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K R Merikangas

Publications and source records attributed to K R Merikangas.

At least 19 recordsLinked to original sources
PubMed1995

Comorbidity and social phobia: evidence from clinical, epidemiologic, and genetic studies.

This paper reviews evidence from clinical, epidemiologic, and family studies regarding the association between social phobia and other syndromes. Social phobia is strongly associated with other anxiety disorders, substance abuse, and affective disorders in both clinical and community samples. An average of 80% of social phobics identified in community samples meet diagnostic criteria for another lifetime condition. Social phobia is most strongly associated with other subtypes of anxiety disorders, with an average of 50% of social phobics in the community reporting a concomitant anxiety disorder including another phobic disorder, generalized anxiety, or panic disorder. Approximately 20% of subjects in the community meet lifetime criteria for a major depressive disorder. The onset of social phobia generally precedes that of all other disorders, with the exception of simple phobia. Both clinical severity and treated prevalence are consistently greater among social phobics with comorbid disorders. The results of family and twin studies reveal that shared etiologic factors explain a substantial proportion of the comorbidity between social phobia and depression, whereas the association between social phobia and alcoholism derives from a nonfamilial causal relationship between the two conditions. Clinical and phenomenologic implications of these findings are discussed.

Adult↗
PubMed1995

Association between psychopathology and headache syndromes.

During the past year, several important papers have confirmed the association between psychological factors and headache. Recent studies are beginning to identify the specificity of the general association of headache subtypes with subtypes of psychiatric disorders and psychological traits. Studies of this topic have increasingly moved from the clinical arena to the community at large. Finally, much of the research on this topic is now driven by the goal of understanding the possible mechanisms for the concurrence of psychopathology and headache.

Headache↗
PubMed1994

Feasibility of half-sibling designs for detecting a genetic component to a disease.

In genetic epidemiology, adoption and twin study designs are the most commonly used designs to identify genetic and common environmental components underlying familial aggregation. Other fixed family set designs such as a half-sibling design can also be applied to test the same hypothesis. The feasibility of half-sibling designs for detecting a genetic (single-locus or multifactorial) source of familial aggregation of a disease is studied and is compared to both adoption and twin study designs. Results are presented for two types of design when the sampling units are relative pairs reared apart (I) or reared together (II). Although they generally require more observations to achieve the same power, designs involving half-siblings may be more feasible in situations where there is greater availability of these relatives.

Adoption↗
PubMed1994

The Zurich Study: XXIII. Epidemiology of headache syndromes in the Zurich cohort study of young adults.

This study examines the 1 year prevalence rates of headache syndromes in an epidemiologic cohort study of young adults ages 29-30 in Zurich, Switzerland. The 1 year prevalence rates of headache subtypes were 3.3% for migraine with aura and 21.3% of migraine without aura as defined by the International Headache Society (IHS) criteria. The demographic distribution, clinical features, sequelae, and treatment patterns of subjects with specific headache subtypes are described. The rates of migraine are compared to those of other community samples that have employed the IHS criteria for headache subtypes. Subjects with migraine reported pervasive impairment in nearly every life role including occupation, leisure, and social relationships. Despite the substantial degree of impairment in occupational and social functioning that was associated with migraine, an extremely low proportion of subjects had received professional treatment for headache. These results suggest that a concerted effort should be directed towards education regarding the classification of headache and the availability of efficacious treatment for migraine.

Absenteeism↗
PubMed1992

The Zurich Study. XIV. Epidemiology of seasonal depression.

In a longitudinal cohort study of young adults from the Canton of Zurich in Switzerland (Zurich Study), seasonal patterns of several psychiatric and psychosomatic syndromes were investigated in two interviews over a period of three years. At an age of 27-28 years, 23% of the depressives, 15% of the neurasthenic subjects, and 14% of the subjects with backache reported an increased susceptibility in autumn and/or winter. With respect to the course we found that 10.4% of the subjects of the longitudinal sample (n = 417) suffered from seasonal depression (including individuals with subsyndromal seasonal difficulties) over two consecutive years. Specific symptoms, such as hypersomnia, increase of appetite or weight gain, were not found to be consistently associated with seasonal depression. A comparison of actual and retrospective reports on seasonal depression resulted in a very low reliability. In view of these results the seasonal subtype of depression should be diagnosed with caution, except when the diagnosis is based on longitudinal observations and/or external sources of information (e.g. family members, partner).

