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Sex Differences in Comorbidity Patterns of Attention-Deficit/Hyperactivity Disorder
National Centre for Register-based Research, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark; Centre for Integrated Register-based Research at Aarhus University (CIRRAU), Aarhus, Denmark.
National Centre for Register-based Research, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark; Centre for Integrated Register-based Research at Aarhus University (CIRRAU), Aarhus, Denmark.
SUNY Upstate Medical University, Syracuse, NY, and the K.G. Jebsen Centre for Research on Neuropsychiatric Disorders, University of Bergen, Norway.
Karolinska Institutet, Stockholm, Sweden.
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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. 412-422.e3Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: To investigate sex differences in associations between attention-deficit/hyperactivity disorder (ADHD) and a spectrum of comorbid disorders.

METHOD: The study population included all children born in Denmark from 1981 through 2013 (N = 1,665,729). Data were merged from Danish registers and information was obtained on birth characteristics, socioeconomic status, familial psychiatric history, and diagnoses of ADHD (n = 32,308) and comorbid disorders. To estimate absolute and relative risks of comorbid disorders, incidence rates and adjusted hazard ratios (HRs) with 95% CIs were calculated for female and male individuals. In addition, interactions between ADHD and sex in association with comorbid disorders were estimated as HR ratios (HRRs) in female and male individuals (95% CIs).

RESULTS: Individuals diagnosed with ADHD had significantly increased absolute and relative risks of all 12 comorbid psychiatric disorders investigated. ADHD-sex interactions were found for some comorbid disorders. Compared with male individuals, ADHD in female individuals showed a stronger association with autism spectrum disorder (HRR 1.86, 95% CI 1.62-2.14), oppositional defiant/conduct disorder (HRR 1.97, 95% CI 1.68-2.30), intellectual disability (HRR 1.79, 95% CI 1.54-2.09), personality disorders (HRR 1.23, 95% CI 1.06-1.43), schizophrenia (HRR 1.21, 95% CI 1.02-1.43), substance use disorders (HRR 1.21, 95% CI 1.07-1.38), and suicidal behavior (1.28, 95% CI 1.12-1.47). The remaining disorders showed no significant sex differences in association with ADHD.

CONCLUSION: This study indicates that the association between ADHD and several comorbid disorders is stronger in female than in male individuals. These important findings add to the literature on sex differences in ADHD and suggest that female individuals diagnosed with ADHD are a more vulnerable group of patients.

Place, publisher, year, edition, pages
Elsevier, 2019. Vol. 58, no 4, p. 412-422.e3
Keywords [en]
ADHD, comorbid disorders, sex differences
National Category
Psychiatry
Identifiers
URN: urn:nbn:se:oru:diva-73543DOI: 10.1016/j.jaac.2018.07.910ISI: 000471838200007PubMedID: 30768399Scopus ID: 2-s2.0-85063339757OAI: oai:DiVA.org:oru-73543DiVA, id: diva2:1303017
Note

Funding Agencies:

iPSYCH grant from the Lundbeck Foundation  

European Union  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: 2019-04-08 Created: 2019-04-08 Last updated: 2019-07-22Bibliographically approved

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Larsson, Henrik

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