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Martin J, Langley K, Cooper M, Rouquette OY, John A, Sayal K, Ford T, Thapar A. Sex differences in attention-deficit hyperactivity disorder diagnosis and clinical care: a national study of population healthcare records in Wales. J Child Psychol Psychiatry 2024. [PMID: 38864317 DOI: 10.1111/jcpp.13987] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 02/22/2024] [Indexed: 06/13/2024]
Abstract
BACKGROUND Population-based studies have observed sex biases in the diagnosis and treatment of attention-deficit hyperactivity disorder (ADHD). Females are less likely to be diagnosed or prescribed ADHD medication. This study uses national healthcare records, to investigate sex differences in diagnosis and clinical care in young people with ADHD, particularly regarding recognition and treatment of other mental health conditions. METHODS The cohort included individuals diagnosed with ADHD, born between 1989 and 2013 and living in Wales between 2000 and 2019. Routine primary and secondary healthcare record data were used to derive diagnoses of ADHD and other neurodevelopmental and mental health conditions, as well as ADHD and antidepressant medications. Demographic variables included ethnicity, socioeconomic deprivation and contact with social services. RESULTS There were 16,458 individuals diagnosed with ADHD (20.3% females, ages 3-30 years), with a male-to-female ratio of 3.9:1. Higher ratios (4.8:1) were seen in individuals diagnosed younger (<12 years), with the lowest ratio (1.9:1) in those diagnosed as adults (>18). Males were younger at first recorded ADHD diagnosis (mean = 10.9 vs. 12.6 years), more likely to be prescribed ADHD medication and younger at diagnosis of co-occurring neurodevelopmental conditions. In contrast, females were more likely to receive a diagnosis of anxiety, depression or another mental health condition and to be prescribed antidepressant medications, prior to ADHD diagnosis. These sex differences were largely stable across demographic groups. CONCLUSIONS This study adds to the evidence base that females with ADHD are experiencing later recognition and treatment of ADHD. The results indicate that this may be partly because of diagnostic overshadowing from other mental health conditions, such as anxiety and depression, or initial misdiagnosis. Further research and dissemination of findings to the public are needed to improve awareness, timely diagnosis and treatment of ADHD in females.
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Affiliation(s)
- Joanna Martin
- Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
- Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK
| | - Kate Langley
- School of Psychology, Cardiff University, Cardiff, UK
| | - Miriam Cooper
- Neurodevelopmental Service, Cwm Taf Morgannwg University Health Board, Merthyr Tydfil, UK
| | - Olivier Y Rouquette
- Institute of Suicide Prevention and Mental Health, Swansea University, Swansea, UK
| | - Ann John
- Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
- Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK
- Institute of Suicide Prevention and Mental Health, Swansea University, Swansea, UK
| | - Kapil Sayal
- Centre for ADHD and Neurodevelopmental Disorders Across the Lifespan, Institute of Mental Health, Nottingham, UK
- Unit of Mental Health and Clinical Neurosciences, School of Medicine, University of Nottingham, Nottingham, UK
| | - Tamsin Ford
- Department of Psychiatry, University of Cambridge, Cambridge, UK
| | - Anita Thapar
- Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
- Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK
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2
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Patel KHS, Walters GB, Stefánsson H, Stefánsson K, Degenhardt F, Nothen M, Van Der Veen T, Demontis D, Borglum A, Kristiansen M, Bass NJ, McQuillin A. Predicting ADHD in alcohol dependence using polygenic risk scores for ADHD. Am J Med Genet B Neuropsychiatr Genet 2024; 195:e32967. [PMID: 37946686 PMCID: PMC11076171 DOI: 10.1002/ajmg.b.32967] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2023] [Revised: 09/15/2023] [Accepted: 10/24/2023] [Indexed: 11/12/2023]
Abstract
Attention deficit hyperactivity disorder (ADHD) is a neurodevelopmental disorder with a high degree of comorbidity, including substance misuse. We aimed to assess whether ADHD polygenic risk scores (PRS) could predict ADHD diagnosis in alcohol dependence (AD). ADHD PRS were generated for 1223 AD subjects with ADHD diagnosis information and 1818 healthy controls. ADHD PRS distributions were compared to evaluate the differences between healthy controls and AD cases with and without ADHD. We found increased ADHD PRS means in the AD cohort with ADHD (mean 0.30, standard deviation (SD) 0.92; p = 3.9 × 10-6); and without ADHD (mean - 0.00, SD 1.00; p = 5.2 × 10-5) compared to the healthy control subjects (mean - 0.17, SD 0.99). The ADHD PRS means differed within the AD group with a higher ADHD PRS mean in those with ADHD, odds ratio (OR) 1.34, confidence interval (CI) 1.10 to 1.65; p = 0.002. This study showed a positive relationship between ADHD PRS and risk of ADHD in individuals with co-occurring AD indicating that ADHD PRS may have utility in identifying individuals that are at a higher or lower risk of ADHD. Further larger studies need to be conducted to confirm the reliability of the results before ADHD PRS can be considered as a robust biomarker for diagnosis.
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Affiliation(s)
- Kejal H S Patel
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK
| | - G Bragi Walters
- deCODE genetics/Amgen, Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | | | - Kári Stefánsson
- deCODE genetics/Amgen, Reykjavik, Iceland
- Faculty of Medicine, University of Iceland, Reykjavík, Iceland
| | - Franziska Degenhardt
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, LVR Klinikum Essen, University of Duisburg-Essen, Essen, Germany
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital, Bonn, Germany
| | - Markus Nothen
- Institute of Human Genetics, University of Bonn, School of Medicine & University Hospital, Bonn, Germany
| | - Tracey Van Der Veen
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK
| | - Ditte Demontis
- Department of Biomedicine-Human Genetics, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Center for Genomics and Personalized Medicine, Aarhus, Denmark
| | - Anders Borglum
- Department of Biomedicine-Human Genetics, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- Center for Genomics and Personalized Medicine, Aarhus, Denmark
| | - Mark Kristiansen
- University College London Genomics, Institute of Child Health, University College London, London, UK
| | - Nicholas J Bass
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK
| | - Andrew McQuillin
- Molecular Psychiatry Laboratory, Division of Psychiatry, University College London, London, UK
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3
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Van Schependom J, Baetens K, Nagels G, Olmi S, Beste C. Neurophysiological avenues to better conceptualizing adaptive cognition. Commun Biol 2024; 7:626. [PMID: 38789522 PMCID: PMC11126671 DOI: 10.1038/s42003-024-06331-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2024] [Accepted: 05/14/2024] [Indexed: 05/26/2024] Open
Abstract
We delve into the human brain's remarkable capacity for adaptability and sustained cognitive functioning, phenomena traditionally encompassed as executive functions or cognitive control. The neural underpinnings that enable the seamless navigation between transient thoughts without detracting from overarching goals form the core of our article. We discuss the concept of "metacontrol," which builds upon conventional cognitive control theories by proposing a dynamic balancing of processes depending on situational demands. We critically discuss the role of oscillatory processes in electrophysiological activity at different scales and the importance of desynchronization and partial phase synchronization in supporting adaptive behavior including neural noise accounts, transient dynamics, phase-based measures (coordination dynamics) and neural mass modelling. The cognitive processes focused and neurophysiological avenues outlined are integral to understanding diverse psychiatric disorders thereby contributing to a more nuanced comprehension of cognitive control and its neural bases in both health and disease.
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Affiliation(s)
- Jeroen Van Schependom
- AIMS Lab, Center for Neurosciences, Vrije Universiteit Brussel, Brussels, Belgium
- Department of Electronics and Informatics (ETRO), Vrije Universiteit Brussel, Brussels, Belgium
| | - Kris Baetens
- Brain, Body and Cognition, Vrije Universiteit Brussel, Brussels, Belgium
| | - Guy Nagels
- AIMS Lab, Center for Neurosciences, Vrije Universiteit Brussel, Brussels, Belgium
- UZ Brussel, Department of Neurology, Brussels, Belgium
- St Edmund Hall, University of Oxford, Oxford, United Kingdom
| | - Simona Olmi
- CNR-Consiglio Nazionale delle Ricerche - Istituto dei Sistemi Complessi, Sesto Fiorentino, Italy
| | - Christian Beste
- Cognitive Neurophysiology, Department of Child and Adolescent Psychiatry, Faculty of Medicine, TU Dresden, Dresden, Germany.
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4
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Maher BS, Bitsko RH, Claussen AH, O'Masta B, Cerles A, Holbrook JR, Mahmooth Z, Chen-Bowers N, Rojo ALA, Kaminski JW, Rush M. Systematic Review and Meta-analysis of the Relationship Between Exposure to Parental Substance Use and Attention-Deficit/Hyperactivity Disorder in Children. PREVENTION SCIENCE : THE OFFICIAL JOURNAL OF THE SOCIETY FOR PREVENTION RESEARCH 2024; 25:291-315. [PMID: 37976008 PMCID: PMC11098969 DOI: 10.1007/s11121-023-01605-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/17/2023] [Indexed: 11/19/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is characterized by persistent patterns of inattention, hyperactivity, and impulsiveness. Among US children and adolescents aged 3-17 years, 9.4% have a diagnosis of ADHD. Previous research suggests possible links between parental substance use and ADHD among children. We conducted a systematic review and meta-analysis of 86 longitudinal or retrospective studies of prenatal or postnatal alcohol, tobacco, or other parental substance use and substance use disorders and childhood ADHD and its related behavioral dimensions of inattention and hyperactivity-impulsivity. Meta-analyses were grouped by drug class and pre- and postnatal periods with combined sample sizes ranging from 789 to 135,732. Prenatal exposure to alcohol or tobacco and parent substance use disorders were consistently and significantly associated with ADHD among children. Other parental drug use exposures resulted in inconsistent or non-significant findings. Prevention and treatment of parental substance use may have potential for impacts on childhood ADHD.
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Affiliation(s)
- Brion S Maher
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Rebecca H Bitsko
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Angelika H Claussen
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | | | - Joseph R Holbrook
- Division of Human Development and Disability, National Center on Birth Defects and Developmental Disabilities, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Naomi Chen-Bowers
- Office Policy, Performance, and Evaluation, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop: H 21-11, Atlanta, GA, 30329, USA
| | | | - Jennifer W Kaminski
- Office Policy, Performance, and Evaluation, Centers for Disease Control and Prevention, 1600 Clifton Road NE, Mailstop: H 21-11, Atlanta, GA, 30329, USA.
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5
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Martin J. Why are females less likely to be diagnosed with ADHD in childhood than males? Lancet Psychiatry 2024; 11:303-310. [PMID: 38340761 DOI: 10.1016/s2215-0366(24)00010-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2023] [Revised: 01/09/2024] [Accepted: 01/10/2024] [Indexed: 02/12/2024]
Abstract
ADHD is less likely to be diagnosed in females than males, especially in childhood. Females also typically receive the diagnosis later than males and are less likely to be prescribed ADHD medication. Understanding why these sex differences in clinical care and treatment for ADHD occur is key to improving timely diagnosis in people affected by ADHD. This Personal View is a conceptual review synthesising literature on this topic. This publication considers potential biological explanations (eg, genetic factors), influence of diagnostic practices (eg, criteria suitability, diagnostic overshadowing, and sex-specific diagnostic thresholds), and sociocultural explanations (eg, sex differences in presentation and compensatory behaviours), for the observed sex differences in ADHD clinical practice. This Personal View also outlines future research directions for improving understanding of sex differences in recognition and diagnosis of ADHD.
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Affiliation(s)
- Joanna Martin
- Centre for Neuropsychiatric Genetics and Genomics and Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK.
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6
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Koller D, Mitjans M, Kouakou M, Friligkou E, Cabrera-Mendoza B, Deak JD, Llonga N, Pathak GA, Stiltner B, Løkhammer S, Levey DF, Zhou H, Hatoum AS, Kember RL, Kranzler HR, Stein MB, Corominas R, Demontis D, Artigas MS, Ramos-Quiroga JA, Gelernter J, Ribasés M, Cormand B, Polimanti R. Genetic contribution to the comorbidity between attention-deficit/hyperactivity disorder and substance use disorders. Psychiatry Res 2024; 333:115758. [PMID: 38335780 PMCID: PMC11157987 DOI: 10.1016/j.psychres.2024.115758] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/27/2023] [Revised: 01/17/2024] [Accepted: 01/23/2024] [Indexed: 02/12/2024]
Abstract
We characterized the genetic architecture of the attention-deficit hyperactivity disorder-substance use disorder (ADHD-SUD) relationship by investigating genetic correlation, causality, pleiotropy, and common polygenic risk. Summary statistics from genome-wide association studies (GWAS) were used to investigate ADHD (Neff = 51,568), cannabis use disorder (CanUD, Neff = 161,053), opioid use disorder (OUD, Neff = 57,120), problematic alcohol use (PAU, Neff = 502,272), and problematic tobacco use (PTU, Neff = 97,836). ADHD, CanUD, and OUD GWAS meta-analyses included cohorts with case definitions based on different diagnostic criteria. PAU GWAS combined information related to alcohol use disorder, alcohol dependence, and the items related to alcohol problematic consequences assessed by the alcohol use disorders identification test. PTU GWAS was generated a multi-trait analysis including information regarding Fagerström Test for Nicotine Dependence and cigarettes per day. Linkage disequilibrium score regression analyses indicated positive genetic correlation with CanUD, OUD, PAU, and PTU. Genomic structural equation modeling showed that these genetic correlations were related to two latent factors: one including ADHD, CanUD, and PTU and the other with OUD and PAU. The evidence of a causal effect of PAU and PTU on ADHD was stronger than the reverse in the two-sample Mendelian randomization analysis. Conversely, similar strength of evidence was found between ADHD and CanUD. CADM2 rs62250713 was a pleiotropic SNP between ADHD and all SUDs. We found seven, one, and twenty-eight pleiotropic variants between ADHD and CanUD, PAU, and PTU, respectively. Finally, OUD, CanUD, and PAU PRS were associated with increased odds of ADHD. Our findings demonstrated the contribution of multiple pleiotropic mechanisms to the comorbidity between ADHD and SUDs.
