Family History of Alcoholism and Gender: Their Combined Effects on DSM-IV Alcohol Dependence and Major Depression

Objective: Data from a representative sample of U.S. adults were used to assess the extent of familial alcoholism, to examine its association with the odds of DSM-IV lifetime alcohol dependence, major depression, and their comorbid occurrence, and to determine whether the magnitude of this association was different for men and women.

Method: Self-report data from a sample of 42,862 U.S. adults (25,043 women) 18 years of age and over were analyzed by means of multiple logistic regression models that predicted the odds of various combinations of DSM-IV alcohol dependence and major depression.

Results: After adjusting for potential confounders through multiple logistic regression, family history saturation was associated with increased odds of dependence only, depression only, and all primary-secondary-concurrent combinations of these two disorders. The estimated effects were greatest for comorbid dependence and depression, next highest for dependence only and lowest for depression only. Differences in odds ratios among these groups increased with degree of family history saturation but were statistically significant at all levels of saturation. The effects of family history were greater for men than women for the outcome of primary depression followed by secondary dependence, but only at the higher levels of saturation. Among persons with lifetime major depression, family history of alcoholism had a positive independent association with the conditional odds of having experienced comorbid alcohol dependence. It had a weaker but still significant association with the odds of comorbid depression, conditional upon having experienced dependence, and this association was stronger among men than among women. For most outcomes, family history effects were stronger for paternal male and maternal female relatives than for paternal female and maternal male relatives.

Conclusions: These findings supported prior research showing more familial alcoholism among persons with comorbid dependence and depression than among those with dependence alone. Gender differences were supportive of the proposed distinction between pure depression and depressive-spectrum disease.