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Rosenqvist, M. A., Sjölander, A., Ystrom, E., Larsson, H. & Reichborn-Kjennerud, T. (2019). Adverse family life events during pregnancy and ADHD symptoms in five-year-old offspring. Journal of Child Psychology and Psychiatry and Allied Disciplines, 60(6), 665-675
Open this publication in new window or tab >>Adverse family life events during pregnancy and ADHD symptoms in five-year-old offspring
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2019 (English)In: Journal of Child Psychology and Psychiatry and Allied Disciplines, ISSN 0021-9630, E-ISSN 1469-7610, Vol. 60, no 6, p. 665-675Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Prenatal exposure to maternal adverse life events has been associated with offspring ADHD, but the role of familial confounding is unclear. We aimed to clarify if adverse life events during pregnancy are related to ADHD symptoms in offspring, taking shared familial factors into account.

METHOD: Data were collected on 34,751 children (including 6,427 siblings) participating in the population-based Norwegian Mother and Child Cohort Study. During pregnancy, mothers reported whether they had experienced specific life events. We assessed ADHD symptoms in five-year-old children with the Conners' Parent Rating Scale-Revised: short form. We modeled the associations between life events and mean ADHD scores with ordinary linear regression in the full cohort, and with fixed-effect linear regression in sibling comparisons to adjust for familial confounding.

RESULTS: Children exposed to adverse life events had higher ADHD scores at age 5, with the strongest effect observed for financial problems (mean differences 0.10 [95% CI: 0.09, 0.11] in adjusted model), and the weakest for having lost someone close (0.02 [95% CI 0.01, 0.04] in adjusted model). Comparing exposure-discordant siblings resulted in attenuated estimates that were no longer statistically significant (e.g. mean difference for financial problems -0.03 [95% CI -0.07, 0.02]). ADHD scores increased if the mother had experienced the event as painful or difficult, and with the number of events, whereas sibling-comparison analyses resulted in estimates attenuated toward the null.

CONCLUSIONS: These results suggest that the association between adverse life events during pregnancy and offspring ADHD symptoms is largely explained by familial factors.

Place, publisher, year, edition, pages
Blackwell Publishing, 2019
Keywords
ADHD, MoBa, adverse life events, antenatal stress, delayed effects, prenatal exposures, the Norwegian Mother and Child Cohort Study
National Category
Psychiatry Occupational Health and Environmental Health
Identifiers
urn:nbn:se:oru:diva-69888 (URN)10.1111/jcpp.12990 (DOI)000468398900008 ()30367686 (PubMedID)2-s2.0-85055549396 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2015‐00075The Research Council of Norway, 231105
Note

Funding agencies:

National Institute of Neurological Disorders and Stroke (NIH/NINDS), UO1 NS 047537‐01, UO1 NS 047537‐06A1

Norwegian Ministry of Health and Care Services Services and the Ministry of Education and Research

National Institute of Environmental Health Sciences (NIH/NIEHS), N01‐ES‐75558

Available from: 2018-11-06 Created: 2018-11-06 Last updated: 2019-06-19Bibliographically approved
Sun, J., Zhan, Y., Mariosa, D., Larsson, H., Almqvist, C., Ingre, C., . . . Fang, F. (2019). Antibiotics Use and Risk of Amyotrophic Lateral Sclerosis in Sweden.. European Journal of Neurology
Open this publication in new window or tab >>Antibiotics Use and Risk of Amyotrophic Lateral Sclerosis in Sweden.
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2019 (English)In: European Journal of Neurology, ISSN 1351-5101, E-ISSN 1468-1331Article in journal (Refereed) Epub ahead of print
Abstract [en]

BACKGROUND AND PURPOSE: Previous animal studies have suggested disrupted intestinal microbiome in amyotrophic lateral sclerosis (ALS). Due to the known effect of antibiotics on gut microflora, the potential role of antibiotics use on the risk of ALS deserves an investigation.

METHODS: A nested case-control study was conducted using several Swedish national registers. We included 2,484 ALS patients diagnosed between July 1, 2006 and December 31, 2013 as cases and randomly selected five controls per case who were individually matched to the case by sex, birth year, and area of residence from the general Swedish population. Information on antibiotics prescriptions before ALS diagnosis was extracted from the Prescribed Drug Register for both cases and controls. Conditional logistic regression model was used to calculate odds ratios (ORs) and 95% confidence intervals (CIs).

