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Pérez-Vigil, A., Fernández de la Cruz, L., Brander, G., Isomura, K., Jangmo, A., Feldman, I., . . . Mataix-Cols, D. (2018). Association of Obsessive-Compulsive Disorder With Objective Indicators of Educational Attainment: A Nationwide Register-Based Sibling Control Study. JAMA psychiatry, 75(1), 47-55
Open this publication in new window or tab >>Association of Obsessive-Compulsive Disorder With Objective Indicators of Educational Attainment: A Nationwide Register-Based Sibling Control Study
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2018 (English)In: JAMA psychiatry, ISSN 2168-6238, E-ISSN 2168-622X, Vol. 75, no 1, p. 47-55Article in journal (Refereed) Published
Abstract [en]

Importance: To our knowledge, the association of obsessive-compulsive disorder (OCD) and academic performance has not been objectively quantified.

Objective: To investigate the association of OCD with objectively measured educational outcomes in a nationwide cohort, adjusting for covariates and unmeasured factors shared between siblings.

Design, Setting, And Participants: This population-based birth cohort study included 2 115 554 individuals who were born in Sweden between January 1, 1976, and December 31, 1998, and followed up through December 31, 2013. Using the Swedish National Patient Register and previously validated International Statistical Classification of Diseases and Related Health Problems, Tenth Revision (ICD-10) codes, we identified persons with OCD; within the cohort, we identified 726 198 families with 2 or more full siblings, and identified 11 482 families with full siblings discordant for OCD. Data analyses were conducted from October 1, 2016, to September 25, 2017.

Main Outcomes and Measures: The study evaluates the following educational milestones: eligibility to access upper secondary school after compulsory education, finishing upper secondary school, starting a university degree, finishing a university degree, and finishing postgraduate education.

Results: Of the 2 115 554 individuals in the cohort, 15 120 were diagnosed with OCD (59% females). Compared with unexposed individuals, those with OCD were significantly less likely to pass all core and additional courses at the end of compulsory school (adjusted odds ratio [aOR] range, 0.35-0.60) and to access a vocational or academic program in upper secondary education (aOR, 0.47; 95% CI, 0.45-0.50 and aOR, 0.61; 95% CI, 0.58-0.63, for vocational and academic programs, respectively). People with OCD were also less likely to finish upper secondary education (aOR, 0.43; 95% CI, 0.41-0.44), start a university degree (aOR, 0.72; 95% CI, 0.69-0.75), finish a university degree (aOR, 0.59; 95% CI, 0.56-0.62), and finish postgraduate education (aOR, 0.52; 95% CI, 0.36-0.77). The results were similar in the sibling comparison models. Individuals diagnosed with OCD before age 18 years showed worse educational attainment across all educational levels compared with those diagnosed at or after age 18 years. Exclusion of patients with comorbid neuropsychiatric disorders, psychotic, anxiety, mood, substance use, and other psychiatric disorders resulted in attenuated estimates, but patients with OCD were still impaired across all educational outcomes.

Conclusions and Relevance: Obsessive-compulsive disorder, particularly when it has an early onset, is associated with a pervasive and profound decrease in educational attainment, spanning from compulsory school to postgraduate education.

Place, publisher, year, edition, pages
Chicago, USA: American Medical Association, 2018
National Category
Psychiatry
Identifiers
urn:nbn:se:oru:diva-63024 (URN)10.1001/jamapsychiatry.2017.3523 (DOI)000419177700010 ()29141084 (PubMedID)
Funder
Swedish Research Council, K2013-61P-22168
Note

Funding Agencies:

International OCD Foundation  

Alicia Koplowitz Foundation  

Junior Researcher grant from the Swedish Research Council for Health, Working Life, and Welfare (FORTE grant)  2015-00569 

Karolinska Institutet PhD stipend (KID-funding) 

Available from: 2017-12-07 Created: 2017-12-07 Last updated: 2018-01-19Bibliographically approved
Wiggs, K. K., Chang, Z., Quinn, P. D., Hur, K., Gibbons, R., Dunn, D., . . . D'Onofrio, B. M. (2018). Attention-deficit/hyperactivity disorder medication and seizures. Neurology, 90(13), e1104-e1110
Open this publication in new window or tab >>Attention-deficit/hyperactivity disorder medication and seizures
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2018 (English)In: Neurology, ISSN 0028-3878, E-ISSN 1526-632X, Vol. 90, no 13, p. e1104-e1110Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: Individuals with attention-deficit/hyperactivity disorder (ADHD) are at increased risk of seizures, but there is uncertainty about whether ADHD medication treatment increases risk among patients with and without preexisting seizures.

