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Dooley N, Healy C, Cotter D, Clarke M, Cannon M. The persistent effects of foetal growth on child and adolescent mental health: longitudinal evidence from a large population-based cohort. Eur Child Adolesc Psychiatry 2023; 32:2067-2076. [PMID: 35861893 PMCID: PMC10533650 DOI: 10.1007/s00787-022-02045-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/13/2021] [Accepted: 07/06/2022] [Indexed: 11/03/2022]
Abstract
Low birth weight for one's gestational age is associated with higher rates of child psychopathology, however, most studies assess psychopathology cross-sectionally. The effect of such foetal growth restriction appears to be strongest for attention problems in childhood, although adult studies have found associations with a range of outcomes, from depression to psychosis. We explore how associations between foetal growth and psychopathology change across age, and whether they vary by sex. We used a large nationally representative cohort of children from Ireland (N ~ 8000). Parents completed the Strengths and Difficulties Questionnaire (SDQ) at 3 time points (age 9, 13 and 17). Outcomes included a total problems scale and subscales measuring attention/hyperactivity, peer, conduct and emotional problems. Foetal growth had significant associations with all problem scales, even after controlling for sex, socioeconomic factors and parental mental health. The magnitude of these effects was small but relatively stable across ages 9-17. In males, foetal growth had the strongest associations with attention/hyperactivity and peer problems, whereas females showed more widespread associations with all four subscales. There was a trend for the association between foetal growth and emotional problems to increase with advancing age, approaching the borderline-abnormal threshold by age 17. Reduced foetal growth predicted persistently higher scores on all measured aspects of child and adolescent psychopathology. Associations with child attention/hyperactivity may generalize to a wider array of adult psychopathologies via adolescent-onset emotional problems. Future studies should explore potential age-dependent effects of foetal growth into the early 20s.
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Affiliation(s)
- Niamh Dooley
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland.
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland.
| | - Colm Healy
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - David Cotter
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
- Department of Psychiatry, Beaumont Hospital, Dublin, Ireland
| | - Mary Clarke
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
- Department of Psychology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Mary Cannon
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
- Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland
- Department of Psychiatry, Beaumont Hospital, Dublin, Ireland
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Isaksson J, Ruchkin V, Ljungström T, Bölte S. Evaluation of Birth Weight and Neurodevelopmental Conditions Among Monozygotic and Dizygotic Twins. JAMA Netw Open 2023; 6:e2321165. [PMID: 37389871 PMCID: PMC10314302 DOI: 10.1001/jamanetworkopen.2023.21165] [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: 02/16/2023] [Accepted: 05/16/2023] [Indexed: 07/01/2023] Open
Abstract
Importance Low birth weight is associated with an increased likelihood of neurodivergence and neurodevelopmental conditions (NDCs) such as autism, attention-deficit/hyperactivity disorder (ADHD), and intellectual disability. However, it is unclear whether birth weight contributes independently to NDCs or whether the association is predominantly driven by genetic predisposition. Objective To estimate the associations between birth weight and dimensional (trait) and categorical (diagnoses) NDC outcomes, while adjusting for genetic risks. Design, Setting, and Participants A co-twin design was applied to this case-control study conducted in Sweden. Diagnostic assessments were conducted between August 2011 and March 2022, within the Roots of Autism and ADHD Twin Study in Sweden (RATSS) during a 2.5-day participant visit to the clinic. The RATSS sample comprised phenotyped monozygotic and dizygotic twins enriched for NDCs. Data analysis was conducted in November 2022. Exposure Birth weight. Main Outcomes and Measures Categorical and dimensional operationalizations of autism, ADHD, and intellectual disability were assessed. Generalized estimating equation models were fitted across and within twin pairs. Results The study sample included 393 twins: 230 were monozygotic and 159 were dizygotic (zygosity was unknown for 4). Their median age was 15 (range, 8-37) years. There were 185 female participants (47.1%) and 208 male participants (52.9%). Across twin pairs, higher birth weight was associated with fewer autistic traits (unstandardized β [B], -5.51 [95% CI, -10.09 to -0.94]) and lower odds of autism diagnosis (OR, 0.63 [95% CI, 0.45 to 0.88]) and intellectual disability (OR, 0.42 [95% CI, 0.19 to 0.92]). Within pairs, the association between birth weight and dimensional autism (B, -17.35 [95% CI, -28.66 to -6.04]) and categorical autism (OR, 0.02 [95% CI, 0.001 to 0.42]) remained among monozygotic pairs but not dizygotic pairs. In addition, higher birth weight was associated with lower odds of ADHD diagnosis (OR, 0.003 [95% CI, 0 to 0.70]), fewer ADHD traits (B, -0.25 [95% CI, -0.39 to -0.11]), and higher IQ ratings (B, 7.43 [95% CI, 1.05 to 13.82]) among monozygotic twins. Conclusions and Relevance The findings of this co-twin study suggest an association between low birth weight and NDCs, but they also acknowledge the importance of genetics because the associations observed were only statically significant among monozygotic twins. It is of pivotal importance to facilitate early identification of factors contributing to fetal growth restriction to minimize detrimental outcomes.
