Hostname: page-component-7c8c6479df-ws8qp Total loading time: 0 Render date: 2024-03-28T16:44:48.766Z Has data issue: false hasContentIssue false

Genetic co-morbidity between neuroticism, anxiety/depression and somatic distress in a population sample of adolescent and young adult twins

Published online by Cambridge University Press:  04 November 2011

N. K. Hansell*
Affiliation:
Genetic Epidemiology, Queensland Institute of Medical Research, Brisbane, Australia
M. J. Wright
Affiliation:
Genetic Epidemiology, Queensland Institute of Medical Research, Brisbane, Australia
S. E. Medland
Affiliation:
Genetic Epidemiology, Queensland Institute of Medical Research, Brisbane, Australia
T. A. Davenport
Affiliation:
Brain and Mind Research Institute, University of Sydney, Sydney, Australia
N. R. Wray
Affiliation:
Genetic Epidemiology, Queensland Institute of Medical Research, Brisbane, Australia
N. G. Martin
Affiliation:
Genetic Epidemiology, Queensland Institute of Medical Research, Brisbane, Australia
I. B. Hickie
Affiliation:
Brain and Mind Research Institute, University of Sydney, Sydney, Australia
*
*Address for correspondence: Dr N. K. Hansell, Genetic Epidemiology, Queensland Institute of Medical Research, Post Office, Royal Brisbane Hospital, Queensland, Australia4029. (Email: Narelle.Hansell@qimr.edu.au)

Abstract

Background

Genetic studies in adults indicate that genes influencing the personality trait of neuroticism account for substantial genetic variance in anxiety and depression and in somatic health. Here, we examine for the first time the factors underlying the relationship between neuroticism and anxiety/depressive and somatic symptoms during adolescence.

Method

The Somatic and Psychological Health Report (SPHERE) assessed symptoms of anxiety/depression (PSYCH-14) and somatic distress (SOMA-10) in 2459 adolescent and young adult twins [1168 complete pairs (35.4% monozygotic, 53% female)] aged 12–25 years (mean=15.5±2.9). Differences between boys and girls across adolescence were explored for neuroticism, SPHERE-34, and the subscales PSYCH-14 and SOMA-10. Trivariate analyses partitioned sources of covariance in neuroticism, PSYCH-14 and SOMA-10.

Results

Girls scored higher than boys on both neuroticism and SPHERE, with SPHERE scores for girls increasing slightly over time, whereas scores for boys decreased or were unchanged. Neuroticism and SPHERE scores were strongly influenced by genetic factors [heritability (h2)=40–52%]. A common genetic source influenced neuroticism, PSYCH-14 and SOMA-10 (impacting PSYCH-14 more than SOMA-10). A further genetic source, independent of neuroticism, accounted for covariation specific to PSYCH-14 and SOMA-10. Environmental influences were largely specific to each measure.

Conclusions

In adolescence, genetic risk factors indexed by neuroticism contribute substantially to anxiety/depression and, to a lesser extent, perceived somatic health. Additional genetic covariation between anxiety/depressive and somatic symptoms, independent of neuroticism, had greatest influence on somatic distress, where it was equal in influence to the factor shared with neuroticism.

Type
Original Articles
Copyright
Copyright © Cambridge University Press 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

