Psychological Medicine



Original Article

Caffeine intake, toxicity and dependence and lifetime risk for psychiatric and substance use disorders: an epidemiologic and co-twin control analysis


KENNETH S. KENDLER a1a2a3c1, JOHN MYERS a1a2 and CHARLES O. GARDNER a1a2
a1 Virginia Institute of Psychiatric and Behavioral Genetics, Medical College of Virginia/Virginia Commonwealth University, Richmond, VA, USA
a2 Department of Psychiatry, Medical College of Virginia/Virginia Commonwealth University, Richmond, VA, USA
a3 Department of Human Genetics, Medical College of Virginia/Virginia Commonwealth University, Richmond, VA, USA

Article author query
kendler ks   [PubMed][Google Scholar] 
myers j   [PubMed][Google Scholar] 
o. gardner c   [PubMed][Google Scholar] 

Abstract

Background. Although caffeine is the most commonly used psychoactive substance and often produces symptoms of toxicity and dependence, little is known, especially in community samples, about the association between caffeine use, toxicity and dependence and risk for common psychiatric and substance use disorders.

Method. Assessments of lifetime maximal caffeine use and symptoms of caffeine toxicity and dependence were available on over 3600 adult twins ascertained from the population-based Virginia Twin Registry. Lifetime histories of major depression (MD), generalized anxiety disorder (GAD) and panic disorder, alcohol dependence, adult antisocial behavior and cannabis and cocaine abuse/dependence were obtained at personal interview. Logistic regression analyses in the entire sample and within monozygotic (MZ) twin pairs were conducted in SAS.

Results. In the entire sample, measures of maximal caffeine use, heavy caffeine use, and caffeine-related toxicity and dependence were significantly and positively associated with all seven psychiatric and substance use disorders. However, within MZ twin pairs, controlling for genetic and family environmental factors, these associations, while positive, were all non-significant. These results were similar when excluding twins who denied regular caffeine use.

Conclusions. Maximal lifetime caffeine intake and caffeine-associated toxicity and dependence are moderately associated with risk for a wide range of psychiatric and substance use disorders. Analyses of these relationships within MZ twin pairs suggest that most of the observed associations are not causal. Rather, familial factors, which are probably in part genetic, predispose to both caffeine intake, toxicity and dependence and the risk for a broad array of internalizing and externalizing disorders.

(Published Online August 8 2006)


Correspondence:
c1 Virginia Commonwealth University, VIPBG, Box 980126, Richmond, VA 23298-0126, USA. (Email: Kendler@vcu.edu)


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