RESULTS: After accounting for potential diagnostic delay in ALS by excluding all prescriptions within one year before diagnosis, any antibiotics use was associated with a higher risk of ALS. The ORs (95% CIs) were 1.06 (0.94-1.19), 1.13 (1.00-1.28), and 1.18 (1.03-1.35) when comparing one, 2-3, and ≥4 prescriptions to no prescription (P for trend = 0.0069). Similar results were noted for antibiotics used for respiratory infections and urinary tract as well as skin and soft tissue infections. Among different individual antibiotics, the risk of ALS was especially increased in relation to more than two prescriptions of beta-lactamase sensitive penicillin (OR=1.28; 95% CI 1.10-1.50).

CONCLUSIONS: Use of antibiotics, especially repeated, might be associated with a higher subsequent risk of ALS.

Place, publisher, year, edition, pages
Blackwell Publishing, 2019
Keywords
Amyotrophic lateral sclerosis, antibiotics, nested case-control study, register-based
National Category
Neurology
Identifiers
urn:nbn:se:oru:diva-74325 (URN)10.1111/ene.13986 (DOI)31087715 (PubMedID)
Available from: 2019-05-20 Created: 2019-05-20 Last updated: 2019-05-20Bibliographically approved
Chen, Q., Larsson, H., Almqvist, C., Chang, Z., Lichtenstein, P., D'Onofrio, B. M. & Ludvigsson, J. F. (2019). Association between pharmacotherapy for ADHD in offspring and depression-related specialty care visits by parents with a history of depression. BMC Psychiatry, 19, Article ID 224.
Open this publication in new window or tab >>Association between pharmacotherapy for ADHD in offspring and depression-related specialty care visits by parents with a history of depression
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2019 (English)In: BMC Psychiatry, ISSN 1471-244X, E-ISSN 1471-244X, Vol. 19, article id 224Article in journal (Refereed) Published
Abstract [en]

Background: Pharmacotherapy is effective in reducing the core symptoms of attention-deficit/hyperactivity disorder (ADHD). We aimed to investigate the concurrent association between pharmacotherapy for ADHD in offspring and depression-related specialty care visits by the parents with a history of depression.

Methods: Using data from a variety of Swedish national registers, we conducted a cohort study with 8-year follow-up of 5605 parents (3872 mothers and 1733 fathers) who had a history of depression and an offspring diagnosed with ADHD. The hazard rate for parental depression-related specialty care visits during exposed periods when the offspring was on medication for treatment of ADHD was compared with the hazard rate during unexposed periods when the offspring was off medication. Within-individual comparisons were employed to control for time-constant confounding factors.

Results: Among mothers, the crude rates of depression-related specialty care visits during exposed and unexposed periods were 61.33 and 63.95 per 100 person-years, respectively. The corresponding rates among fathers were 49.23 and 54.65 per 100 person-years. When the same parent was compared with him or herself, fathers showed a decreased hazard rate for depression-related visits during exposed periods when the offspring was on medication for treatment of ADHD as compared to unexposed periods (hazard ratio, 0.79 [95% confidence interval, 0.70 to 0.90]). No statistically significant associations were observed in mothers.

Conclusions: Among parents with a history of depression, pharmacotherapy for ADHD in offspring is concurrently associated with a decreased rate of depression-related specialty care visits in fathers but not in mothers. Future research with refined measures of parental depression and other time-varying familial factors is needed to better understand the mechanisms underlying the association.

Place, publisher, year, edition, pages
BMC, 2019
Keywords
ADHD, Pharmacotherapy, Depression, Offspring, Parents
National Category
Psychiatry
Identifiers
urn:nbn:se:oru:diva-75725 (URN)10.1186/s12888-019-2211-7 (DOI)000475947500001 ()31315609 (PubMedID)2-s2.0-85069537504 (Scopus ID)
Funder
Swedish Research Council, 2013-2280
Note

Funding Agencies:

Swedish Initiative for Research on Microdata in the Social And Medical Sciences (SIMSAM)  340-2013-5867 

National Institute of Mental Health (NIMH)  1R01MH102221 

Available from: 2019-08-13 Created: 2019-08-13 Last updated: 2019-08-13Bibliographically approved
Pettersson, E., Larsson, H., D'Onofrio, B., Almqvist, C. & Lichtenstein, P. (2019). Association of Fetal Growth With General and Specific Mental Health Conditions. JAMA psychiatry, 76(5), 536-543
Open this publication in new window or tab >>Association of Fetal Growth With General and Specific Mental Health Conditions
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2019 (English)In: JAMA psychiatry, ISSN 2168-6238, E-ISSN 2168-622X, Vol. 76, no 5, p. 536-543Article in journal (Refereed) Published
Abstract [en]

Importance: It is unclear if the associations between fetal growth and later mental health conditions remain after controlling for familial factors and psychiatric comorbidity.