METHODS: We followed a sample of 801,838 patients with ADHD who had prescribed drug claims from the Truven Health MarketScan Commercial Claims and Encounters databases to examine whether ADHD medication increases the likelihood of seizures among ADHD patients with and without a history of seizures. First, we assessed overall risk of seizures among patients with ADHD. Second, within-individual concurrent analyses assessed odds of seizure events during months when a patient with ADHD received ADHD medication compared with when the same individual did not, while adjusting for antiepileptic medications. Third, within-individual long-term analyses examined odds of seizure events in relation to the duration of months over the previous 2 years patients received medication.

RESULTS: Patients with ADHD were at higher odds for any seizure compared with non-ADHD controls (odds ratio [OR] = 2.33, 95% confidence interval [CI] = 2.24-2.42 males; OR = 2.31, 95% CI = 2.22-2.42 females). In adjusted within-individual comparisons, ADHD medication was associated with lower odds of seizures among patients with (OR = 0.71, 95% CI = 0.60-0.85) and without (OR = 0.71, 95% CI = 0.62-0.82) prior seizures. Long-term within-individual comparisons suggested no evidence of an association between medication use and seizures among individuals with (OR = 0.87, 95% CI = 0.59-1.30) and without (OR = 1.01, 95% CI = 0.80-1.28) a seizure history.

CONCLUSIONS: Results reaffirm that patients with ADHD are at higher risk of seizures. However, ADHD medication was associated with lower risk of seizures within individuals while they were dispensed medication, which is not consistent with the hypothesis that ADHD medication increases risk of seizures.

Place, publisher, year, edition, pages
AAN Publications, 2018
National Category
Psychiatry
Identifiers
urn:nbn:se:oru:diva-65286 (URN)10.1212/WNL.0000000000005213 (DOI)29476037 (PubMedID)
Available from: 2018-03-05 Created: 2018-03-05 Last updated: 2018-04-13Bibliographically approved
Taylor, M. J., Gustafsson, P., Larsson, H., Gillberg, C., Lundström, S. & Lichstenstein, P. (2018). Examining the Association Between Autistic Traits and Atypical Sensory Reactivity: A Twin Study. Journal of the American Academy of Child and Adolescent Psychiatry, 57(2), 96-102
Open this publication in new window or tab >>Examining the Association Between Autistic Traits and Atypical Sensory Reactivity: A Twin Study
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2018 (English)In: Journal of the American Academy of Child and Adolescent Psychiatry, ISSN 0890-8567, E-ISSN 1527-5418, Vol. 57, no 2, p. 96-102Article in journal (Refereed) Published
Abstract [en]

Objective: Atypical responses to sensory stimuli are common features of autism spectrum disorders (ASD). Consequently, atypical sensory reactivity (SR) is now a diagnostic feature of ASD. Quantitative genetic research on ASD has overlooked these symptoms, however. We therefore investigated the association between autistic traits and SR using twin methods.

Method: Autistic traits and SR were assessed by 2 separate scales in 12,419 Swedish twin pairs (n = 3,586 monozygotic [MZ], n = 8,833 dizygotic [DZ]) when the twins were 9 or 12 years of age. The classic twin design estimated the degree to which etiological factors associated with autistic traits were also associated with SR, and the degree to which such shared factors explained the covariance between these phenotypes. DeFries Fulker analysis estimated the genetic correlation between screening diagnoses of ASD, defined broadly and strictly, and SR.

Results: Autistic traits and SR were both highly heritable (62%-75% and 66%-71%, respectively). There was a moderate phenotypic correlation between autistic traits and SR (r = 0.47). Genetic influences on these phenotypes correlated moderately (genetic correlation = 0.60). These overlapping genetic factors explained most of the correlation between autistic traits and SR. Genetic correlations with SR increased for broad ASD (genetic correlation = 0.72) and strict ASD (genetic correlation = 0.80).