Adult↗
PubMed1992

Vulnerability to substance abuse and psychopathology among siblings of opioid abusers.

Vulnerability to drug abuse and psychopathology was explored among siblings of 201 opioid-addicted probands. Disorders were evaluated based on family histories among 476 siblings; a subset of 133 siblings was also directly interviewed. Results indicated that a) siblings of opiate addicts had substantially higher rates of several disorders in comparison with rates in the community; b) as compared with parents of addicts, siblings had elevated rates of substance abuse and antisocial personality; c) the presence of a major psychiatric disorder significantly increased the risk of developing substance abuse among siblings; and d) psychopathology appeared to precede drug abuse in terms of age of onset in this group. Results obtained with the interviewed sample of siblings were replicated in the overall group. Findings of the study are discussed in terms of implications for the classification and treatment of substance abuse.

Adult↗
PubMed1992

A study of twins and stroke.

BACKGROUND AND PURPOSE: Although there are strong genetic contributions to coronary artery disease, only a few studies have considered heritable influences on stroke. METHODS: We investigated the role of genetic factors in stroke using the Twin Registry maintained by the National Academy of Sciences-National Research Council. The registry includes 15,948 male twin pairs born between 1917 and 1927. In 1985, 9,475 twins responded to a mailed questionnaire, which covered vascular risk factors, cardiac events, and stroke. RESULTS: Analysis of twin pairs in which both responded to the questionnaire, and a question on stroke, indicated proband concordance rates of 17.7% for monozygotic pairs and 3.6% for dizygotic pairs (relative risk = 4.3; chi 2 = 4.94, df = 1; p less than 0.05). CONCLUSIONS: This nearly fivefold increase in the prevalence of stroke among the monozygotic compared with the dizygotic twin pairs suggests that genetic factors are involved in the etiology of stroke. The twin study paradigm holds considerable promise for identifying both genetic and environmental influences on stroke.

Cerebrovascular Disorders↗
PubMed1990

Migraine and psychopathology. Results of the Zurich cohort study of young adults.

We present data regarding the association of psychiatric syndromes and migraine headache from a prospective epidemiologic cohort study of 27- and 28-year-olds in Zurich, Switzerland. The prevalence of migraine of 13.3% approximates estimates from previous epidemiologic studies in other regions of the world. Consistent with previous reports, there was a strong association between migraine and depression. However, this is the first study to demonstrate this association in an unselected epidemiologic sample with standardized assessment of psychiatric diagnoses by direct interview. The association between migraine and the anxiety disorders was even stronger than that for the affective disorders. The combination of anxiety disorder and major depression, but not pure anxiety disorders, nor pure depression, were significantly associated with migraine. Our data suggest that migraine with anxiety and depression may constitute a distinct syndrome comprising anxiety, often manifested in early childhood, followed by the occurrence of migraine headaches, and then by discrete episodes of depressive disorder in adulthood. Because of the prospective longitudinal design of this study, future assessments of this cohort will provide further information on the stability of these findings and the course of this cohort as subjects proceed through adulthood.

Adolescent↗
PubMed1990

The genetic epidemiology of alcoholism.