Objective: To examine the associations between fetal growth and general and specific mental health conditions, controlling for familial factors.

Design, Setting, and Participants: This register-based study conducted in Sweden analyzed 546 894 pairs of full siblings born between January 1, 1973, and December 31, 1998. Sibling pairs were followed up through December 31, 2013. First, population-based and within-sibling pair associations (which controlled for time-invariant familial confounders) between fetal growth and the outcomes were estimated. Second, exploratory factor analysis was applied to the outcomes to derive 1 general factor and 4 specific and independent factors. Third, the general and specific factors were regressed on fetal growth. Statistical analysis was performed from March 27, 2017, to October 27, 2018.

Main Outcome and Measures: The outcomes were 11 psychiatric diagnoses (depression, anxiety, obsessive-compulsive disorder, posttraumatic stress disorder, bipolar disorder, alcohol abuse, drug use, attention-deficit/hyperactivity disorder, autism, schizophrenia, and schizoaffective disorder) and court convictions of violent crimes. Birth weight (in kilograms) statistically adjusted for gestational age was the exposure.

Results: The mean (SD) age of the 1 093 788 participants was 27.2 (6.8) years (range, 15.1-40.9 years) and 51.5% were male. Nine outcomes were significantly associated with birth weight in the population at large: depression (odds ratio [OR], 0.96; 95% CI, 0.95-0.98), anxiety (OR, 0.94; 95% CI, 0.92-0.95), posttraumatic stress disorder (OR, 0.91; 95% CI, 0.89-0.93), bipolar disorder (OR, 0.94; 95% CI, 0.89-1.00), alcohol abuse (OR, 0.89; 95% CI, 0.87-0.91), drug use (OR, 0.83; 95% CI, 0.80-0.85), violent crimes (OR, 0.85; 95% CI, 0.83-0.86), attention-deficit/hyperactivity disorder (OR, 0.88; 95% CI, 0.86-0.90), and autism (OR, 0.95; 95% CI, 0.92-0.97). Only depression (OR, 0.95; 95% CI 0.92-0.98), obsessive-compulsive disorder (OR, 0.93; 95% CI, 0.87-0.99), attention-deficit/hyperactivity disorder (OR, 0.86; 95% CI, 0.82-0.89), and autism (OR, 0.72; 95% CI, 0.69-0.76) remained significantly associated within sibling pairs. An exploratory factor analysis indicated that 1 general and 4 specific factors (capturing anxiety, externalizing, neurodevelopmental, and psychotic conditions) fit the outcomes well. Across almost all sensitivity analyses, an increase in birth weight by 1 kg significantly reduced the general (β, -0.047; 95% CI, -0.071 to -0.023) and the specific neurodevelopmental factors (β, -0.159; 95% CI, -0.190 to -0.128) within sibling pairs.

Conclusions and Relevance: Controlling for familial confounders, reduced fetal growth was associated with a small but significant increase in the general factor of psychopathology and a moderate increase in a specific neurodevelopmental factor.

Place, publisher, year, edition, pages
American Medical Association, 2019
National Category
Psychiatry
Identifiers
urn:nbn:se:oru:diva-72370 (URN)10.1001/jamapsychiatry.2018.4342 (DOI)000467491200015 ()30725083 (PubMedID)2-s2.0-85061261014 (Scopus ID)
Note

Funding Agency:

Swedish Research Council through the Swedish Initiative for Research on Microdata in the Social and Medical Sciences (SIMSAM)  340-2013-5867