Conclusion: The genetic overlap observed between autistic traits and SR lends quantitative genetic support to the notion that ASD and SR are strongly linked. Stich symptoms may thus comprise part of the ASD genotype, as well as phenotype. Associations persisted across all definitions of ASD, indicating a genetic link between the broader ASD phenotype and SR.

Place, publisher, year, edition, pages
Elsevier, 2018
Keyword
autism, twin study, sensory reactivity, genetics
National Category
Psychiatry Pediatrics
Identifiers
urn:nbn:se:oru:diva-65028 (URN)10.1016/j.jaac.2017.11.019 (DOI)000424074800009 ()2-s2.0-85041181247 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and WelfareSwedish Research Council
Note

Funding Agencies:

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

Ann Marie and Per Ahlqvist Foundation 

Available from: 2018-02-16 Created: 2018-02-16 Last updated: 2018-02-16Bibliographically approved
Brikell, I., Ghirardi, L., D'Onofrio, B. M., Dunn, D. W., Almqvist, C., Dalsgaard, S., . . . Larsson, H. (2018). Familial Liability to Epilepsy and Attention-Deficit/Hyperactivity Disorder: A Nationwide Cohort Study. Biological Psychiatry, 83(2), 173-180
Open this publication in new window or tab >>Familial Liability to Epilepsy and Attention-Deficit/Hyperactivity Disorder: A Nationwide Cohort Study
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2018 (English)In: Biological Psychiatry, ISSN 0006-3223, E-ISSN 1873-2402, Vol. 83, no 2, p. 173-180Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Epilepsy and attention-deficit/hyperactivity disorder (ADHD) are strongly associated; however, the underlying factors contributing to their co-occurrence remain unclear. A shared genetic liability has been proposed as one possible mechanism. Therefore, our goal in this study was to investigate the familial coaggregation of epilepsy and ADHD and to estimate the contribution of genetic and environmental risk factors to their co-occurrence.

METHODS: We identified 1,899,654 individuals born between 1987 and 2006 via national Swedish registers and linked each individual to his or her biological relatives. We used logistic regression to estimate the association between epilepsy and ADHD within individual and across relatives. Quantitative genetic modeling was used to decompose the cross-disorder covariance into genetic and environmental factors.

RESULTS: Individuals with epilepsy had a statistically significant increased risk of ADHD (odds ratio [OR] = 3.47, 95% confidence interval [CI] = 3.33-3.62). This risk increase extended to children whose mothers had epilepsy (OR = 1.85, 95% CI = 1.75-1.96), children whose fathers had epilepsy (OR = 1.64, 95% CI = 1.54-1.74), full siblings (OR = 1.56, 95% CI = 1.46-1.67), maternal half siblings (OR = 1.28, 95% CI = 1.14-1.43), paternal half siblings (OR = 1.10, 95% CI = 0.96-1.25), and cousins (OR = 1.15, 95% CI = 1.10-1.20). The genetic correlation was 0.21 (95% CI = 0.02-0.40) and explained 40% of the phenotypic correlation between epilepsy and ADHD, with the remaining variance largely explained by nonshared environmental factors (49%, nonshared environmental correlation = 0.36, 95% CI = 0.23-0.49). The contribution of shared environmental factors to the cross-disorder overlap was not statistically significant (11%, shared environmental correlation = 0.32, 95% CI = 20.16-0.79).

CONCLUSIONS: This study demonstrates a strong and etiologically complex association between epilepsy and ADHD, with shared familial factors and risk factors unique to the individual contributing to co-occurrence of the disorders. Our findings suggest that epilepsy and ADHD may share less genetic risk as compared with other neurodevelopmental disorders.

