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, 1990). However, this does not clarify whether individuals meeting diagnostic criteria for specific psychiatric disorders while actively misusing drugs or alcohol would continue to meet these criteria after a period of abstinence. Penick et al. (1988), for example, provided data showing that the absolute number and relative risk of psychiatric syndromes identified in substance use disorder treatment patients were stable up to 1 bepotastine year following treatment; however, it is not clear how continued sobriety versus relapse figured into these outcomes. Verheul et al. (2000) found that recovery of substance use covaries with recovery from some but not other types of psychiatric problems. Ramsey et al. (2004) found that up to one third of patients deemed to have ��secondary�� depression continued to be clinically depressed up to 1 year see more after successful alcoholism treatment. These findings are consistent with other epidemiological data from the National Epidemiologic Survey on Alcohol and Related Conditions showing that ��only a few individuals�� had anxiety or mood disorders that both began after the onset of an alcohol disorder and ceased being symptomatic during periods of prolonged abstinence (Grant et al., 2004, p. 107). Similarly, it appears that successful treatment of an anxiety disorder does not appreciably affect comorbid hazardous drinking and AUDs (Thomas et al., 2008). These data would appear to suggest that even if a psychiatric disorder or substance use disorder is caused (��induced��) by the other, it would not necessarily resolve once the primary condition was successfully treated. This conclusion is also consistent with the observations and intuitions of several pre-modern researchers that secondary comorbid conditions can evolve into independent disorders (e.g., Ullman, 1952). Relapse. A final issue to consider in distinguishing initiating from maintaining causal influences in comorbid disorders is the relative ��no man��s land�� of relapses to substance use in this formulation. Perhaps causal influences related to initiating disorder onsets, but not their offsets, regain causal potency in terms of relapse. For example, relapses to alcohol and drug use following treatment are commonly associated with exacerbations in psychiatric symptoms, and patients often attribute their relapses to worsening affect and anxiety (Kranzler et al., 1996; Najavits et al., 2007); however, disentangling Selleck Olaparib the cause-and-effect relationships between comorbid conditions and relapse remains notoriously difficult (Booth et al., 1991). For example, both affective disorders and substance use disorders are characterized by cycles of remission and relapse even when no comorbidity is present. Modern family studies of comorbidity Family studies probe the possibility of a shared heritable etiology of comorbid disorders by evaluating their direct (��true��) transmission (e.g., depression in proband to depression in offspring) versus their cross-transmission (e.g.