APA (2000). Diagnostic and Statistical Manual of Mental Disorders. American Psychiatric Association: Washington, DC.Google Scholar
Angold, A, Erkanli, A, Silberg, J, Eaves, L, Costello, EJ (2002). Depression scale scores in 8–17-year-olds: effects of age and gender. Journal of Child Psychology and Psychiatry 43, 10521063.CrossRefGoogle ScholarPubMed
Bartels, M, van de Aa, N, van Beijsterveldt, CE, Middeldorp, CM, Boomsma, DI (2011). Adolescent self-report of emotional and behavioral problems: interactions of genetic factors with sex and age. Journal of the Canadian Academy of Child and Adolescent Psychiatry 20, 3552.Google ScholarPubMed
Birley, AJ, Gillespie, NA, Heath, AC, Sullivan, PF, Boomsma, DI, Martin, NG (2006). Heritability and nineteen-year stability of long and short EPQ-R Neuroticism scales. Personality and Individual Differences 40, 737747.CrossRefGoogle Scholar
Boomsma, DI, Beem, AL, van den Berg, M, Dolan, CV, Koopmans, JR, Vink, JM, de Geus, EJ, Slagboom, PE (2000). Netherlands twin family study of anxious depression (NETSAD). Twin Research 3, 323334.CrossRefGoogle ScholarPubMed
Costa, PT, McCrae, RR (1992). Revised NEO Personality Inventory (NEO PI-R) and NEO Five-Factor Inventory (NEO-FFI): Professional Manual. PAR: Lutz.Google Scholar
Dimsdale, JE, Dantzer, R (2011). A biological substrate for somatoform disorders: importance of pathophysiology. Psychosomatic Medicine 69, 850854.CrossRefGoogle Scholar
Eysenck, HJ, Eysenck, SBG (1975). Manual for the Eysenck Personality Questionnaire (Adult and Junior). Digits: San Diego, CA.Google Scholar
Eysenck, SBG (1972). Junior Eysenck Personality Inventory. EdITS/Educational and Industrial Testing Service: San Diego, CA.Google Scholar
Fanous, A, Gardner, CO, Prescott, CA, Cancro, R, Kendler, KS (2002). Neuroticism, major depression and gender: a population-based twin study. Psychological Medicine 32, 719728.CrossRefGoogle Scholar
Feigon, SA, Waldman, ID, Levy, F, Hay, DA (2001). Genetic and environmental influences on separation anxiety disorder symptoms and their moderation by age and sex. Behavior Genetics 31, 403411.CrossRefGoogle ScholarPubMed
Franic, S, Middeldorp, CM, Dolan, CV, Ligthart, L, Boomsma, DI (2010). Childhood and adolescent anxiety and depression: beyond heritability. Journal of the American Academy of Child & Adolescent Psychiatry 49, 820829.CrossRefGoogle ScholarPubMed
Freeman, MF, Tukey, JW (1950). Transformations related to the angular scale and the square root. Annals of Mathematical Statistics 21, 607611.CrossRefGoogle Scholar
Frokjaer, VG, Vinberg, M, Erritzoe, D, Baare, W, Holst, KK, Mortensen, EL, Arfan, H, Madsen, J, Jernigan, TL, Kessing, LV, Knudsen, GM (2010). Familial risk for mood disorder and the personality risk factor, neuroticism, interact in their association with frontolimbic serotonin 2A receptor binding. Neuropsychopharmacology 35, 11291137.CrossRefGoogle ScholarPubMed
Gillespie, N, Kirk, KM, Heath, AC, Martin, NG, Hickie, I (1999). Somatic distress as a distinct psychological dimension. Social Psychiatry and Psychiatric Epidemiology 34, 451458.CrossRefGoogle ScholarPubMed
Gillespie, NA, Evans, DE, Wright, MM, Martin, NG (2004). Genetic simplex modeling of Eysenck's dimensions of personality in a sample of young Australian twins. Twin Research 7, 637648.CrossRefGoogle Scholar