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Affiliation(s)
- Johan Isaksson
- Child and Adolescent Psychiatry Unit, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
- Center of Neurodevelopmental Disorders, Centre for Psychiatry Research, Department of Women’s and Children’s Health, Karolinska Institutet and Stockholm Health Care Services, Stockholm, Sweden
| | - Vladislav Ruchkin
- Child and Adolescent Psychiatry Unit, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
- Child Study Center, Yale University School of Medicine, New Haven, Connecticut
- Sala Forensic Psychiatric Clinic, Sala, Sweden
| | - Therese Ljungström
- Child and Adolescent Psychiatry Unit, Department of Medical Sciences, Uppsala University, Uppsala, Sweden
| | - Sven Bölte
- Center of Neurodevelopmental Disorders, Centre for Psychiatry Research, Department of Women’s and Children’s Health, Karolinska Institutet and Stockholm Health Care Services, Stockholm, Sweden
- Curtin Autism Research Group, School of Occupational Therapy, Social Work and Speech Pathology, Curtin University, Perth, Australia
- Child and Adolescent Psychiatry, Stockholm Health Care Services, Stockholm, Sweden
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Fitzallen GC, Taylor HG, Liley HG, Bora S. Within- and between-twin comparisons of risk for childhood behavioral difficulties after preterm birth. Pediatr Res 2023:10.1038/s41390-023-02579-1. [PMID: 37041209 DOI: 10.1038/s41390-023-02579-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Revised: 01/27/2023] [Accepted: 02/17/2023] [Indexed: 04/13/2023]
Abstract
BACKGROUND Preterm birth and multiple gestation are independently associated with adverse neurodevelopmental outcomes. The objective of this study was to describe risks of screening positive for attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), and anxiety in preterm-born twin children by zygosity (monozygotic, dizygotic) and birth order (first-born, second-born). METHODS Caregivers of 349 preterm-born twin pairs (42% monozygotic) aged 3-18 years reported child behavioral outcomes on Strengths and Weaknesses of ADHD Symptoms and Normal Behavior; Social Responsiveness Scale, Second Edition; and Preschool Anxiety Scale or Screen for Child Anxiety and Related Emotional Disorders. RESULTS Concordance for behavioral outcomes in twin pairs ranged from 80.06 to 89.31% for ADHD, 61.01 to 84.23% for ASD, and 64.76 to 73.35% for anxiety. Monozygotic twins had a greater risk than dizygotic of screening positive for inattention (risk ratio = 2.91, 95% CI = 1.48-5.72) and social anxiety (1.79, 1.23-2.61). Relative to first-born, second-born twins had a greater risk of screening positive for hyperactivity/impulsivity (1.51, 1.06-2.16); overall ASD (2.38, 1.62-3.49); difficulties with social awareness (2.68, 1.94-3.71), social cognition (4.45, 3.06-6.46), and social communication (2.36, 1.56-3.57); restricted/repetitive behavior (1.91, 1.30-2.81); overall anxiety (1.34, 1.10-1.64); generalized anxiety (1.34, 1.11-1.60); and social anxiety (1.32, 1.06-1.64). CONCLUSION The current findings emphasize considering zygosity and birth order in preterm and multiple birth outcomes research, and highlight clinical implications for discharge planning, neurodevelopmental surveillance, and facilitating parenting and family support. IMPACT Zygosity and birth order are important determinants of behavioral and socioemotional outcomes in preterm-born twins. Among 349 preterm-born twin pairs aged 3-18 years (42% monozygotic), 61-89% demonstrated concordance for behavioral and socioemotional outcomes. Monozygosity had greater risks than dizygosity for positive screening of inattention and social anxiety. Second-born twins had greater risks than first-born for hyperactivity/impulsivity, social difficulties (awareness, cognition, communication), restricted/repetitive behavior, and anxiety (generalized, social). These findings have implications for discharge planning, neurodevelopmental surveillance, and facilitating parenting and family support.
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Affiliation(s)
- Grace C Fitzallen
- School of Psychological Sciences, College of Health and Medicine, University of Tasmania, Launceston, TAS, Australia
- School of Psychology, Faculty of Health and Behavioural Sciences, The University of Queensland, Brisbane, QLD, Australia
- Mater Research Institute, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - H Gerry Taylor
- Center for Biobehavioral Health, Abigail Wexner Research Institute at Nationwide Children's Hospital, and Department of Pediatrics, The Ohio State University, Columbus, OH, USA
| | - Helen G Liley
- Mater Research Institute, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia
| | - Samudragupta Bora
- Mater Research Institute, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.
- Department of Pediatrics, University Hospitals Rainbow Babies & Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, OH, USA.
