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January 24, 1986

Suicide and Affective Disorder Among the Old Order Amish-Reply

Author Affiliations

University of Miami School of Medicine

JAMA. 1986;255(4):468. doi:10.1001/jama.1986.03370040038021

In Reply.—  We appreciate Dr deGruy's raising a point we could not cover in our article. His salient observation is that our published pedigrees show instances of intermarriage between those with a positive family history for affective disorders. In response to the first question, the frequency of assortative mating (homogamy) between spouses both having a psychiatric illness does not appear greater than would be predicted by random selection. Even though the spouse may be well, over half of our bipolar pedigrees have a positive family history on both sides of the family.1 Whether this assortative mating increases the suicidal potential has not been well investigated in studies.Research does show that a systematic assortative mating does increase the transmission of major affective disorders.2-4 Our data (unpublished) would support this finding of higher morbid risk as well as greater comorbidity in the extended families on both sides. Furthermore, recent