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Affiliation(s)
- Dora Koller
- Department of Psychiatry, Yale School of Medicine, New Haven, CA, USA; Veterans Affairs Connecticut Healthcare Center, West Haven, CA, USA; Department of Genetics, Microbiology, and Statistics, Faculty of Biology, University of Barcelona, Catalonia, Spain.
| | - Marina Mitjans
- Department of Genetics, Microbiology, and Statistics, Faculty of Biology, University of Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Institute of Biomedicine of the University of Barcelona (IBUB), Barcelona, Catalonia Spain; Sant Joan de Déu Research Institute (IR-SJD), Esplugues de Llobregat, Catalonia, Spain
| | - Manuela Kouakou
- Department of Psychiatry, Yale School of Medicine, New Haven, CA, USA
| | - Eleni Friligkou
- Department of Psychiatry, Yale School of Medicine, New Haven, CA, USA; Veterans Affairs Connecticut Healthcare Center, West Haven, CA, USA
| | - Brenda Cabrera-Mendoza
- Department of Psychiatry, Yale School of Medicine, New Haven, CA, USA; Veterans Affairs Connecticut Healthcare Center, West Haven, CA, USA
| | - Joseph D Deak
- Department of Psychiatry, Yale School of Medicine, New Haven, CA, USA; Veterans Affairs Connecticut Healthcare Center, West Haven, CA, USA
| | - Natalia Llonga
- Psychiatric Genetics Unit, Group of Psychiatry Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Gita A Pathak
- Department of Psychiatry, Yale School of Medicine, New Haven, CA, USA; Veterans Affairs Connecticut Healthcare Center, West Haven, CA, USA
| | - Brendan Stiltner
- Department of Psychiatry, Yale School of Medicine, New Haven, CA, USA; Veterans Affairs Connecticut Healthcare Center, West Haven, CA, USA
| | - Solveig Løkhammer
- Department of Psychiatry, Yale School of Medicine, New Haven, CA, USA; NORMENT, Department of Clinical Science, University of Bergen, Bergen, Norway; Dr. Einar Martens Research Group for Biological Psychiatry, Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, Bergen, Norway
| | - Daniel F Levey
- Department of Psychiatry, Yale School of Medicine, New Haven, CA, USA; Veterans Affairs Connecticut Healthcare Center, West Haven, CA, USA
| | - Hang Zhou
- Department of Psychiatry, Yale School of Medicine, New Haven, CA, USA; Veterans Affairs Connecticut Healthcare Center, West Haven, CA, USA
| | - Alexander S Hatoum
- Department of Psychological and Brain Sciences, Washington University in Saint Louis, St. Louis, MO, USA
| | - Rachel L Kember
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA; Mental Illness Research, Education and Clinical Center, Veterans Integrated Service Network 4, Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
| | - Henry R Kranzler
- Department of Psychiatry, University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA; Mental Illness Research, Education and Clinical Center, Veterans Integrated Service Network 4, Crescenz Veterans Affairs Medical Center, Philadelphia, Pennsylvania, USA
| | - Murray B Stein
- Department of Psychiatry, University of California, San Diego, La Jolla, USA; Herbert Wertheim School of Public Health, University of California, San Diego, La Jolla, USA; VA San Diego Healthcare System, San Diego, CA, La Jolla, USA
| | - Roser Corominas
- Department of Genetics, Microbiology, and Statistics, Faculty of Biology, University of Barcelona, Catalonia, Spain; Institute of Biomedicine of the University of Barcelona (IBUB), Barcelona, Catalonia Spain; Sant Joan de Déu Research Institute (IR-SJD), Esplugues de Llobregat, Catalonia, Spain; Biomedical Network Research Centre on Rare Disorders (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Ditte Demontis
- Department of Biomedicine - Human Genetics, Aarhus University, Aarhus, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark; Center for Genomics and Personalized Medicine, Aarhus, Denmark; The Novo Nordisk Foundation Center for Genomic Mechanisms of Disease, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - María Soler Artigas
- Department of Genetics, Microbiology, and Statistics, Faculty of Biology, University of Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Psychiatric Genetics Unit, Group of Psychiatry Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain; Department of Mental Health, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Josep Antoni Ramos-Quiroga
- Department of Genetics, Microbiology, and Statistics, Faculty of Biology, University of Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Psychiatric Genetics Unit, Group of Psychiatry Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autonoma de Barcelona, Barcelona, Spain
| | - Joel Gelernter
- Department of Psychiatry, Yale School of Medicine, New Haven, CA, USA; Veterans Affairs Connecticut Healthcare Center, West Haven, CA, USA; Department of Genetics, Yale School of Medicine, New Haven, CT, USA; Department of Neuroscience, Yale School of Medicine, New Haven, CT, USA
| | - Marta Ribasés
- Department of Genetics, Microbiology, and Statistics, Faculty of Biology, University of Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain; Psychiatric Genetics Unit, Group of Psychiatry Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain; Department of Mental Health, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Bru Cormand
- Department of Genetics, Microbiology, and Statistics, Faculty of Biology, University of Barcelona, Catalonia, Spain; Institute of Biomedicine of the University of Barcelona (IBUB), Barcelona, Catalonia Spain; Sant Joan de Déu Research Institute (IR-SJD), Esplugues de Llobregat, Catalonia, Spain; Biomedical Network Research Centre on Rare Disorders (CIBERER), Instituto de Salud Carlos III, Madrid, Spain
| | - Renato Polimanti
- Department of Psychiatry, Yale School of Medicine, New Haven, CA, USA; Veterans Affairs Connecticut Healthcare Center, West Haven, CA, USA; Wu Tsai Institute, Yale University, New Haven, CT, USA
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7
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LaBianca S, Brikell I, Helenius D, Loughnan R, Mefford J, Palmer CE, Walker R, Gådin JR, Krebs M, Appadurai V, Vaez M, Agerbo E, Pedersen MG, Børglum AD, Hougaard DM, Mors O, Nordentoft M, Mortensen PB, Kendler KS, Jernigan TL, Geschwind DH, Ingason A, Dahl AW, Zaitlen N, Dalsgaard S, Werge TM, Schork AJ. Polygenic profiles define aspects of clinical heterogeneity in attention deficit hyperactivity disorder. Nat Genet 2024; 56:234-244. [PMID: 38036780 DOI: 10.1038/s41588-023-01593-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 10/25/2023] [Indexed: 12/02/2023]
Abstract
Attention deficit hyperactivity disorder (ADHD) is a complex disorder that manifests variability in long-term outcomes and clinical presentations. The genetic contributions to such heterogeneity are not well understood. Here we show several genetic links to clinical heterogeneity in ADHD in a case-only study of 14,084 diagnosed individuals. First, we identify one genome-wide significant locus by comparing cases with ADHD and autism spectrum disorder (ASD) to cases with ADHD but not ASD. Second, we show that cases with ASD and ADHD, substance use disorder and ADHD, or first diagnosed with ADHD in adulthood have unique polygenic score (PGS) profiles that distinguish them from complementary case subgroups and controls. Finally, a PGS for an ASD diagnosis in ADHD cases predicted cognitive performance in an independent developmental cohort. Our approach uncovered evidence of genetic heterogeneity in ADHD, helping us to understand its etiology and providing a model for studies of other disorders.
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Affiliation(s)
- Sonja LaBianca
- Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services Copenhagen, Roskilde, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen, Denmark
| | - Isabell Brikell
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen, Denmark
- National Centre for Register-based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark
| | - Dorte Helenius
- Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services Copenhagen, Roskilde, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen, Denmark
| | - Robert Loughnan
- Department of Cognitive Science, University of California, San Diego, La Jolla, CA, USA
- Center for Population Neuroscience and Genetics, Laureate Institute for Brain Research, Tulsa, OK, USA
| | - Joel Mefford
- Department of Neurology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Clare E Palmer
- Center for Human Development, University of California, San Diego, La Jolla, CA, USA
| | - Rebecca Walker
- Department of Human Genetics, University of California, Los Angeles, Los Angeles, CA, USA
- Center for Autism Research and Treatment, Semel Institute, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Jesper R Gådin
- Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services Copenhagen, Roskilde, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen, Denmark
| | - Morten Krebs
- Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services Copenhagen, Roskilde, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen, Denmark
| | - Vivek Appadurai
- Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services Copenhagen, Roskilde, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen, Denmark
| | - Morteza Vaez
- Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services Copenhagen, Roskilde, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen, Denmark
| | - Esben Agerbo
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen, Denmark
- National Centre for Register-based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark
- Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark
| | - Marianne Giørtz Pedersen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen, Denmark
- National Centre for Register-based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark
- Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark
| | - Anders D Børglum
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen, Denmark
- Department of Biomedicine - Human Genetics, Aarhus University, Aarhus, Denmark
- Centre for Integrative Sequencing, Aarhus University, Aarhus, Denmark
| | - David M Hougaard
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen, Denmark
- Center for Neonatal Screening, Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | - Ole Mors
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen, Denmark
- Psychosis Research Unit, Aarhus University Hospital - Psychiatry, Aarhus, Denmark
| | - Merete Nordentoft
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen, Denmark
- Copenhagen Mental Health Center, Mental Health Services Capital Region of Denmark Copenhagen, Copenhagen, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Preben Bo Mortensen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen, Denmark
- National Centre for Register-based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark
- Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark
| | - Kenneth S Kendler
- Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Terry L Jernigan
- Department of Cognitive Science, University of California, San Diego, La Jolla, CA, USA
- Center for Human Development, University of California, San Diego, La Jolla, CA, USA
- Department of Psychiatry, University of California, San Diego, La Jolla, CA, USA
- Department of Radiology, University of California, San Diego, La Jolla, CA, USA
| | - Daniel H Geschwind
- Department of Neurology, University of California, Los Angeles, Los Angeles, CA, USA
- Department of Human Genetics, University of California, Los Angeles, Los Angeles, CA, USA
- Center for Autism Research and Treatment, Semel Institute, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
- Program in Neurobehavioral Genetics, Semel Institute, David Geffen School of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Andrés Ingason
- Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services Copenhagen, Roskilde, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen, Denmark
| | - Andrew W Dahl
- Section of Genetic Medicine, University of Chicago, Chicago, IL, USA
| | - Noah Zaitlen
- Department of Neurology, University of California, Los Angeles, Los Angeles, CA, USA
| | - Søren Dalsgaard
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen, Denmark
- National Centre for Register-based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark
- Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark
| | - Thomas M Werge
- Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services Copenhagen, Roskilde, Denmark.
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen, Denmark.
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.
| | - Andrew J Schork
- Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services Copenhagen, Roskilde, Denmark.
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen, Denmark.
- Neurogenomics Division, The Translational Genomics Research Institute, Phoenix, AZ, USA.
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8
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Gelner H, Karska J, Gawęda Ł, Samochowiec J, Misiak B. Effects of the interaction between PTSD and ADHD symptoms on the level of reporting psychotic-like experiences: findings from a non-clinical population. Front Psychiatry 2023; 14:1232606. [PMID: 37867761 PMCID: PMC10587572 DOI: 10.3389/fpsyt.2023.1232606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/31/2023] [Accepted: 09/21/2023] [Indexed: 10/24/2023] Open
Abstract
Objective Psychotic-like experiences (PLEs) are increasingly being recognized as subclinical phenomena that might predict the development of various mental disorders that are not limited to the psychosis spectrum. Accumulating evidence suggests that attention-deficit/hyperactivity disorder (ADHD) and post-traumatic stress disorder (PTSD) are highly comorbid mental disorders. However, their interactive effect on the occurrence of PLEs has not been investigated so far. Therefore, in the present study we aimed to investigate the effect of interaction between ADHD and PTSD symptoms on the level of psychotic-like experiences (PLEs) in the non-clinical sample. Methods The study included 3,000 individuals aged 18-35 years with a negative history of psychiatric treatment. The symptoms of ADHD and PTSD were assessed using self-reports. Results There was a significant association of the interaction between ADHD and PTSD with the level of reporting PLEs. This association remained significant after adjustment for age, gender, the level of education, the current vocational situation, lifetime history of problematic substance use, and depressive symptoms. Post-hoc tests demonstrated significantly higher levels of reporting PLEs in participants with positive screening for both ADHD and PTSD compared to other subgroups of participants. Also, individuals with positive screening for one vulnerability (either ADHD or PTSD) reported significantly higher levels of reporting PLEs compared to those with a negative screening for ADHD and PTSD. In turn, no significant differences between individuals reporting one vulnerability, i.e., between those with positive screening for ADHD and those with positive screening for PTSD, were observed. Conclusion Findings from the present study imply that both PTSD and ADHD symptoms the interaction effect on the level of reporting PLEs that might be of importance for early intervention strategies. However, observed associations require replication in clinical samples.
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Affiliation(s)
- Hanna Gelner
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | - Julia Karska
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
| | - Łukasz Gawęda
- Experimental Psychopathology Lab, Institute of Psychology, Polish Academy of Sciences, Warsaw, Poland
| | - Jerzy Samochowiec
- Department of Psychiatry, Pomeranian Medical University, Szczecin, Poland
| | - Błażej Misiak
- Department of Psychiatry, Wroclaw Medical University, Wroclaw, Poland
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9
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Ribasés M, Mitjans M, Hartman CA, Soler Artigas M, Demontis D, Larsson H, Ramos-Quiroga JA, Kuntsi J, Faraone SV, Børglum AD, Reif A, Franke B, Cormand B. Genetic architecture of ADHD and overlap with other psychiatric disorders and cognition-related phenotypes. Neurosci Biobehav Rev 2023; 153:105313. [PMID: 37451654 PMCID: PMC10789879 DOI: 10.1016/j.neubiorev.2023.105313] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/27/2022] [Revised: 06/30/2023] [Accepted: 07/08/2023] [Indexed: 07/18/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) co-occurs with many other psychiatric disorders and traits. In this review, we summarize and interpret the existing literature on the genetic architecture of these comorbidities based on hypothesis-generating approaches. Quantitative genetic studies indicate that genetic factors play a substantial role in the observed co-occurrence of ADHD with many different disorders and traits. Molecular genetic correlations derived from genome-wide association studies and results of studies based on polygenic risk scores confirm the general pattern but provide effect estimates that are smaller than those from twin studies. The identification of the specific genetic variants and biological pathways underlying co-occurrence using genome-wide approaches is still in its infancy. The first analyses of causal inference using genetic data support causal relationships between ADHD and comorbid disorders, although bidirectional effects identified in some instances point to complex relationships. While several issues in the methodology and inferences from the results are still to be overcome, this review shows that the co-occurrence of ADHD with many psychiatric disorders and traits is genetically interpretable.
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Affiliation(s)
- M Ribasés
- Department of Mental Health, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain; Department of Genetics, Microbiology, and Statistics, Faculty of Biology, Universitat de Barcelona, Barcelona, Spain
| | - M Mitjans
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain; Department of Genetics, Microbiology, and Statistics, Faculty of Biology, Universitat de Barcelona, Barcelona, Spain; Institut de Biomedicina de la Universitat de Barcelona (IBUB), Barcelona, Catalonia, Spain; Institut de Recerca Sant Joan de Déu (IRSJD), Esplugues de Llobregat, Catalonia, Spain
| | - C A Hartman
- Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University of Groningen, University Medical Center Groningen, Groningen, the Netherlands
| | - M Soler Artigas
- Department of Mental Health, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain; Department of Genetics, Microbiology, and Statistics, Faculty of Biology, Universitat de Barcelona, Barcelona, Spain
| | - D Demontis
- Department of Biomedicine/Human Genetics, Aarhus University, Aarhus, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Denmark; Center for Genomics and Personalized Medicine, Aarhus, Denmark; The Novo Nordisk Foundation Center for Genomic Mechanisms of Disease, Broad Institute of MIT and Harvard, Cambridge, MA 02142, USA
| | - H Larsson
- School of Medical Sciences, Örebro University, Örebro, Sweden; Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - J A Ramos-Quiroga
- Department of Mental Health, Hospital Universitari Vall d'Hebron, Barcelona, Spain; Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain; Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - J Kuntsi
- Social, Genetic and Developmental Psychiatry Centre; Institute of Psychiatry, Psychology and Neuroscience, King's College London, UK
| | - S V Faraone
- Departments of Psychiatry and of Neuroscience and Physiology, Norton College of Medicine, SUNY Upstate Medical University, Syracuse, NY, USA
| | - A D Børglum
- Department of Biomedicine/Human Genetics, Aarhus University, Aarhus, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Denmark; Center for Genomics and Personalized Medicine, Aarhus, Denmark
| | - A Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - B Franke
- Departments of Cognitive Neuroscience and Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, the Netherlands.
| | - B Cormand
- Department of Genetics, Microbiology, and Statistics, Faculty of Biology, Universitat de Barcelona, Barcelona, Spain; Institut de Biomedicina de la Universitat de Barcelona (IBUB), Barcelona, Catalonia, Spain; Institut de Recerca Sant Joan de Déu (IRSJD), Esplugues de Llobregat, Catalonia, Spain; Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBER-ER), Instituto de Salud Carlos III, Madrid, Spain.