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Dooley N, Healy C, Brannigan R, Cotter D, Clarke M, Cannon M. Explaining the Association Between Fetal Growth and Childhood ADHD Symptoms: Cross-cohort Replication. Res Child Adolesc Psychopathol 2023; 51:247-259. [PMID: 36114937 PMCID: PMC9867674 DOI: 10.1007/s10802-022-00971-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/19/2022] [Indexed: 01/26/2023]
Abstract
The association between restricted fetal growth and symptoms of attention deficit/hyperactivity disorder (ADHD) in childhood is well-replicated and robust. However, fetal growth is determined by many prenatal factors and associations with mental health may be confounded by familial and social context. In this study, we sought to quantify the relative contributions of prenatal factors and familial confounds to the association between fetal growth and ADHD symptoms. Two independent cohorts were analyzed, the Adolescent Brain Cognitive Development study (ABCD; United States) and the Growing Up in Ireland (GUI) study. ADHD symptoms were measured by the Child Behavior Checklist (ABCD) and the Strengths & Difficulties questionnaire (GUI) at age 9-10. Using sequential regression models, we assessed the change-in-association between fetal growth and ADHD symptoms after controlling for sex, familial factors (socioeconomic/demographic factors & family psychiatric history) and prenatal factors (pregnancy complications & maternal substance-use during pregnancy). Converging findings from cohorts suggested that over a quarter of the association between fetal growth and ADHD symptoms is attributable to familial confounds. The degree to which the association was explained by prenatal factors differed by cohort-pregnancy complications explained a larger proportion of the effect in ABCD (7.9%) than GUI (2.7%), and maternal substance-use explained a larger proportion of the effect in GUI (22.7%) compared to ABCD (4.8%). Different explanations of the fetal growth-ADHD association across cohorts suggests cohort-specific, and potentially nationally-specific, risk factors for fetal growth and related neurodevelopmental outcomes. The evidence suggests early prevention of ADHD in Ireland should focus on minimizing maternal smoking during pregnancy. In the US, prevention and treatment of pregnancy complications are highlighted as viable targets for intervention.
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Affiliation(s)
- Niamh Dooley
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland.
| | - Colm Healy
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
- Department of Psychology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Ross Brannigan
- Data Science Centre, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - David Cotter
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
- Department of Psychiatry, Beaumont Hospital, Dublin, Ireland
| | - Mary Clarke
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
- Department of Psychology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Mary Cannon
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland
- Department of Psychiatry, Beaumont Hospital, Dublin, Ireland
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Beer RJ, Cnattingius S, Susser ES, Villamor E. Associations of preterm birth, small-for-gestational age, preeclampsia and placental abruption with attention-deficit/hyperactivity disorder in the offspring: Nationwide cohort and sibling-controlled studies. Acta Paediatr 2022; 111:1546-1555. [PMID: 35485179 PMCID: PMC9544732 DOI: 10.1111/apa.16375] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Revised: 04/21/2022] [Accepted: 04/26/2022] [Indexed: 11/26/2022]
Abstract
Aim The aim of this study was to investigate preterm birth, small‐for‐gestational age (SGA), preeclampsia and placental abruption in relation to attention‐deficit/hyperactivity disorder (ADHD) in offspring. Methods We conducted a population‐based cohort study among non‐malformed live‐born singleton children in Sweden born during 2002–2014. Using national registries with recorded information, we followed 1,212,201 children for an ADHD diagnosis from 3 to 15 years. We compared ADHD rates between exposure categories using adjusted hazard ratios (HR) with 95% confidence intervals (CI) from Cox proportional hazards models. We also conducted sibling‐controlled analyses among 751,464 full siblings. Results There were 27,665 ADHD diagnoses in the cohort. Compared with term birth (≥37 weeks), adjusted HR (95% CI) for ADHD increased with decreasing gestational age: 1.18 (1.11, 1.25), 1.61 (1.37, 1.89) and 2.79 (2.23, 3.49) for 32–36 weeks, 28–31 weeks and 22–27 weeks. Both spontaneous and medically indicated preterm birth were associated with ADHD. SGA was related to 1.62 (1.49, 1.77) times higher ADHD incidence. Preeclampsia, but not placental abruption, was associated with ADHD. Sibling‐controlled analyses showed similar results. Preterm birth did not fully explain the associations of SGA or preeclampsia with ADHD. Conclusion Preterm birth, SGA and preeclampsia are related to ADHD incidence in offspring.
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Affiliation(s)
- Rachael J. Beer
- Department of Epidemiology University of Michigan School of Public Health Ann Arbor Michigan USA
| | - Sven Cnattingius
- Division of Clinical Epidemiology Department of Medicine (Solna) Karolinska Institutet Stockholm Sweden
| | - Ezra S. Susser
- Department of Epidemiology Mailman School of Public Health Columbia University, and New York State Psychiatric Institute New York New York USA
| | - Eduardo Villamor
- Department of Epidemiology University of Michigan School of Public Health Ann Arbor Michigan USA
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Yuchi W, Brauer M, Czekajlo A, Davies HW, Davis Z, Guhn M, Jarvis I, Jerrett M, Nesbitt L, Oberlander TF, Sbihi H, Su J, van den Bosch M. Neighborhood environmental exposures and incidence of attention deficit/hyperactivity disorder: A population-based cohort study. ENVIRONMENT INTERNATIONAL 2022; 161:107120. [PMID: 35144157 DOI: 10.1016/j.envint.2022.107120] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/15/2021] [Revised: 01/23/2022] [Accepted: 01/26/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND Emerging studies have associated low greenspace and high air pollution exposure with risk of child attention deficit/hyperactivity disorder (ADHD). Population-based studies are limited, however, and joint effects are rarely evaluated. We investigated associations of ADHD incidence with greenspace, air pollution, and noise in a population-based birth cohort. METHODS We assembled a cohort from administrative data of births from 2000 to 2001 (N ∼ 37,000) in Metro Vancouver, Canada. ADHD was identified by hospital records, physician visits, and prescriptions. Cox proportional hazards models were applied to assess associations between environmental exposures and ADHD incidence adjusting for available covariates. Greenspace was estimated using vegetation percentage derived from linear spectral unmixing of Landsat imagery. Fine particulate matter (PM2.5) and nitrogen dioxide (NO2) were estimated using land use regression models; noise was estimated using a deterministic model. Exposure period was from birth until the age of three. Joint effects of greenspace and PM2.5 were analysed in two-exposure models and by categorizing values into quintiles. RESULTS During seven-year follow-up, 1217 ADHD cases were diagnosed. Greenspace was associated with lower incidence of ADHD (hazard ratio, HR: 0.90 [0.81-0.99] per interquartile range increment), while PM2.5 was associated with increased incidence (HR: 1.11 [1.06-1.17] per interquartile range increment). NO2 (HR: 1.01 [0.96, 1.07]) and noise (HR: 1.00 [0.95, 1.05]) were not associated with ADHD. There was a 50% decrease in the HR for ADHD in locations with the lowest PM2.5 and highest greenspace exposure, compared to a 62% increase in HR in locations with the highest PM2.5 and lowest greenspace exposure. Effects of PM2.5 were attenuated by greenspace in two-exposure models. CONCLUSIONS We found evidence suggesting environmental inequalities where children living in greener neighborhoods with low air pollution had substantially lower risk of ADHD compared to those with higher air pollution and lower greenspace exposure.
