Genetic and Cultural Transmission of Alcohol Use Disorder in Swedish Twin Pedigrees

Objective: Using Swedish nationwide registry data, we investigated the contribution of genetic and environmental risk factors to the etiology of alcohol use disorder (AUD) by extended twin pedigree modeling. Method: AUD was defined using public inpatient, outpatient, prescription, and criminal records. Three-generational pedigrees were selected for index individuals born between 1980 and 1990, obtained from the national twin and genealogical registers, whose parents were twins. Relatives of the twins included in the pedigrees were their parents, siblings, spouses, and children. Genetic structural equation modeling was applied to the population-based data on AUD, using OpenMx, with age used as a covariate. Results: Analyses including up to 162,469 individuals in 18,971 pedigrees estimated AUD prevalence at 5%-12%in men and 2%-5% in women. Results indicated substantial heritability (about 50%-60%), of which a portion upwards of 5% was attributable to the consequences of assortative mating. Contributions of shared envi-ronmental factors to AUD, which represent a mix of within-and cross -generational effects, appeared to be moderate (about 10%-20%). Unique environment accounted for the remaining variance (about 20%-30%). Sex differences in the magnitude of the variance components suggested higher heritability in men and correspondingly higher shared environ-mental contributions in women. Conclusions: Using objective registry data, we found that AUD is highly heritable. Furthermore, shared envi-ronmental factors contributed significantly to the liability of AUD in both men and women. (J. Stud. Alcohol Drugs, 84, 368-377, 2023)