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. 2020 Sep;208(9):637-645.
doi: 10.1097/NMD.0000000000001190.

Within-Family Transmission of Alcohol Use Disorder in Parent-Offspring, Sibling, and Cousin Pairs: A Contagion Model

Kenneth S Kendler, Henrik Ohlsson  1 , Jan Sundquist, Kristina Sundquist
Affiliations

Within-Family Transmission of Alcohol Use Disorder in Parent-Offspring, Sibling, and Cousin Pairs: A Contagion Model

Kenneth S Kendler et al. J Nerv Ment Dis. 2020 Sep.

Abstract

To determine whether alcohol use disorder (AUD) is transmitted within families as predicted by contagion, we examined parent-offspring, siblings, and cousin pairs ascertained from Swedish registries with a primary case with AUD. Our outcome variable was AUD registration in at-risk secondary cases. In offspring, risks for AUD registration in the 3 years after a parental index registration residing in the same household, neighborhood, or municipality increased by 1.6%, -0.5%, and 0.3%, respectively. For siblings of sibling index cases, parallel results were 3.2%, 1.2%, and 0.3%. For cousins of cousin index cases, no excess risk was seen for those residing in the same neighborhood or municipality. In siblings, AUD transmission was stronger in same versus opposite sex pairs and from older to younger versus younger to older siblings. These results support the hypothesis that AUD is transmitted among close family relationships and over limited geographical distances by a temporally dynamic contagion model.

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Conflict of interest statement

Conflicts of Interest: None of the authors have any conflicts of interest to declare.

Figures

FIGURE A1.
FIGURE A1.
Siblings. Age 25–30 in secondary case in the same SAMS.
FIGURE A2.
FIGURE A2.
Siblings. Age 35–40 in secondary case in the same SAMS.
FIGURE A3.
FIGURE A3.
Total effect of transmission in siblings in the same SAMS at Ages 25–30 and 35–40.
FIGURE 1.
FIGURE 1.
Increase in risk for alcohol use disorder registration (±95% CIs) in offspring, siblings and cousins of index cases 3 years before and 3 years after alcohol use disorder registration in the index relative, depicted by the “AUD parent” dotted line, as a function of the proximity of the index and secondary case. The “No AUD parent” dotted line depicts results in offspring or siblings of controls. The “AUD parent (expected)” dotted line depicts the results expected in the at-risk secondary cases if their parent did not have an index registration for alcohol use disorder.
FIGURE 2.
FIGURE 2.
Increased risk for alcohol use disorder registration in potential secondary cases 1–3 years after alcohol use disorder registration in index relative as a function of the proximity of the primary and secondary case. Asterisks above each column reflects the statistical significance of that analysis: * <0.05; ** <0.001; *** <0.0001.
FIGURE 3.
FIGURE 3.
(A) Increased risk for alcohol use disorder registration in offspring 1–3 years after alcohol use disorder registration in a parent as a function of sex and age differences in the primary and secondary case. Asterisks by the name of the variable under examination indicates whether the results in those analyses are statistically heterogeneous: * <0.05; ** <0.001; *** <0.0001. (B) Increased risk for alcohol use disorder registration in other siblings 1–3 years after alcohol use disorder registration in a sibling primary case as a function of sex, age differences and the younger vs older relationship in the primary and secondary case. Asterisks above each column reflects the statistical significance of that analysis. Asterisks by the name of the variable under examination indicates whether the results in those analyses are statistically heterogeneous: * <0.05; ** <0.001; *** <0.0001.
FIGURE 3.
FIGURE 3.
(A) Increased risk for alcohol use disorder registration in offspring 1–3 years after alcohol use disorder registration in a parent as a function of sex and age differences in the primary and secondary case. Asterisks by the name of the variable under examination indicates whether the results in those analyses are statistically heterogeneous: * <0.05; ** <0.001; *** <0.0001. (B) Increased risk for alcohol use disorder registration in other siblings 1–3 years after alcohol use disorder registration in a sibling primary case as a function of sex, age differences and the younger vs older relationship in the primary and secondary case. Asterisks above each column reflects the statistical significance of that analysis. Asterisks by the name of the variable under examination indicates whether the results in those analyses are statistically heterogeneous: * <0.05; ** <0.001; *** <0.0001.
FIGURE 4.
FIGURE 4.
Increased risk for alcohol use disorder registration in potential secondary cases 1–3 years after alcohol use disorder registration in the primary case in parents, siblings and cousins as a function of the source of registration for alcohol use disorder in the primary and secondary case. Med, medical registry; Cr, criminal registry. Asterisks above each column reflects the statistical significance of that analysis. Asterisks by the name of the group of relatives indicated whether the results in that class are statistically heterogeneous: * <0.05; ** <0.001; *** <0.0001
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