The inheritance of affective disorders: a review of data and of hypotheses

A genetic factor in affective disorders is suggested by twin and family history studies. The form of disorder (BP or UP) is transmitted within families. Early onset of affective disorder is associated with increased morbid risk of the disorder in relatives, but age at onset is not itself a transmitted factor. Female relatives have higher prevalence of illness, but sex of the ill person does not appear to be a factor in transmission. Genetic models of multifactorial or single-gene autosomal inheritance are compatible with some but not all of the family history studies reported. The hypothesis of sex-linked transmission of BP illness has been proposed, and some pedigrees compatible with X-linkage have been reported, but family studies do not suggest that this is generally present. Other possible modes of inheritance remain to be tested. Investigative strategies for identification of the "affective genotype" are discussed on the basis of biochemical, pharmacological, or other characteristics of persons with the disorders and their relatives, and on the basis of studies of known linkage markers.