Available from: 2019-02-12 Created: 2019-02-12 Last updated: 2019-06-18Bibliographically approved
Taylor, M. J., Martin, J., Lu, Y., Brikell, I., Lundström, S., Larsson, H. & Lichtenstein, P. (2019). Association of Genetic Risk Factors for Psychiatric Disorders and Traits of These Disorders in a Swedish Population Twin Sample. JAMA psychiatry, 76(3), 280-289
Open this publication in new window or tab >>Association of Genetic Risk Factors for Psychiatric Disorders and Traits of These Disorders in a Swedish Population Twin Sample
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2019 (English)In: JAMA psychiatry, ISSN 2168-6238, E-ISSN 2168-622X, Vol. 76, no 3, p. 280-289Article in journal (Refereed) Published
Abstract [en]

Importance: Psychiatric traits associated with categorically defined psychiatric disorders are heritable and present to varying degrees in the general population. It is commonly assumed that diagnoses represent the extreme end of continuously distributed traits in the population, but this assumption has yet to be robustly tested for many psychiatric phenotypes.

Objective: To assess whether genetic risk factors associated with psychiatric disorders are also associated with continuous variation in milder population traits.

Design, Setting, and Participants: This study combined a novel twin analytic approach with polygenic risk score (PRS) analyses in a large population-based twin sample. Phenotypic and genetic data were available from the Child and Adolescent Twin Study in Sweden. Inpatient data were available for January 1, 1987, to December 31, 2014, and outpatient data for January 1, 2001, to December 31, 2013. The last day of follow-up was December 31, 2014. Data analysis was performed from January 1, 2017, to September 30, 2017.

Main Outcomes and Measures: Questionnaires that assessed traits of autism spectrum disorder (ASD), attention-deficit/hyperactivity disorder (ADHD), learning difficulties, tic disorders (TDs), obsessive-compulsive disorder (OCD), anxiety, major depressive disorder (MDD), mania, and psychotic experiences were administered to a large Swedish twin sample. Individuals with clinical psychiatric diagnoses were identified using the Swedish National Patient Register. Joint categorical/continuous twin modeling was used to estimate genetic correlations between psychiatric diagnoses and continuous traits. The PRSs for psychiatric disorders were calculated based on independent discovery genetic data. The association between PRSs for each disorder and associated continuous traits was tested.

Results: Phenotype data were available for 13 923 twin pairs (35.1% opposite sex and 31.7% same-sex females) at 9 years of age, 5165 pairs (36.9% opposite sex and 34.0% same-sex females) at 15 years of age, and 4273 pairs (36.5% opposite sex and 34.4% same-sex females) at 18 years of age. Genetic data were available for 13 412 individuals (50.2% females). Twin genetic correlations between numerous psychiatric diagnoses and corresponding traits ranged from 0.31 to 0.69. Disorder PRSs were associated with related population traits for ASD (β [SE] = 0.04 [0.01] at 9 years of age), ADHD (β [SE] = 0.27 [0.03] at 9 years of age), TDs (β [SE] = 0.02 [0.004] at 9 years of age), OCD (β [SE] = 0.13 [0.05] at 18 years of age), anxiety (β [SE] = 0.18 [0.08] at 9 years of age; β [SE] = 0.07 [0.02] at 15 years of age; and β [SE] = 0.40 [0.17] at 18 years of age), MDD (β [SE] = 0.10 [0.03] at 9 years of age; β [SE] = 0.11 [0.02] at 15 years of age; and β [SE] = 0.41 [0.10] at 18 years of age), and schizophrenia (β [SE] = 0.02 [0.01] at 18 years of age). Polygenic risk scores for depressive symptoms were associated with MDD diagnoses (odds ratio, 1.16; 95% CI, 1.02-1.32).

Conclusions and Relevance: These results suggest that genetic factors associated with psychiatric disorders are also associated with milder variation in characteristic traits throughout the general population for many psychiatric phenotypes. This study suggests that many psychiatric disorders are likely to be continuous phenotypes rather than the categorical entities currently defined in diagnostic manuals, which has strong implications for genetic research in particular.

