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Marc N. Potenza, MD, PhD; Hong Xian, PhD; Kamini Shah, MHS; Jeffrey F. Scherrer, PhD; Seth A. Eisen, MD

Arch Gen Psychiatry. 2005;62:1015-1021.

Context  Although pathological gambling (PG) and major depression (MD) frequently co-occur, little is known regarding the relative contributions of environmental and genetic factors to the codevelopment of the disorders.

Objectives  To estimate environmental and genetic contributions to PG and MD as defined in DSM-III-R and the lifetime co-occurrence of PG and MD.

Design  Survey data from the Vietnam Era Twin Registry were examined in biometric models.

Setting  Telephone interview.

Participants  Of 10 253 eligible participants, 7869 were successfully interviewed.

Main Outcome Measures  Estimated genetic, shared environmental, and unique environmental contributions to PG and MD and their lifetime co-occurrence in bivariate models.

Results  Elevated odds ratios for MD were associated with those of PG (4.06; 95% confidence interval, 2.68-6.13), and the association remained significant following adjustment for sociodemographic and other psychiatric variables (odds ratio = 1.98; 95% confidence interval, 1.14-3.45). The best-fitting bivariate model indicated that 66% of the variance in PG and 41% of the variance in MD were owing to genetic factors, and 34% of the variance in PG and 59% of the variance in MD were owing to unique environmental factors. There was a substantial correlation between the genetic components of PG and MD (r_A = 0.58), with 34% of the genetic variance for each disorder also contributing to that of the other. The best-fitting model estimated that 100% of the total overlap between PG and MD was genetic.

Conclusions  The correlation between PG and MD in middle-aged men appears to be largely influenced by overlapping genetic factors. Future research is needed to determine the extent to which these findings extend to other groups (eg, women), identify specific genes, and generate improved prevention and treatment strategies.

Author Affiliations: Department of Psychiatry, Yale University School of Medicine and Connecticut Mental Health Center, New Haven (Dr Potenza); Research Service (Drs Xian, Shah, Scherrer, and Eisen) and Medical Service (Dr Eisen), St Louis Veterans Affairs Medical Center, St Louis, Mo; and Departments of Internal Medicine (Drs Xian, Shah, and Eisen) and Psychiatry (Drs Scherrer and Eisen), Washington University School of Medicine, St Louis.

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