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10
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Kheirkhah MT, Mokarrami M, Kazemitabar M, Garcia D. Inequalities in care for Iranian women suffering from the comorbidity of substance use and mental illness: The need for integrated treatment. Health Promot Perspect 2023; 13:198-201. [PMID: 37808943 PMCID: PMC10558971 DOI: 10.34172/hpp.2023.24] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 05/27/2023] [Indexed: 10/10/2023] Open
Abstract
This paper addresses the comorbidity of substance use and mental illness among women in Iran and the barriers they encounter in accessing treatment. Research has demonstrated a higher prevalence of comorbidity of substance use disorders and mental illness among women than men. It has been suggested that women in Iran may face numerous barriers to appropriate care, such as stigma and discrimination associated with substance use. Integrated treatment for co-occurring disorders (CODs) has been highly beneficial and effective; however, personal and structural limitations impede this treatment approach, which explains the need to develop a situation- and culture-specific program. Needs assessment is necessary to achieve an integrated treatment, and the Iranian government should take the lead in this endeavor. However, if this seems unlikely, non-governmental organizations could be called upon to promote it.
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Affiliation(s)
| | - Mehran Mokarrami
- Faculty of Psychology and Education, University of Tehran, Tehran, Iran
| | - Maryam Kazemitabar
- Yale School of Medicine, Yale University, New Haven, CT, USA
- VA Connecticut Healthcare System, West Haven, USA
| | - Danilo Garcia
- Department of Behavioral Sciences and Learning, Linköping University, Linköping, Sweden
- Centre for Ethics, Law and Mental Health (CELAM), University of Gothenburg, Gothenburg, Sweden
- Department of Psychology, Lund University, Lund, Sweden
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11
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Brancati GE, De Rosa U, De Dominicis F, Petrucci A, Nannini A, Medda P, Schiavi E, Perugi G. History of Childhood/Adolescence Referral to Speciality Care or Treatment in Adult Patients with Attention-Deficit/Hyperactivity Disorder: Mutual Relations with Clinical Presentation, Psychiatric Comorbidity and Emotional Dysregulation. Brain Sci 2023; 13:1251. [PMID: 37759852 PMCID: PMC10526193 DOI: 10.3390/brainsci13091251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 08/16/2023] [Accepted: 08/26/2023] [Indexed: 09/29/2023] Open
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a neurodevelopmental condition that only rarely remits in adulthood. While several studies underlined differences between child and adult ADHD, the relationship between adult clinical presentation and early referral/treatment has been rarely investigated. In our study, 100 adults with ADHD were recruited and subdivided according to a history of referral to speciality care or treatment with methylphenidate (MPH) during childhood/adolescence. The early referral was associated with a history of disruptive behaviors during childhood/adolescence. Current ADHD symptoms were more pronounced in patients first referred during childhood/adolescence but never treated with MPH. Early MPH treatment was associated with lower rates of mood disorders and lower severity of emotional dysregulation at the time of assessment. Negative emotionality mediated the relationship between MPH treatment and mood disorders comorbidity. ADHD patients first referred during childhood/adolescence are characterized by more externalizing features than those first referred in adulthood. MPH treatment during the developmental age may have a role in preventing mood disorders in patients with ADHD, possibly by reducing emotional dysregulation.
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Affiliation(s)
- Giulio Emilio Brancati
- Department of Clinical and Experimental Medicine, University Hospital of Pisa, 56100 Pisa, Italy (A.N.)
| | - Ugo De Rosa
- Department of Clinical and Experimental Medicine, University Hospital of Pisa, 56100 Pisa, Italy (A.N.)
| | | | - Alessandra Petrucci
- Department of Clinical and Experimental Medicine, University Hospital of Pisa, 56100 Pisa, Italy (A.N.)
| | - Alessandro Nannini
- Department of Clinical and Experimental Medicine, University Hospital of Pisa, 56100 Pisa, Italy (A.N.)
| | - Pierpaolo Medda
- Psychiatry Unit 2, Azienda Ospedaliero-Universitaria Pisana, Via Roma 67, 56126 Pisa, Italy; (P.M.)
| | - Elisa Schiavi
- Psychiatry Unit 2, Azienda Ospedaliero-Universitaria Pisana, Via Roma 67, 56126 Pisa, Italy; (P.M.)
| | - Giulio Perugi
- Department of Clinical and Experimental Medicine, University Hospital of Pisa, 56100 Pisa, Italy (A.N.)
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12
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Langley K, Del Pozo-Banos M, Daalsgard S, Paranjothy S, Riglin L, John A, Thapar A. Can a nation-wide e-cohort of ADHD and ASD in childhood be established using Welsh routinely available datasets? BMJ Open 2023; 13:e071851. [PMID: 37604636 PMCID: PMC10445352 DOI: 10.1136/bmjopen-2023-071851] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 07/24/2023] [Indexed: 08/23/2023] Open
Abstract
OBJECTIVES We investigated the feasibility and validity of establishing a nationwide e-cohort of individuals with a diagnosis of attention deficit hyperactivity disorder (ADHD) and/or autism spectrum disorder (ASD) for future longitudinal research. DESIGN Individuals with a childhood diagnosis of ADHD/ASD as recorded on routinely available healthcare datasets were compared with matched controls and a sample of directly assessed individuals with ADHD. SETTING This study used data from the Welsh Secure Anonymised Information Linkage Databank in Wales, UK. Routinely collected data from primary care, emergency department and hospital admissions were linked at person level. PARTICIPANTS All individuals in Wales, UK born between 1 January 1991 and 31 December 2000. Individuals with a recorded diagnosis of ADHD and/or ASD by age 18 years were identified using International Classification of Diseases, 10th Revision and National Health Service (NHS) READ codes and matched to 3 controls each and 154 individuals with ADHD recruited from an established research study. OUTCOME MEASURES Recorded service use for anxiety and depression, alcohol and drug use and self-harm including emergency department use in young adulthood (age 16-25 years). RESULTS 7726 individuals had a recorded diagnosis of ADHD (80% male) and 5001 of ASD (79% male); 1.4% and 0.9% of the population, respectively. Cox's regression analyses showed ADHD was associated with increased risks of anxiety/depression (HR: 2.36, 95% CI: 2.20 to 2.53), self-harm (HR: 5.70, 95% CI: 5.07 to 6.40), alcohol (HR: 3.95, 95% CI: 3.42 to 4.56), drug use (HR: 5.88, 95% CI: 5.08 to 6.80) and emergency department service use (HR: 1.36, 95% CI: 1.31 to 1.41). Those with ASD were at increased risk of anxiety/depression (HR: 2.11, 95% CI: 1.91 to 2.34), self-harm (HR: 2.93, 95% CI: 2.45 to 3.50) and drug use (HR: 2.21, 95% CI: 1.66 to 2.95) but not alcohol use. The ADHD e-cohort were similar to the directly assessed cohort. CONCLUSIONS Our identification strategy demonstrated the feasibility of establishing a large e-cohort of those with ADHD/ASD with expected patterns of poorer early adult outcomes, demonstrating a valid method of identifying large samples for future longitudinal studies without selective attrition.
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Affiliation(s)
- Kate Langley
- School of Psychology, Cardiff University, Cardiff, UK
| | - Marcos Del Pozo-Banos
- Population Data Science, Swansea University, Swansea, UK
- Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK
| | - Søren Daalsgard
- National Centre for Register-based Research, School of Business and Social Sciences, Aarhus University, Aarhus, Denmark
- Institute of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Child and Adolescent Psychiatry, Mental Health Services of the Capital Region, Glostrup, Denmark
| | | | - Lucy Riglin
- Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK
- Division of Psychological Medicine and Clinical Neurosciences; Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Cardiff, UK
| | - Ann John
- Population Data Science, Swansea University, Swansea, UK
- Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK
| | - Anita Thapar
- Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK
- Division of Psychological Medicine and Clinical Neurosciences; Centre for Neuropsychiatric Genetics and Genomics, School of Medicine, Cardiff University, Cardiff, UK
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13
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Morales-Muñoz I, Paavonen EJ, Kantojärvi K, Härkänen T, Saarenpää-Heikkilä O, Kylliäinen A, Himanen SL, Paunio T. Genetic background to attention deficit and hyperactivity disorder and attention deficit and hyperactivity disorder symptoms at the age of 5 years: the role of sleep duration. Sleep 2023; 46:zsad047. [PMID: 36861221 PMCID: PMC10799321 DOI: 10.1093/sleep/zsad047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2022] [Revised: 02/13/2023] [Indexed: 03/03/2023] Open
Abstract
STUDY OBJECTIVES We studied the associations between polygenic risk score (PRS) for attention deficit and hyperactivity disorder (ADHD) and (1) ADHD symptoms in 5-year-old children, (2) sleep duration throughout childhood, and (3) the interaction between PRS for ADHD and short sleep duration relative to ADHD symptoms at 5 years. METHODS This study is based on the population-based CHILD-SLEEP birth cohort (N = 1420 children). PRS was used to quantitate the genetic risk for ADHD. Parent-reported ADHD symptoms at 5 years were obtained from 714 children, using the Strengths and Difficulties Questionnaire (SDQ) and the Five-to-Fifteen (FTF). Our primary outcomes were SDQ-hyperactivity and FTF-ADHD total scores. Parent-reported sleep duration was measured at 3, 8, 18, 24 months, and 5 years in the whole sample and actigraphy-based sleep duration at 2 and 24 months in a subsample. RESULTS PRS for ADHD associated with SDQ-hyperactivity (β = 0.214, p = .012) and FTF-ADHD total (β = 0.639, p = .011), and FTF-inattention and hyperactivity subscale scores (β = 0.315, p = .017 and β = 0.324, p = .030), but not with sleep duration at any time point. Significant interactions were found between high PRS for ADHD and parent-reported short sleep throughout childhood in FTF-ADHD total score (F = 4.28, p = .039) and FTF-inattention subscale (F = 4.66, p = .031). We did not find any significant interaction between high PRS for ADHD and actigraphy-based short sleep. CONCLUSIONS Parent-reported short sleep moderates the association between genetic risk of ADHD and ADHD symptoms in early childhood in the general population, so that children with short sleep, in combination with high genetic risk for ADHD, could be at highest risk for ADHD symptoms.
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Affiliation(s)
- Isabel Morales-Muñoz
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
- Institute for Mental Health, School of Psychology, University of Birmingham, Birmingham, UK
| | - E Juulia Paavonen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
- Pediatric Research Center, Child Psychiatry, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Katri Kantojärvi
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Psychiatry and SleepWell Research Program, Faculty of Medicine, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
| | - Tommi Härkänen
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
| | - Outi Saarenpää-Heikkilä
- Pediatric Clinics, Tampere University Hospital, Tampere, Finland
- Faculty of Medicine and Life Sciences, Tampere University, Tampere, Finland
| | - Anneli Kylliäinen
- Psychology, Faculty of Social Sciences, Tampere University, Tampere, Finland
| | - Sari-Leena Himanen
- Department of Clinical Neurophysiology, Tampere University Hospital, Tampere, Finland
- Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland
| | - Tiina Paunio
- Department of Public Health and Welfare, Finnish Institute for Health and Welfare, Helsinki, Finland
- Department of Psychiatry and SleepWell Research Program, Faculty of Medicine, University of Helsinki and Helsinki University Central Hospital, Helsinki, Finland
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14
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Rádosi A, Ágrez K, Pászthy B, Réthelyi JM, Ulbert I, Bunford N. Concurrent and Prospective Associations of Reward Response with Affective and Alcohol Problems: ADHD-Related Differential Vulnerability. J Youth Adolesc 2023:10.1007/s10964-023-01794-7. [PMID: 37270465 DOI: 10.1007/s10964-023-01794-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2023] [Accepted: 05/19/2023] [Indexed: 06/05/2023]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a heterogeneous disorder. Data on the role of transdiagnostic, intermediate phenotypes in ADHD-relevant characteristics and outcomes are needed to advance conceptual understanding and approaches to precision psychiatry. Specifically, the extent to which the association between neural response to reward and ADHD-associated affective, externalizing, internalizing, and substance use problems differ depending on ADHD status is unknown. Aims were to examine, in 129 adolescents, whether concurrent and prospective associations of fMRI-measured initial response to reward attainment (relative to loss) with affectivity and externalizing, internalizing, and alcohol use problems differs between youth at-risk for (i.e., subclinical) (n = 50) and not at-risk for ADHD. Adolescents were, on average, 15.29 years old (SD = 1.00; 38% female), 50 were at-risk for (Mage = 15.18 years, SD = 1.04; 22% female) and 79 not at-risk for (Mage = 15.37 years, SD = 0.98; 48.1% female) ADHD. Both concurrent and prospective relations differed given ADHD risk: across analyses, in at-risk youth, greater superior frontal gyrus response was associated with lower concurrent depressive problems but in not at-risk youth, these characteristics were not related. Controlling for baseline use, in at-risk youth, greater putamen response was associated with greater 18-month hazardous alcohol use, whereas in not at-risk youth, greater putamen response was associated with lower use. Where in brain and for which outcomes modulate (direction of) observed relations: superior frontal gyrus response is relevant for depressive problems whereas putamen response is relevant for alcohol problems and greater neural responsivity is linked to less depressive but to more alcohol problems in adolescents at-risk for ADHD and less alcohol problems in adolescents not at-risk. Differences in neural response to reward differentially confer vulnerability for adolescent depressive and alcohol problems depending on ADHD risk.
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Affiliation(s)
- Alexandra Rádosi
- Clinical and Developmental Neuropsychology Research Group, Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Budapest, Hungary
- Doctoral School of Mental Health Sciences, Semmelweis University, Budapest, Hungary
| | - Kristóf Ágrez
- Clinical and Developmental Neuropsychology Research Group, Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Budapest, Hungary
| | - Bea Pászthy
- Department of Pediatrics, Semmelweis University, Budapest, Hungary
| | - János M Réthelyi
- Department of Psychiatry and Psychotherapy, Semmelweis University, Budapest, Hungary
| | - István Ulbert
- Integrative Neuroscience Research Group, Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Budapest, Hungary
- Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Budapest, Hungary
| | - Nóra Bunford
- Clinical and Developmental Neuropsychology Research Group, Institute of Cognitive Neuroscience and Psychology, Research Centre for Natural Sciences, Budapest, Hungary.