Place, publisher, year, edition, pages
American Medical Association, 2019
National Category
Psychiatry
Identifiers
urn:nbn:se:oru:diva-71751 (URN)10.1001/jamapsychiatry.2018.3652 (DOI)000460506700011 ()30566181 (PubMedID)2-s2.0-85059175163 (Scopus ID)
Funder
Wellcome trust, 106047Forte, Swedish Research Council for Health, Working Life and Welfare, 2012-1678 2014-0834 2014-0322Swedish Research Council, 340-2013-5867 2014-3831
Note

Funding Agencies:

Judah Foundation  

Tourette Association of America  

National Institutes of Health  NS40024  NS016648  MH079489  MH073250 

American Recovery and Re-investment Act  MH079489  NS040024-0751  NSw040024-09S1  MH092289  MH092290  MH092291  MH092292  RO1MH092293  MH092513  MH092516  MH092520  NS40024-07S1  NS16648-29S1  MH071507  MH079487  MH079488  MH079494 

New Jersey Center for Tourette Syndrome and Associated Disorders 

Available from: 2019-01-23 Created: 2019-01-23 Last updated: 2019-06-18Bibliographically approved
Brander, G., Isomura, K., Chang, Z., Kuja-Halkola, R., Almqvist, C., Larsson, H., . . . Fernández de la Cruz, L. (2019). Association of Tourette Syndrome and Chronic Tic Disorder With Metabolic and Cardiovascular Disorders. JAMA Neurology, 76(4), 454-461
Open this publication in new window or tab >>Association of Tourette Syndrome and Chronic Tic Disorder With Metabolic and Cardiovascular Disorders
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2019 (English)In: JAMA Neurology, ISSN 2168-6149, E-ISSN 2168-6157, Vol. 76, no 4, p. 454-461Article in journal (Refereed) Published
Abstract [en]

Importance: There are limited data concerning the risk of metabolic and cardiovascular disorders among individuals with Tourette syndrome (TS) or chronic tic disorder (CTD).

Objective: To investigate the risk of metabolic and cardiovascular disorders among individuals with TS or CTD over a period of 40 years.

Design, Settings, and Participants: This longitudinal population-based cohort study included all individuals living in Sweden between January 1, 1973, and December 31, 2013. Families with clusters of full siblings discordant for TS or CTD were further identified. Data analyses were conducted from August 1, 2017, to October 11, 2018.

Exposures: Previously validated International Classification of Diseases diagnoses of TS or CTD in the Swedish National Patient Register.

Main Outcomes and Measures: Registered diagnoses of obesity, dyslipidemia, hypertension, type 2 diabetes, and cardiovascular diseases (including ischemic heart diseases, arrhythmia, cerebrovascular diseases and transient ischemic attack, and arteriosclerosis).

Results: Of the 14 045 026 individuals in the cohort, 7804 individuals (5964 males [76.4%]; median age at first diagnosis, 13.3 years [interquartile range, 9.9-21.3 years]) had a registered diagnosis of TS or CTD in specialist care. Of 2 675 482 families with at least 2 singleton full siblings, 5141 families included siblings who were discordant for these disorders. Individuals with TS or CTD had a higher risk of any metabolic or cardiovascular disorders compared with the general population (hazard ratio adjusted by sex and birth year [aHR], 1.99; 95% CI, 1.90-2.09) and sibling controls (aHR for any disorder, 1.37; 95% CI, 1.24-1.51). Specifically, individuals with TS or CTD had higher risks for obesity (aHR, 2.76; 95% CI, 2.47-3.09), type 2 diabetes (aHR, 1.67; 95% CI, 1.42-1.96), and circulatory system diseases (aHR, 1.76; 95% CI, 1.67-1.86). The risk of any cardiometabolic disorder was significantly greater in males than in females (aHR, 2.13; 95% CI, 2.01-2.26 vs aHR, 1.79; 95% CI, 1.64-1.96), as was the risk of obesity (aHR, 3.24; 95% CI, 2.83-3.70 vs aHR, 1.97; 95% CI, 1.59-2.44). The risks were already evident from childhood (the groups were significantly different by age 8 years) and were significantly reduced with the exclusion of individuals with comorbid attention-deficit/hyperactivity disorder (aHR, 1.52; 95% CI, 1.42-1.62), while excluding other comorbidities did not significantly affect the results. Compared with patients with TS or CTD who were not taking antipsychotics, patients with a longer duration of antipsychotic treatment (>1 year) had significantly lower risks of metabolic and cardiovascular disorders.

Conclusions and Relevance: The findings of this study suggest that TS and CTD are associated with a substantial risk of metabolic and cardiovascular disorders. The results highlight the importance of carefully monitoring cardiometabolic health in patients with TS or CTD across the lifespan, particularly in those with comorbid attention-deficit/hyperactivity disorder.

