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Across the nine possible mating types, we see both direct transmission (MD\u2009\u2192\u2009MD, AUD\u2009\u2192\u2009AUD) and also, less strongly, indirect transmission: MD\u2009\u2192\u2009AUD and AUD\u2009\u2192\u2009MD. Risks in offspring accumulate with multiple affected parents, which reveals the impact of interactive effects in risk prediction. Interestingly, the risk for comorbid AUD\/MD in offspring is higher when one parent has MD and the other AUD rather than when one parent has both disorders. Modest sex effects are seen, with maternal\u2010offspring transmission sometimes significantly stronger than paternal\u2010offspring transmission. In most comparisons, parental\u2010offspring transmission was modestly stronger for same\u2010sex versus opposite\u2010sex parent\u2010offspring pairs. These results suggest that MD\/AUD comorbidity in Sweden is due, at least in part, to correlated familial liability transmitted by direct and indirect paths across generations. We could reject the hypothesis that an AUD\/MD syndrome was specifically transmitted from parents to offspring.<\/jats:p>","DOI":"10.1002\/ajmg.b.33052","type":"journal-article","created":{"date-parts":[[2025,8,15]],"date-time":"2025-08-15T02:49:53Z","timestamp":1755226193000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["The Impact of the Parental Patterns of Morbidity and Comorbidity in the Cross\u2010Generational Transmission of Risk for Major Depression and Alcohol Use Disorder"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8689-6570","authenticated-orcid":false,"given":"Kenneth S.","family":"Kendler","sequence":"first","affiliation":[{"name":"Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University  Richmond Virginia USA"},{"name":"Department of Psychiatry Virginia Commonwealth University  Richmond Virginia USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1372-5508","authenticated-orcid":false,"given":"Linda","family":"Abrahamsson","sequence":"additional","affiliation":[{"name":"Center for Primary Health Care Research, Lund University  Malm\u00f6 Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jan","family":"Sundquist","sequence":"additional","affiliation":[{"name":"Center for Primary Health Care Research, Lund University  Malm\u00f6 Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kristina","family":"Sundquist","sequence":"additional","affiliation":[{"name":"Center for Primary Health Care Research, Lund University  Malm\u00f6 Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,8,14]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1992.01820090056010"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1126\/science.abo2059"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.comppsych.2013.10.007"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/YPG.0000000000000201"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.3109\/09540268909089422"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2015.0584"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/0376-8716(95)01160-4"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1001\/archpsyc.1993.01820210024003"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2014.2138"},{"key":"e_1_2_12_12_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.b.32977"},{"key":"e_1_2_12_13_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2017.4457"},{"key":"e_1_2_12_14_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajmg.b.32909"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.ajp.2018.17111251"},{"key":"e_1_2_12_16_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41398\u2010021\u201001454\u2010z"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamapsychiatry.2017.3828"},{"key":"e_1_2_12_18_1","first-page":"23","volume-title":"Treatment Strategies for Patients With Psychiatric Comorbidity","author":"Kessler R. 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