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Associations Between Attention-Deficit/Hyperactivity Disorder (ADHD), ADHD Medication and Shorter Height: A Quasi-Experimental and Family-based Study
Örebro University, School of Medical Sciences.ORCID iD: 0000-0003-4206-8401
Örebro University, School of Medical Sciences.ORCID iD: 0000-0002-4811-2330
Karolinska Institutet, Stockholm, Sweden.
Karolinska Institutet, Stockholm, Sweden; Child and Adolescent Psychiatry Stockholm, Stockholm Health Care Services, Region Stockholm, Sweden.
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2023 (English)In: Journal of the American Academy of Child and Adolescent Psychiatry, ISSN 0890-8567, E-ISSN 1527-5418, Vol. 62, no 12, p. 1316-1325Article in journal (Refereed) Published
Abstract [en]

OBJECTIVE: The association between attention-deficit/hyperactivity disorder (ADHD) and shorter height is unclear. This study examined the risk of shorter height in individuals with ADHD, and the influence of prenatal factors, ADHD medication, psychiatric comorbidity, socioeconomic factors and familial liability.

METHOD: We draw on Swedish National Registers for two different study designs. First, height data for 14,268 individuals with ADHD and 71,339 controls were stratified into two groups: 1: Before and 2: After stimulant treatment were introduced in Sweden. Second, we used a family-based design including 833,172 relatives without ADHD with different levels of relatedness to the individuals with ADHD and matched controls.

RESULTS: ADHD was associated with shorter height both before (below average height: OR=1.31, 95 % CI=1.22-1.41) and after (below average height: OR=1.21, 95 % CI=1.13-1.31) stimulants for ADHD were introduced in Sweden and was of similar magnitude in both cohorts. The association between ADHD and shorter height attenuated after adjustment for prenatal factors, psychiatric disorders and SES. Relatives of individuals with ADHD had an increased risk of shorter height (below average height in full siblings: OR=1.14, 95 % CI=1.09-1.19; maternal half siblings: OR=1.10, 95 % CI=1.01-1.20; paternal half siblings: OR=1.15, 95 % CI=1.07-1.24, first full cousins: OR=1.10, 95 % CI=1.08-1.12).

CONCLUSION: Our findings suggest that ADHD is associated with shorter height. On a population level, this association was present both before and after ADHD-medications were available in Sweden. The association between ADHD and height was partly explained by prenatal factors, psychiatric comorbidity, low SES and a shared familial liability for ADHD.

Place, publisher, year, edition, pages
Elsevier, 2023. Vol. 62, no 12, p. 1316-1325
Keywords [en]
ADHD, ADHD medication, adult height
National Category
Psychiatry
Identifiers
URN: urn:nbn:se:oru:diva-105677DOI: 10.1016/j.jaac.2023.03.015ISI: 001131825800001PubMedID: 37084883Scopus ID: 2-s2.0-85159192997OAI: oai:DiVA.org:oru-105677DiVA, id: diva2:1752628
Funder
Swedish Research Council, 2017-00788; SLS-969059The Swedish Brain Foundation, FO2021-0115Region Stockholm, 2019-01172Forte, Swedish Research Council for Health, Working Life and Welfare, PD20-0036Available from: 2023-04-24 Created: 2023-04-24 Last updated: 2025-03-06Bibliographically approved
In thesis
1. The extent to which neurodevelopmental disorders are associated with functional and physical outcomes, and why?
Open this publication in new window or tab >>The extent to which neurodevelopmental disorders are associated with functional and physical outcomes, and why?
2025 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Attention-Deficit/Hyperactivity Disorder (ADHD) and Autism (ASD) are two neurodevelopmental conditions with early onset in the developmental period, high heritability and relatively high stability through the lifespan. The evi-dence base for these findings is considerable. Less researched, however, is the extent to which neurodevelopmental conditions are associated with func-tional and physical outcomes. The impact of ADHD/ASD on physical out-comes like height, obesity, and real-life functional outcomes such as relational instability, job shifting, and residential moves remain unclear. There is also a knowledge gap to what extent there is sex differences in these associations and if the associations are present through the life span. And lastly, a detailed un-derstanding about why these associations is present is also lacking. The overarching goal of this thesis was therefore to advance the understanding of the extent to which neurodevelopmental disorders are associated with functional and physical outcomes, and why. In study I-IV, we used data from Swedish population registers. We found that individuals with ASD and their relatives are at increased risk for obesity, and that the risk is partly familial in nature (study I). Further, our findings suggest that ADHD, rather than ADHD medication, is associated with shorter height and that the association between ADHD and shorter height is partly due to a shared familial liability (study II). We also found that both men and women (from young to older adulthood) with ADHD have a higher rate of residential moves, relational instability and job shifting (study III). Finally, we found that individuals with ADHD have an increased risk of sleeping disorders, from childhood to older adulthood (study IV).

The findings from this thesis highlight the importance of a life-span per-spective of neurodevelopmental disorders, and importantly - a focus that ex-tends beyond the core ADHD symptoms to include psychiatric and physical comorbidity as well as real-life functional outcomes. Thus, our findings also point to the need for integrated care between psychiatric and physical care and helping people with neurodevelopmental conditions to navigate across health care and social systems for their functional and physical problems.

Place, publisher, year, edition, pages
Örebro: Örebro University, 2025. p. 76
Series
Örebro Studies in Medicine, ISSN 1652-4063 ; 314
Keywords
ADHD, Autism, Functional impairments, Somatic problems
National Category
General Practice
Identifiers
urn:nbn:se:oru:diva-117316 (URN)9789175296289 (ISBN)9789175296296 (ISBN)
Public defence
2025-03-06, Örebro universitet, Campus USÖ, hörsal X1, Södra Grev Rosengatan 32, Örebro, 09:00 (Swedish)
Opponent
Supervisors
Available from: 2024-11-13 Created: 2024-11-13 Last updated: 2025-03-06Bibliographically approved

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Ahlberg, RickardGarcia-Argibay, MiguelLudvigsson, Jonas F.Larsson, Henrik

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