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Interstitial cystitis and panic disorder: a potential genetic syndrome
Myrna M Weissman1, Raz Gross, Abby Fyer
1Departments of Psychiatry and Urology, College of Physicians and Surgeons, Columbia University, New York, NY 10032, USA. mmw3@columbia.edu
Archives of General Psychiatry
|March 3, 2004
Summary
Patients with interstitial cystitis (IC) and their families show higher rates of panic disorder (PD) and related syndrome conditions. This suggests a potential genetic link between IC and PD, supporting a familial syndrome hypothesis.
Area of Science:
- Genetics
- Psychiatry
- Urology
Background:
- Genetic linkage studies suggested a syndrome in families with panic disorder (PD), including bladder problems (possibly interstitial cystitis [IC]), thyroid disorders, headaches, and mitral valve prolapse.
- Previous studies indicated a potential genetic marker on chromosome 13 associated with these conditions, particularly bladder issues.
- Urologic problems were identified via medical history, with a urologist suggesting they could be IC.
Purpose of the Study:
- To determine if patients diagnosed with IC and their first-degree relatives (FDRs) exhibit increased rates of the proposed syndrome conditions.
- To validate that the bladder problems in the linkage study could be IC.
- To provide further support for the existence of a familial panic syndrome.
Main Methods:
- A case-control and family history study was conducted.
- Participants included 146 probands (67 with IC, 79 with other urologic disorders) and 815 FDRs from two metropolitan urology clinics.
- Lifetime rates of syndrome conditions were assessed in probands and FDRs, who were blinded to the proband's urologic or psychiatric diagnoses.
Main Results:
- Patients with IC showed a significantly higher lifetime prevalence of PD (OR, 4.05; P =.02) and a trend towards higher prevalence of any syndrome disorder (OR, 2.22; P =.09) compared to controls.
- First-degree relatives of probands with IC were significantly more likely to have PD, thyroid disorder, urologic problems, and any syndrome disorder (adjusted OR, 1.95; P =.02).
- These familial results were independent of PD in the proband and robust to various statistical controls.
Conclusions:
- The increased frequency of these disorders in IC patients and their FDRs aligns with previous genetic linkage findings in PD families.
- These results suggest that the bladder problems identified in the linkage study may indeed be IC.
- A familial, possibly pleiotropic, syndrome encompassing IC, PD, thyroid disorders, and other autonomic/neuromuscular conditions warrants further investigation.