Researchers from the Departments of Psychiatry (PTM, RAD, MNP) and Child Study Center (MNP) at Yale University’s School of Medicine examined data from the National Epidemiological Survey on Alcohol and Related Conditions (NESARC) to assess the prevalence of multiple psychiatric disorders—including alcohol abuse, nicotine dependence, mania, schizoid personality disorder, panic disorder—in both male and female children. Lead researcher Peter Morgan and his team studied 23,006 males and 17,368 females who grew up with and without an alcohol abusing mother or father, and measured the occurrence of disorders based on gender and maternal or paternal alcoholism.

As a result, researchers found a higher prevalence of psychiatric disorders in children of alcoholic parents than children without a history of familial alcohol abuse, regardless of their gender and the gender of the alcoholic parent. However, the gender of the alcohol abusing parent and their child created differing increases in the pervasiveness of specific disorders. For example, sons of alcoholic fathers were associated with an increased risk of mania, but sons of alcoholic mothers were at higher risk of panic disorder. Female offspring showed the greatest disparity among psychiatric risks. Daughters of alcoholic fathers were associated with an increased risk of alcohol abuse, but daughters of alcoholic mothers were associated with increased risk of nicotine dependence, alcohol abuse, mania, and schizoid personality disorder. Female children of alcohol abusing mothers were at the greatest risk of adulthood psychiatric illness than any other child-parent ratio.

Alcohol use disorders may directly affect the health, behavior, and productivity of the individual experiencing it, but ultimately alcoholism is a family disease. Not only does the alcoholic’s behavior affect their relationships with family members, causing various behavioral and developmental problems, but their dependencies have shown to cause specific effects on their offspring’s psychopathology that otherwise could have been prevented. During adolescence, children of alcoholic parents are susceptible to the negative effects of a parent’s drinking problem, and as adults these children face the greatest risk of essentially every type of chronic mental illness. Based on the finding from this new study, specialized intervention and prevention strategies can be implemented that target the psychiatric disorders that are specific to gender-related influences between parents and their offspring. The greater occurrence of multiple psychiatric disorders among daughters of alcoholic mothers, for example, can help families, medical professionals, and policymakers identify individuals that are at highest risk and encourage preventative strategies to aid these families.

The Yale’s research team’s study is available online and in the October 2010 print issue of Alcoholism: Clinical & Experimental Research.

Sources: Morgan, Peter T., Rani A. Desai, and Marc N. Potenza. October, 2010. Gender-Related Influences of Parental Alcoholism on the Prevalence of Psychiatric Illnesses: Analysis of the National Epidemiologic Survey on Alcohol and Related Conditions. Alcoholism: Clinical & Experimental Research. Published online July 20, 2010. DOI: 10.1111/j.1530-0277.2010.01263.x.

HealthDay News, Mom’s Alcoholism Especially Tough on Daughter’s Mental Health, July 20, 2010

"Cytokines are proteins which mediate and regulate the inflammatory reaction in infectious and autoimmune diseases," explained Pilar A. Sáiz, associate professor of psychiatry at the University of Oviedo, Spain and corresponding author for the study.

"Clinical observation of increased circulating levels of pro-inflammatory cytokines such as IL-1 and TNFα in patients with alcohol liver disease suggests that they might play a role on the pathogenesis of the disease. Additionally, these cytokines act in the central nervous system affecting the functionality of the serotoninergic and dopaminergic systems, which have been also related to the pathophysiology of AD, and with the brain reward systems involved in alcohol reinforcement."

Sáiz and her colleagues recruited 200 (169 males, 31 females) AD patients from an outpatient detoxification unit, as well as 420 (216 males, 204 females) healthy individuals without a history of drug/alcohol/psychiatric problems (known as "controls"), from the north of Spain. All of the Spanish Caucasian participants were genotyped for four polymorphisms—IL-1α -889 C/T, IL-1ß +3953 C/T, IL-1RA (86bp)n, and TNFα -308A/G—and assessed at baseline and again at six months for alcohol intake, addiction severity, and biomarkers of alcohol intake.

"We found that AD male patients and healthy control male patients differed in the genotype frequencies of the IL-1RA polymorphism owing to an excess of the A1/A1 genotype in the AD males," said Sáiz. "On the other hand, analysis of the IL-1 gene complex revealed a higher frequency of the IL-1a -889C / IL-1b +3953C / IL-1RA A2 haplotype in the control group than among the AD patients, as well as in the abstainers after six months of follow-up compared to the non-abstinent patients."

A haplotype is a combination of alleles at multiple loci that are transmitted together on the same chromosome, Sáiz explained. Prior research has suggested that the study of single polymorphisms may miss more complex haplotype effects, she added.

"In short, this haplotype seemed to exert a protective effect and was related to better outcomes," said Sáiz. "These findings provide further tentative evidence of the role of the IL-1 gene complex in AD as well as evidence that the nature of the associations may be direct, gender-specific, or involve haplotype effects."

She cautioned readers to remember, however, that AD is influenced by both genetic and environmental factors. "We are talking about a multifactorial polygenic disorder caused by a combination of small variations in different genes, often in concert with environmental factors," she said. "In spite of great efforts, the exact genes related to the pathophysiology of alcoholism are yet unknown. Our work represents a small piece of the puzzle."