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15
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Hámori G, File B, Fiáth R, Pászthy B, Réthelyi JM, Ulbert I, Bunford N. Adolescent ADHD and electrophysiological reward responsiveness: A machine learning approach to evaluate classification accuracy and prognosis. Psychiatry Res 2023; 323:115139. [PMID: 36921508 DOI: 10.1016/j.psychres.2023.115139] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 02/12/2023] [Accepted: 02/28/2023] [Indexed: 03/18/2023]
Abstract
We evaluated event-related potential (ERP) indices of reinforcement sensitivity as ADHD biomarkers by examining, in N=306 adolescents (Mage=15.78, SD=1.08), the extent to which ERP amplitude and latency variables measuring reward anticipation and response (1) differentiate, in age- and sex-matched subsamples, (i) youth with vs. without ADHD, (ii) youth at-risk for vs. not at-risk for ADHD, and, in the with ADHD subsample, (iii) youth with the inattentive vs. the hyperactive/impulsive (H/I) and combined presentations. We further examined the extent to which ERP variables (2) predict, in the ADHD subsample, substance use (i) concurrently and (ii) prospectively at 18-month follow-up. Linear support vector machine analyses indicated ERPs weakly differentiate youth with/without (65%) - and at-risk for/not at-risk for (63%) - ADHD but better differentiate ADHD presentations (78%). Regression analyses showed in adolescents with ADHD, ERPs explain a considerable proportion of variance (50%) in concurrent alcohol use and, controlling for concurrent marijuana and tobacco use, explain a considerable proportion of variance (87 and 87%) in, and predict later marijuana and tobacco use. Findings are consistent with the dual-pathway model of ADHD. Results also highlight limitations of a dichotomous, syndromic classification and indicate differences in neural reinforcement sensitivity are a promising ADHD prognostic biomarker.
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Affiliation(s)
- György Hámori
- Clinical and Developmental Neuropsychology Research Group, Research Centre for Natural Sciences, Institute of Cognitive Neuroscience and Psychology, Magyar Tudósok körútja 2, Budapest 1117, Hungary; Department of Cognitive Science, Faculty of Natural Sciences, Budapest University of Technology and Economics, Műegyetem rkp. 3., Budapest H-1111, Hungary
| | - Bálint File
- Research Centre for Natural Sciences, Integrative Neuroscience Research Group, Institute of Cognitive Neuroscience and Psychology, Magyar Tudósok körútja 2, Budapest 1117, Hungary; Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Práter utca 50/A, Budapest 1083, Hungary; Theoretical Neuroscience and Complex Systems Research Group, Wigner Research Centre for Physics, Konkoly-Tege Miklós út 29-33, Budapest 1121, Hungary
| | - Richárd Fiáth
- Research Centre for Natural Sciences, Integrative Neuroscience Research Group, Institute of Cognitive Neuroscience and Psychology, Magyar Tudósok körútja 2, Budapest 1117, Hungary; Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Práter utca 50/A, Budapest 1083, Hungary
| | - Bea Pászthy
- Department of Paediatrics, Semmelweis University, Faculty of Medicine, Bókay János u. 53-54, Budapest 1083, Hungary
| | - János M Réthelyi
- Department of Psychiatry and Psychotherapy, Semmelweis University, Faculty of Medicine, Balassa u. 6, Budapest 1083, Hungary
| | - István Ulbert
- Research Centre for Natural Sciences, Integrative Neuroscience Research Group, Institute of Cognitive Neuroscience and Psychology, Magyar Tudósok körútja 2, Budapest 1117, Hungary; Faculty of Information Technology and Bionics, Pázmány Péter Catholic University, Práter utca 50/A, Budapest 1083, Hungary
| | - Nóra Bunford
- Clinical and Developmental Neuropsychology Research Group, Research Centre for Natural Sciences, Institute of Cognitive Neuroscience and Psychology, Magyar Tudósok körútja 2, Budapest 1117, Hungary.
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16
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Weiss F, Tidona S, Carli M, Perugi G, Scarselli M. Triple Diagnosis of Attention-Deficit/Hyperactivity Disorder with Coexisting Bipolar and Alcohol Use Disorders: Clinical Aspects and Pharmacological Treatments. Curr Neuropharmacol 2023; 21:1467-1476. [PMID: 36306451 PMCID: PMC10472804 DOI: 10.2174/1570159x20666220830154002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2022] [Revised: 06/13/2022] [Accepted: 08/03/2022] [Indexed: 11/22/2022] Open
Abstract
Attention-Deficit/Hyperactivity Disorder (ADHD), Bipolar Disorder (BD) and Alcohol Use Disorder (AUD) are common medical conditions often coexisting and exerting mutual influence on disease course and pharmacological treatment response. Each disorder, when considered separately, relies on different therapeutic approaches, making it crucial to detect the plausible association between them. Treating solely the emerging condition (e.g., alcoholism) and disregarding the patient's whole psychopathological ground often leads to treatment failure and relapse. Clinical experience and scientific evidence rather show that tailoring treatments for these three conditions considering their co-occurrence as a sole complex disorder yields more fulfilling and durable clinical outcomes. In light of the above considerations, the purpose of the present review is to critically discuss the pharmacological strategies in the personalized treatment of complex conditions defined by ADHD-bipolarityalcoholism coexistence.
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Affiliation(s)
- Francesco Weiss
- Psychiatry Unit 2, Department of Clinical and Experimental Medicine, Faculty of Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Simone Tidona
- Psychiatry Unit 2, Department of Clinical and Experimental Medicine, Faculty of Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Marco Carli
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa 56126, Italy
| | - Giulio Perugi
- Psychiatry Unit 2, Department of Clinical and Experimental Medicine, Faculty of Medicine and Surgery, University of Pisa, Pisa, Italy
| | - Marco Scarselli
- Department of Translational Research and New Technologies in Medicine and Surgery, University of Pisa, Pisa 56126, Italy
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Brikell I, Wimberley T, Albiñana C, Vilhjálmsson BJ, Agerbo E, Børglum AD, Demontis D, Schork AJ, LaBianca S, Werge T, Hougaard DM, Nordentoft M, Mors O, Mortensen PB, Petersen LV, Dalsgaard S. Interplay of ADHD Polygenic Liability With Birth-Related, Somatic, and Psychosocial Factors in ADHD: A Nationwide Study. Am J Psychiatry 2023; 180:73-88. [PMID: 36069019 DOI: 10.1176/appi.ajp.21111105] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Attention deficit hyperactivity disorder (ADHD) is a multifactorial neurodevelopmental disorder, yet the interplay between ADHD polygenic risk scores (PRSs) and other risk factors remains relatively unexplored. The authors investigated associations, confounding, and interactions of ADHD PRS with birth-related, somatic, and psychosocial factors previously associated with ADHD. METHODS Participants included a random general population sample (N=21,578) and individuals diagnosed with ADHD (N=13,697) from the genotyped Danish iPSYCH2012 case cohort, born between 1981 and 2005. The authors derived ADHD PRSs and identified 24 factors previously associated with ADHD using national registers. Logistic regression was used to estimate associations of ADHD PRS with each risk factor in the general population. Cox models were used to evaluate confounding of risk factor associations with ADHD diagnosis by ADHD PRS and parental psychiatric history, and interactions between ADHD PRS and each risk factor. RESULTS ADHD PRS was associated with 12 of 24 risk factors (odds ratio range, 1.03-1.30), namely, small gestational age, infections, traumatic brain injury, and most psychosocial risk factors. Nineteen risk factors were associated with ADHD diagnosis (odds ratio range, 1.20-3.68), and adjusting for ADHD PRS and parental psychiatric history led to only minor attenuations. Only the interaction between ADHD PRS and maternal autoimmune disease survived correction for multiple testing. CONCLUSIONS Higher ADHD PRS in the general population is associated with small increases in risk for certain birth-related and somatic ADHD risk factors, and broadly to psychosocial adversity. Evidence of gene-environment interaction was limited, as was confounding by ADHD PRS and family psychiatric history on ADHD risk factor associations. This suggests that the majority of the investigated ADHD risk factors act largely independently of current ADHD PRS to increase risk of ADHD.
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Affiliation(s)
- Isabell Brikell
- iPSYCH-Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen and Aarhus, Denmark (all authors); National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark (Brikell, Wimberley, Albiñana, Vilhjálmsson, Agerbo, Mortensen, Petersen, Dalsgaard); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Brikell); Center for Integrated Register-Based Research-CIRRAU, Aarhus University, Aarhus, Denmark (Wimberley, Agerbo, Mortensen, Dalsgaard); Bioinformatics Research Center, Aarhus University, Aarhus, Denmark (Vilhjálmsson); Department of Biomedicine and Center for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark (Børglum, Demontis); Center for Genomics and Personalized Medicine, Central Region Denmark and Aarhus University, Aarhus, Denmark (Børglum, Demontis); Neurogenomics Division, Translational Genomics Research Institute, Phoenix (Schork); Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services Copenhagen, Roskilde, Denmark (Schork, LaBianca, Werge, Nordentoft); Department of Clinical Medicine, University of Copenhagen, Copenhagen (Werge); Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen (Werge); Department for Congenital Disorders, Statens Serum Institut, Copenhagen (Hougaard); Copenhagen Research Center for Mental Health, Mental Health Services-CORE in the Capital Region of Denmark (Nordentoft); Psychosis Research Unit, Aarhus University Hospital-Psychiatry, Denmark (Mors)
| | - Theresa Wimberley
- iPSYCH-Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen and Aarhus, Denmark (all authors); National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark (Brikell, Wimberley, Albiñana, Vilhjálmsson, Agerbo, Mortensen, Petersen, Dalsgaard); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Brikell); Center for Integrated Register-Based Research-CIRRAU, Aarhus University, Aarhus, Denmark (Wimberley, Agerbo, Mortensen, Dalsgaard); Bioinformatics Research Center, Aarhus University, Aarhus, Denmark (Vilhjálmsson); Department of Biomedicine and Center for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark (Børglum, Demontis); Center for Genomics and Personalized Medicine, Central Region Denmark and Aarhus University, Aarhus, Denmark (Børglum, Demontis); Neurogenomics Division, Translational Genomics Research Institute, Phoenix (Schork); Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services Copenhagen, Roskilde, Denmark (Schork, LaBianca, Werge, Nordentoft); Department of Clinical Medicine, University of Copenhagen, Copenhagen (Werge); Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen (Werge); Department for Congenital Disorders, Statens Serum Institut, Copenhagen (Hougaard); Copenhagen Research Center for Mental Health, Mental Health Services-CORE in the Capital Region of Denmark (Nordentoft); Psychosis Research Unit, Aarhus University Hospital-Psychiatry, Denmark (Mors)
| | - Clara Albiñana
- iPSYCH-Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen and Aarhus, Denmark (all authors); National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark (Brikell, Wimberley, Albiñana, Vilhjálmsson, Agerbo, Mortensen, Petersen, Dalsgaard); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Brikell); Center for Integrated Register-Based Research-CIRRAU, Aarhus University, Aarhus, Denmark (Wimberley, Agerbo, Mortensen, Dalsgaard); Bioinformatics Research Center, Aarhus University, Aarhus, Denmark (Vilhjálmsson); Department of Biomedicine and Center for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark (Børglum, Demontis); Center for Genomics and Personalized Medicine, Central Region Denmark and Aarhus University, Aarhus, Denmark (Børglum, Demontis); Neurogenomics Division, Translational Genomics Research Institute, Phoenix (Schork); Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services Copenhagen, Roskilde, Denmark (Schork, LaBianca, Werge, Nordentoft); Department of Clinical Medicine, University of Copenhagen, Copenhagen (Werge); Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen (Werge); Department for Congenital Disorders, Statens Serum Institut, Copenhagen (Hougaard); Copenhagen Research Center for Mental Health, Mental Health Services-CORE in the Capital Region of Denmark (Nordentoft); Psychosis Research Unit, Aarhus University Hospital-Psychiatry, Denmark (Mors)
| | - Bjarni Jóhann Vilhjálmsson
- iPSYCH-Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen and Aarhus, Denmark (all authors); National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark (Brikell, Wimberley, Albiñana, Vilhjálmsson, Agerbo, Mortensen, Petersen, Dalsgaard); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Brikell); Center for Integrated Register-Based Research-CIRRAU, Aarhus University, Aarhus, Denmark (Wimberley, Agerbo, Mortensen, Dalsgaard); Bioinformatics Research Center, Aarhus University, Aarhus, Denmark (Vilhjálmsson); Department of Biomedicine and Center for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark (Børglum, Demontis); Center for Genomics and Personalized Medicine, Central Region Denmark and Aarhus University, Aarhus, Denmark (Børglum, Demontis); Neurogenomics Division, Translational Genomics Research Institute, Phoenix (Schork); Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services Copenhagen, Roskilde, Denmark (Schork, LaBianca, Werge, Nordentoft); Department of Clinical Medicine, University of Copenhagen, Copenhagen (Werge); Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen (Werge); Department for Congenital Disorders, Statens Serum Institut, Copenhagen (Hougaard); Copenhagen Research Center for Mental Health, Mental Health Services-CORE in the Capital Region of Denmark (Nordentoft); Psychosis Research Unit, Aarhus University Hospital-Psychiatry, Denmark (Mors)
| | - Esben Agerbo
- iPSYCH-Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen and Aarhus, Denmark (all authors); National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark (Brikell, Wimberley, Albiñana, Vilhjálmsson, Agerbo, Mortensen, Petersen, Dalsgaard); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Brikell); Center for Integrated Register-Based Research-CIRRAU, Aarhus University, Aarhus, Denmark (Wimberley, Agerbo, Mortensen, Dalsgaard); Bioinformatics Research Center, Aarhus University, Aarhus, Denmark (Vilhjálmsson); Department of Biomedicine and Center for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark (Børglum, Demontis); Center for Genomics and Personalized Medicine, Central Region Denmark and Aarhus University, Aarhus, Denmark (Børglum, Demontis); Neurogenomics Division, Translational Genomics Research Institute, Phoenix (Schork); Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services Copenhagen, Roskilde, Denmark (Schork, LaBianca, Werge, Nordentoft); Department of Clinical Medicine, University of Copenhagen, Copenhagen (Werge); Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen (Werge); Department for Congenital Disorders, Statens Serum Institut, Copenhagen (Hougaard); Copenhagen Research Center for Mental Health, Mental Health Services-CORE in the Capital Region of Denmark (Nordentoft); Psychosis Research Unit, Aarhus University Hospital-Psychiatry, Denmark (Mors)
| | - Anders D Børglum
- iPSYCH-Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen and Aarhus, Denmark (all authors); National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark (Brikell, Wimberley, Albiñana, Vilhjálmsson, Agerbo, Mortensen, Petersen, Dalsgaard); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Brikell); Center for Integrated Register-Based Research-CIRRAU, Aarhus University, Aarhus, Denmark (Wimberley, Agerbo, Mortensen, Dalsgaard); Bioinformatics Research Center, Aarhus University, Aarhus, Denmark (Vilhjálmsson); Department of Biomedicine and Center for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark (Børglum, Demontis); Center for Genomics and Personalized Medicine, Central Region Denmark and Aarhus University, Aarhus, Denmark (Børglum, Demontis); Neurogenomics Division, Translational Genomics Research Institute, Phoenix (Schork); Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services Copenhagen, Roskilde, Denmark (Schork, LaBianca, Werge, Nordentoft); Department of Clinical Medicine, University of Copenhagen, Copenhagen (Werge); Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen (Werge); Department for Congenital Disorders, Statens Serum Institut, Copenhagen (Hougaard); Copenhagen Research Center for Mental Health, Mental Health Services-CORE in the Capital Region of Denmark (Nordentoft); Psychosis Research Unit, Aarhus University Hospital-Psychiatry, Denmark (Mors)