Place, publisher, year, edition, pages
Elsevier, 2018
Keyword
ADHD, Comorbidity, Epilepsy, Genetics, Neurodevelopment, Risk factors
National Category
Neurology Psychiatry
Identifiers
urn:nbn:se:oru:diva-63770 (URN)10.1016/j.biopsych.2017.08.006 (DOI)000417608300014 ()28950988 (PubMedID)2-s2.0-85029753462 (Scopus ID)
Funder
Swedish Research Council, 2013-2280 2014-3831
Note

Funding Agencies:

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

National Institute of Mental Health  1R01MH102221 

Available from: 2018-01-03 Created: 2018-01-03 Last updated: 2018-01-03Bibliographically approved
Rydell, M., Lundström, S., Gillberg, C., Lichtenstein, P. & Larsson, H. (2018). Has the attention deficit hyperactivity disorder phenotype become more common in children between 2004 and 2014? Trends over 10 years from a Swedish general population sample. Journal of Child Psychology and Psychiatry and Allied Disciplines
Open this publication in new window or tab >>Has the attention deficit hyperactivity disorder phenotype become more common in children between 2004 and 2014? Trends over 10 years from a Swedish general population sample
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2018 (English)In: Journal of Child Psychology and Psychiatry and Allied Disciplines, ISSN 0021-9630, E-ISSN 1469-7610Article in journal (Refereed) Epub ahead of print
Abstract [en]

BACKGROUND: Studies have reported increases in clinically diagnosed and treated attention deficit hyperactivity disorder (ADHD) during the last decade, but it is unclear if this reflects an increase in the underlying ADHD phenotype. We aimed to clarify if there has been an increase in the prevalence of ADHD-like traits in the general population from 2004 to 2014.

METHOD: Data were collected from 9-year-old twins (19,271), participating in the population-based Child and Adolescent Twin Study in Sweden between 2004 and 2014. We assessed lifetime ADHD symptoms using the Autism-Tics, ADHD and other Comorbidities inventory. Research proxies for diagnostic-level ADHD and subthreshold ADHD were derived from this scale. We modeled the lifetime prevalence of diagnostic-level and subthreshold ADHD with logistic regression, and assessed mean ADHD scores each year with linear regression. Lifetime prevalence of clinically diagnosed ADHD was retrieved from the National Patient Register and modeled with logistic regression.

RESULTS: The prevalence of diagnostic-level ADHD based on parent ratings did not differ significantly over time from 2004 to 2014 (OR 1.37; 95% CI: 0.77-2.45; p-value .233). Both subthreshold ADHD and mean ADHD scores increased significantly over time (both p-values <.001). Clinically diagnosed ADHD increased more than fivefold from 2004 to 2014 (OR 5.27, 95% CI: 1.85-14.96).

CONCLUSIONS: We found no evidence of an increase in ADHD-like traits at the extreme end of the distribution from 2004 to 2014, but small increases in normal and subthreshold variations of ADHD-like traits were observed. This suggests that the increased rates of clinically diagnosed ADHD might reflect changes in diagnostic and treatment practices of ADHD, administrative changes in reporting diagnoses, greater awareness of ADHD, better access to healthcare, or current overdiagnosis, rather than an increase in the ADHD phenotype.

Keyword
ADHD, epidemiology, lifetime prevalence, time trends
National Category
Psychiatry
Identifiers
urn:nbn:se:oru:diva-65448 (URN)10.1111/jcpp.12882 (DOI)29484650 (PubMedID)
Available from: 2018-03-05 Created: 2018-03-05 Last updated: 2018-03-05Bibliographically approved
Brew, B. K., Lundholm, C., Viktorin, A., Lichtenstein, P., Larsson, H. & Almqvist, C. (2018). Longitudinal depression or anxiety in mothers and offspring asthma: a Swedish population-based study. International Journal of Epidemiology, 47(1), 166-174
Open this publication in new window or tab >>Longitudinal depression or anxiety in mothers and offspring asthma: a Swedish population-based study
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2018 (English)In: International Journal of Epidemiology, ISSN 0300-5771, E-ISSN 1464-3685, Vol. 47, no 1, p. 166-174Article in journal (Refereed) Published
Abstract [en]

Background: Previous research has found that maternal stress during pregnancy increases the risk of offspring asthma. However, whether this association is consistent with a causal interpretation has never been tested. The objective is to determine whether there is a critical exposure period for maternal depression or anxiety on offspring asthma or whether cumulative exposure is most important, and to investigate evidence of confounding.