Gillespie, NA, Zhu, G, Heath, AC, Hickie, IB, Martin, NG (2000). The genetic aetiology of somatic distress. Psychological Medicine 30, 10511061.CrossRefGoogle ScholarPubMed
Goldberg, DA (1996). A dimensional model for common mental disorders. British Journal of Psychiatry 168, 4449.CrossRefGoogle Scholar
Hamilton, BA, Naismith, SL, Scott, EM, Purcell, S, Hickie, IB (2011). Disability is already pronounced in young people with early stages of affective disorders: data from an early intervention service. Journal of Affective Disorders 131, 8491.CrossRefGoogle ScholarPubMed
Happonen, M, Pulkkinen, L, Kaprio, J, van der Meere, J, Viken, RJ, Rose, RJ (2002). The heritability of depressive symptoms: multiple informants and multiple measures. Journal of Child Psychology and Psychiatry 43, 471479.CrossRefGoogle ScholarPubMed
Hetrick, SE, Parker, AG, Hickie, IB, Purcell, R, Yung, AR, McGorry, PD (2008). Early identification and intervention in depressive disorders: towards a clinical staging model. Psychotherapy and Psychosomatics 77, 263270.CrossRefGoogle ScholarPubMed
Hettema, JM, Neale, MC, Myers, JM, Prescott, CA, Kendler, KS (2006). A population-based twin study of the relationship between neuroticism and internalizing disorders. American Journal of Psychiatry 163, 857864.CrossRefGoogle ScholarPubMed
Hettema, JM, Prescott, CA, Kendler, KS (2004). Genetic and environmental sources of covariation between generalized anxiety disorder and neuroticism. American Journal of Psychiatry 161, 15811587.CrossRefGoogle ScholarPubMed
Hickie, I, Bennett, B, Lloyd, A, Heath, A, Martin, N (1999 a). Complex genetic and environmental relationships between psychological distress, fatigue and immune functioning: a twin study. Psychological Medicine 29, 269277.CrossRefGoogle ScholarPubMed
Hickie, I, Davenport, T, Wakefield, D, Vollmer-Conna, U, Cameron, B, Vernon, SD, Reeves, WC, Lloyd, A (2006). Post-infective and chronic fatigue syndromes precipitated by viral and non-viral pathogens: prospective cohort study. British Medical Journal 333, 575.CrossRefGoogle ScholarPubMed
Hickie, I, Hadzi-Pavlovic, D, Ricci, C (1997). Reviving the diagnosis of neurasthenia. Psychological Medicine 27, 989994.CrossRefGoogle ScholarPubMed
Hickie, I, Kirk, K, Martin, N (1999 b). Unique genetic and environmental determinants of prolonged fatigue: a twin study. Psychological Medicine 29, 259268.CrossRefGoogle ScholarPubMed
Hickie, I, Koschera, A, Hadzi-Pavlovic, D, Bennett, B, Lloyd, A (1999 c). The temporal stability and co-morbidity of prolonged fatigue: a longitudinal study in primary care. Psychological Medicine 29, 855861.CrossRefGoogle ScholarPubMed
Hickie, I, Lloyd, A, Wakefield, D, Parker, G (1990). The psychiatric status of patients with the chronic fatigue syndrome. British Journal of Psychiatry 156, 534540.CrossRefGoogle ScholarPubMed
Hickie, IB, Davenport, TA, Hadzi-Pavlovic, D, Koschera, A, Naismith, SL, Scott, EM, Wilhelm, KA (2001 a). Development of a simple screening tool for common mental disorders in general practice. Medical Journal of Australia 175, S10S24.Google ScholarPubMed
Hickie, IB, Davenport, TA, Scott, EM, Hadzi-Pavlovic, D, Naismith, SL, Koschera, A (2001 b). Unmet need for recognition of common mental disorders in Australian general practice. Medical Journal of Australia 175 (Suppl.) S18S24.Google ScholarPubMed
Hickie, IB, Rogers, NL (2011). Novel melatonin-based therapies: potential advances in the treatment of major depression. Lancet 378, 621631.CrossRefGoogle ScholarPubMed