| | - Ditte Demontis
- iPSYCH-Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen and Aarhus, Denmark (all authors); National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark (Brikell, Wimberley, Albiñana, Vilhjálmsson, Agerbo, Mortensen, Petersen, Dalsgaard); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Brikell); Center for Integrated Register-Based Research-CIRRAU, Aarhus University, Aarhus, Denmark (Wimberley, Agerbo, Mortensen, Dalsgaard); Bioinformatics Research Center, Aarhus University, Aarhus, Denmark (Vilhjálmsson); Department of Biomedicine and Center for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark (Børglum, Demontis); Center for Genomics and Personalized Medicine, Central Region Denmark and Aarhus University, Aarhus, Denmark (Børglum, Demontis); Neurogenomics Division, Translational Genomics Research Institute, Phoenix (Schork); Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services Copenhagen, Roskilde, Denmark (Schork, LaBianca, Werge, Nordentoft); Department of Clinical Medicine, University of Copenhagen, Copenhagen (Werge); Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen (Werge); Department for Congenital Disorders, Statens Serum Institut, Copenhagen (Hougaard); Copenhagen Research Center for Mental Health, Mental Health Services-CORE in the Capital Region of Denmark (Nordentoft); Psychosis Research Unit, Aarhus University Hospital-Psychiatry, Denmark (Mors)
| | - Andrew J Schork
- iPSYCH-Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen and Aarhus, Denmark (all authors); National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark (Brikell, Wimberley, Albiñana, Vilhjálmsson, Agerbo, Mortensen, Petersen, Dalsgaard); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Brikell); Center for Integrated Register-Based Research-CIRRAU, Aarhus University, Aarhus, Denmark (Wimberley, Agerbo, Mortensen, Dalsgaard); Bioinformatics Research Center, Aarhus University, Aarhus, Denmark (Vilhjálmsson); Department of Biomedicine and Center for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark (Børglum, Demontis); Center for Genomics and Personalized Medicine, Central Region Denmark and Aarhus University, Aarhus, Denmark (Børglum, Demontis); Neurogenomics Division, Translational Genomics Research Institute, Phoenix (Schork); Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services Copenhagen, Roskilde, Denmark (Schork, LaBianca, Werge, Nordentoft); Department of Clinical Medicine, University of Copenhagen, Copenhagen (Werge); Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen (Werge); Department for Congenital Disorders, Statens Serum Institut, Copenhagen (Hougaard); Copenhagen Research Center for Mental Health, Mental Health Services-CORE in the Capital Region of Denmark (Nordentoft); Psychosis Research Unit, Aarhus University Hospital-Psychiatry, Denmark (Mors)
| | - Sonja LaBianca
- iPSYCH-Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen and Aarhus, Denmark (all authors); National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark (Brikell, Wimberley, Albiñana, Vilhjálmsson, Agerbo, Mortensen, Petersen, Dalsgaard); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Brikell); Center for Integrated Register-Based Research-CIRRAU, Aarhus University, Aarhus, Denmark (Wimberley, Agerbo, Mortensen, Dalsgaard); Bioinformatics Research Center, Aarhus University, Aarhus, Denmark (Vilhjálmsson); Department of Biomedicine and Center for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark (Børglum, Demontis); Center for Genomics and Personalized Medicine, Central Region Denmark and Aarhus University, Aarhus, Denmark (Børglum, Demontis); Neurogenomics Division, Translational Genomics Research Institute, Phoenix (Schork); Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services Copenhagen, Roskilde, Denmark (Schork, LaBianca, Werge, Nordentoft); Department of Clinical Medicine, University of Copenhagen, Copenhagen (Werge); Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen (Werge); Department for Congenital Disorders, Statens Serum Institut, Copenhagen (Hougaard); Copenhagen Research Center for Mental Health, Mental Health Services-CORE in the Capital Region of Denmark (Nordentoft); Psychosis Research Unit, Aarhus University Hospital-Psychiatry, Denmark (Mors)
| | - Thomas Werge
- iPSYCH-Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen and Aarhus, Denmark (all authors); National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark (Brikell, Wimberley, Albiñana, Vilhjálmsson, Agerbo, Mortensen, Petersen, Dalsgaard); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Brikell); Center for Integrated Register-Based Research-CIRRAU, Aarhus University, Aarhus, Denmark (Wimberley, Agerbo, Mortensen, Dalsgaard); Bioinformatics Research Center, Aarhus University, Aarhus, Denmark (Vilhjálmsson); Department of Biomedicine and Center for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark (Børglum, Demontis); Center for Genomics and Personalized Medicine, Central Region Denmark and Aarhus University, Aarhus, Denmark (Børglum, Demontis); Neurogenomics Division, Translational Genomics Research Institute, Phoenix (Schork); Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services Copenhagen, Roskilde, Denmark (Schork, LaBianca, Werge, Nordentoft); Department of Clinical Medicine, University of Copenhagen, Copenhagen (Werge); Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen (Werge); Department for Congenital Disorders, Statens Serum Institut, Copenhagen (Hougaard); Copenhagen Research Center for Mental Health, Mental Health Services-CORE in the Capital Region of Denmark (Nordentoft); Psychosis Research Unit, Aarhus University Hospital-Psychiatry, Denmark (Mors)
| | - David M Hougaard
- iPSYCH-Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen and Aarhus, Denmark (all authors); National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark (Brikell, Wimberley, Albiñana, Vilhjálmsson, Agerbo, Mortensen, Petersen, Dalsgaard); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Brikell); Center for Integrated Register-Based Research-CIRRAU, Aarhus University, Aarhus, Denmark (Wimberley, Agerbo, Mortensen, Dalsgaard); Bioinformatics Research Center, Aarhus University, Aarhus, Denmark (Vilhjálmsson); Department of Biomedicine and Center for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark (Børglum, Demontis); Center for Genomics and Personalized Medicine, Central Region Denmark and Aarhus University, Aarhus, Denmark (Børglum, Demontis); Neurogenomics Division, Translational Genomics Research Institute, Phoenix (Schork); Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services Copenhagen, Roskilde, Denmark (Schork, LaBianca, Werge, Nordentoft); Department of Clinical Medicine, University of Copenhagen, Copenhagen (Werge); Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen (Werge); Department for Congenital Disorders, Statens Serum Institut, Copenhagen (Hougaard); Copenhagen Research Center for Mental Health, Mental Health Services-CORE in the Capital Region of Denmark (Nordentoft); Psychosis Research Unit, Aarhus University Hospital-Psychiatry, Denmark (Mors)
| | - Merete Nordentoft
- iPSYCH-Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen and Aarhus, Denmark (all authors); National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark (Brikell, Wimberley, Albiñana, Vilhjálmsson, Agerbo, Mortensen, Petersen, Dalsgaard); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Brikell); Center for Integrated Register-Based Research-CIRRAU, Aarhus University, Aarhus, Denmark (Wimberley, Agerbo, Mortensen, Dalsgaard); Bioinformatics Research Center, Aarhus University, Aarhus, Denmark (Vilhjálmsson); Department of Biomedicine and Center for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark (Børglum, Demontis); Center for Genomics and Personalized Medicine, Central Region Denmark and Aarhus University, Aarhus, Denmark (Børglum, Demontis); Neurogenomics Division, Translational Genomics Research Institute, Phoenix (Schork); Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services Copenhagen, Roskilde, Denmark (Schork, LaBianca, Werge, Nordentoft); Department of Clinical Medicine, University of Copenhagen, Copenhagen (Werge); Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen (Werge); Department for Congenital Disorders, Statens Serum Institut, Copenhagen (Hougaard); Copenhagen Research Center for Mental Health, Mental Health Services-CORE in the Capital Region of Denmark (Nordentoft); Psychosis Research Unit, Aarhus University Hospital-Psychiatry, Denmark (Mors)
| | - Ole Mors
- iPSYCH-Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen and Aarhus, Denmark (all authors); National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark (Brikell, Wimberley, Albiñana, Vilhjálmsson, Agerbo, Mortensen, Petersen, Dalsgaard); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Brikell); Center for Integrated Register-Based Research-CIRRAU, Aarhus University, Aarhus, Denmark (Wimberley, Agerbo, Mortensen, Dalsgaard); Bioinformatics Research Center, Aarhus University, Aarhus, Denmark (Vilhjálmsson); Department of Biomedicine and Center for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark (Børglum, Demontis); Center for Genomics and Personalized Medicine, Central Region Denmark and Aarhus University, Aarhus, Denmark (Børglum, Demontis); Neurogenomics Division, Translational Genomics Research Institute, Phoenix (Schork); Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services Copenhagen, Roskilde, Denmark (Schork, LaBianca, Werge, Nordentoft); Department of Clinical Medicine, University of Copenhagen, Copenhagen (Werge); Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen (Werge); Department for Congenital Disorders, Statens Serum Institut, Copenhagen (Hougaard); Copenhagen Research Center for Mental Health, Mental Health Services-CORE in the Capital Region of Denmark (Nordentoft); Psychosis Research Unit, Aarhus University Hospital-Psychiatry, Denmark (Mors)
| | - Preben Bo Mortensen
- iPSYCH-Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen and Aarhus, Denmark (all authors); National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark (Brikell, Wimberley, Albiñana, Vilhjálmsson, Agerbo, Mortensen, Petersen, Dalsgaard); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Brikell); Center for Integrated Register-Based Research-CIRRAU, Aarhus University, Aarhus, Denmark (Wimberley, Agerbo, Mortensen, Dalsgaard); Bioinformatics Research Center, Aarhus University, Aarhus, Denmark (Vilhjálmsson); Department of Biomedicine and Center for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark (Børglum, Demontis); Center for Genomics and Personalized Medicine, Central Region Denmark and Aarhus University, Aarhus, Denmark (Børglum, Demontis); Neurogenomics Division, Translational Genomics Research Institute, Phoenix (Schork); Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services Copenhagen, Roskilde, Denmark (Schork, LaBianca, Werge, Nordentoft); Department of Clinical Medicine, University of Copenhagen, Copenhagen (Werge); Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen (Werge); Department for Congenital Disorders, Statens Serum Institut, Copenhagen (Hougaard); Copenhagen Research Center for Mental Health, Mental Health Services-CORE in the Capital Region of Denmark (Nordentoft); Psychosis Research Unit, Aarhus University Hospital-Psychiatry, Denmark (Mors)
| | - Liselotte Vogdrup Petersen
- iPSYCH-Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen and Aarhus, Denmark (all authors); National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark (Brikell, Wimberley, Albiñana, Vilhjálmsson, Agerbo, Mortensen, Petersen, Dalsgaard); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Brikell); Center for Integrated Register-Based Research-CIRRAU, Aarhus University, Aarhus, Denmark (Wimberley, Agerbo, Mortensen, Dalsgaard); Bioinformatics Research Center, Aarhus University, Aarhus, Denmark (Vilhjálmsson); Department of Biomedicine and Center for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark (Børglum, Demontis); Center for Genomics and Personalized Medicine, Central Region Denmark and Aarhus University, Aarhus, Denmark (Børglum, Demontis); Neurogenomics Division, Translational Genomics Research Institute, Phoenix (Schork); Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services Copenhagen, Roskilde, Denmark (Schork, LaBianca, Werge, Nordentoft); Department of Clinical Medicine, University of Copenhagen, Copenhagen (Werge); Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen (Werge); Department for Congenital Disorders, Statens Serum Institut, Copenhagen (Hougaard); Copenhagen Research Center for Mental Health, Mental Health Services-CORE in the Capital Region of Denmark (Nordentoft); Psychosis Research Unit, Aarhus University Hospital-Psychiatry, Denmark (Mors)
| | - Søren Dalsgaard
- iPSYCH-Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen and Aarhus, Denmark (all authors); National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark (Brikell, Wimberley, Albiñana, Vilhjálmsson, Agerbo, Mortensen, Petersen, Dalsgaard); Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm (Brikell); Center for Integrated Register-Based Research-CIRRAU, Aarhus University, Aarhus, Denmark (Wimberley, Agerbo, Mortensen, Dalsgaard); Bioinformatics Research Center, Aarhus University, Aarhus, Denmark (Vilhjálmsson); Department of Biomedicine and Center for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark (Børglum, Demontis); Center for Genomics and Personalized Medicine, Central Region Denmark and Aarhus University, Aarhus, Denmark (Børglum, Demontis); Neurogenomics Division, Translational Genomics Research Institute, Phoenix (Schork); Institute of Biological Psychiatry, Mental Health Center Sct. Hans, Mental Health Services Copenhagen, Roskilde, Denmark (Schork, LaBianca, Werge, Nordentoft); Department of Clinical Medicine, University of Copenhagen, Copenhagen (Werge); Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen (Werge); Department for Congenital Disorders, Statens Serum Institut, Copenhagen (Hougaard); Copenhagen Research Center for Mental Health, Mental Health Services-CORE in the Capital Region of Denmark (Nordentoft); Psychosis Research Unit, Aarhus University Hospital-Psychiatry, Denmark (Mors)
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Wu J, Li P, Luo H, Lu Y. Complementary and Alternative Medicine Use by ADHD Patients: A Systematic Review. J Atten Disord 2022; 26:1833-1845. [PMID: 35880494 DOI: 10.1177/10870547221111557] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
OBJECTIVE This study aimed to review the prevalence of complementary and alternative medicine (CAM) use and its different used types, characteristics of the studied cohorts, the reasoning for CAM use, and possible predictive factors for its use amongst ADHD patients. METHOD The Web of Science Core Collection, PubMed, and Scopus were searched from inception to 10 February 2022. All of the original papers published in English which report data on CAM use by patients with ADHD were included. RESULTS Twelve original researches including 4,447 patients were included. The prevalence of CAM use varied from 7.5% to 67.6%. The most-reported CAM modalities were dietary modifications and natural products. Moreover, higher parental education should be considered as a predictive factor for CAM use. CONCLUSION CAM use by ADHD patients seems to be prevalent. Healthcare providers should be trained about the most commonly used CAM therapies and their possible adverse events.
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Affiliation(s)
| | - Ping Li
- Sichuan University, Chengdu, China
| | - Hong Luo
- Sichuan University, Chengdu, China
| | - You Lu
- Sichuan University, Chengdu, China
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Langley K, Martin J, Thapar A. Genetics of Attention-Deficit Hyperactivity Disorder. Curr Top Behav Neurosci 2022; 57:243-268. [PMID: 35538303 DOI: 10.1007/7854_2022_338] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
Attention-Deficit Hyperactivity Disorder (ADHD) has long been recognized as being a highly heritable condition and our understanding of the genetic contributions to ADHD has grown over the past few decades. This chapter will discuss the studies that have examined its heritability and the efforts to identify specific genetic risk-variants at the molecular genetic level. We outline the various techniques that have been used to characterize genetic contributions to ADHD, describing what we have learnt so far, what there is still to learn and the methodologies that can be used to further our knowledge. In doing so we will discuss research into rare and common genetic variants, polygenic risk scores, and gene-environment interplay, while also describing what genetic studies have revealed about the biological processes involved in ADHD and what they have taught us about the overlap between ADHD and other psychiatric and somatic disorders. Finally, we will discuss the strengths and limitations of the current methodologies and clinical implications of genetic research to date.
