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Kenneth S. Kendler, MD; Carol A. Prescott, PhD; Michael C. Neale, PhD; Nancy L. Pedersen, PhD

Arch Gen Psychiatry. 1997;54(2):178-184.

Abstract
Background
Temperance boards were established in Sweden to register and follow up individuals who were seen in legal or medical settings with problems of alcohol abuse. These records, available in a large epidemiologic twin population, have provided an objective and validated measure of alcohol abuse.

Methods
We examined Swedish temperance board registrations from 1929 to 1974 (n=2516 individual twins) in all male-male Swedish twin pairs of known zygosity from the population-based Swedish Twin Registry; these twin pairs were born from 1902 to 1949 (n=8935 pairs).

Results
The lifetime prevalence and probandwise concordance rates for temperance board registrations were 13.2% and 47.9%, respectively, in monozygotic twins and 14.6% and 32.8%, respectively, in dizygotic twins. Model fitting suggested that genetic and familial-environmental risk factors accounted for 54% (95% confidence interval [CI], 47%-61%) and 14% (95% CI, 8%-19%) of the liability to temperance board registration, respectively; these estimates were stable across birth cohorts. High genetic liability was reflected by large numbers of temperance board registrations and registrations for criminal alcohol use. Elevated familial-environmental liability was indicated by an early age at first registration.

Conclusions
Genetic factors are of major etiologic importance for alcohol abuse in men, while familialenvironmental factors play a significant but less important role. The etiologic importance of these factors has remained constant in Sweden for men who were born in the first half of the 20th century.

Author Affiliations
From the Departments of Psychiatry (Drs Kendler, Prescott, and Neale) and Human Genetics (Dr Kendler), Medical College of Virginia/Virginia Commonwealth University, Richmond, and the Institute of Environmental Medicine, Karolinska Institute, Stockholm, Sweden (Dr Pedersen).

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