Kato, K, Sullivan, PF, Evengard, B, Pedersen, NL (2009). A population-based twin study of functional somatic syndromes. Psychological Medicine 39, 497505.CrossRefGoogle ScholarPubMed
Kendler, KS, Gardner, CO, Gatz, M, Pederson, NL (2007). The sources of co-morbidity between major depression and generalized anxiety disorder in a Swedish national twin sample. Psychological Medicine 37, 453462.CrossRefGoogle Scholar
Kendler, KS, Gardner, CO, Lichtenstein, P (2008). A developmental twin study of symptoms of anxiety and depression: evidence for genetic innovation and attenuation. Psychological Medicine 38, 15671575.CrossRefGoogle ScholarPubMed
Kirk, KM, Hickie, IB, Martin, NG (1999). Fatigue as related to anxiety and depression in a community-based sample of twins aged over 50. Social Psychiatry and Psychiatric Epidemiology 34, 8590.CrossRefGoogle Scholar
Kirmayer, LJ, Robbins, JM, Paris, J (1994). Somatoform disorders: personality and the social matrix of somatic distress. Journal of Abnormal Psychology 103, 125136.CrossRefGoogle ScholarPubMed
Kotov, R, Gamez, W, Schmidt, F, Watson, D (2010). Linking ‘big’ personality traits to anxiety, depressive, and substance use disorders: a meta-analysis. Psychological Bulletin 136, 768821.CrossRefGoogle ScholarPubMed
Kraemer, HC (2007). DSM categories and dimensions in clinical and research contexts. International Journal of Methods in Psychiatric Research 16, S8–S15.CrossRefGoogle ScholarPubMed
Krueger, RF, Chentsova-Dutton, YE, Markon, KE, Goldberg, D, Ormel, J (2003). A cross-cultural study of the structure of comorbidity among common psychopathological syndromes in the general health care setting. Journal of Abnormal Psychology 112, 437447.CrossRefGoogle ScholarPubMed
Lamb, DJ, Middeldorp, CM, van Beijsterveldt, CEM, Bartels, M, van der Aa, N, Polderman, TJC, Boomsma, DI (2010). Heritability of anxious-depressive and withdrawn behavior: age-related changes during adolescence. Journal of American Academy of Child & Adolescent Psychiatry 49, 248255.Google ScholarPubMed
McCrae, RR, Costa, PT (2004). A contemplated revision of the NEO Five-Factor Inventory. Personality and Individual Differences 36, 587596.CrossRefGoogle Scholar
McCrae, RR, Costa, PT (2010). NEO Inventories for the NEO Personality Inventory-3 (NEO-PI-3), NEO Five-Factor Inventory-3 (NEO-FFI-3), NEO Personality Inventory-Revised (NEO PI-R): Professional Manual. PAR: Lutz, FL.Google Scholar
McCrae, RR, Costa, PT Jr., Terracciano, A, Parker, WD, Mills, CJ, de Fruyt, F, Mervielde, I (2002). Personality trait development from age 12 to age 18: longitudinal, cross-sectional, and cross-cultural analyses. Journal of Personality and Social Psychology 83, 14561468.CrossRefGoogle ScholarPubMed
McGorry, P (2011). Transition to adulthood: the critical period for pre-emptive, disease-modifying care for schizophrenia and related disorders. Schizophrenia Bulletin 37, 524530.CrossRefGoogle ScholarPubMed
McGorry, PD, Purcell, R, Goldstone, S, Amminger, GP (2011). Age of onset and timing of treatment for mental and substance use disorders: implications for preventive intervention strategies and models of care. Current Opinion in Psychiatry 24, 301306.CrossRefGoogle ScholarPubMed
McGregor, B, Pfitzner, J, Zhu, G, Grace, M, Eldridge, A, Pearson, J, Mayne, C, Aitken, JF, Green, AC, Martin, NG (1999). Genetic and environmental contributions to size, color, shape, and other characteristics of melanocytic naevi in a sample of adolescent twins. Genetic Epidemiology 16, 4053.3.0.CO;2-1>CrossRefGoogle Scholar