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Affiliation(s)
- Weiran Yuchi
- School of Population and Public Health, Faculty of Medicine, The University of British Columbia, 2206 East Mall, Vancouver, British Columbia, Canada
| | - Michael Brauer
- School of Population and Public Health, Faculty of Medicine, The University of British Columbia, 2206 East Mall, Vancouver, British Columbia, Canada
| | - Agatha Czekajlo
- Department of Forest Resource Management, Faculty of Forestry, The University of British Columbia, 2424 Main Mall, Vancouver, Canada
| | - Hugh W Davies
- School of Population and Public Health, Faculty of Medicine, The University of British Columbia, 2206 East Mall, Vancouver, British Columbia, Canada
| | - Zoë Davis
- Department of Forest and Conservation Sciences, Faculty of Forestry, The University of British Columbia, 2424 Main Mall, Vancouver, Canada
| | - Martin Guhn
- School of Population and Public Health, Faculty of Medicine, The University of British Columbia, 2206 East Mall, Vancouver, British Columbia, Canada
| | - Ingrid Jarvis
- Department of Forest and Conservation Sciences, Faculty of Forestry, The University of British Columbia, 2424 Main Mall, Vancouver, Canada
| | - Michael Jerrett
- Fielding School of Public Health, University of California at Los Angeles, 650 Charles E. Young Drive South, Los Angeles, CA, the United States
| | - Lorien Nesbitt
- Department of Forest Resource Management, Faculty of Forestry, The University of British Columbia, 2424 Main Mall, Vancouver, Canada
| | - Tim F Oberlander
- School of Population and Public Health, Faculty of Medicine, The University of British Columbia, 2206 East Mall, Vancouver, British Columbia, Canada; Department of Pediatrics, The University of British Columbia, 4480 Oak St. Vancouver, Canada
| | - Hind Sbihi
- School of Population and Public Health, Faculty of Medicine, The University of British Columbia, 2206 East Mall, Vancouver, British Columbia, Canada; BC Centre for Disease Control, Vancouver, Canada
| | - Jason Su
- School of Public Health, University of California at Berkeley, 2121 Berkeley Way West, Berkeley, CA, the United States
| | - Matilda van den Bosch
- School of Population and Public Health, Faculty of Medicine, The University of British Columbia, 2206 East Mall, Vancouver, British Columbia, Canada; Department of Forest and Conservation Sciences, Faculty of Forestry, The University of British Columbia, 2424 Main Mall, Vancouver, Canada; ISGlobal, Parc de Recerca Biomèdica de Barcelona, Doctor Aiguader 88, 08003 Barcelona, Spain; Universitat Pompeu Fabra, Plaça de la Mercè, 10-12, 08002 Barcelona, Spain; Centro de Investigación Biomédica en Red Instituto de Salud Carlos III, Calle de Melchor Fernández Almagro, 3, 28029, Madrid, Spain.
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Dooley N, Clarke M, Cotter D, Cannon M. Birth Weight and Childhood Psychopathology in the ABCD Cohort: Association is Strongest for Attention Problems and is Moderated by Sex. Res Child Adolesc Psychopathol 2022; 50:563-575. [PMID: 35072847 PMCID: PMC9054906 DOI: 10.1007/s10802-021-00859-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/10/2021] [Indexed: 12/23/2022]
Abstract
Many studies have shown low birth weight is associated with psychopathology later in life, particularly attention-deficit/hyperactivity disorder (ADHD). The association is well-replicated, independent from a variety of potential familial confounds, and follows a dose-response curve (decreasing birth weight linked with increasing odds of disorder). However, the specificity of the association to attention problems is called into question by the extent of comorbidity in ADHD, and recent findings that the association is stronger for autism than ADHD. We test the relative dose-response strength of birth weight on multiple aspects of behavior to explore specificity of the effect to attention problems. We also test recent suggestions that the association between birth weight and attention problems is driven by males. Our sample consisted of 9,076 children aged 9-10 from the United States (Adolescent Brain Cognitive Development study). Outcomes included 9 problem-scales and the total problems scale from the Child Behavior Checklist (CBCL). Attention problems were the most strongly associated with birth weight after controlling for gestational age, potential familial confounds, and multiple testing, supporting the outcome-specificity of this association. Contrary to recent registry-based findings, an association between birth weight and an autism scale was not observed. Sex moderated the effect of birth weight on total problems, attention problems and aggressive behavior such that these inverse associations were strongly driven by males. Our findings have strong implications for sex-specific prediction and etiological models of childhood psychopathology.