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Affiliation(s)
- Kate Langley
- School of Psychology, Cardiff University, Cardiff, UK. .,MRC Centre for Psychiatric Genetics and Genomics, Cardiff University, Cardiff, UK.
| | - Joanna Martin
- MRC Centre for Psychiatric Genetics and Genomics, Cardiff University, Cardiff, UK.,Division of Psychological Medicine, School of Medicine, Cardiff University, Cardiff, UK.,Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK
| | - Anita Thapar
- MRC Centre for Psychiatric Genetics and Genomics, Cardiff University, Cardiff, UK.,Division of Psychological Medicine, School of Medicine, Cardiff University, Cardiff, UK.,Wolfson Centre for Young People's Mental Health, Cardiff University, Cardiff, UK
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20
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Taubin D, Wilson JC, Wilens TE. ADHD and Substance Use Disorders in Young People: Considerations for Evaluation, Diagnosis, and Pharmacotherapy. Child Adolesc Psychiatr Clin N Am 2022; 31:515-530. [PMID: 35697399 DOI: 10.1016/j.chc.2022.01.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
Co-occurring ADHD and substance use disorder (SUD) is a common clinical presentation associated with significant impairment requiring careful evaluation, diagnosis, and treatment. Treatment with medication, along with cognitive behavioral therapy, is generally regarded as effective in addressing symptoms and impairments associated with both disorders. Options for pharmacotherapy include stimulant and nonstimulant therapies administered with careful monitoring of dosage and compliance to optimize efficacy. In high-risk groups such as college students and/or those with SUD, prescribers should address risks of stimulant misuse and diversion through patient and family education, medication monitoring, and other risk-reducing practices.
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Affiliation(s)
- Daria Taubin
- Pediatric Psychopharmacology Program, Division of Child and Adolescent Psychiatry, Massachusetts General Hospital, Warren Building 628B, 55 Fruit Street, Boston, MA 02114, USA
| | - Julia C Wilson
- Pediatric Psychopharmacology Program, Division of Child and Adolescent Psychiatry, Massachusetts General Hospital, Warren Building 628B, 55 Fruit Street, Boston, MA 02114, USA
| | - Timothy E Wilens
- Division of Child and Adolescent Psychiatry, Child Psychiatry Service, Massachusetts General Hospital, 55 Fruit Street, YAW 6A, Boston, MA 02114, USA; Center for Addiction Medicine, Massachusetts General Hospital, Boston, MA 02114, USA; Massachusetts General Hospital, and Harvard Medical School, Boston, MA 02114, USA.
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21
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Rodrigue AL, Mathias SR, Knowles EEM, Mollon J, Almasy L, Schultz L, Turner J, Calhoun V, Glahn DC. Specificity of Psychiatric Polygenic Risk Scores and their Effects on Associated Risk Phenotypes. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2022. [PMID: 37519455 PMCID: PMC10382704 DOI: 10.1016/j.bpsgos.2022.05.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Background Polygenic risk scores (PRSs) are indices of genetic liability for illness, but their clinical utility for predicting risk for a specific psychiatric disorder is limited. Genetic overlap among disorders and their effects on allied phenotypes may be a possible explanation, but this has been difficult to quantify given focus on singular disorders and/or allied phenotypes. Methods We constructed PRSs for 5 psychiatric disorders (schizophrenia, bipolar disorder, major depressive disorder, autism spectrum disorder, attention-deficit/hyperactivity disorder) and 3 nonpsychiatric control traits (height, type II diabetes, irritable bowel disease) in the UK Biobank (N = 31,616) and quantified associations between PRSs and phenotypes allied with mental illness: behavioral (symptoms, cognition, trauma) and brain measures from magnetic resonance imaging. We then evaluated the extent of specificity among PRSs and their effects on these allied phenotypes. Results Correlations among psychiatric PRSs replicated previous work, with overlap between schizophrenia and bipolar disorder, which was distinct from overlap between autism spectrum disorder and attention-deficit/hyperactivity disorder; overlap between psychiatric and control PRSs was minimal. There was, however, substantial overlap of PRS effects on allied phenotypes among psychiatric disorders and among psychiatric disorders and control traits, where the extent and pattern of overlap was phenotype specific. Conclusions Results show that genetic distinctions between psychiatric disorders and between psychiatric disorders and control traits exist, but this does not extend to their effects on allied phenotypes. Although overlap can be informative, work is needed to construct PRSs that will function at the level of specificity needed for clinical application.
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22
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Haan E, Sallis HM, Zuccolo L, Labrecque J, Ystrom E, Reichborn-Kjennerud T, Andreassen O, Havdahl A, Munafò MR. Prenatal smoking, alcohol and caffeine exposure and maternal-reported attention deficit hyperactivity disorder symptoms in childhood: triangulation of evidence using negative control and polygenic risk score analyses. Addiction 2022; 117:1458-1471. [PMID: 34791750 PMCID: PMC7613851 DOI: 10.1111/add.15746] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/23/2021] [Accepted: 10/29/2021] [Indexed: 01/29/2023]
Abstract
BACKGROUND AND AIMS Studies have indicated that maternal prenatal substance use may be associated with offspring attention deficit hyperactivity disorder (ADHD) via intrauterine effects. We measured associations between prenatal smoking, alcohol and caffeine consumption with childhood ADHD symptoms accounting for shared familial factors. DESIGN First, we used a negative control design comparing maternal and paternal substance use. Three models were used for negative control analyses: unadjusted (without confounders), adjusted (including confounders) and mutually adjusted (including confounders and partner's substance use). The results were meta-analysed across the cohorts. Secondly, we used polygenic risk scores (PRS) as proxies for exposures. Maternal PRS for smoking, alcohol and coffee consumption were regressed against ADHD symptoms. We triangulated the results across the two approaches to infer causality. SETTING We used data from three longitudinal pregnancy cohorts: Avon Longitudinal Study of Parents and Children (ALSPAC) in the United Kingdom, Generation R study (GenR) in the Netherlands and Norwegian Mother, Father and Child Cohort study (MoBa) in Norway. PARTICIPANTS Phenotype data available for children were: NALSPAC = 5455-7751; NGENR = 1537-3119; NMOBA = 28 053-42 206. Genotype data available for mothers was: NALSPAC = 7074; NMOBA = 14 583. MEASUREMENTS A measure of offspring ADHD symptoms at age 7-8 years was derived by dichotomizing scores from questionnaires and parental self-reported prenatal substance use was measured at the second pregnancy trimester. FINDINGS The pooled estimate for maternal prenatal substance use showed an association with total ADHD symptoms [odds ratio (OR)SMOKING = 1.11, 95% confidence interval (CI) = 1.00-1.23; ORALCOHOL = 1.27, 95% CI = 1.08-1.49; ORCAFFEINE = 1.05, 95% CI = 1.00-1.11], while not for fathers (ORSMOKING = 1.03, 95% CI = 0.95-1.13; ORALCOHOL = 0.83, 95% CI = 0.47-1.48; ORCAFFEINE = 1.02, 95% CI = 0.97-1.07). However, maternal associations did not persist in sensitivity analyses (substance use before pregnancy, adjustment for maternal ADHD symptoms in MoBa). The PRS analyses were inconclusive for an association in ALSPAC or MoBa. CONCLUSIONS There appears to be no causal intrauterine effect of maternal prenatal substance use on offspring attention deficit hyperactivity disorder symptoms.
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Affiliation(s)
- Elis Haan
- School of Psychological Science, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Hannah M. Sallis
- School of Psychological Science, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Luisa Zuccolo
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
- Department of Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Jeremy Labrecque
- Department of Epidemiology, Erasmus MC, Rotterdam, the Netherlands
| | - Eivind Ystrom
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
- School of Pharmacy, University of Oslo, Oslo, Norway
| | - Ted Reichborn-Kjennerud
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
- Institute of Clinical Medicine, University of Oslo, Oslo, Norway
| | - Ole Andreassen
- NORMENT Centre, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Division of Mental Health and Addiction, Oslo University Hospital, Oslo, Norway
| | - Alexandra Havdahl
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
- Nic Waals Institute, Lovisenberg Diaconal Hospital, Oslo, Norway
| | - Marcus R. Munafò
- School of Psychological Science, University of Bristol, Bristol, UK
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
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23
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Jean FAM, Arsandaux J, Montagni I, Collet O, Fatséas M, Auriacombe M, Ramos-Quiroga JA, Côté SM, Tzourio C, Galéra C. Attention deficit hyperactivity disorder symptoms and cannabis use after one year among students of the i-Share cohort. Eur Psychiatry 2022; 65:1-18. [PMID: 35348052 PMCID: PMC9058443 DOI: 10.1192/j.eurpsy.2022.14] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/08/2021] [Revised: 02/27/2022] [Accepted: 02/27/2022] [Indexed: 11/25/2022] Open
Abstract
Background Cannabis use in university students is associated with academic achievement failure and health issues. The objective of the study was to evaluate the association between attention deficit hyperactivity disorder (ADHD) symptoms and cannabis use after 1 year among students according to previous cannabis use. Methods Students in France were recruited from February 2013 to July 2020 in the i-Share cohort. 4,270 participants were included (2,135 who never used cannabis at inclusion and 2,135 who did). The Adult ADHD Self-Report Scale (ASRS) was used to assess ADHD symptoms at inclusion. Cannabis use frequency was evaluated 1 year after inclusion. Multinomial regressions were conducted to assess the association between inclusion ADHD symptoms and cannabis use after 1 year. Results Increase in ASRS scores was linked with a greater probability to use cannabis after 1 year and to have a higher cannabis use frequency (once a year—once a month adjusted odds ratio [OR]: 1.24 (1.15–1.34), more than once a month adjusted OR: 1.43 (1.27–1.61)). Among participants who never used cannabis at inclusion, this association disappeared (once a year—once a month adjusted OR: 1.15 (0.95–1.39), more than once a month adjusted OR: 1.16 (0.67–2)) but remained in participants who ever used cannabis at inclusion (once a year—once a month adjusted OR: 1.17 (1.06–1.29), more than once a month adjusted OR: 1.35 (1.18–1.55)). Conclusions High levels of ADHD symptoms in students could lead to continued cannabis use rather than new initiations.
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Affiliation(s)
- François Arnaud Matthieu Jean
- Department of Psychiatry, Dr Jean Eric Techer Hospital, Calais, France
- University of Bordeaux, Faculty of Medicine, Bordeaux, France
- Bordeaux Population Health Research Center, National Institute of Health and Medical Research (Institut National de la Santé et de la Recherche Médicale—INSERM), Bordeaux, France
| | - Julie Arsandaux
- University of Bordeaux, Faculty of Medicine, Bordeaux, France
- Bordeaux Population Health Research Center, National Institute of Health and Medical Research (Institut National de la Santé et de la Recherche Médicale—INSERM), Bordeaux, France
| | - Ilaria Montagni
- University of Bordeaux, Faculty of Medicine, Bordeaux, France
- Bordeaux Population Health Research Center, National Institute of Health and Medical Research (Institut National de la Santé et de la Recherche Médicale—INSERM), Bordeaux, France
| | - Ophélie Collet
- University of Bordeaux, Faculty of Medicine, Bordeaux, France
- Bordeaux Population Health Research Center, National Institute of Health and Medical Research (Institut National de la Santé et de la Recherche Médicale—INSERM), Bordeaux, France
| | - Mélina Fatséas
- University of Bordeaux, Faculty of Medicine, Bordeaux, France
- Charles Perrens Hospital, Bordeaux, France
- Centre Hospitalier Universitaire de Bordeaux (CHU de Bordeaux), Bordeaux, France
- National Center for Scientific Research (Centre national de la recherche scientifique—CNRS), Institut de Neurosciences Cognitives et Intégratives d’Aquitaine (INCIA), Bordeaux, France
| | - Marc Auriacombe
- University of Bordeaux, Faculty of Medicine, Bordeaux, France
- Charles Perrens Hospital, Bordeaux, France
- Centre Hospitalier Universitaire de Bordeaux (CHU de Bordeaux), Bordeaux, France
- National Center for Scientific Research (Centre national de la recherche scientifique—CNRS), Addiction Team/SANPSY, Bordeaux, France
| | - Josep Antoni Ramos-Quiroga
- Group of Psychiatry, Mental Health and Addiction, Vall d’Hebron Research Institute (VHIR), Barcelona, Spain
- Department of Psychiatry, Hospital Universitari Vall d’Hebron, Barcelona, Spain
- Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Barcelona, Spain
- Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Sylvana M. Côté
- University of Bordeaux, Faculty of Medicine, Bordeaux, France
- Bordeaux Population Health Research Center, National Institute of Health and Medical Research (Institut National de la Santé et de la Recherche Médicale—INSERM), Bordeaux, France
- University of Montreal, Quebec, Canada
| | - Christophe Tzourio
- University of Bordeaux, Faculty of Medicine, Bordeaux, France
- Bordeaux Population Health Research Center, National Institute of Health and Medical Research (Institut National de la Santé et de la Recherche Médicale—INSERM), Bordeaux, France
- Centre Hospitalier Universitaire de Bordeaux (CHU de Bordeaux), Bordeaux, France
| | - Cédric Galéra
- University of Bordeaux, Faculty of Medicine, Bordeaux, France
- Bordeaux Population Health Research Center, National Institute of Health and Medical Research (Institut National de la Santé et de la Recherche Médicale—INSERM), Bordeaux, France
- Charles Perrens Hospital, Bordeaux, France
- Centre Hospitalier Universitaire de Bordeaux (CHU de Bordeaux), Bordeaux, France
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24
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Fernàndez-Castillo N, Cabana-Domínguez J, Corominas R, Cormand B. Molecular genetics of cocaine use disorders in humans. Mol Psychiatry 2022; 27:624-639. [PMID: 34453125 PMCID: PMC8960411 DOI: 10.1038/s41380-021-01256-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/19/2020] [Revised: 07/01/2021] [Accepted: 07/30/2021] [Indexed: 12/11/2022]
Abstract
Drug addiction, one of the major health problems worldwide, is characterized by the loss of control in drug intake, craving, and withdrawal. At the individual level, drugs of abuse produce serious consequences on health and have a negative impact on the family environment and on interpersonal and work relationships. At a wider scale, they have significant socio-economic and public health consequences and they cause delinquency and citizen insecurity. Cocaine, a psychostimulant substance, is one of the most used illicit drugs, especially in America, Western Europe, and Australia. Cocaine use disorders (CUD) are complex multifactorial conditions driven by both genetic and environmental influences. Importantly, not all people who use cocaine develop CUD, and this is due, at least in part, to biological factors that are encoded in the genome of individuals. Acute and repeated use of cocaine induces epigenetic and gene expression changes responsible for the neuronal adaptations and the remodeling of brain circuits that lead to the transition from use to abuse or dependence. The purpose of this review is to delineate such factors, which should eventually help to understand the inter-individual variability in the susceptibility to cocaine addiction. Heritability estimates for CUD are high and genetic risk factors for cocaine addiction have been investigated by candidate gene association studies (CGAS) and genome-wide association studies (GWAS), reviewed here. Also, the high comorbidity that exists between CUD and several other psychiatric disorders is well known and includes phenotypes like schizophrenia, aggression, antisocial or risk-taking behaviors. Such comorbidities are associated with a worse lifetime trajectory, and here we report shared genetic factors that may contribute to them. Gene expression changes and epigenetic modifications induced by cocaine use and chronic abuse in humans are addressed by reviewing transcriptomic studies performed on neuronal cells and on postmortem brains. We report some genes which expression is altered by cocaine that also bear genetic risk variants for the disorder. Finally, we have a glance to the pharmacogenetics of CUD treatments, still in early stages. A better understanding of the genetic underpinnings of CUD will foster the search of effective treatments and help to move forward to personalized medicine.
