Background. The risk for panic disorder (PD) is substantially increased in
relatives of probands with PD. Prior literature provides only limited infor
mation about the degree to which this increase is due to genetic factors or
family environment.
Methods. In personal interviews with both members of 3194 twin pairs, we as
sessed the lifetime history of lifetime panic attacks and PD. Twin resembla
nce was assessed by tetrachoric correlation and single and multiple thresho
ld biometrical model fitting.
Results. As fully syndromal PD, by DSM-III-R criteria, was too rare to anal
yse usefully we examined four other dichotomous definitions of increasing s
tringency: panic probe and very broad, broad and intermediate PD. For all f
our definitions and for the multiple threshold analyses, the best-fit model
indicated that twin resemblance was due solely to genetic factors with a m
oderate heritability (33-43 %). For the broad and intermediate dichotomous
definitions of PD, however, a model with twin resemblance due to familial-e
nvironmental factors fit nearly as well. No gender effects were seen on the
genetic risk factors for these PD-like syndromes.
Conclusion. Even with large epidemiological samples of twins, studying diso
rders as uncommon as PD is problematical. Despite these difficulties, our r
esults suggest that: (i) narrowly and broadly defined PD are probably on th
e same continuum of liability; (ii) twin resemblance for these PD-like synd
romes is likely due largely to genetic factors with a moderate level of her
itability although a contribution of familial-environmental factors cannot
be excluded; and, (iii) the same familial risk factors impact, to a similar
degree, on the liability to PD in males and females.