What is the role of paternal genetic transmission on risk for PTSD and internalizing and externalizing disorders?

Background: We utilize a novel contrastive genetic-epidemiological method, the Maternal Half-Sibling Families with Discordant Fathers (MHSFDF) design, to examine cross-generational genetic transmission of posttraumatic stress disorder (PTSD) and related internalizing major depression (MD), and externalizing disorders: alcohol use disorder (AUD) and drug use disorder (DUD).

Methods: Using Swedish national registries, we identified 72,467 maternal half-sibling pairs reared together whose biological fathers were discordant for the diagnoses of PTSD, MD, AUD, and DUD. Offspring selected had to have less than 1 year of contact with their affected fathers. We examined the differences in outcome for within- and cross-disorder risk of diagnosis in the half-siblings with an affected versus unaffected father.

Results: Paternal PTSD increased the risk of PTSD (HR: 1.43, 95% CI: 1.05-1.96) and MD (HR: 1.55, CI: 1.28-1.88) in offspring. It did not, however, elevate the risk of externalizing disorders (AUD or DUD). Offspring of fathers with AUD, DUD, or MD had increased risk of PTSD, suggesting sharing of vertically transmitted genetic risk between these disorders. No sex effects were found for any studied diagnosis.

Conclusions: This study is the first to show cross-generation genetic transmission for PTSD using the MHSFDF design. The pattern of cross-disorder genetic risk broadly supported an internalizing versus externalizing disorder split.