Methods: The study population included all children born in Sweden from July 2006 to December 2009 (n = 360 526). Information about childhood asthma, maternal depression or anxiety (diagnosis or medication) and covariates was obtained from the Swedish national health registers. The associations between exposure periods (pre-conception, pregnancy, postnatal or current) and childhood asthma were estimated using structured life course approach hypothesis testing. Paternal and cousin analyses were used to test for evidence of confounding from shared genes and environment.

Results: For childhood asthma, cumulative exposure best described the effect of exposure to maternal depression or anxiety up to a maximum of any two exposure periods [adjusted odds ratio 1.44, 95% confidence interval (CI) 1.38, 1.52]. The hypotheses of a critical period were not supported. The paternal and cousin analyses indicated minimal influence from familial confounding.

Conclusions: These findings support an association between cumulative exposure to maternal depression or anxiety and asthma development in offspring. This association is unique for maternal depression or anxiety and not due to familial confounding. The clinical implication is that effective psychological management of women with chronic distress may reduce offspring asthma risk.

Place, publisher, year, edition, pages
Oxford University Press, 2018
Keyword
Asthma, anxiety, children, depression, mothers
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:oru:diva-62418 (URN)10.1093/ije/dyx208 (DOI)000426148300029 ()29040553 (PubMedID)2-s2.0-85042681005 (Scopus ID)
Funder
Swedish Heart Lung FoundationForte, Swedish Research Council for Health, Working Life and Welfare
Note

Funding Agencies:

Swedish Research Council through the Swedish Initiative for research on Microdata in the Social And Medical sciences (SIMSAM)  340-2013-5867

Swedish Asthma and Allergy Association's Research Foundation  

Stockholm County Council (ALF project) 

Commission under a COFAS Marie Curie Fellowship  2015-01208

Available from: 2017-12-11 Created: 2017-12-11 Last updated: 2018-03-15Bibliographically approved
Beckman, K., Mittendorfer-Rutz, E., Waern, M., Larsson, H., Runeson, B. & Dahlin, M. (2018). Method of self-harm in adolescents and young adults and risk of subsequent suicide. Journal of Child Psychology and Psychiatry and Allied Disciplines
Open this publication in new window or tab >>Method of self-harm in adolescents and young adults and risk of subsequent suicide
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2018 (English)In: Journal of Child Psychology and Psychiatry and Allied Disciplines, ISSN 0021-9630, E-ISSN 1469-7610Article in journal (Refereed) Epub ahead of print
Abstract [en]

BACKGROUND: Self-harm is common in youth and an important risk factor for suicide. Certain self-harm methods might indicate a higher risk of suicide. The main aim of this study was to determine whether some methods of self-harm in adolescents (10-17 years) and young adults (18-24 years) are associated with a particularly high risk of suicide. A secondary aim was to ascertain how different self-harm methods might affect the probability of psychiatric follow-up.

METHOD: Five Swedish registers were linked in a national population-based cohort study. All nonfatal self-harm events recorded in specialist health care, excluding psychiatry and primary care services, among 10-24 year olds between 2000 and 2009 were included. Methods were classified as poisoning, cutting/piercing, violent method (gassing, hanging, strangulation/suffocation, drowning, jumping and firearms), other and multiple methods. Hazard Ratios (HR) for suicide were calculated in Cox regression models for each method with poisoning as the reference. Odds Ratios (OR) for psychiatric inpatient care were determined in logistic regression models. Analyses were adjusted for important covariates and stratified by age group and treatment setting (inpatient/outpatient).

RESULTS: Among adolescents with initial medical hospitalisation, use of a violent method was associated with a near eightfold increase in HR for suicide compared to self-poisoning in the adjusted analysis [HR 7.8; 95% confidence interval (CI) 3.2-19.0]. Among hospitalised young adult women, adjusted HRs were elevated fourfold for both cutting [4.0 (1.9-8.8)] and violent methods [3.9 (1.5-10.6)]. Method of self-harm did not affect suicide risk in young adult men. Adolescents using violent methods had an increased probability of psychiatric inpatient care following initial treatment for self-harm.