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Affiliation(s)
- Noèlia Fernàndez-Castillo
- Departament de Genètica, Microbiologia i Estadística, Facultat de Biologia, Universitat de Barcelona, Barcelona, Catalonia, Spain. .,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid, Spain. .,Institut de Biomedicina de la Universitat de Barcelona (IBUB), Barcelona, Catalonia, Spain. .,Institut de Recerca Sant Joan de Déu (IR-SJD), Esplugues de Llobregat, Catalonia, Spain.
| | - Judit Cabana-Domínguez
- grid.5841.80000 0004 1937 0247Departament de Genètica, Microbiologia i Estadística, Facultat de Biologia, Universitat de Barcelona, Barcelona, Catalonia Spain ,grid.452372.50000 0004 1791 1185Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid, Spain ,grid.5841.80000 0004 1937 0247Institut de Biomedicina de la Universitat de Barcelona (IBUB), Barcelona, Catalonia Spain ,grid.411160.30000 0001 0663 8628Institut de Recerca Sant Joan de Déu (IR-SJD), Esplugues de Llobregat, Catalonia Spain
| | - Roser Corominas
- grid.5841.80000 0004 1937 0247Departament de Genètica, Microbiologia i Estadística, Facultat de Biologia, Universitat de Barcelona, Barcelona, Catalonia Spain ,grid.452372.50000 0004 1791 1185Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid, Spain ,grid.5841.80000 0004 1937 0247Institut de Biomedicina de la Universitat de Barcelona (IBUB), Barcelona, Catalonia Spain ,grid.411160.30000 0001 0663 8628Institut de Recerca Sant Joan de Déu (IR-SJD), Esplugues de Llobregat, Catalonia Spain
| | - Bru Cormand
- Departament de Genètica, Microbiologia i Estadística, Facultat de Biologia, Universitat de Barcelona, Barcelona, Catalonia, Spain. .,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Instituto de Salud Carlos III, Madrid, Spain. .,Institut de Biomedicina de la Universitat de Barcelona (IBUB), Barcelona, Catalonia, Spain. .,Institut de Recerca Sant Joan de Déu (IR-SJD), Esplugues de Llobregat, Catalonia, Spain.
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25
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Brikell I, Burton C, Mota NR, Martin J. Insights into attention-deficit/hyperactivity disorder from recent genetic studies. Psychol Med 2021; 51:2274-2286. [PMID: 33814023 DOI: 10.1017/s0033291721000982] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a common and highly heritable neurodevelopmental disorder (NDD). In this narrative review, we summarize recent advances in quantitative and molecular genetic research from the past 5-10 years. Combined with large-scale international collaboration, these advances have resulted in fast-paced progress in understanding the etiology of ADHD and how genetic risk factors map on to clinical heterogeneity. Studies are converging on a number of key insights. First, ADHD is a highly polygenic NDD with a complex genetic architecture encompassing risk variants across the spectrum of allelic frequencies, which are implicated in neurobiological processes. Second, genetic studies strongly suggest that ADHD diagnosis shares a large proportion of genetic risks with continuously distributed traits of ADHD in the population, with shared genetic risks also seen across development and sex. Third, ADHD genetic risks are shared with those implicated in many other neurodevelopmental, psychiatric and somatic phenotypes. As sample sizes and the diversity of genetic studies continue to increase through international collaborative efforts, we anticipate further success with gene discovery, characterization of how the ADHD phenotype relates to other human traits and growing potential to use genomic risk factors for understanding clinical trajectories and for precision medicine approaches.
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Affiliation(s)
- Isabell Brikell
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- National Centre for Register-based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark
| | - Christie Burton
- Neurosciences and Mental Health, Hospital for Sick Children, Toronto, Canada
| | - Nina Roth Mota
- Department of Human Genetics, Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Joanna Martin
- MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK
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26
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Ronald A, de Bode N, Polderman TJC. Systematic Review: How the Attention-Deficit/Hyperactivity Disorder Polygenic Risk Score Adds to Our Understanding of ADHD and Associated Traits. J Am Acad Child Adolesc Psychiatry 2021; 60:1234-1277. [PMID: 33548493 PMCID: PMC11164195 DOI: 10.1016/j.jaac.2021.01.019] [Citation(s) in RCA: 51] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/05/2020] [Revised: 01/04/2021] [Accepted: 01/28/2021] [Indexed: 12/21/2022]
Abstract
OBJECTIVE To investigate, by systematically reviewing the literature, whether the attention-deficit/hyperactivity disorder (ADHD) polygenic risk score (PRS) associates with ADHD and related traits in independent clinical and population samples. METHOD PubMed, Embase and PsychoInfo were systematically searched, alongside study bibliographies. Quality assessments were conducted, and a best-evidence synthesis was applied. Studies were excluded when the predictor was not based on the latest ADHD genome-wide association study, when PRS was not based on genome-wide results, or when the study was a review. Initially, 197 studies were retrieved (February 22, 2020), and a second search (June 3, 2020) yielded a further 49 studies. From both searches, 57 studies were eligible, and 44 studies met inclusion criteria. RESULTS Included studies were published in the last 3 years. Over 80% of the studies were rated excellent, based on a standardized quality assessment. Evidence of associations between ADHD PRS and the following categories was strong: ADHD, ADHD traits, brain structure, education, externalizing behaviors, neuropsychological constructs, physical health, and socioeconomic status. Evidence for associations with addiction, autism, and mental health were mixed and were, so far, inconclusive. Odds ratios for PRS associating with ADHD ranged from 1.22% to 1.76%; variance explained in dimensional assessments of ADHD traits was 0.7% to 3.3%. CONCLUSION A new wave of high-quality research using the ADHD PRS has emerged. Eventually, symptoms may be partly identified based on PRS, but the current ADHD PRS is useful for research purposes only. This review shows that the ADHD PRS is robust and reliable, associating not only with ADHD but many outcomes and challenges known to be linked to ADHD.
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Affiliation(s)
| | - Nora de Bode
- Vrije Universiteit Amsterdam, the Netherlands, and Amsterdam UMC, the Netherlands
| | - Tinca J C Polderman
- Vrije Universiteit Amsterdam, the Netherlands, and Amsterdam UMC, the Netherlands.
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27
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Livingston LA. Substance use, coping, and compensation in autism. Lancet Psychiatry 2021; 8:641-642. [PMID: 34217428 DOI: 10.1016/s2215-0366(21)00205-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 05/25/2021] [Accepted: 05/25/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Lucy Anne Livingston
- School of Psychology, Cardiff University, Cardiff CF10 3AT, UK; Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK.
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28
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Luderer M, Ramos Quiroga JA, Faraone SV, Zhang James Y, Reif A. Alcohol use disorders and ADHD. Neurosci Biobehav Rev 2021; 128:648-660. [PMID: 34265320 DOI: 10.1016/j.neubiorev.2021.07.010] [Citation(s) in RCA: 22] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2020] [Revised: 07/05/2021] [Accepted: 07/09/2021] [Indexed: 12/18/2022]
Abstract
Despite a growing literature on the complex bidirectional relationship of ADHD and substance use, reviews specifically focusing on alcohol are scarce. ADHD and AUD show a significant genetic overlap, including genes involved in gluatamatergic and catecholaminergic neurotransmission. ADHD drives risky behavior and negative experiences throughout the lifespan that subsequently enhance a genetically increased risk for Alcohol Use Disorders (AUD). Impulsive decisions and a maladaptive reward system make individuals with ADHD vulnerable for alcohol use and up to 43 % develop an AUD; in adults with AUD, ADHD occurs in about 20 %, but is vastly under-recognized and under-treated. Thus, routine screening and treatment procedures need to be implemented in AUD treatment. Long-acting stimulants or non-stimulants can be used to treat ADHD in individuals with AUD. However, it is crucial to combine medical treatment for ADHD with pharmacotherapy and psychotherapy for AUD, and other comorbid disorders. Identification of individuals at risk for AUD, especially those with ADHD and conduct disorder or oppositional defiant disorder, is a key factor to prevent negative outcomes.
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Affiliation(s)
- Mathias Luderer
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Frankfurt am Main, Germany.
| | - Josep Antoni Ramos Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Catalonia, Spain; Department of Psychiatryand Forensic Medicine, Universitat Autònoma deBarcelona, Bellaterra, Catalonia, Spain; Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Institut de Recerca (VHIR), Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Catalonia, Spain
| | - Stephen V Faraone
- Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, Syracuse, NY, USA; Department of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Yanli Zhang James
- Department of Psychiatry and Behavioral Sciences, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University, Frankfurt, Frankfurt am Main, Germany
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29
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Wang Y, Wang T, Du Y, Hu D, Zhang Y, Li H, Pei W. Polygenic risk of genes involved in the catecholamine and serotonin pathways for ADHD in children. Neurosci Lett 2021; 760:136086. [PMID: 34174344 DOI: 10.1016/j.neulet.2021.136086] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 06/17/2021] [Accepted: 06/21/2021] [Indexed: 12/11/2022]
Abstract
It is general acknowledged that genes play a vital role in the etiology of attention deficit/hyperactivity disorder (ADHD). The relationship between the genes involved in catecholamine (dopamine, noradrenaline)/serotonin transmissions and ADHD has been widely described in medical literature. A pathway-based study was conducted in this study to test the association of gene-gene interaction and the cumulative effect of genetic polymorphisms within the dopamine, norepinephrine, and serotonin neurotransmitter pathways with ADHD susceptibility. A case-control study was conducted among Chinese children, and 168 ADHD patients and 233 controls were recruited using a combination diagnosis according to the DSM-IV ADHD rating scale. Classification and regression tree (CART) analysis was conducted to explore the gene-gene interaction, and logistic regression modal was applied to estimate the polygenic risk of the potential multiple genetic variants. The results of CART analyses indicated that the children carrying the combination of ADRA2A rs553668GG/GA and SLC6A4 rs6354 GG/GT genotypes displayed a 6.15-fold increased risk of ADHD, compared to those with the combination of ADRA2A rs553668 AA and ANKK1 rs1800497 AA genotypes. The unfavorable alleles of ADRA2A rs553668 G, DRD2 rs1124491 G and SLC6A4 rs6354 G showed cumulative effects on ADHD, and the OR for ADHD may increase by 1.42 times when the number of unfavorable allele number increased by one. Those findings reveal the importance of the gene-gene interactions and polygenic effects of many common variants to ADHD susceptibility, even the effect of each variant is very small.
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Affiliation(s)
- Yanni Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, PR China.
| | - Tingwei Wang
- Department of Maternal, Child and Adolescent Health, School of Public Health, Lanzhou University, Lanzhou, Gansu, PR China
| | - Yukai Du
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Dan Hu
- Department of Maternal and Child Health, School of Public Health, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, Hubei, PR China
| | - Yu Zhang
- Department of Psychological and Behavioral Development, Liuzhou Women and Children Healthcare Hospital, Liuzhou, Guangxi, PR China
| | - Honghui Li
- Department of Psychological and Behavioral Development, Liuzhou Women and Children Healthcare Hospital, Liuzhou, Guangxi, PR China
| | - Wenyan Pei
- Lanzhou Military Region Out-patient Department, Lanzhou, Gansu, PR China
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30
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Does Cannabis, Cocaine and Alcohol Use Impact Differently on Adult Attention Deficit/Hyperactivity Disorder Clinical Picture? J Clin Med 2021; 10:jcm10071481. [PMID: 33918432 PMCID: PMC8038274 DOI: 10.3390/jcm10071481] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 03/20/2021] [Accepted: 03/22/2021] [Indexed: 12/18/2022] Open
Abstract
While the association between adult Attention Deficit/Hyperactivity Disorder (A-ADHD) and Substance Use Disorders (SUDs) has been widely explored, less attention has been dedicated to the various substance use variants. In a previous paper, we identified two variants: type 1 (use of stimulants/alcohol) and type 2 (use of cannabinoids). In this study, we compared demographic, clinical and symptomatologic features between Dual Disorder A-ADHD (DD/A-ADHD) patients according to our substance use typology, and A-ADHD without DD (NDD/A-ADHD) ones. NDD patients were more frequently diagnosed as belonging to inattentive ADHD subtype compared with type 1 DD/A-ADHD patients, but not with respect to type 2 DD/ADHD. NDD/A-ADHD patients showed less severe symptoms of hyperactivity/impulsivity than DD/A-ADHD type 1, but not type 2. Type 1 and type 2 patients shared the feature of displaying higher impulsiveness than NDD/A-ADHD ones. General psychopathology scores were more severe in type 2 DD/ADHD patients, whereas type 1 patients showed greater similarity to NDD/A-ADHD. Legal problems were more strongly represented in type 1 than in type 2 patients or NDD/A-ADHD ones. Our results suggest that type 1 and type 2 substance use differ in their effects on A-ADHD patients-an outcome that brings with it different likely implications in dealing with the diagnostic and therapeutic processes.
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31
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Vilar-Ribó L, Sánchez-Mora C, Rovira P, Richarte V, Corrales M, Fadeuilhe C, Arribas L, Casas M, Ramos-Quiroga JA, Ribasés M, Soler Artigas M. Genetic overlap and causality between substance use disorder and attention-deficit and hyperactivity disorder. Am J Med Genet B Neuropsychiatr Genet 2021; 186:140-150. [PMID: 33244849 DOI: 10.1002/ajmg.b.32827] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/03/2020] [Revised: 10/13/2020] [Accepted: 11/08/2020] [Indexed: 12/18/2022]
Abstract
Substance use disorder (SUD) often co-occur at high prevalence with other psychiatric conditions. Among them, attention-deficit and hyperactivity disorder (ADHD) is present in almost one out of every four subjects with SUD and is associated with higher severity, more frequent polysubstance dependence and increased risk for other mental health problems in SUD patients. Despite studies suggesting a genetic basis in the co-occurrence of these two conditions, the genetic factors involved in the joint development of both disorders and the mechanisms mediating these causal relationships are still unknown. In this study, we tested whether the genetic liability to five SUD-related phenotypes share a common background in the general population and clinically diagnosed ADHD individuals from an in-house sample of 989 subjects and further explored the genetic overlap and the causal relationship between ADHD and SUD using pre-existing GWAS datasets. Our results confirm a common genetic background between ADHD and SUD and support the current literature on the causal effect of the liability to ADHD on the risk for SUD. We added novel findings on the effect of the liability of lifetime cannabis use on ADHD and found evidence of shared genetic background underlying SUD in general population and in ADHD, at least for lifetime cannabis use, alcohol dependence and smoking initiation. These findings are in agreement with the high comorbidity observed between ADHD and SUD and highlight the need to control for substance use in ADHD and to screen for ADHD comorbidity in all SUD patients to provide optimal clinical interventions.