Place, publisher, year, edition, pages
American Medical Association, 2019
National Category
Psychiatry Neurology
Identifiers
urn:nbn:se:oru:diva-71659 (URN)10.1001/jamaneurol.2018.4279 (DOI)000463873600014 ()30640363 (PubMedID)2-s2.0-85059958711 (Scopus ID)
Funder
The Karolinska Institutet's Research FoundationForte, Swedish Research Council for Health, Working Life and Welfare, 2014-2780 2015-00569
Note

Funding Agencies:

Tourettes Action  TALFC17

Swedish Research Council through the Swedish Initiative for Research on Microdata in the Social and Medical Sciences  340-2013-5867

Available from: 2019-01-22 Created: 2019-01-22 Last updated: 2019-06-18Bibliographically approved
Molero, Y., Larsson, H., D'Onofrio, B. M., Sharp, D. J. & Fazel, S. (2019). Associations between gabapentinoids and suicidal behaviour, unintentional overdoses, injuries, road traffic incidents, and violent crime: population based cohort study in Sweden. BMJ. British Medical Journal, 365, Article ID l2147.
Open this publication in new window or tab >>Associations between gabapentinoids and suicidal behaviour, unintentional overdoses, injuries, road traffic incidents, and violent crime: population based cohort study in Sweden
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2019 (English)In: BMJ. British Medical Journal, E-ISSN 1756-1833, Vol. 365, article id l2147Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To examine associations between gabapentinoids and adverse outcomes related to coordination disturbances (head or body injuries, or both and road traffic incidents or offences), mental health (suicidal behaviour, unintentional overdoses), and criminality.

DESIGN: Population based cohort study.

SETTING: High quality prescription, patient, death, and crime registers, Sweden.

PARTICIPANTS: 191 973 people from the Swedish Prescribed Drug Register who collected prescriptions for gabapentinoids (pregabalin or gabapentin) during 2006 to 2013.

MAIN OUTCOME MEASURES: Primary outcomes were suicidal behaviour, unintentional overdoses, head/body injuries, road traffic incidents and offences, and arrests for violent crime. Stratified Cox proportional hazards regression was conducted comparing treatment periods with non-treatment periods within an individual. Participants served as their own control, thus accounting for time invariant factors (eg, genetic and historical factors), and reducing confounding by indication. Additional adjustments were made by age, sex, comorbidities, substance use, and use of other antiepileptics.

RESULTS: During the study period, 10 026 (5.2%) participants were treated for suicidal behaviour or died from suicide, 17 144 (8.9%) experienced an unintentional overdose, 12 070 (6.3%) had a road traffic incident or offence, 70 522 (36.7%) presented with head/body injuries, and 7984 (4.1%) were arrested for a violent crime. In within-individual analyses, gabapentinoid treatment was associated with increased hazards of suicidal behaviour and deaths from suicide (age adjusted hazard ratio 1.26, 95% confidence interval 1.20 to 1.32), unintentional overdoses (1.24, 1.19 to 1.28), head/body injuries (1.22, 1.19 to 1.25), and road traffic incidents and offences (1.13, 1.06 to 1.20). Associations with arrests for violent crime were less clear (1.04, 0.98 to 1.11). When the drugs were examined separately, pregabalin was associated with increased hazards of all outcomes, whereas gabapentin was associated with decreased or no statistically significant hazards. When stratifying on age, increased hazards of all outcomes were associated with participants aged 15 to 24 years.

CONCLUSIONS: This study suggests that gabapentinoids are associated with an increased risk of suicidal behaviour, unintentional overdoses, head/body injuries, and road traffic incidents and offences. Pregabalin was associated with higher hazards of these outcomes than gabapentin.

Place, publisher, year, edition, pages
BMJ Publishing Group Ltd, 2019
National Category
Forensic Science
Identifiers
urn:nbn:se:oru:diva-74706 (URN)10.1136/bmj.l2147 (DOI)000472050600003 ()31189556 (PubMedID)2-s2.0-85067227906 (Scopus ID)
Funder
Wellcome trust, 202836/Z/16/ZForte, Swedish Research Council for Health, Working Life and Welfare, 2015-0028The Karolinska Institutet's Research Foundation, 2016fobi50581
Note

Funding Agency:

Swedish Research Council through the Swedish Initiative for Research on Microdata and the Social and Medical Sciences  340-2013-5867