CONCLUSIONS: Violent self-harm requiring medical hospitalisation may signal particularly high risk of future suicide in adolescents (both sexes) and in young adult women. For the latter group this is the case for cutting requiring hospitalisation as well.

Keyword
Adolescence, epidemiology, mental health, self-harm, suicide
National Category
Psychiatry
Identifiers
urn:nbn:se:oru:diva-65572 (URN)10.1111/jcpp.12883 (DOI)29504652 (PubMedID)
Available from: 2018-03-08 Created: 2018-03-08 Last updated: 2018-03-08Bibliographically approved
Wolf, A., Fanshawe, T. R., Sariaslan, A., Cornish, R., Larsson, H. & Fazel, S. (2018). Prediction of violent crime on discharge from secure psychiatric hospitals: A clinical prediction rule (FoVOx). European psychiatry, 47, 88-93
Open this publication in new window or tab >>Prediction of violent crime on discharge from secure psychiatric hospitals: A clinical prediction rule (FoVOx)
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2018 (English)In: European psychiatry, ISSN 0924-9338, E-ISSN 1778-3585, Vol. 47, p. 88-93Article in journal (Refereed) Published
Abstract [en]

Background: Current approaches to assess violence risk in secure hospitals are resource intensive, limited by accuracy and authorship bias and may have reached a performance ceiling. This study seeks to develop scalable predictive models for violent offending following discharge from secure psychiatric hospitals.

Methods: We identified all patients discharged from secure hospitals in Sweden between January 1, 1992 and December 31, 2013. Using multiple Cox regression, pre-specified criminal, sociodemographic, and clinical risk factors were included in a model that was tested for discrimination and calibration in the prediction of violent crime at 12 and 24 months post-discharge. Risk cut-offs were pre-specified at 5% (low vs. medium) and 20% (medium vs. high).

Results: We identified 2248 patients with 2933 discharges into community settings. We developed a 12-item model with good measures of calibration and discrimination (area under the curve = 0.77 at 12 and 24 months). At 24 months post-discharge, using the 5% cut-off, sensitivity was 96% and specificity was 21%. Positive and negative predictive values were 19% and 97%, respectively. Using the 20% cut-off, sensitivity was 55%, specificity 83% and the positive and negative predictive values were 37% and 91%, respectively. The model was used to develop a free online tool (FoVOx).

Interpretation: We have developed a prediction score in a Swedish cohort of patients discharged from secure hospitals that can assist in clinical decision-making. Scalable predictive models for violence risk are possible in specific patient groups and can free up clinical time for treatment and management. Further evaluation in other countries is needed.

Funding: Wellcome Trust (202836/Z/16/Z) and the Swedish Research Council. The funding sources had no involvement in writing of the manuscript or decision to submit or in data collection, analysis or interpretation or any aspect pertinent to the study.

Place, publisher, year, edition, pages
Elsevier, 2018
Keyword
Forensic psychiatry, Violence, Psychometry and assessments in psychiatry, Risk assessment, Crime, Secure hospital, Clinical prediction
National Category
Psychiatry
Identifiers
urn:nbn:se:oru:diva-64527 (URN)10.1016/j.eurpsy.2017.07.011 (DOI)000419527700013 ()29161680 (PubMedID)2-s2.0-85034666587 (Scopus ID)
Funder
Wellcome trust, 202836/Z/16/ZSwedish Research Council
Available from: 2018-01-25 Created: 2018-01-25 Last updated: 2018-01-25Bibliographically approved
Martin, J., Taylor, M. J., Rydell, M., Riglin, L., Eyre, O., Lu, Y., . . . Lichtenstein, P. (2018). Sex-specific manifestation of genetic risk for attention deficit hyperactivity disorder in the general population. Journal of Child Psychology and Psychiatry and Allied Disciplines
Open this publication in new window or tab >>Sex-specific manifestation of genetic risk for attention deficit hyperactivity disorder in the general population
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2018 (English)In: Journal of Child Psychology and Psychiatry and Allied Disciplines, ISSN 0021-9630, E-ISSN 1469-7610Article in journal (Refereed) Epub ahead of print
Abstract [en]

BACKGROUND: Attention deficit hyperactivity disorder (ADHD) is more commonly diagnosed in males than in females. A growing body of research suggests that females with ADHD might be underdiagnosed or receive alternative diagnoses, such as anxiety or depression. Other lines of reasoning suggest that females might be protected from developing ADHD, requiring a higher burden of genetic risk to manifest the disorder.