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Affiliation(s)
- Niamh Dooley
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland. .,Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland.
| | - Mary Clarke
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland.,Department of Psychology, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - David Cotter
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland.,Department of Psychiatry, Beaumont Hospital, Dublin, Ireland
| | - Mary Cannon
- Department of Psychiatry, Royal College of Surgeons in Ireland, Dublin, Ireland.,Trinity College Institute of Neuroscience, Trinity College Dublin, Dublin, Ireland.,Department of Psychiatry, Beaumont Hospital, Dublin, Ireland
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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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Wu W, Zhang B, Li D, Yan M, Deng Q, Kang Y, Du J, Gao X, Yan H. Development and validation of nomogram for prediction of low birth weight: a large-scale cross-sectional study in northwest China. J Matern Fetal Neonatal Med 2021; 35:7562-7570. [PMID: 34304668 DOI: 10.1080/14767058.2021.1956457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Birth weight is closely related to infant survival and future health, growth and development. In developing countries, the incidence of low birth weight is twice as high as in developed countries. Due to the low economic and medical level in northwest China, the problem of low birth weight needs to be solved urgently. METHODS We developed the predictive model based on data sets from a cross-sectional study conducted in northwest China, and data were collected from August 2013 to November 2013. A total of 27,233 patients were included in the study. Least Absolute Shrinkage and Selection Operator (LASSO) regression was used to select the optimal predictive characteristics among risk factors. The selected characteristics in the LASSO regression were used in multivariate logistic regression to build the prediction model. C-index and calibration plot were used to evaluate the degree of discrimination and calibration of the model. The decision curve is used to evaluate the net benefit rate of the application of the predictive tool. Bootstrapping validation was used for internal validation. RESULTS Nomogram included gestational age, the sex of the attendance, the mother's education level, antenatal care, the mother's occupation, pregnancy-induced hypertension, family income, exposure to pesticides and nutritional supplements. The C-index of the predicted nomogram was 0.698(95% confidence interval: 0.671-0.725), C-index of internal verification was 0.694, indicating that the model had a good identification ability. Calibration plot showed that the model had good calibration. Decision curve indicated that patients with a threshold probability of low birth weight between 1% and 71% would benefit more from using the prediction tool. CONCLUSION The use of this predictive model will contribute to clinicians and pregnant women to make personalized predictions easily and quickly so that early lifestyle detection and medical intervention can be undertaken by physicians and patients.
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Affiliation(s)
- Wentao Wu
- Department of Epidemiology and Health Statistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Binyan Zhang
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Daning Li
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Miaojia Yan
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Qiwei Deng
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Yijun Kang
- Department of Epidemiology and Health Statistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Jiaoyang Du
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Xiangyu Gao
- School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
| | - Hong Yan
- Department of Epidemiology and Health Statistics, School of Public Health, Xi'an Jiaotong University Health Science Center, Xi'an, China
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Hassan S, Jahanfar S, Inungu J, Craig JM. Low birth weight as a predictor of adverse health outcomes during adulthood in twins: a systematic review and meta-analysis. Syst Rev 2021; 10:186. [PMID: 34167585 PMCID: PMC8228924 DOI: 10.1186/s13643-021-01730-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 06/01/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Low birth weight might affect adverse health outcomes during a lifetime. Our study analyzes the association between low birth weight and negative health outcomes during adulthood in twin populations. METHODS Searches were conducted using databases inclusive of MEDLINE, CINAHL, Web of Science, and EBSCO. Observational studies on twins with low birth weight and adverse health outcomes during adulthood were included. Two reviewers independently screened the papers, and a third reviewer resolved the conflicts between the two reviewers. Following abstract and title screening, full-texts were screened to obtain eligibility. Eligible full-text articles were then assessed for quality using a modified Downs and Black checklist. Studies with a score within one standard deviation of the mean were included in the analysis. A fixed-effect model was used for analysis. RESULTS 3987 studies were screened describing low birth weight as a risk factor for adverse health outcomes during adulthood for all twelve-body systems (circulatory, digestive, endocrine, lymphatic, muscular, nervous, reproductive, respiratory, skeletal, urinary, and integumentary systems). One hundred fourteen articles made it through full-text screening, and 14 of those articles were assessed for quality. Five papers were selected to perform two meta-analyses for two outcomes: asthma and cerebral palsy. For asthma, the meta-analyses of three studies suggested a higher odds of low birth weight twins developing asthma (OR 1.33, 95% CI 1.24-1.44, I2 = 77%). Meta-analysis for cerebral palsy included two studies and suggested a 4.88 times higher odds of low birth weight twins developing cerebral palsy compared to normal birth weight twins (OR 4.88, 95% CI 2.34-10.19, I2 = 79%). We could not find enough studies for other adverse health outcomes to pool data for a Forest plot. CONCLUSIONS The odds of low birth weight were found to be high in both asthma and cerebral palsy. There are not enough studies of similar nature (study types, similar body systems) to ensure a meaningful meta-analysis. We recommend that future research considers following up on twins to obtain data about adverse health outcomes during their adult lives.
