Abstract
Background: Affective disorders have a long-term impact on psychiatric health and are caused by multiple interacting factors including familial risk, childhood adversity, life events and personality traits.Methods: In this study, monozygotic twins (MZ) at familial risk (indexed by affective disorder in their co-twin; high-risk group), affected MZ twins (indexed by a diagnosis with affective disorder) and MZ twins with no family history of affective disorder (low-risk group) were identified through cross-linking of nation-wide Danish registers. In total, 204 MZ twins were included and psychopathology, personality traits and life adversity were evaluated by semi-structured interviews and questionnaires.Results: Affected MZ twins presented with more subclinical affective symptoms and were functionally impaired as evidenced by higher unemployment rates and reduced functional status. The affected and the high-risk groups reported more childhood adversity and had experienced more stressful life events than the low-risk group. A direct comparison within the discordant twin pairs showed that the high-risk twins presented fewer affective symptoms, better functional status, more extraversion and lower neuroticism scores than their affected co-twins although they had equal levels of life adversity as their affected co-twins.Conclusion: These findings add to the evidence indicating that patients experience higher neuroticism, persistent subclinical symptoms and reduced socio-occupational function after affective episodes. Additionally, neuroticism and extraversion seem capable of moderating the sensitivity to exposure from the environment.
Highlights
Affective disorders are among the most disabling diseases worldwide [1] and there is a need for better identification of risk and resilience markers and improve early intervention
Geneenvironment interactions reflect a causal mechanism where one genetic variant or one environmental factor contributes to the causation of a condition in the same individual with the genetic factor influencing the sensitivity to exposure from the environment [10] and thereby explain why individuals respond differently to environmental factors and are more prone to affective disorder after exposure to a stressful life events (SLE) [11]
The aims were to first to investigate whether affective symptoms, functional status, childhood adversity, SLE and personality traits are associated with risk for affective disorders by comparing a cohort of MZ twin pairs discordant and concordant for affective disorder with MZ twin pairs with no history of affective disorders, and second to investigate in the discordant pairs, whether childhood adversity and personality traits significantly differ within the pairs
Summary
Affective disorders are among the most disabling diseases worldwide [1] and there is a need for better identification of risk and resilience markers and improve early intervention. Including identical twins in a high-risk design creates an innovative approach by using an “ultra high-risk” design in the study of risk and resilience factors, as the healthy identical twin have resisted the disorder onset irrespectively of their genetic predisposition. They may express traits associated with resilience and/or compensatory mechanisms. Affective disorders have a long-term impact on psychiatric health and are caused by multiple interacting factors including familial risk, childhood adversity, life events and personality traits
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