Martin, NG, Jardine, R, Andrews, G, Heath, AC (1988). Anxiety disorders and neuroticism: are there genetic factors specific to panic. Acta Psychiatrica Scandinavica 77, 698706.CrossRefGoogle ScholarPubMed
Medland, SE, Nyholt, DR, Painter, JN, McEvoy, BP, McRae, AF, Zhu, G, Gordon, SD, Ferreira, MA, Wright, MJ, Henders, AK, Campbell, MJ, Duffy, DL, Hansell, NK, Macgregor, S, Slutske, WS, Heath, AC, Montgomery, GW, Martin, NG (2009). Common variants in the trichohyalin gene are associated with straight hair in Europeans. American Journal of Human Genetics 85, 750755.CrossRefGoogle ScholarPubMed
Merikangas, KR, He, JP, Burstein, M, Swanson, SA, Avenevoli, S, Cui, L, Benjet, C, Georgiades, K, Swendsen, J (2010). Lifetime prevalence of mental disorders in US adolescents: results from the National Comorbidity Survey Replication – Adolescent Supplement (NCS-A). Journal of the American Academy of Child and Adolescent Psychiatry 49, 980989.CrossRefGoogle ScholarPubMed
Neale, MC, Boker, SM, Xie, G, Maes, HH (2003). Mx: Statistical Modeling. Department of Psychiatry: Richmond, VA.Google Scholar
Neale, MC, Cardon, LR (1992). Methodology for Genetic Studies of Twins and Families. Kluwer Academic Publishers: Dordrecht.CrossRefGoogle Scholar
Neale, MC, Eaves, LJ, Kendler, KS (1994). The power of the classical twin study to resolve variation in threshold traits. Behavior Genetics 24, 239258.CrossRefGoogle ScholarPubMed
Parker, JD, Taylor, GJ, Bagby, RM (1989). The alexithymia construct: relationship with sociodemographic variables and intelligence. Comprehensive Psychiatry 30, 434441.CrossRefGoogle ScholarPubMed
Pennebaker, JW, Watson, D (1991). The psychology of somatic symptoms. In Current Concepts of Somatization (ed. Kirmayer, L. J. and Robbins, J. M.). American Psychiatric Press: Washington DC.Google Scholar
Raison, CL, Capuron, L, Miller, AH (2006). Cytokines sing the blues: inflammation and the pathogenesis of depression. Trends in Immunology 27, 2431.CrossRefGoogle ScholarPubMed
Rettew, DC, Vink, JM, Willemsen, G, Doyle, A, Hudziak, JJ, Boomsma, DI (2006). The genetic architecture of neuroticism in 3301 Dutch adolescent twins as a function of age and sex: a study from the Dutch Twin Register. Twin Research and Human Genetics 9, 2429.CrossRefGoogle ScholarPubMed
Rice, F, Harold, GT, Thapar, A (2002). Assessing the effects of age, sex, and shared environment on the genetic aetiology of depression in childhood and adolescence. Journal of Child Psycholgy & Psychiatry 43, 10391051.CrossRefGoogle ScholarPubMed
Rief, W, Hennings, A, Riemer, S, Euteneuer, F (2010). Psychobiological differences between depression and somatization. Journal of Psychosomatic Research 68, 496502.CrossRefGoogle ScholarPubMed
Rief, W, Pilger, F, Ihle, D, Verlerk, R, Scharpe, S, Maes, M (2004). Psychobiological aspects of somatoform disorders: contributions of monoaminergic transmitter systems. Neuropsychobiology 49, 2429.CrossRefGoogle ScholarPubMed
Robbins, JM, Kirmayer, LJ (1991). Cognitive and social factors in somatization. In Current Concepts of Somatization: Research and Clinical Perspectives (ed. Kirmayer, L. J. and Robbins, J. M.), pp. 107141. American Psychiatric Press: Washington DC.Google Scholar