METHODS: We tested these two hypotheses, using common variant genetic data from two population-based cohorts. First, we tested whether females and males diagnosed with anxiety or depression differ in terms of their genetic risk for ADHD, assessed as polygenic risk scores (PRS). Second, we tested whether females and males with ADHD differed in ADHD genetic risk burden. We used three different diagnostic definitions: registry-based clinical diagnoses, screening-based research diagnoses and algorithm-based research diagnoses, to investigate possible referral biases.

RESULTS: In individuals with a registry-based clinical diagnosis of anxiety or depression, females had higher ADHD PRS than males [OR(CI) = 1.39 (1.12-1.73)] but there was no sex difference for screening-based [OR(CI) = 1.15 (0.94-1.42)] or algorithm-based [OR(CI) = 1.04 (0.89-1.21)] diagnoses. There was also no sex difference in ADHD PRS in individuals with ADHD diagnoses that were registry-based [OR(CI) = 1.04 (0.84-1.30)], screening-based [OR(CI) = 0.96 (0.85-1.08)] or algorithm-based [OR(CI) = 1.15 (0.78-1.68)].

CONCLUSIONS: This study provides genetic evidence that ADHD risk may be more likely to manifest or be diagnosed as anxiety or depression in females than in males. Contrary to some earlier studies, the results do not support increased ADHD genetic risk in females with ADHD as compared to affected males.

Place, publisher, year, edition, pages
Blackwell Publishing, 2018
Keyword
ADHD, ALSPAC, CATSS, anxiety, depression, genetics
National Category
Psychiatry
Identifiers
urn:nbn:se:oru:diva-65198 (URN)10.1111/jcpp.12874 (DOI)29451303 (PubMedID)
Available from: 2018-02-23 Created: 2018-02-23 Last updated: 2018-02-23Bibliographically approved
Brew, B. K., Lundholm, C., Gong, T., Larsson, H. & Almqvist, C. (2018). The familial aggregation of atopic diseases and depression or anxiety in children. Clinical and Experimental Allergy
Open this publication in new window or tab >>The familial aggregation of atopic diseases and depression or anxiety in children
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2018 (English)In: Clinical and Experimental Allergy, ISSN 0954-7894, E-ISSN 1365-2222Article in journal (Refereed) Epub ahead of print
Abstract [en]

BACKGROUND: Children with asthma and atopic diseases have an increased risk of depression or anxiety. Each of these diseases have strong genetic and environmental components, therefore it seems likely that there is a shared liability rather than causative risk.

OBJECTIVE: To investigate the existence and nature of familial aggregation for the comorbidity of atopic diseases and depression or anxiety.

METHODS: Participants came from the Childhood and Adolescent Twin Study in Sweden (CATSS), n= 14197. Current and ever asthma, eczema, hayfever and food-allergy were reported by parents. Internalizing disorders were identified using validated questionnaires. Familial co-aggregation analysis compared monozygotic MZ twins and same-sex dizygotic DZ twins for atopic disease in one 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.

RESULTS: Familial co-aggregation analysis found that if one twin had at least one current atopic disease the partner twin was at risk of having an internalizing disorder regardless of their own atopic status (Adjusted OR 1.22 (95% CI 1.08, 1.37). Similar results were found for each atopic disease ever and current. MZ associations were not higher than DZ associations suggesting that the liability is not genetic in nature. Including other familial candidates to the models made little difference to effect estimates.

CONCLUSIONS AND CLINICAL RELEVANCE: Atopic diseases and depression or anxiety tend to occur together in families, therefore when treating for one 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.

National Category
Psychiatry
Identifiers
urn:nbn:se:oru:diva-65571 (URN)10.1111/cea.13127 (DOI)29513367 (PubMedID)
Available from: 2018-03-08 Created: 2018-03-08 Last updated: 2018-03-08Bibliographically approved
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Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-6851-3297

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