-incongruent psychotic features: keep separate or combine? Evidence from a family study. Am J Psychiatry 1992; 149: 1666–1673.
Mortensen PB, Pedersen CB, Melbye M, Mors O, Ewald H . Individual and familial risk factors for bipolar affective disorders in Denmark. Arch Gen Psychiatry 2003; 60: 1209–1215.
Lichtenstein P, Yip BH, Bjork C, Pawitan Y, Cannon TD, Sullivan PF et al. Common genetic determinants of schizophrenia and bipolar disorder in Swedish families: a population-based study. Lancet 2009; 373: 234–239.
Van Snellenberg JX, de Candia T . Meta-analytic evidence for familial coaggregation of schizophrenia and bipolar disorder. Arch Gen Psychiatry 2009; 66: 748–755.
Gershon ES, Hamovit J, Guroff JJ, Dibble E, Leckman JF, Sceery W et al. A family study of schizoaffective, bipolar I, bipolar II, unipolar, and normal control probands. Arch Gen Psychiatry 1982; 39: 1157–1167.
Tsuang MT, Winokur G, Crowe RR . Morbidity risks of schizophrenia and affective disorders among first degree relatives of patients with schizophrenia, mania, depression and surgical conditions. Br J Psychiatry 1980; 137: 497–504.
Taylor MA, Berenbaum SA, Jampala VC, Cloninger CR . Are schizophrenia and affective disorder related? preliminary data from a family study. Am J Psychiatry 1993; 150: 278–285.
Kendler KS, McGuire M, Gruenberg AM, Walsh D . Examining the validity of DSM-III-R schizoaffective disorder and its putative subtypes in the Roscommon Family Study. Am J Psychiatry 1995; 152: 755–764.
Tsuang MT, Faraone SV, Fleming JA . Familial transmission of major affective disorders. Is there evidence supporting the distinction between unipolar and bipolar disorders? Br J Psychiatry 1985; 146: 268–271.
Kendler KS, McGuire M, Gruenberg AM, O'Hare A, Spellman M, Walsh D . The Roscommon Family Study. I. Methods, diagnosis of probands, and risk of schizophrenia in relatives. Arch Gen Psychiatry 1993; 50: 527–540.
Craddock N, Owen MJ . The beginning of the end for the Kraepelinian dichotomy. Br J Psychiatry 2005; 186: 364–366.
Spitzer RL, Endicott J, Robins E . Research diagnostic criteria: rationale and reliability. Arch Gen Psychiatry 1978; 35: 773–782.
Weissman MM, Merikangas KR, Wickramaratne P, Kidd KK, Prusoff BA, Leckman JF et al. Understanding the clinical heterogeneity of major depression using family data. Arch Gen Psychiatry 1986; 43: 430–434.
Faraone SV, Blehar M, Pepple J, Moldin SO, Norton J, Nurnberger JI et al. Diagnostic accuracy and confusability analyses: an application to the Diagnostic Interview for Genetic Studies. Psychol Med 1996; 26: 401–410.
Nurnberger JI Jr, Blehar MC, Kaufmann CA, York-Cooler C, Simpson SG, Harkavy-Friedman J et al. Diagnostic interview for genetic studies. Rationale, unique features, and training. NIMH Genetics Initiative. Arch Gen Psychiatry 1994; 51: 849–859, discussion 863-844.
Preisig M, Fenton BT, Matthey ML, Berney A, Ferrero F . Diagnostic interview for genetic studies (DIGS): inter-rater and test-retest reliability of the French version. Eur Arch Psychiatry Clin Neurosci 1999; 249: 174–179.
Berney A, Preisig M, Matthey ML, Ferrero F, Fenton BT . Diagnostic interview for genetic studies (DIGS): inter-rater and test-retest reliability of alcohol and drug diagnoses. Drug Alcohol Depend 2002; 65: 149–158.
Leboyer M, Barbe B, Gorwood P, Teherani M, Allilaire JF, Preisig M et al Interview Diagnostique Pour les Etudes Genetiques. INSERM: Paris, France, 1995.
Andreasen NC, Endicott J, Spitzer RL, Winokur G . The family history method using diagnostic criteria: reliability and validity. Arch Gen Psychiatry 1977; 34: 1229–1235.
Rougemont-Buecking A, Rothen S, Jeanpretre N, Lustenberger Y, Vandeleur CL, Ferrero F et al. Inter-informant agreement on diagnoses and prevalence estimates of anxiety disorders: direct interview versus family history method. Psychiatry Res 2008; 157: 211–223.
Vandeleur CL, Rothen S, Jeanpretre N, Lustenberger Y, Gamma F, Ayer E et al. Inter-informant agreement and prevalence estimates for substance use disorders: direct interview versus family history method. Drug Alcohol Depend 2008; 92: 9–19.
Rothen S, Vandeleur CL, Lustenberger Y, Jeanpretre N, Ayer E, Gamma F et al. Parent-child agreement and prevalence estimates of diagnoses in childhood: direct interview versus family history method. Int J Methods Psychiatr Res 2009; 18: 96–109.
Leckman JF, Sholomskas D, Thompson WD, Belanger A, Weissman MM . Best estimate of lifetime psychiatric diagnosis: a methodological study. Arch Gen Psychiatry 1982; 39: 879–883.
Liang KY, Zeger SL . Longitudinal data analysis using generalized linear models. Biometrika 1986; 73: 13–22.
McGuffin P, Rijsdijk F, Andrew M, Sham P, Katz R, Cardno A . The heritability of bipolar affective disorder and the genetic relationship to unipolar depression. Arch Gen Psychiatry 2003; 60: 497–502.
Craddock N, Owen MJ . The Kraepelinian dichotomy—going, going... but still not gone. Br J Psychiatry 2010; 196: 92–95.
Cosgrove VE, Suppes T . Informing DSM-5: biological boundaries between bipolar I disorder, schizoaffective disorder, and schizophrenia. BMC Med 2013; 11: 127.
Regier DA, Narrow WE, Clarke DE, Kraemer HC, Kuramoto SJ, Kuhl EA et al. DSM-5 field trials in the United States and Canada, Part II: test-retest reliability of selected categorical diagnoses. Am J Psychiatry 2013; 170: 59–70.
Solomon DA, Leon AC, Endicott J, Coryell WH, Mueller TI, Posternak MA et al. Unipolar mania over the course of a 20-year follow-up study. Am J Psychiatry 2003; 160: 2049–2051.
Acknowledgements
This research was supported by five grants from the Swiss National Foundation (SNF: No.3200-040677, No.32003B-105969 and No.32003B-118326 to FF; No.3200-049746 and No.3200-061974 to MP), and a grant from GlaxoSmithKline Clinical Genetics. The funders had no involvement in any aspect of this study. We thank the participants and the collaborators who contributed to the coordination of the study and the collection of data. Special thanks to Professor Pierre-François Leyvraz, Dr Nicolas Favarger and Professor Daniel Egloff from the Orthopedic Department in Lausanne as well as to Professor Pierre Hoffmeyer from the Orthopedic Department in Geneva for their help with the recruitment of the comparison subjects of this study. The National Institute of Mental Health Intramural Program also contributed to this study. The views expressed herein are those of the author and do not represent those of the US federal government.
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Vandeleur, C., Merikangas, K., Strippoli, MP. et al. Specificity of psychosis, mania and major depression in a contemporary family study. Mol Psychiatry 19, 209–213 (2014). https://doi.org/10.1038/mp.2013.132
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DOI: https://doi.org/10.1038/mp.2013.132
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