Available from: 2019-06-17 Created: 2019-06-17 Last updated: 2019-07-23Bibliographically approved
Chen, Q., Hartman, C. A., Kuja-Halkola, R., Faraone, S. V., Almqvist, C. & Larsson, H. (2019). Attention-deficit/hyperactivity disorder and clinically diagnosed obesity in adolescence and young adulthood: a register-based study in Sweden. Psychological Medicine, 49(11), 1841-1849
Open this publication in new window or tab >>Attention-deficit/hyperactivity disorder and clinically diagnosed obesity in adolescence and young adulthood: a register-based study in Sweden
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2019 (English)In: Psychological Medicine, ISSN 0033-2917, E-ISSN 1469-8978, Vol. 49, no 11, p. 1841-1849Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: A recent family study of young adult males suggests a shared familial liability between attention-deficit/hyperactivity disorder (ADHD) and high body mass index (BMI), and a genome-wide meta-analysis reported a genetic correlation of 0.26 between ADHD and BMI. To date, it is unclear whether these findings generalize to the relationship between ADHD and clinically diagnosed obesity.

METHOD: By linking the Swedish national registers, we identified 25 38 127 individuals born between 1973 and 2000, together with their siblings and cousins. The risk of clinical obesity in individuals with ADHD was compared with the risk in those without ADHD. The relative contributions of genetic and environmental factors to the association between ADHD and clinical obesity were examined via assessment of the familial co-aggregation of the two conditions and quantitative genetic analysis.

RESULTS: Individuals with ADHD were at an increased risk of clinical obesity compared with those without (risk difference 3.73%, 95% confidence interval (CI) 3.55-3.90%; risk ratio 3.05, 95% CI 2.95-3.15). Familial co-aggregation of ADHD and clinical obesity was detected and the strength of the co-aggregation decreased by decreasing genetic relatedness. The correlation between the liabilities to ADHD and clinical obesity can be entirely attributed to their genetic correlation (rg 0.30, 95% CI 0.17-0.44).

CONCLUSION: The association between ADHD and clinical obesity in adolescence and young adulthood can be entirely attributed to genetic underpinnings shared by the two conditions. Children with ADHD should be monitored for weight gain so that preventive measures can be taken for those on a suboptimal trajectory.

Place, publisher, year, edition, pages
Cambridge University Press, 2019
Keywords
ADHD, family study, obesity, quantitative genetics
National Category
Psychiatry
Identifiers
urn:nbn:se:oru:diva-71725 (URN)10.1017/S0033291718002532 (DOI)000477655600008 ()30220266 (PubMedID)2-s2.0-85053719311 (Scopus ID)
Funder
Swedish Research Council, 2014-3831
Note

Funding Agencies:

Shire International GmbH

Swedish Initiative for Research on Microdata in the Social And Medical Sciences (SIMSAM) framework  340-2013-5867 

European Union  667302  728018  602805 

K.G. Jebsen Centre for Research on Neuropsychiatric Disorders, University of Bergen, Bergen, Norway  

National Institute of Mental Health  5R01MH101519  U01 MH109536-01 

Available from: 2019-01-23 Created: 2019-01-23 Last updated: 2019-08-12Bibliographically approved
Ghirardi, L., Larsson, H., Chang, Z., Chen, Q., Quinn, P. D., Hur, K., . . . D'Onofrio, B. M. (2019). Attention-Deficit/Hyperactivity Disorder Medication and Unintentional Injuries in Children and Adolescents.. Journal of the American Academy of Child and Adolescent Psychiatry
Open this publication in new window or tab >>Attention-Deficit/Hyperactivity Disorder Medication and Unintentional Injuries in Children and Adolescents.
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2019 (English)In: Journal of the American Academy of Child and Adolescent Psychiatry, ISSN 0890-8567, E-ISSN 1527-5418Article in journal (Refereed) Epub ahead of print
Abstract [en]

OBJECTIVE: Our objective was to determine whether ADHD medication is associated with a decreased risk of unintentional injuries in children and adolescents in the United States across sexes, age groups and injury types.

