A high risk twin study of combat-related PTSD comorbidity

Karestan C. Koenen, Michael J. Lyons, Jack Goldberg, John Simpson, Wesley M. Williams, Rosemary Toomey, Seth A. Eisen, William R. True, Marylene Cloitre, Jessica Wolfe, Ming T. Tsuang

Research output: Contribution to journalArticlepeer-review

70 Scopus citations


Combat-related posttraumatic stress disorder (PTSD) is highly comorbid with other mental disorders. However, the nature of the relationship between PTSD and other mental disorders remains unclear. A discordant high-risk twin design was used on data from a sub-sample of the male-male twin pair members of the Vietnam Era Twin Registry to examine whether patterns of comorbidity are consistent with a psychopathological response to combat exposure or reflect familial vulnerability to psychopathology. Mental disorders were assessed via the Mental Health Diagnostic Interview Schedule Version III - Revised. Discordant monozygotic within-pair comparisons revealed that PTSD probands had higher symptom counts and diagnostic prevalences of mood and anxiety disorders than their non-combat exposed co-twins. Monozygotic co-twins of PTSD probands had significantly more mood disorder symptoms than monozygotic co-twins of combat controls or dizygotic co-twins of veterans with PTSD, These findings suggest that a) major depression, generalized anxiety disorder and panic disorder are part of a post-combat response syndrome; b) a shared familial vulnerability also contributes to the association between PTSD and major depression, PTSD and dysthymia, and c) this shared vulnerability is mediated by genetic factors.

Original languageEnglish
Pages (from-to)218-226
Number of pages9
JournalTwin Research
Issue number3
StatePublished - Jun 2003

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