Children of parents with AUD at risk for psychiatric, substance use disorders

A recent study has identified three components of familial and potential genetic liability to alcohol use disorder (AUD), namely a nonspecific risk of common internalizing and externalizing disorders, a moderately specific risk of externalizing disorders, and a highly specific AUD risk.

In this study, the authors examined a total of 1,244,516 offspring in intact families (mean age at follow-up 37.7 years). They calculated hazard ratios for offspring of parents with AUD using Cox models for risk of five disorders assessed from Swedish medical and criminal registries: AUD, drug use disorders, attention deficit hyperactivity disorder (ADHD), major depression, and anxiety disorders.

Children showed the highest risk for AUD (hazard ratio [HR], 2.36), followed by drug use disorder (HR, 2.04), ADHD (HR, 1.82), major depression (HR, 1.43), and anxiety disorder (HR, 1.43). AUD risk was statistically identical between offsprings of mothers with AUD and those of fathers with AUD, and between sons and daughters of a parent with AUD.

All risks were higher for children having two parents with AUD than for those having only one parent with AUD, but the risk increase for both parents with AUD was highest for AUD, followed by drug use disorder, and ADHD.

In addition, age at AUD onset of the parents was more strongly predictive of the risk in children for AUD and drug use disorder, followed by ADHD, major depression and anxiety disorders. Notably, the number of recurrences of the parents with AUD equally predicted the risks for these disorders.

“The risk pattern of disorders for the offspring of not-lived-with fathers with AUD was similar to that in the main analysis of intact families,” the authors said. “No evidence was found for sex-specific transmission of AUD or a familial female protective effect.”