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Hartman CA, Chen Q, Solberg BS, Du Rietz E, Klungsøyr K, Cortese S, Dalsgaard S, Haavik J, Ribasés M, Mostert JC, Libutzki B, Kittel-Schneider S, Cormand B, Vos M, Larsson H, Reif A, Faraone SV, Bellato A. Anxiety, mood, and substance use disorders in adult men and women with and without Attention-Deficit/Hyperactivity Disorder: a substantive and methodological overview. Neurosci Biobehav Rev 2023; 151:105209. [PMID: 37149075 DOI: 10.1016/j.neubiorev.2023.105209] [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: 07/25/2022] [Revised: 04/16/2023] [Accepted: 05/01/2023] [Indexed: 05/08/2023]
Abstract
Knowledge on psychiatric comorbidity in adult ADHD is essential for prevention, detection, and treatment of these conditions. This review (1) focuses on large studies (n> 10,000; surveys, claims data, population registries) to identify (a) overall, (b) sex- and (c) age-specific patterns of comorbidity of anxiety disorders (ADs), major depressive disorder (MDD), bipolar disorder (BD) and substance use disorders (SUDs) in adults with ADHD relative to adults without ADHD; and (2) describes methodological challenges relating to establishing comorbidity in ADHD in adults as well as priorities for future research. Meta-analyses (ADHD: n=550,748; no ADHD n=14,546,814) yielded pooled odds ratios of 5.0(CI:3.29-7.46) for AD, 4.5(CI:2.44-8.34) for MDD, 8.7(CI:5.47-13.89) for BD and 4.6(CI:2.72-7.80) for SUDs, indicating strong differences in adults with compared to adults without ADHD. Moderation by sex was not found: high comorbidity held for both men and women with sex-specific patterns as in the general population: higher prevalences of ADs, MDD and BD in women and a higher prevalence of SUDs in men. Insufficient data on different phases of the adult lifespan prevented conclusions on developmental changes in comorbidity. We discuss methodological challenges, knowledge gaps, and future research priorities.
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Affiliation(s)
- Catharina A Hartman
- University Medical Center Groningen, Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University of Groningen, the Netherlands.
| | - Qi Chen
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Berit Skretting Solberg
- Child- and adolescent psychiatric outpatient unit, Hospital Betanien, Bergen, Norway; Department of Biomedicine, University of Bergen, Norway
| | - Ebba Du Rietz
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Kari Klungsøyr
- Department of Global Public Health and Primary Care, University of Bergen, Norway; Department of Health Promotion, Norwegian Institute of Public Health, Bergen, Norway
| | - Samuele Cortese
- Centre for Innovation in Mental Health, School of Psychology, Faculty of Environmental and Life Sciences, University of Southampton, Southampton, UK; Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, Southampton, UK; Solent NHS Trust, Southampton, UK; Hassenfeld Children's Hospital at NYU Langone, New York University Child Study Center, New York City, New York, USA; Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, UK
| | - Søren Dalsgaard
- NCRR - National Centre for Register-based Research, Aarhus University, Aarhus, Denmark; iPSYCH - The Lundbeck Foundation Initiative for Integrative Psychiatric Research, Copenhagen and Aarhus, Denmark; CIRRAU - Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark
| | - Jan Haavik
- Department of Biomedicine, University of Bergen, Norway; Bergen Center of Brain Plasticity, Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Marta Ribasés
- Department of Psychiatry, Mental Health and Addictions, Hospital Universitari Vall d'Hebron, 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, Catalonia, Spain; Department of Genetics, Microbiology & Statistics, University of Barcelona, Barcelona, Spain
| | - Jeanette C Mostert
