Familial relationship between mood disorders and alcoholism

Clinical and epidemiological studies have consistently revealed an associat ion between alcohol use disorders and both bipolar and nonbipolar mood diso rders. However, the evidence regarding the nature of these associations is unclear. The familial patterns of alcohol and affective disorders were exam ined using data from a controlled family study of probands with alcohol and anxiety disorders who were sampled from treatment settings and the communi ty. The substantial degree of comorbidity between mood and anxiety disorder s among probands allowed for the examination of comorbidity and familial ag gregation of alcohol and mood disorders, The major findings are that (1) al coholism was associated with bipolar and nonbipolar mood disorders in the r elatives; (2) there was a strong degree of familial aggregation of alcohol dependence and both types of mood disorders were observed; and (3) there wa s no evidence of cross-aggregation (i.e., increase in mood disorders among probands with alcohol dependence, and vice versa) between alcoholism and mo od disorders. The independent familiar aggregation of bipolar disorder and alcoholism and the finding that the onset of bipolar disorder tended to pre cede that of alcoholism are compatible with a self-medication hypothesis as the explanation for the frequent co-occurrence of these disorders. In cont rast, the independent familial aggregation and the tendency of an earlier o nset of alcoholism than that of nonbipolar depression suggest that unipolar mood disorders are frequently secondary to alcoholism. Copyright (C) 2001 by W.B. Saunders Company.