Despite the variability in sampling and methodology, the majority of the family, twin and adoption studies suggest that alcoholism is familial, a significant proportion of which can be attributed to genetic factors. However, the specific components of alcoholism that may be inherited have yet to be identified. To date, there are no biological trait markers for which there is evidence for specificity for alcoholism. The three major levels of enquiry regarding possible mechanisms for the transmission of alcoholism and the involvement of genes and gene products in its development are factors related to exposure, metabolism, or pharmacological effects of ethanol. Exposure to ethanol is an obvious precondition for the development of tolerance and/or dependence. Therefore, identification of factors which enhance (or decrease) exposure are important goals of studies of the pathogenesis of alcoholism. It is likely that demographic, cultural and environmental factors (i.e. sex, age, religious affiliation, social group influences, income, availability of alcohol, etc.) play a crucial role in mediating exposure to alcohol. The key to alcoholism is likely to reside in the effects of alcohol on the brain. In contrast to nicotine, the opioids, and catecholamines, no specific receptor for ethanol has been found. Thus, one major focus of current research on possible central nervous system (CNS) mechanisms for the effect of alcohol includes assessment of the role of alcohol in the stimulation of brain reward or reinforcement systems. Alternately, alcohol may produce dependence by normalizing abnormal baseline states such as irritability, hyperexcitability, dysphoria, impulsiveness, or stress/tension level. The results of animal studies have yielded information on the central effects of alcohol including sensitivity of neuronal membranes, proteins, and ion channels to alcohol, and factors related to the binding and release of neurotransmitters and neuromodulators including dopamine, norepinephrine, gamma aminobutyric acid, pro-opiomelanocortin, glutamate receptors and the endorphin system (Institute of Medicine, 1987). In addition to possible genetic explanations for the strong degree of familial aggregation of alcoholism, alternative explanations need to be further evaluated. These include: modelling of parental behaviour; possible changes in the susceptibility of the foetus to alcohol as a result of in utero maternal ingestion of alcohol; results of negligent rearing manifested in dietary deficiency, exposure to toxic substances, or brain trauma, which so often characterize the homes of alcoholic parents; or damage to paternal germ cells from alcohol.

Adoption↗
PubMed1990

Inverse relationship between defensiveness and lifetime prevalence of psychiatric disorder.

Defensiveness (the tendency not to report unfavorable information about oneself), as measured by the Marlowe-Crowne Social Desirability Scale, has been shown to be inversely correlated with self-reported symptoms. In this family study of depression, direct interviews with 380 subjects combined with relatives' reports revealed a similar inverse relationship between defensiveness and lifetime prevalence of any psychiatric disorder, especially when diagnostic status was most certain and among those at greater risk for psychopathology. The authors conclude that the Marlowe-Crowne scale measures a factor or trait associated with the relative absence of psychiatric disorder, not the underreporting or denial of disorder.

Adult↗
PubMed1990

Comorbidity for alcoholism and depression.

There has been a dramatic increase in attention to comorbidity between psychiatric disorders and substance abuse in both clinical and research settings. Patients with major psychiatric conditions and substance abuse often fall between the cracks in clinical settings because of administrative distinctions between substance abuse and mental health. This article reviews the evidence regarding an association between alcoholism and depression in clinical and epidemiologic studies. Longitudinal and family-genetic studies are also reviewed to address possible mechanisms for the association between alcoholism and depression.

Alcoholism↗
PubMed1989

Linkage studies of bipolar disorder: methodologic and analytic issues. Report of MacArthur Foundation Workshop on Linkage and Clinical Features in Affective Disorders.

To review the findings of the linkage studies of affective disorders, a workshop, "Linkage and Clinical Features in Affective Disorders," was organized by the MacArthur Foundation Mental Health Research Network I on the Psychobiology of Depression meeting in Alexandria, Va, April 13 to 15, 1989. The major goals of the workshop for affective disorders were to explore the relationship between genetic and clinical heterogeneity, to identify major impediments to linkage studies, and to develop recommendations for the application of standardized methods of conducting linkage studies. The participants in the conference presented detailed demographic and clinical data from most of the published linkage studies of affective disorders. No systematic correspondence between genetic and clinical subtypes of bipolar disorder pedigrees was evident. The major problems hampering the linkage analyses of psychiatric disorders that were identified follow: (1) the major psychiatric disorders--the affective disorders in particular--constituting complex human disorders; (2) the lack of valid definitions of affective disorders; (3) comorbidity between the affective disorders with other disorders; (4) nonrandom mating; (5) a cohort effect, with younger birth cohorts exhibiting higher rates of affective disorders; and (6) the lack of replication of current linkage studies. The recommendations that were made for linkage study designs that incorporate some of the complexities of the affective disorders are reported.