- Department of Psychiatry, Donders Institute for Brain, Behaviour and Cognition, Radboud University Medical Center Nijmegen, the Netherlands; Department of Genetics, Radboud University Medical Center, Nijmegen, the Netherlands
| | - Berit Libutzki
- University Medical Center Groningen, Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University of Groningen, the Netherlands
| | - Sarah Kittel-Schneider
- Department of Psychiatry, Psychotherapy and Psychosomatic, University Hospital Würzburg, Würzburg, Germany
| | - Bru Cormand
- Department of Genetics, Microbiology and Statistics, Faculty of Biology, University of Barcelona, Barcelona, Catalonia, Spain; Biomedical Network Research Centre on Rare Diseases (CIBERER), Instituto de Salud Carlos III, 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
| | - Melissa Vos
- University Medical Center Groningen, Groningen, Department of Psychiatry, Interdisciplinary Center Psychopathology and Emotion regulation (ICPE), University of Groningen, the Netherlands
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Andreas Reif
- Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University Hospital Frankfurt - Goethe University, Frankfurt am Main, Germany
| | - Stephen V Faraone
- Departments of Psychiatry and of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA
| | - Alessio Bellato
- School of Psychology, University of Nottingham, Semenyih, Malaysia
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Wang R, Snieder H, Hartman CA. Familial co-aggregation and shared heritability between depression, anxiety, obesity and substance use. Transl Psychiatry 2022; 12:108. [PMID: 35296640 PMCID: PMC8927111 DOI: 10.1038/s41398-022-01868-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 02/22/2022] [Accepted: 02/24/2022] [Indexed: 11/09/2022] Open
Abstract
Depression, anxiety, obesity and substance use are heritable and often co-occur. However, the mechanisms underlying this co-occurrence are not fully understood. We estimated their familial aggregation and co-aggregation as well as heritabilities and genetic correlations to improve etiological understanding. Data came from the multi-generational population-based Lifelines Cohort Study (n = 162,439). Current depression and anxiety were determined using the MINI International Neuropsychiatric Interview. Smoking, alcohol and drug use were assessed by self-report questionnaires. Body mass index (BMI) and obesity were calculated by measured height and weight. Modified Cox proportional hazards models estimated recurrence risk ratios (λR), and restricted maximum likelihood variance decomposition methods estimated heritabilities (h2) and genetic correlations (rG). All analyses were adjusted for age, age2, and sex. Depression, anxiety, obesity and substance use aggregated within families (λR first-degree relative = 1.08-2.74) as well as between spouses (λR = 1.11-6.60). All phenotypes were moderately heritable (from h2depression = 0.25 to h2BMI = 0.53). Depression, anxiety, obesity and smoking showed positive familial co-aggregation. That is, each of these traits confers increased risk on the other ones within families, consistent with the positive genetic correlations between these phenotypes (rG = 0.16-0.94). The exception was obesity, which showed a negative co-aggregation with alcohol and drug use and vice versa, consistent with the negative genetic correlations of BMI with alcohol (rG = -0.14) and soft drug use (rG = -0.10). Patterns of cross-phenotype recurrence risk highlight the co-occurrence among depression, anxiety, obesity and substance use within families. Patterns of genetic overlap between these phenotypes provide clues to uncovering the mechanisms underlying familial co-aggregation.
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Affiliation(s)
- Rujia Wang
- Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands.
