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Each of these diseases has strong genetic and environmental components; therefore, it seems likely that there is a shared liability rather than causative risk.<\/jats:p><\/jats:sec><jats:sec><jats:title>Objective<\/jats:title><jats:p>To investigate the existence and nature of familial aggregation for the comorbidity of atopic diseases and depression or anxiety.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Participants came from the Childhood and Adolescent Twin Study in Sweden (<jats:styled-content style=\"fixed-case\">CATSS<\/jats:styled-content>), n = 14 197. Current and ever asthma, eczema, hay fever and food allergy were reported by parents. Internalizing disorders were identified using validated questionnaires. Familial co\u2010aggregation analysis compared monozygotic (<jats:styled-content style=\"fixed-case\">MZ<\/jats:styled-content>) twins and same\u2010sex dizygotic (<jats:styled-content style=\"fixed-case\">DZ<\/jats:styled-content>) twins for atopic disease in 1 twin with internalizing disorder in the other to test for genetic liability. Several familial liability candidates were also tested including parental education, recent maternal psychological stress, childhood family trauma and parental country of birth.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Familial co\u2010aggregation analysis found that if 1 twin had at least 1 current atopic disease the partner twin was at risk of having an internalizing disorder regardless of their own atopic status (adjusted <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 1.22 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.08, 1.37). Similar results were found for each atopic disease ever and current. <jats:styled-content style=\"fixed-case\">MZ<\/jats:styled-content> associations were not higher than <jats:styled-content style=\"fixed-case\">DZ<\/jats:styled-content> associations, suggesting that the liability is not genetic in nature. Including other familial candidates to the models made little difference to effect estimates.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions and Clinical Relevance<\/jats:title><jats:p>Atopic diseases and depression or anxiety tend to occur together in families; therefore, when treating for 1 disease, the physician should consider comorbidity in both the individual and the individual's siblings. We did not find evidence to support a genetic explanation for comorbidity, and further exploration is needed to disentangle the environmental and epigenetic reasons for familial aggregation.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cea.13127","type":"journal-article","created":{"date-parts":[[2018,3,7]],"date-time":"2018-03-07T15:23:33Z","timestamp":1520436213000},"page":"703-711","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":48,"title":["The familial aggregation of atopic diseases and depression or anxiety in children"],"prefix":"10.1111","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9885-8261","authenticated-orcid":false,"given":"B. 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