METHOD: We used de-identified inpatient, outpatient, and filled prescription claims data from the Truven Health MarketScan® Research Databases. Individuals were followed from January 1, 2005, date of first ADHD diagnosis or medication prescription, or age 6, whichever occurred last, until December 31, 2014, first healthcare insurance disenrollment, or the first year at which their age was recorded as 19, whichever occurred first. A person was considered on ADHD medication during a given month if a prescription was filled in that month. The outcome was defined as emergency department visits for injuries, including traumatic brain injuries, with unintentional causes. Odds of having the outcome were compared between medicated and un-medicated months at the population-level and in within-individual analyses using logistic regression.

RESULTS: Among 1 968 146 individuals diagnosed with ADHD or receiving ADHD medication, 87 154 had at least one event. At the population-level, medication use was associated a lower risk of injuries, both in boys (OR= 0.85; 95% CI: 0.84-0.86) and girls (OR=0.87; 95% CI: 0.85-0.89). Similar results were obtained from within-individual analysis among male (OR= 0.72; 95% CI: 0.70-0.74) and female (OR= 0.72; 95% CI: 0.69-0.75) children, and among male (OR= 0.64; 95% CI: 0.60-0.67) and female (OR= 0.65; 95% CI: 0.60-0.71) adolescents. Similar results were found for traumatic brain injuries.

CONCLUSION: ADHD medication use was associated with a reduction of different types of unintentional injuries in children and adolescents of both sexes.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
Children, attention-deficit disorder with hyperactivity/drug therapy
National Category
Psychiatry Neurology
Identifiers
urn:nbn:se:oru:diva-75591 (URN)10.1016/j.jaac.2019.06.010 (DOI)31302218 (PubMedID)
Available from: 2019-08-16 Created: 2019-08-16 Last updated: 2019-08-16Bibliographically approved
Jangmo, A., Stålhandske, A., Chang, Z., Chen, Q., Almqvist, C., Feldman, I., . . . Larsson, H. (2019). Attention-Deficit/Hyperactivity Disorder, School Performance, and Effect of Medication. Journal of the American Academy of Child and Adolescent Psychiatry, 58(4), 423-432
Open this publication in new window or tab >>Attention-Deficit/Hyperactivity Disorder, School Performance, and Effect of Medication
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2019 (English)In: Journal of the American Academy of Child and Adolescent Psychiatry, ISSN 0890-8567, E-ISSN 1527-5418, Vol. 58, no 4, p. 423-432Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: Individuals with attention-deficit/hyperactivity disorder (ADHD) are at increased risk for poor school performance, and pharmacological treatment of ADHD may have beneficial effects on school performance. Conclusions from previous research have been limited by small sample sizes, outcome measures, and treatment follow-up. The current study analyzed school performance in students with ADHD compared to students without ADHD, and the association between pharmacological treatment of ADHD and school performance.

METHOD: A linkage of Swedish national registers covering 657,720 students graduating from year 9 of compulsory school provided measures of school performance, electronically recorded dispensations of ADHD medication, and potentially confounding background factors such as parental socioeconomic status. Primary measures of school performance included student eligibility to upper secondary school and grade point sum.

RESULTS: ADHD was associated with substantially lower school performance independent of socioeconomic background factors. Treatment with ADHD medication for 3 months was positively associated with all primary outcomes, including a decreased risk of no eligibility to upper secondary school, odds ratio = 0.80, 95% confidence interval (CI) = 0.76-0.84, and a higher grade point sum (range, 0.0-320.0) of 9.35 points, 95% CI = 7.88-10.82; standardized coefficient = 0.20.

CONCLUSION: ADHD has a substantial negative impact on school performance, whereas pharmacological treatment for ADHD is associated with higher levels in several measures of school performance. Our findings emphasize the importance of detection and treatment of ADHD at an early stage to reduce the negative impact on school performance.

Place, publisher, year, edition, pages
Elsevier, 2019
Keywords
ADHD, medication, school performance, treatment
National Category
Public Health, Global Health, Social Medicine and Epidemiology Psychiatry
Identifiers
urn:nbn:se:oru:diva-73544 (URN)10.1016/j.jaac.2018.11.014 (DOI)000471838200008 ()30768391 (PubMedID)2-s2.0-85063357633 (Scopus ID)
Funder
Swedish Research Council, 2013-2280 538-2013-8864
Note

Funding Agencies:

Swedish Initiative for Research on Micro data in the Social and Medical Sciences (SIMSAM)  340-2013-5867 

National Institute of Mental Health  1R01MH102221 

Available from: 2019-04-08 Created: 2019-04-08 Last updated: 2019-07-22Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-6851-3297

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