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Affiliation(s)
- Sapha Hassan
- Central Michigan University, Mount Pleasant, USA
| | - Shayesteh Jahanfar
- Department of Public Health and Community Medicine, Tufts School of Medicine, 145 Harrison Ave, Boston, MA, 02111, USA.
| | | | - Jeffrey M Craig
- Deakin University, IMPACT - the Institute for Mental and Physical Health and Clinical Translation, School of Medicine, Geelong, Australia
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11
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Parental Age and the Risk of ADHD in Offspring: A Systematic Review and Meta-Analysis. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:ijerph18094939. [PMID: 34066379 PMCID: PMC8124990 DOI: 10.3390/ijerph18094939] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 04/26/2021] [Accepted: 04/29/2021] [Indexed: 01/24/2023]
Abstract
Evidence has suggested that parental age at birth is a risk factor of offspring attention deficit/hyperactivity disorder (ADHD). We conducted a meta-analysis of observational studies investigating the association between parental age and offspring ADHD. We conducted a systematic search that followed the recommended guidelines for performing meta-analyses on PUBMED, EMBASE, and Web of Science up to 8 April 2021. We calculated pooled risk estimates from individual age with and without adjusting for possible confounding factors. Dose–response analysis for parental age and ADHD risk was performed. Eleven studies were selected in this meta-analysis, which included 111,101 cases and 4,417,148 participants. Compared with the reference points, the lowest parental age category was associated with an increased risk of ADHD in the offspring, with adjusted odds ratios (ORs) of 1.49 (95% confidence intervals (95%CI) 1.19–1.87) and 1.75 (95%CI 1.31–2.36) for the mother and father, respectively. The highest parental age was statistically insignificant, with adjusted ORs of 1.11 (95%CI 0.79–1.55) and 0.93 (95%CI 0.70–1.23) for mother and father separately. Dose–response analysis indicated a non-linear relationship of parental age with offspring ADHD, with the lowest ADHD risk at 31–35 years old. The results of this meta-analysis support an association between young parental age and the risk of ADHD. More high-quality studies are needed to establish whether the association with parental age is causal.
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12
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The association between ADHD and physical health: a co-twin control study. Sci Rep 2020; 10:22388. [PMID: 33372183 PMCID: PMC7769983 DOI: 10.1038/s41598-020-78627-1] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 11/27/2020] [Indexed: 12/14/2022] Open
Abstract
Attention-deficit/hyperactivity disorder (ADHD) has been associated with increased risk for physical comorbidity. This study used a twin cohort to investigate the association between physical diseases and phenotypic variations of ADHD. A twin cohort enriched for ADHD and other neurodevelopmental conditions were analysed. The Attention Problems subscale of the Child Behavior Checklist/Adult Behavior Checklist (CBCL/ABCL-AP) was used to measure the participants’ severity of ADHD symptoms. Physical health issues were obtained with a validated questionnaire and were tested in relation to ADHD symptom severity in a co-twin control model. Neurological problems were significantly associated with a diagnosis of ADHD. A conditional model for the analysis of within-twin pair effects revealed an inverse association between digestive problems and the severity of ADHD symptoms, after adjusting for co-existing autism spectrum disorder and ADHD medications. Our findings suggest that individuals with ADHD are susceptible to neurological problems, why a thorough neurological check-up is indicated in clinical practice for this population. In addition, health conditions of digestive system could be considered as a non-shared environmental factor for behavioral phenotypes in ADHD. It supports the possible role of gut-brain axis in the underpinnings of ADHD symptoms, at least for a subgroup of individuals with certain genetic predisposition.
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13
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Early environmental risk factors for neurodevelopmental disorders - a systematic review of twin and sibling studies. Dev Psychopathol 2020; 33:1448-1495. [PMID: 32703331 PMCID: PMC8564717 DOI: 10.1017/s0954579420000620] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
While neurodevelopmental disorders (NDDs) are highly heritable, several environmental risk factors have also been suggested. However, the role of familial confounding is unclear. To shed more light on this, we reviewed the evidence from twin and sibling studies. A systematic review was performed on case control and cohort studies including a twin or sibling within-pair comparison of neurodevelopmental outcomes, with environmental exposures until the sixth birthday. From 7,315 screened abstracts, 140 eligible articles were identified. After adjustment for familial confounding advanced paternal age, low birth weight, birth defects, and perinatal hypoxia and respiratory stress were associated with autism spectrum disorder (ASD), and low birth weight, gestational age and family income were associated with attention-deficit/hyperactivity disorder (ADHD), categorically and dimensionally. Several previously suspected factors, including pregnancy-related factors, were deemed due to familial confounding. Most studies were conducted in North America and Scandinavia, pointing to a global research bias. Moreover, most studies focused on ASD and ADHD. This genetically informed review showed evidence for a range of environmental factors of potential casual significance in NDDs, but also points to a critical need of more genetically informed studies of good quality in the quest of the environmental causes of NDDs.