Bipolar Disorder↗
PubMed1988

Lifetime prevalence and age of onset of psychiatric disorders: recall 4 years later.

The blind test-retest reliability of lifetime prevalence and age of onset of psychiatric diagnoses, based on the SADS-L interview and RDC over a three-to-five year period, was examined in 143 probands and their relatives. Reliability of lifetime prevalence of major depression was excellent; reliability of antisocial personality, panic disorder, drug abuse, GAD, depressive personality, and alcoholism was good; reliability of obsessive-compulsive disorder and phobia was acceptable but lower. The reliability of hyperthymia or cyclothymia was not acceptable. Reliability for major depression did not vary substantially by age or sex of the informant, but recall of major depression was significantly higher in the probands than in their relatives. The test-retest reliability for the age of onset of major depression and panic disorder was excellent, and for phobia, GAD and alcoholism, was acceptable. Both probands and relatives recalled the age of onset of their depression fairly accurately. However, there was a reduction in agreement over time. Recall after 3-4 yr was better than 5-6 yr. There was a tendency for older respondents to systematically increase the age of onset of their depression across the two interviews, although the increase was only a few years. Recall of age of onset did not differ significantly by sex of respondent or whether the respondent was a proband or relative. These findings are discussed in light of several available studies of reliability of lifetime prevalence of psychiatric diagnoses.

Actuarial Analysis↗
PubMed1988

Migraine and depression: association and familial transmission.

We have studied the association between migraine and major depression in a group of 133 probands with major depression, a group of 82 normal community controls and 400 interviewed first-degree relatives of the probands and controls. There was a significant association between depression and migraine among both the probands and the relatives. We also found that concomitant symptoms of anxiety were prominent among the depressed persons with migraine. Both depression and migraine were strongly familial but their association did not appear to be highly transmissible. Rather, our data suggested that depression may either be a sequela of migraine or the diathesis which results in both migraine and depression.

Adolescent↗
PubMed1988

Assortative mating and affective disorders: psychopathology in offspring.

Familial aggregation has been frequently observed among probands with depression, anxiety disorders, and alcoholism (Gershon et al. 1976; Goodwin et al. 1973; Crowe et al. 1983). Because of the familial nature of these disorders, offspring of such probands have been identified to be at high risk for developing these illnesses themselves (Tarter 1983). Information regarding such risk has come from several sources: retrospective studies of patients with psychiatric disorders; studies of children whose parents are being treated for these disorders; and longitudinal follow-up studies of children with symptoms of the disorder.

Adolescent↗
PubMed1988

Delusional depression and bipolar spectrum: evidence for a possible association from a family study of children.

Recent pedigree studies demonstrating a possible linkage of bipolar disorder to markers on different chromosomes have included family members with major depression and cyclothymia as affected. There is general agreement that cyclothymia is related to bipolar disorder and that major depression is heterogenous. It is unclear which subtype of major depression is related to bipolar disorder. Data suggesting a relationship between delusional subtype of major depression and bipolar spectrum are presented. The data derive from a direct-interview study of 220 offspring (ages 6 to 23 years) of probands with either delusional or nondelusional major depression and normal controls. The children of delusional as contrasted with nondelusional probands had nearly a threefold increase in cyclothymia, were more often described by health professionals as hyperactive, and had increased school and social impairments. These findings in children replicate earlier findings in adults on the possible relationship between delusional depression and bipolar disorder and its spectrum. The findings must be considered tentative, however, because of the small sample of children in the subgroups of interest.

Adolescent↗