| | - Harold Snieder
- grid.4494.d0000 0000 9558 4598Department of Epidemiology, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
| | - Catharina A. Hartman
- grid.4494.d0000 0000 9558 4598Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, Netherlands
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Cederbaum JA, Lee WJ, Okine L, Duan L, Lee JO. Using the Theory of Reasoned Action to examine grandparent and maternal substance use on the cannabis use of children of teen mothers. Drug Alcohol Depend 2021; 228:109019. [PMID: 34509738 PMCID: PMC8713458 DOI: 10.1016/j.drugalcdep.2021.109019] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/01/2021] [Revised: 07/15/2021] [Accepted: 07/18/2021] [Indexed: 12/28/2022]
Abstract
BACKGROUND Parental cannabis use is associated with increased risks of cannabis use among offspring, yet few studies have explored the mechanisms influencing intergenerational continuity in cannabis use. To understand the mechanism by which intergenerational cannabis use is influenced, this work explores cannabis use across three generations using a family expansion of the Theory of Reasoned Action (TRA). METHODS Data come from the Young Women and Child Development Study which began when teen mothers were pregnant and followed mother-child dyads for 17 years (N = 240). Constructs include cannabis use of grandparents, mothers, and teens, and TRA constructs of behavioral and normative beliefs, intention, and behavior. Hypotheses were tested using Structural Equation Modeling. RESULTS Grandfather's cannabis use was significantly linked to mother's normative beliefs (β = .22, p = .006), but not attitudes (β = .12, p = .182). Teen mothers' attitude was associated with intention (β = .79, p < .001); intention predicted cannabis behavior (β = .61, p < .001). Teen mothers' cannabis use was predictive of adolescent's attitude (β = .21, p = .002); attitude predicted intention (β = .73, p < .001) and intention predicted behavior (β = .60, p < .001). DISCUSSION Parents play an influential role in the cannabis use behaviors of adolescents. Future work should consider interventions that target both parent and adolescents, increasing knowledge and skills related to parent-child communication, parental monitoring, and positive parental role modeling to reduce intergenerational continuity of cannabis use.
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Affiliation(s)
| | - Woo Jung Lee
- University of Southern California, Suzanne Dworak-Peck School of Social Work, United States.
| | - Lucinda Okine
- University of Southern California, Suzanne Dworak-Peck School of Social Work, United States.
| | - Lei Duan
- University of Southern California, Suzanne Dworak-Peck School of Social Work, United States.
| | - Jungeun Olivia Lee
- University of Southern California, Suzanne Dworak-Peck School of Social Work, United States.
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Coelho CM, Gonçalves-Bradley D, Zsido AN. Who worries about specific phobias? - A population-based study of risk factors. J Psychiatr Res 2020; 126:67-72. [PMID: 32417598 DOI: 10.1016/j.jpsychires.2020.05.001] [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: 03/23/2020] [Revised: 04/28/2020] [Accepted: 05/01/2020] [Indexed: 10/24/2022]
Abstract
Although specific phobia is one of the most prevalent lifetime anxiety disorders, little is known about the particular risk factors related to its development. The underlying goal of this study was to analyse the risk factors associated with worrying about specific phobias (SP) in a representative sample of community dwelling adults. The sample was composed of 8461 participants (mean age 47.68 years, range 18-85, 54.60% female), from the Australian National Mental Health Survey. A total of 188 participants (2.22%) reported worrying about SPs. Multivariate logistic regression analysis indicated that female sex (odds ratio (OR) = 1.98, p < 0.0001) and a comorbid diagnosis of lifetime major depression disorder (OR = 2.80, p < 0.0001) were the factors most strongly associated with worrying about SPs. Having experienced traumatic experiences involving significant others (OR = 1.18, p = 0.02), the number of chronic diseases (OR = 1.21, p < 0.01), and a comorbid diagnosis of substance use (OR = 2.80, p = 0.02) were also associated. Our results are in line with previous studies focusing on other anxiety disorders. We provide further evidence that substance dependence appears to serve as a unique risk factor for the subsequent onset of SP. Further empirical and clinical implications are discussed.
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Affiliation(s)
- Carlos M Coelho
- School of Psychology, ISMAI University Institute of Maia, Portugal; School of Health of Porto Polytechnic, Psychosocial Rehabilitation Lab, Center for Rehabilitation Research, Porto, Portugal; Department of Psychology, Faculty of Psychology, Chulalongkorn University, Bangkok, Thailand
| | | | - Andras N Zsido
- Institute of Psychology, University of Pécs, Pécs, Hungary.