Ruscio, J, Ruscio, AM (2000). Informing the continuity controversy: a taxometric analysis of depression. Journal of Abnormal Psychology 109, 473487.CrossRefGoogle ScholarPubMed
Sakashita, C, Slade, T, Andrews, G (2007). Empirical investigation of two assumptions in the diagnosis of DSM-IV major depressive episode. Australian and New Zealand Journal of Psychiatry 41, 1723.CrossRefGoogle ScholarPubMed
Slade, T, Andrews, G (2005). Latent structure of depression in a community sample: a taxometric analysis. Psychological Medicine 35, 489497.CrossRefGoogle Scholar
Sund, AM, Larsson, B, Wichstrom, L (2001). Depressive symptoms among young Norwegian adolescents as measured by The Mood and Feelings Questionnaire (MFQ). European Child & Adolescent Psychiatry 10, 222229.CrossRefGoogle ScholarPubMed
Sutin, AR, Terracciano, A, Deiana, B, Naitza, S, Ferrucci, L, Uda, M, Schlessinger, D, Costa, PT Jr. (2010). High neuroticism and low conscientiousness are associated with interleukin-6. Psychological Medicine 40, 14851493.CrossRefGoogle ScholarPubMed
Terracciano, A, Costa, Jr. PT, McCrae, RR (2006). Personality plasticity after age 30. Personality and Social Psychology Bulletin 32, 999–1009.CrossRefGoogle ScholarPubMed
Ustun, TB, Sartorius, N (eds.) (1995). Mental Illness in General Health Care: An International Study. John Wiley & Sons: London.Google Scholar
Vaccarino, AL, Sills, TL, Evans, KR, Kalali, AH (2009). Multiple pain complaints in patients with major depressive disorder. Psychosomatic Medicine 71, 159162.CrossRefGoogle ScholarPubMed
Vallejo, MA, Jordan, CM, Diaz, MI, Comeche, MI, Ortega, J (2007). Psychological assessment via the internet: a reliability and validity study of online (vs paper-and-pencil) versions of the General Health Questionnaire-28 (GHQ-28) and the Symptoms Check-List-90-Revised (SCL-90-R). Journal of Medical Internet Research 9, e2.CrossRefGoogle ScholarPubMed
van der Linden, G, Chalder, T, Hickie, I, Koschera, A, Sham, P, Wessely, S (1999). Fatigue and psychiatric disorder: different or the same? Psychological Medicine 29, 863868.CrossRefGoogle ScholarPubMed
Vassend, O, Roysamb, E, Nielsen, CS (2011). Neuroticism and self-reported somatic health: a twin study. Psychology & Health. Published online: 14 June 2011. doi:10.1080/08870446.2010.540665.Google Scholar
Vercoulen, JH, Swanink, CM, Zitman, FG, Vreden, SG, Hoofs, MP, Fennis, JF, Galama, JM, van der Meer, JW, Bleijenberg, G (1996). Randomised, double-blind, placebo-controlled study of fluoxetine in chronic fatigue syndrome. Lancet 347, 858861.CrossRefGoogle ScholarPubMed
Vollmer-Conna, U, Fazou, C, Cameron, B, Li, H, Brennan, C, Luck, L, Davenport, T, Wakefield, D, Hickie, I, Lloyd, A (2004). Production of pro-inflammatory cytokines correlates with the symptoms of acute sickness behaviour in humans. Psychological Medicine 34, 12891297.CrossRefGoogle ScholarPubMed
Wijeratne, C, Hickie, I, Davenport, T (2006). Is there an independent somatic symptom dimension in older people? Journal of Psychosomatic Research 61, 197204.CrossRefGoogle ScholarPubMed
Wray, NR, Birley, AJ, Sullivan, PF, Visscher, PM, Martin, NG (2007). Genetic and phenotypic stability of measures of neuroticism over 22 years. Twin Research and Human Genetics 10, 695702.CrossRefGoogle ScholarPubMed
Wright, MJ, Martin, NG (2004). The Brisbane Adolescent Twin Study: outline of study methods and research projects. Australian Journal of Psychology 56, 6578.CrossRefGoogle Scholar