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Bruce J. Rounsaville, MD; Thomas R. Kosten, MD; Myrna M. Weissman, PhD; Brigitte Prusoff, PhD; David Pauls, PhD; Susan Foley Anton, PhD; Kathleen Merikangas, PhD

Arch Gen Psychiatry. 1991;48(1):33-42.

Abstract
• Previous research has documented high rates of major depression and antisocial personality in opiate addicts. This study was designed to investigate the relationship of dual diagnosis in opiate-addicted probands to family history of psychiatric disorders and substance use disorders in biological relatives. Psychiatric disorders and substance use disorders were evaluated using direct interview and family history in a sample of 877 first-degree relatives of 201 opiate addicts and 360 relatives of 82 normal controls. Results indicate that (1) compared with relatives of normal subjects, opiate addicts' relatives had substantially higher rates of alcoholism, drug abuse, depression, and antisocial personality; (2) relatives of depressed opiate-addicted probands had elevated rates of major depression and anxiety disorders but not of other disorders, suggesting the validity of subtyping opiate addicts by the presence or absence of major depression; and (3) in contrast, relatives of antisocial opiate addicts had rates of disorders that were not significantly different from those of relatives of opiate addicts without antisocial personality. Implications of these findings for the classification and treatment of substance abuse are discussed.

Author Affiliations
From the Department of Psychiatry (Drs Rounsaville, Kosten, Prusoff, Foley, and Merikangas) and the Child Study Center (Dr Pauls), Yale University, New Haven, Conn; and the Department of Psychiatry, College of Physicians and Surgeons, Columbia University, New York State Psychiatric Institute, New York (Dr Weissman).

Footnotes
Accepted for publication March 8, 1990.

Reprint requests to Substance Abuse Treatment Unit, Yale University School of Medicine, 27 Sylvan Ave, New Haven, CT 06519 (Dr Rounsaville).

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