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14
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Møllegaard S. The effect of birth weight on behavioral problems in early adolescence: New evidence from monozygotic twins. ECONOMICS AND HUMAN BIOLOGY 2020; 36:100828. [PMID: 31835188 DOI: 10.1016/j.ehb.2019.100828] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/13/2019] [Revised: 11/05/2019] [Accepted: 11/13/2019] [Indexed: 06/10/2023]
Abstract
It is well-established that the prenatal period is a critical and sensitive period of an individual's life, linking prenatal circumstances to short- and long-term outcomes such as infant mortality, educational and occupational success. However, little is known about how prenatal nurture affects intermediate outcomes and noncognitive characteristics such as behavior and behavioral problems. In this paper, I investigate the effects of birth weight on behavioral problems at age 12. I comprehensively control for confounders related to family background and genetics by employing a research design exploiting differences among Danish monozygotic twins. I find that birth weight has a statistically significant negative effect on behavioral problems measured using the Strengths and Difficulties Questionnaire, and that birth weight affects boys and girls differently: birth weight is significantly negatively associated with emotional problems among girls and hyperactivity among boys.
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Affiliation(s)
- Stine Møllegaard
- Department of Sociology, University of Copenhagen, Copenhagen, Denmark.
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15
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Ghirardi L, Pettersson E, Taylor MJ, Freitag CM, Franke B, Asherson P, Larsson H, Kuja-Halkola R. Genetic and environmental contribution to the overlap between ADHD and ASD trait dimensions in young adults: a twin study. Psychol Med 2019; 49:1713-1721. [PMID: 30191778 PMCID: PMC6601357 DOI: 10.1017/s003329171800243x] [Citation(s) in RCA: 44] [Impact Index Per Article: 8.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2018] [Revised: 08/02/2018] [Accepted: 08/08/2018] [Indexed: 12/11/2022]
Abstract
BACKGROUND Traits of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are strongly associated in children and adolescents, largely due to genetic factors. Less is known about the phenotypic and aetiological overlap between ADHD and ASD traits in adults. METHODS We studied 6866 individuals aged 20-28 years from the Swedish Study of Young Adult Twins. Inattention (IA) and hyperactivity/impulsivity (HI) were assessed using the WHO Adult ADHD Self-Report Scale-V1.1. Repetitive and restricted behaviours (RRB) and social interaction and communication (SIC) were assessed using the Autism-Tics, ADHD, and other Comorbidities inventory. We used structural equation modelling to decompose covariance between these ADHD and ASD trait dimensions into genetic and shared/non-shared environmental components. RESULTS At the phenotypic level, IA was similarly correlated with RRB (r = 0.33; 95% Confidence Interval (CI) 0.31-0.36) and with SIC (r = 0.32; 95% CI 0.29-0.34), whereas HI was more strongly associated with RRB (r = 0.38; 95% CI 0.35-0.40) than with SIC (r = 0.24; 95% CI 0.21-0.26). Genetic and non-shared environmental effects accounted for similar proportions of the phenotypic correlations, whereas shared environmental effects were of minimal importance. The highest genetic correlation was between HI and RRB (r = 0.56; 95% 0.46-0.65), and the lowest was between HI and SIC (r = 0.33; 95% CI 0.23-0.43). CONCLUSIONS We found evidence for dimension-specific phenotypic and aetiological overlap between ADHD and ASD traits in adults. Future studies investigating mechanisms underlying comorbidity between ADHD and ASD may benefit from exploring several symptom-dimensions, rather than considering only broad diagnostic categories.
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Affiliation(s)
- Laura Ghirardi
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Erik Pettersson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Mark J. Taylor
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Christine M. Freitag
- Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy, University Hospital Frankfurt, Goethe University, Frankfurt am Main, Germany
| | - Barbara Franke
- Department of Human Genetics and Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands
| | - Philip Asherson
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology, and Neuroscience, King's College London, London, UK
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Ralf Kuja-Halkola
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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16
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Örtqvist L, Engberg H, Strandqvist A, Nordenström A, Holmdahl G, Nordenskjöld A, Frisén L. Psychiatric symptoms in men with hypospadias - preliminary results of a cross-sectional cohort study. Acta Paediatr 2019; 108:1156-1162. [PMID: 30466142 DOI: 10.1111/apa.14658] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 07/12/2018] [Accepted: 11/19/2018] [Indexed: 11/30/2022]
Abstract
AIM Population studies have shown an increased risk of neurodevelopmental disorders in males born with the congenital condition hypospadias, where the opening of the urethra is on the underside of the penis. We investigated overall psychiatric morbidity in cases and matched controls. METHODS This study compared 167 men born with hypospadias from 1959 to 1994 in Stockholm or Gothenburg in Sweden using hospital registers. They were compared with controls from the Swedish population registry, who were contacted by regular mail and students who were recruited by local advertisements. The total sample had a mean age of 33.5 years (range: 19-54). They completed self-rating scales for depressive, anxiety and obsessive-compulsive symptoms and symptoms of attention deficit hyperactivity disorder. In addition, 33 cases and 47 controls underwent psychiatric morbidity interviews that covered the 17 most common psychiatric diagnoses. RESULTS A fifth (21%) of both the cases and controls reported current or previous psychiatric symptoms. There were no significant differences in self-rated depression, anxiety or obsessive-compulsive disorder symptoms between the patients and controls or between the different phenotype groups. The distribution was not significantly affected by the severity of hypospadias. CONCLUSION Psychiatric morbidity was no higher in men with hypospadias than population-based controls.