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Affiliation(s)
- Laura Vilar-Ribó
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain.,Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Cristina Sánchez-Mora
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain.,Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Department of Genetics, Microbiology, and Statistics, Faculty of Biology, Universitat de Barcelona, Barcelona, Spain
| | - Paula Rovira
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain.,Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Vanesa Richarte
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Montserrat Corrales
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Christian Fadeuilhe
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Lorena Arribas
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain.,Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain
| | - Miquel Casas
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Josep Antoni Ramos-Quiroga
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain.,Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Marta Ribasés
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain.,Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Department of Genetics, Microbiology, and Statistics, Faculty of Biology, Universitat de Barcelona, Barcelona, Spain
| | - María Soler Artigas
- Psychiatric Genetics Unit, Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain.,Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Instituto de Salud Carlos III, Madrid, Spain.,Department of Genetics, Microbiology, and Statistics, Faculty of Biology, Universitat de Barcelona, Barcelona, Spain
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32
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Østergaard SD, Trabjerg BB, Als TD, Climent CA, Privé F, Vilhjálmsson BJ, Bækvad-Hansen M, Bybjerg-Grauholm J, Hougaard DM, Nordentoft M, Werge T, Demontis D, Mortensen PB, Børglum AD, Mors O, Agerbo E. Polygenic risk score, psychosocial environment and the risk of attention-deficit/hyperactivity disorder. Transl Psychiatry 2020; 10:335. [PMID: 33009369 PMCID: PMC7532146 DOI: 10.1038/s41398-020-01019-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/24/2020] [Accepted: 09/21/2020] [Indexed: 12/20/2022] Open
Abstract
The objective of the present study was to investigate whether the polygenic liability for attention-deficit/hyperactivity disorder (ADHD) and the psychosocial environment impact the risk of ADHD in interaction or independently of each other. We conducted a register- and biobank-based cohort study of 13,725 individuals with ADHD and 20,147 randomly drawn population-based controls. These 33,872 cohort members were genotyped on the Infinium PsychChip v1.0 array (Illumina). Subsequently, we calculated the polygenic risk score (PRS) for ADHD and extracted register data regarding the following risk factors pertaining to the psychosocial environment for each cohort member at the time of birth: maternal/paternal history of mental disorders, maternal/paternal education, maternal/paternal work status, and maternal/paternal income. We used logistic regression analyses to assess the main effects of the PRS for ADHD and the psychosocial environment on the risk of ADHD. Subsequently, we evaluated whether the effect of the PRS and the psychosocial environment act independently or in interaction upon the risk of ADHD. We found that ADHD was strongly associated with the PRS (odds ratio: 6.03, 95%CI: 4.74-7.70 for highest vs. lowest 2% liability). All risk factors pertaining to the psychosocial environment were associated with an increased risk of ADHD. These associations were only slightly attenuated after mutual adjustments. We found no statistically significant interaction between the polygenic liability and the psychosocial environment upon the risk of ADHD. In conclusion, we found main effects of both polygenic liability and risk factors pertaining to the psychosocial environment on the risk of ADHD-in the expected direction.
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Grants
- R165-2013-15320, R102-A9118, R155-2014-1724 and R248-2017-2003 Lundbeckfonden (Lundbeck Foundation)
- R165-2013-15320, R102-A9118, R155-2014-1724 and R248-2017-2003 Lundbeckfonden (Lundbeck Foundation)
- R165-2013-15320, R102-A9118, R155-2014-1724 and R248-2017-2003 Lundbeckfonden (Lundbeck Foundation)
- R165-2013-15320, R102-A9118, R155-2014-1724 and R248-2017-2003 Lundbeckfonden (Lundbeck Foundation)
- R165-2013-15320, R102-A9118, R155-2014-1724 and R248-2017-2003 Lundbeckfonden (Lundbeck Foundation)
- R165-2013-15320, R102-A9118, R155-2014-1724 and R248-2017-2003 Lundbeckfonden (Lundbeck Foundation)
- R165-2013-15320, R102-A9118, R155-2014-1724 and R248-2017-2003 Lundbeckfonden (Lundbeck Foundation)
- R165-2013-15320, R102-A9118, R155-2014-1724 and R248-2017-2003 Lundbeckfonden (Lundbeck Foundation)
- R165-2013-15320, R102-A9118, R155-2014-1724 and R248-2017-2003 Lundbeckfonden (Lundbeck Foundation)
- R165-2013-15320, R102-A9118, R155-2014-1724 and R248-2017-2003 Lundbeckfonden (Lundbeck Foundation)
- R165-2013-15320, R102-A9118, R155-2014-1724 and R248-2017-2003 Lundbeckfonden (Lundbeck Foundation)
- R165-2013-15320, R102-A9118, R155-2014-1724 and R248-2017-2003 Lundbeckfonden (Lundbeck Foundation)
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Affiliation(s)
- Søren D Østergaard
- Department of Affective Disorders, Aarhus University Hospital - Psychiatry, Aarhus, Denmark
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
| | - Betina B Trabjerg
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- NCRR - National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
| | - Thomas D Als
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Department of Biomedicine and Center for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark
| | - Clara Albiñana Climent
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- NCRR - National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
| | - Florian Privé
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- NCRR - National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
| | - Bjarni Jóhann Vilhjálmsson
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- NCRR - National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
| | - Marie Bækvad-Hansen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | - Jonas Bybjerg-Grauholm
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | - David M Hougaard
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Department for Congenital Disorders, Statens Serum Institut, Copenhagen, Denmark
| | - Merete Nordentoft
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Copenhagen Research Center for Mental Health - CORE, Mental Health Center Copenhagen, Copenhagen University Hospital, Copenhagen, Denmark
| | - Thomas Werge
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Research Institute of Biological Psychiatry, Mental Health Center Sanct Hans, Copenhagen University Hospital, Roskilde, Denmark
| | - Ditte Demontis
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Department of Biomedicine and Center for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark
- Center for Genomics and Personalized Medicine, Aarhus, Denmark
| | - Preben B Mortensen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- NCRR - National Centre for Register-based Research, Aarhus University, Aarhus, Denmark
- CIRRAU - Centre for Integrated Register-based Research at Aarhus University, Aarhus, Denmark
| | - Anders D Børglum
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Department of Biomedicine and Center for Integrative Sequencing, iSEQ, Aarhus University, Aarhus, Denmark
- Center for Genomics and Personalized Medicine, Aarhus, Denmark
| | - Ole Mors
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- Psychosis Research Unit, Aarhus University Hospital - Psychiatry, Aarhus, Denmark
| | - Esben Agerbo
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark.
- NCRR - National Centre for Register-based Research, Aarhus University, Aarhus, Denmark.
- CIRRAU - Centre for Integrated Register-based Research at Aarhus University, Aarhus, Denmark.
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33
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Takahashi N, Nishimura T, Harada T, Okumura A, Choi D, Iwabuchi T, Kuwabara H, Takagai S, Nomura Y, Newcorn JH, Takei N, Tsuchiya KJ. Polygenic risk score analysis revealed shared genetic background in attention deficit hyperactivity disorder and narcolepsy. Transl Psychiatry 2020; 10:284. [PMID: 32801330 PMCID: PMC7429956 DOI: 10.1038/s41398-020-00971-7] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2020] [Revised: 07/28/2020] [Accepted: 07/30/2020] [Indexed: 02/06/2023] Open
Abstract
Attention deficit hyperactive disorder (ADHD) is a highly heritable neurodevelopmental disorder, and excessive daytime sleepiness is frequently observed in ADHD patients. Excessive daytime sleepiness is also a core symptom of narcolepsy and essential hypersomnia (EHS), which are also heritable conditions. Psychostimulants are effective for the symptomatic control of ADHD (primary recommended intervention) and the two sleep disorders (frequent off-label use). However, the common biological mechanism for these disorders has not been well understood. Using a previously collected genome-wide association study of narcolepsy and EHS, we calculated polygenic risk scores (PRS) for each individual. We investigated a possible genetic association between ADHD and narcolepsy traits in the Hamamatsu Birth Cohort for mothers and children (HBC study) (n = 876). Gene-set enrichment analyses were used to identify common pathways underlying these disorders. Narcolepsy PRS were significantly associated with ADHD traits both in the hyperactivity domain (e.g., P-value threshold < 0.05, β [SE], 5.815 [1.774]; P = 0.002) and inattention domain (e.g., P-value threshold < 0.05, β [SE], 5.734 [1.761]; P = 0.004). However, EHS PRS was not significantly associated with either domain of ADHD traits. Gene-set enrichment analyses revealed that pathways related to dopaminergic signaling, immune systems, iron metabolism, and glial cell function involved in both ADHD and narcolepsy. Findings indicate that ADHD and narcolepsy are genetically related, and there are possible common underlying biological mechanisms for this relationship. Future studies replicating these findings would be warranted to elucidate the genetic vulnerability for daytime sleepiness in individuals with ADHD.
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Affiliation(s)
- Nagahide Takahashi
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan.
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Osaka/Kanazawa/Hamamatsu/Chiba/Fukui, Japan.
- Department of Child and Adolescent Psychiatry, Nagoya University Graduate School of Medicine, Nagoya, Japan.
| | - Tomoko Nishimura
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Osaka/Kanazawa/Hamamatsu/Chiba/Fukui, Japan
| | - Taeko Harada
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Osaka/Kanazawa/Hamamatsu/Chiba/Fukui, Japan
| | - Akemi Okumura
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Osaka/Kanazawa/Hamamatsu/Chiba/Fukui, Japan
| | - Damee Choi
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Osaka/Kanazawa/Hamamatsu/Chiba/Fukui, Japan
| | - Toshiki Iwabuchi
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Osaka/Kanazawa/Hamamatsu/Chiba/Fukui, Japan
| | - Hitoshi Kuwabara
- Department of Psychiatry, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Shu Takagai
- Department of Child and Adolescent Psychiatry, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - Yoko Nomura
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
- Queens College and Graduate Center, City University of New York, New York, NY, USA
| | - Jeffrey H Newcorn
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Nori Takei
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Osaka/Kanazawa/Hamamatsu/Chiba/Fukui, Japan
- Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK
| | - Kenji J Tsuchiya
- Research Center for Child Mental Development, Hamamatsu University School of Medicine, Hamamatsu, Japan
- United Graduate School of Child Development, Osaka University, Kanazawa University, Hamamatsu University School of Medicine, Chiba University and University of Fukui, Osaka/Kanazawa/Hamamatsu/Chiba/Fukui, Japan
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34
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Lundervold AJ, Jensen DA, Haavik J. Insomnia, Alcohol Consumption and ADHD Symptoms in Adults. Front Psychol 2020; 11:1150. [PMID: 32536897 PMCID: PMC7269111 DOI: 10.3389/fpsyg.2020.01150] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 05/05/2020] [Indexed: 12/03/2022] Open
Abstract
Introduction Substance use disorders and insomnia are common in the general population, and particularly among adults with attention-deficit/hyperactivity disorder (ADHD). Here we investigated the relationship between insomnia, alcohol consumption and ADHD symptoms. Methods Adults with an ADHD diagnosis (n = 235, 41.3% males) and controls (n = 184, 38% males) completed a questionnaire assessing insomnia (Bergen Insomnia Scale), alcohol consumption (Alcohol Use Disorders Identification Test), and current ADHD symptoms (Adult ADHD Self-report Scale). The majority of the sample (95%) gave additional information about childhood ADHD symptoms (Wender Utah Rating Scale), and information about lifetime occurrence of an internalizing disorder was included as part of background information. Results Compared to controls, the ADHD group reported a higher frequency of insomnia, a higher quantity of consumed alcohol and a higher frequency of internalizing disorders. Current and childhood ADHD symptoms were more severe in those with than without insomnia. Scores on ADHD symptom scales were explained by the presence of insomnia and internalizing disorders, while the contribution from alcohol consumption was restricted to the control group. Discussion The high functional impact of insomnia, alcohol misuse and internalizing disorders is well known. The present study contributed by focusing on their relations to ADHD symptoms, and by showing that strong relations were not restricted to adults with a clinical ADHD diagnosis. By this, the results put a critical light on a categorical delineation between adults with an ADHD diagnosis and population selected controls, and call for further studies including dimensional metrics of ADHD symptoms and co-occurring problems.
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Affiliation(s)
- Astri J Lundervold
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Daniel A Jensen
- Department of Biological and Medical Psychology, University of Bergen, Bergen, Norway
| | - Jan Haavik
- Department of Biomedicine, University of Bergen, Bergen, Norway.,Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
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35
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Sánchez-García NC, González RA, Ramos-Quiroga JA, van den Brink W, Luderer M, Blankers M, Grau-Lopez L, Levin FR, Kaye S, Demetrovics Z, van de Glind G, Schellekens A, Vélez-Pastrana MC. Attention Deficit Hyperactivity Disorder Increases Nicotine Addiction Severity in Adults Seeking Treatment for Substance Use Disorders: The Role of Personality Disorders. Eur Addict Res 2020; 26:191-200. [PMID: 32564016 DOI: 10.1159/000508545] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2020] [Accepted: 05/07/2020] [Indexed: 11/19/2022]
Abstract
AIMS To examine the role of attention deficit/hyperactivity disorder (ADHD) and impulsive personality disorders in nicotine addiction severity among treatment-seeking substance use disorder (SUD) patients. METHODS In a cross-sectional study, we examined data from the second International ADHD in Substance Use Disorders Prevalence Study (IASP-2) on 402 adults in SUD treatment from Puerto Rico, Hungary, and Australia using diagnostic interviews for ADHD, antisocial (ASP) and borderline (BPD) personality disorders, and the self-report Fagerström Test of Nicotine Dependence (FTND). We compared SUD patients with and without ADHD on nicotine addiction severity. We tested direct and indirect pathways from ADHD to nicotine addiction and mediation through ASP and BPD. RESULTS Overall, 81.4% of SUD patients reported current cigarette smoking. SUD patients with ADHD had higher FTND scores and smoked more cigarettes than those without ADHD, with an earlier onset and more years of smoking. ASP mediated the effect of ADHD on all aspects of nicotine addiction severity, whereas BPD did so only on some aspects of nicotine addiction severity. CONCLUSIONS SUD patients with comorbid ADHD show more severe nicotine addiction than those without, which is largely explained by comorbid impulsive personality disorders. In SUD patients, it is important to screen for adult ADHD and other psychiatric disorders, especially those with impulse control deficits such as ASP and BPD.
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Affiliation(s)
| | - Rafael A González
- National Adoption and Fostering Service & National Conduct Problems Team, Michael Rutter Centre, South London and Maudsley NHS Foundation Trust, London, United Kingdom.,Centre for Mental Health, Division of Brain Sciences, Department of Medicine, Imperial College London, London, United Kingdom
| | - Josep A Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, CIBERSAM, Barcelona, Spain.,Group of Psychiatry, Mental Health and Addiction, Vall d'Hebron Research Institute, Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Wim van den Brink
- Amsterdam University Medical Centers, Academic Medical Center, University of Amsterdam, Department of Psychiatry, Amsterdam, The Netherlands
| | - Mathias Luderer
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital, Goethe University Frankfurt, Frankfurt, Germany
| | - Matthijs Blankers
- Department of Research, Arkin Mental Health Care, Amsterdam, The Netherlands.,Trimbos Institute, Netherlands Institute of Mental Health and Addiction, Utrecht, The Netherlands.,Department of Psychiatry, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | - Lara Grau-Lopez
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, CIBERSAM, Barcelona, Spain.,Department of Psychiatry and Forensic Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Frances R Levin
- Department of Psychiatry, Columbia University Medical Center, New York, New York, USA.,CUMC/Herbert Pardes Building, New York State Psychiatric Institute, New York, New York, USA
| | - Sharlene Kaye
- Research Unit, Justice Health and Forensic Mental Health Network, Sydney, New South Wales, Australia.,National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia
| | - Zsolt Demetrovics
- Department of Clinical Psychology and Addictions, Institute of Psychology, ELTE Eötvös Loránd University, Budapest, Hungary
| | - Geurt van de Glind
- Department of Psychiatry, Donders Centre for Medical Neuroscience, Radboudumc, Nijmegen, The Netherlands.,Department of Psychiatry, Nijmegen Institute for Scientist Practitioners in Addiction, Nijmegen, The Netherlands
| | - Arnt Schellekens
- Department of Psychiatry, Donders Centre for Medical Neuroscience, Radboudumc, Nijmegen, The Netherlands.,Department of Psychiatry, Nijmegen Institute for Scientist Practitioners in Addiction, Nijmegen, The Netherlands
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