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Research Review: The strength of the genetic overlap between ADHD and other psychiatric symptoms - a systematic review and meta-analysis
Örebro University, School of Medical Sciences.ORCID iD: 0000-0002-9375-6303
Örebro University, School of Law, Psychology and Social Work. Department of Psychology, University of Southern California, Los Angeles, CA, USA.ORCID iD: 0000-0001-8768-6954
Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Solna, Sweden.
Department of Medical Epidemiology and Biostatistics, Karolinska Institute, Solna, Sweden.
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2020 (English)In: Journal of Child Psychology and Psychiatry, ISSN 0021-9630, E-ISSN 1469-7610, Vol. 61, no 11, p. 1173-1183Article, review/survey (Refereed) Published
Abstract [en]

Background: Attention-deficit/hyperactivity disorder (ADHD) frequently co-occurs with other psychiatric disorders. Twin studies have established that these co-occurrences are in part due to shared genetic risks. However, the strength of these genetic overlaps and the potential heterogeneity accounted for by type of psychiatric symptoms, age, and methods of assessment remain unclear. We conducted a systematic review to fill this gap.

Methods: We searched PubMed, PsycINFO, Embase, and Web of Science until March 07, 2019. Genetic correlations (r(g)) were used as effect size measures.

Results: A total of 31 independent studies fulfilled the inclusion criteria. The pooled estimates showed that the associations between ADHD and other psychiatric symptoms were partly explained by shared genetic factors, with a pooled genetic correlation of 0.50, 95% confidence interval: 0.46-0.60. The genetic correlations (r(g)) between ADHD and externalizing (r(g) = .49 [0.37-0.61]), internalizing (r(g) = .50 [0.39-0.69]), and neurodevelopmental (r(g) = .56 [0.47-0.66]) symptoms were similar in magnitude. The genetic correlations in childhood and adulthood werer(g) = .53 (0.43-0.63) andr(g) = .51 (0.44-0.56), respectively. For methods of assessment, the genetic correlations were also similar in strength, self-reportsr(g) = .52 (0.47-0.58), other informantsr(g) = .55 (0.41-0.69), and combined ratersr(g) = .50 (0.33-0.65).

Conclusions: These findings indicate that the co-occurrence of externalizing, internalizing, and neurodevelopmental disorder symptoms in individuals with ADHD symptoms in part is due to a shared genetic risk.
Place, publisher, year, edition, pages
Blackwell Publishing, 2020. Vol. 61, no 11, p. 1173-1183
Keywords [en]
ADHD, externalizing, genetic, internalizing, neurodevelopmental, overlap, twins
National Category
Psychiatry
Identifiers
URN: urn:nbn:se:oru:diva-80610DOI: 10.1111/jcpp.13233ISI: 000562305600001PubMedID: 32157695Scopus ID: 2-s2.0-85081327389OAI: oai:DiVA.org:oru-80610DiVA, id: diva2:1414522
Funder
Swedish Research Council, 2018-01041 2018-02599The Swedish Brain Foundation, FO2018-0273Available from: 2020-03-13 Created: 2020-03-13 Last updated: 2023-08-28Bibliographically approved
In thesis
1. How is ADHD associated with comorbidities and health related outcomes?: The role of familial factors and ADHD during pregnancy
Open this publication in new window or tab >>How is ADHD associated with comorbidities and health related outcomes?: The role of familial factors and ADHD during pregnancy
2021 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Background: Attention-Deficit/Hyperactivity Disorder (ADHD) is a common neurodevelopmental disorder characterized by impaired attention and hyperactivity/impulsivity. ADHD is associated with several comorbidities and health-related outcomes. However, it is uncertain whether ADHD is more strongly associated with certain disorder domains, and whether ADHD-related comorbidities and health-related outcomes is important to consider during pregnancy. 

Aims: To expand the knowledge regarding the genetic overlap between ADHD and other psychiatric disorder symptoms, and to increase the awareness and understanding related to ADHD in women, with a focus on adverse health behaviors, mental health problems, and pregnancy outcomes. 

Methods: The present thesis includes one systematic review and metaanalysis (Study I), and three studies based on population-based register data from Sweden (Study II, III, and IV), and Norway (Study II).

Results: Individuals with ADHD have an increased liability to meet criteria for externalizing, internalizing and neurodevelopmental disordersymptoms, and these co-occurrences are partly due to shared genetic risks. Further, ADHD is an important risk factor to consider before, during and after pregnancy, as ADHD increases the risk of smoking during pregnancy, mental health problems postpartum, and adverse pregnancy outcomes.

Conclusions: The genetic overlaps between ADHD and other psychiatric disorder symptoms were similar across disorder dimensions. Further, results demonstrated that ADHD is an important risk factor to consider in women surrounding pregnancy. These findings point towards the importance of recognizing that women diagnosed with ADHD need to be prioritized and allowed more attention and support by the healthcare system, specifically during their fertile years. 
Place, publisher, year, edition, pages
Örebro: Örebro University, 2021. p. 49
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 238
Keywords
ADHD, Comorbidities, Health-Related, Pregnancy, Smoking, Psychiatric, Postpartum, Outcomes
National Category
General Practice
Identifiers
urn:nbn:se:oru:diva-90510 (URN)978-91-7529-386-8 (ISBN)
Public defence
2021-06-04, Örebro universitet, Campus USÖ, hörsal C1, Södra Grev Rosengatan 32, Örebro, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2021-03-17 Created: 2021-03-17 Last updated: 2021-06-03Bibliographically approved

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Andersson, AnneliTuvblad, CatherineLarsson, Henrik

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