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A Swedish Longitudinal, Population-Based Twin Study

Kenneth S. Kendler, MD; Margaret Gatz, PhD; Charles O. Gardner, PhD; Nancy L. Pedersen, PhD

Arch Gen Psychiatry. 2006;63:1113-1120.

Context  Prior studies suggest that the personality traits of neuroticism and extroversion may be related to the liability to major depression (MD).

Objective  To clarify the magnitude and nature of the association between neuroticism and extroversion and the risk for MD.

Design  Longitudinal population-based twin cohort.

Setting  General community.

Participants  A total of 20 692 members of same-sex twin pairs from the population-based Swedish Twin Registry who completed a self-report questionnaire assessing neuroticism and extroversion in 1972 and 1973 and were personally interviewed for lifetime history of MD more than 25 years later.

Main Outcome Measure  Lifetime history of modified DSM-IV MD.

Results  Levels of neuroticism strongly predicted the risks for both lifetime and new-onset MD. Twin modeling indicated that the association between neuroticism and MD resulted largely from shared genetic risk factors, with a genetic correlation of +0.46 to +0.47. Levels of extroversion were weakly and inversely related to the risks for lifetime and new-onset MD. This effect disappeared when we controlled for the level of neuroticism. Twin modeling produced similar results.

Conclusions  Results from both longitudinal and genetic analyses support the hypothesis that neuroticism strongly reflects the liability to MD. This association arises largely because neuroticism indexes the genetic risk for depressive illness. However, substantial proportions of the genetic vulnerability to MD are not reflected in neuroticism. By contrast, extroversion is only weakly related to risk for MD.

Author Affiliations: Departments of Psychiatry (Drs Kendler and Gardner) and Human Genetics (Dr Kendler), Medical College of Virginia/Virginia Commonwealth University, Richmond; Department of Psychology, University of Southern California, Los Angeles (Drs Gatz and Pedersen); and Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Stockholm, Sweden (Drs Gatz and Pedersen).

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