The interplay between family history and social support in the risk for psychiatric disorders in the All of Us Cohort

Background: Family history is a well-established transdiagnostic risk factor for psychiatric disorders, while perceived social support is a protective factor. However, it remains unclear whether social support buffers the risk conferred by family history across a range of psychiatric conditions within a single, large cohort.Methods: We used data from the NIH All of Us Research Program (N=276,261; age M=56.97, SD=16.97; 61.4% female). Logistic regression analyses examined family history of disorders (depression, anxiety, PTSD, bipolar-disorder, schizophrenia), social support, and electronic health records.Results: Family history of a matched disorder was the strongest predictor for each diagnosis (ORs from 1.45 95% CI [1.41, 1.50] for depression to 2.69 95% CI [2.27, 3.16] for PTSD); significant cross-disorder effects supported a transdiagnostic model. Higher social support was associated with lower odds (ORs from 0.942 95% CI [0.932, 0.953] for bipolar to 0.986 95% CI [0.980, 0.991] for anxiety). A significant interaction was found for depression (OR=0.981 95% CI [0.965, 0.997]) and anxiety (OR=0.979 95% CI [0.960, 0.999]), where higher social support buffered familial risk.Conclusions: While family history and low social support are broad risk factors, the protective buffering effect of social support on familial risk appears to be specific to depression and anxiety. Clinical assessments should incorporate family history, and interventions bolstering social support may be effective for preventing these disorders in at-risk individuals.