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Koskela M, Chudal R, Luntamo T, Suominen A, Steinhausen HC, Sourander A. The impact of parental psychopathology and sociodemographic factors in selective mutism - a nationwide population-based study. BMC Psychiatry 2020; 20:221. [PMID: 32398046 PMCID: PMC7216734 DOI: 10.1186/s12888-020-02637-6] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/04/2019] [Accepted: 04/30/2020] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND Selective mutism (SM) is nowadays considered a relatively rare anxiety disorder characterized by children failing to speak in certain situations. Research on risk factors for SM are limited in comparison to other psychiatric disorders. The aim of this study was to examine several potential risk factors for SM in a large nationwide cohort, namely parental psychopathology, parental age, maternal SES, urbanicity, maternal marital status and parental immigration status. METHODS This nested case-control study comprised 860 cases with SM, identified from the Finnish Hospital Discharge Register and 3250 controls matched for sex and age from the Finnish Central Population Register. Conditional logistic regression was used to examine the association between the risk factors and SM. RESULTS If both parents had any psychiatric disorder, this almost tripled their odds of having a child with SM (OR 2.8, 95% CI 2.0-4.0). There were increased rates of all types of psychiatric disorders in the parents of the children with SM, with a wider range of diagnoses among the mothers than fathers. Fathers over 35 years (OR 1.4, 95% CI 1.1-1.8) were significantly more likely to have children with SM. Offspring of a single mother had a 2-fold (OR = 2.0, 95% CI 1.4-3.0) increased odds of SM than mothers who were married or in a relationship. CONCLUSIONS Several parental psychiatric disorders were associated with offspring SM. This points towards a shared aetiology of psychiatric disorders. Findings on paternal age and single motherhood help to improve our understanding of risk factors for SM.
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Affiliation(s)
- Miina Koskela
- Research Centre for Child Psychiatry, Institute of Clinical Medicine, Faculty of Medicine, University of Turku, Lemminkäisenkatu 3 / Teutori (3rd floor), 20014, Turku, Finland.
| | - Roshan Chudal
- grid.1374.10000 0001 2097 1371Research Centre for Child Psychiatry, Institute of Clinical Medicine, Faculty of Medicine, University of Turku, Lemminkäisenkatu 3 / Teutori (3rd floor), 20014 Turku, Finland
| | - Terhi Luntamo
- grid.1374.10000 0001 2097 1371Research Centre for Child Psychiatry, Institute of Clinical Medicine, Faculty of Medicine, University of Turku, Lemminkäisenkatu 3 / Teutori (3rd floor), 20014 Turku, Finland
| | - Auli Suominen
- grid.1374.10000 0001 2097 1371Research Centre for Child Psychiatry, Institute of Clinical Medicine, Faculty of Medicine, University of Turku, Lemminkäisenkatu 3 / Teutori (3rd floor), 20014 Turku, Finland ,grid.410552.70000 0004 0628 215XTurku University Central Hospital, Turku, Finland
| | - Hans-Christoph Steinhausen
- grid.412556.10000 0004 0479 0775Department of Child and Adolescent Psychiatry, Psychiatric University Clinic, Zurich, Switzerland ,grid.6612.30000 0004 1937 0642Clinical Psychology and Epidemiology, Department of Psychology, University of Basel, Basel, Switzerland ,grid.10825.3e0000 0001 0728 0170Department of Child and Adolescent Psychiatry, University of Southern Denmark, Odense, Denmark ,Child and Adolescent Mental Health Centre, Capital Region Psychiatry, Copenhagen, Denmark
| | - Andre Sourander
- grid.1374.10000 0001 2097 1371Research Centre for Child Psychiatry, Institute of Clinical Medicine, Faculty of Medicine, University of Turku, Lemminkäisenkatu 3 / Teutori (3rd floor), 20014 Turku, Finland ,grid.410552.70000 0004 0628 215XDepartment of Child Psychiatry, Turku University Hospital, Turku, Finland ,grid.1374.10000 0001 2097 1371INVEST Research Flagship, University of Turku, Turku, Finland
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