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How should we construct psychiatric family history scores? A comparison of alternative approaches from the Dunedin Family Health History Study

Published online by Cambridge University Press:  26 March 2008

B. J. Milne ,
T. E. Moffitt ,
R. Crump ,
R. Poulton ,
M. Rutter ,
M. R. Sears ,
A. Taylor  and
A. Caspi
B. J. Milne*
Affiliation:
Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, UK
T. E. Moffitt
Affiliation:
Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, UK Departments of Psychology and Neuroscience, and Psychiatry and Behavioral Sciences, and Institute for Genome Sciences and Policy, Duke University, Durham, NC, USA
R. Crump
Affiliation:
Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
R. Poulton
Affiliation:
Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
M. Rutter
Affiliation:
Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, UK
M. R. Sears
Affiliation:
Department of Medicine, McMaster University, Firestone Institute for Respiratory Health, St Joseph's Healthcare, Hamilton, Ontario, Canada
A. Taylor
Affiliation:
Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, UK
A. Caspi
Affiliation:
Social, Genetic, and Developmental Psychiatry Centre, Institute of Psychiatry, King's College London, London, UK Departments of Psychology and Neuroscience, and Psychiatry and Behavioral Sciences, and Institute for Genome Sciences and Policy, Duke University, Durham, NC, USA
*
*Address for correspondence: Mr B. Milne, SGDP Centre, Institute of Psychiatry, PO80, De Crespigny Park, London SE5 8AF, UK. (Email: b.milne@iop.kcl.ac.uk)
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Abstract

Background

There is increased interest in assessing the family history of psychiatric disorders for both genetic research and public health screening. It is unclear how best to combine family history reports into an overall score. We compare the predictive validity of different family history scores.

Method

Probands from the Dunedin Study (n=981, 51% male) had their family history assessed for nine different conditions. We computed four family history scores for each disorder: (1) a simple dichotomous categorization of whether or not probands had any disordered first-degree relatives; (2) the observed number of disordered first-degree relatives; (3) the proportion of first-degree relatives who are disordered; and (4) Reed's score, which expressed the observed number of disordered first-degree relatives in terms of the number expected given the age and sex of each relative. We compared the strength of association between each family history score and probands' disorder outcome.

Results

Each score produced significant family history associations for all disorders. The scores that took account of the number of disordered relatives within families (i.e. the observed, proportion, and Reed's scores) produced significantly stronger associations than the dichotomous score for conduct disorder, alcohol dependence and smoking. Taking account of family size (i.e. using the proportion or Reed's score) produced stronger family history associations depending on the prevalence of the disorder among family members.

Conclusions

Dichotomous family history scores can be improved upon by considering the number of disordered relatives in a family and the population prevalence of the disorder.

Keywords

Family historypredictive validityprevalencepsychiatry
Type
Original Articles
Information
Psychological Medicine , Volume 38 , Issue 12 , December 2008 , pp. 1793 - 1802
Copyright
Copyright © 2008 Cambridge University Press

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