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Affiliation(s)
- Lisa Örtqvist
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
- Department of Paediatric Surgery Astrid Lindgren Children's Hospital Karolinska University Hospital Stockholm Sweden
| | - Hedvig Engberg
- Department of Clinical Neuroscience Karolinska Institutet Stockholm Sweden
| | - Anna Strandqvist
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
| | - Anna Nordenström
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
- Department of Pediatric Endocrinology Astrid Lindgren Children's Hospital, Karolinska Stockholm Sweden
| | - Gundela Holmdahl
- Women's and Children's Health University Hospital Sahlgrenska Academy Gothenburg Sweden
- Department of Pediatric Surgery Queen Silvia's Children's Hospital Gothenburg Sweden
| | - Agneta Nordenskjöld
- Department of Women's and Children's Health Karolinska Institutet Stockholm Sweden
- Department of Paediatric Surgery Astrid Lindgren Children's Hospital Karolinska University Hospital Stockholm Sweden
| | - Louise Frisén
- Department of Clinical Neuroscience Karolinska Institutet Stockholm Sweden
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17
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Pettersson E, Larsson H, D’Onofrio B, Almqvist C, Lichtenstein P. Association of Fetal Growth With General and Specific Mental Health Conditions. JAMA Psychiatry 2019; 76:536-543. [PMID: 30725083 PMCID: PMC6495458 DOI: 10.1001/jamapsychiatry.2018.4342] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Abstract
IMPORTANCE It is unclear if the associations between fetal growth and later mental health conditions remain after controlling for familial factors and psychiatric comorbidity. OBJECTIVE To examine the associations between fetal growth and general and specific mental health conditions, controlling for familial factors. DESIGN, SETTING, AND PARTICIPANTS This register-based study conducted in Sweden analyzed 546 894 pairs of full siblings born between January 1, 1973, and December 31, 1998. Sibling pairs were followed up through December 31, 2013. First, population-based and within-sibling pair associations (which controlled for time-invariant familial confounders) between fetal growth and the outcomes were estimated. Second, exploratory factor analysis was applied to the outcomes to derive 1 general factor and 4 specific and independent factors. Third, the general and specific factors were regressed on fetal growth. Statistical analysis was performed from March 27, 2017, to October 27, 2018. MAIN OUTCOME AND MEASURES The outcomes were 11 psychiatric diagnoses (depression, anxiety, obsessive-compulsive disorder, posttraumatic stress disorder, bipolar disorder, alcohol abuse, drug use, attention-deficit/hyperactivity disorder, autism, schizophrenia, and schizoaffective disorder) and court convictions of violent crimes. Birth weight (in kilograms) statistically adjusted for gestational age was the exposure. RESULTS The mean (SD) age of the 1 093 788 participants was 27.2 (6.8) years (range, 15.1-40.9 years) and 51.5% were male. Nine outcomes were significantly associated with birth weight in the population at large: depression (odds ratio [OR], 0.96; 95% CI, 0.95-0.98), anxiety (OR, 0.94; 95% CI, 0.92-0.95), posttraumatic stress disorder (OR, 0.91; 95% CI, 0.89-0.93), bipolar disorder (OR, 0.94; 95% CI, 0.89-1.00), alcohol abuse (OR, 0.89; 95% CI, 0.87-0.91), drug use (OR, 0.83; 95% CI, 0.80-0.85), violent crimes (OR, 0.85; 95% CI, 0.83-0.86), attention-deficit/hyperactivity disorder (OR, 0.88; 95% CI, 0.86-0.90), and autism (OR, 0.95; 95% CI, 0.92-0.97). Only depression (OR, 0.95; 95% CI 0.92-0.98), obsessive-compulsive disorder (OR, 0.93; 95% CI, 0.87-0.99), attention-deficit/hyperactivity disorder (OR, 0.86; 95% CI, 0.82-0.89), and autism (OR, 0.72; 95% CI, 0.69-0.76) remained significantly associated within sibling pairs. An exploratory factor analysis indicated that 1 general and 4 specific factors (capturing anxiety, externalizing, neurodevelopmental, and psychotic conditions) fit the outcomes well. Across almost all sensitivity analyses, an increase in birth weight by 1 kg significantly reduced the general (β, -0.047; 95% CI, -0.071 to -0.023) and the specific neurodevelopmental factors (β, -0.159; 95% CI, -0.190 to -0.128) within sibling pairs. CONCLUSIONS AND RELEVANCE Controlling for familial confounders, reduced fetal growth was associated with a small but significant increase in the general factor of psychopathology and a moderate increase in a specific neurodevelopmental factor.
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Affiliation(s)
- Erik Pettersson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden,School of Medical Sciences, Örebro University, Örebro, Sweden
| | - Brian D’Onofrio
- Department of Psychology, University of Indiana, Bloomington
| | - Catarina Almqvist
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden,Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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18
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Zhang-James Y, Vaudel M, Mjaavatten O, Berven FS, Haavik J, Faraone SV. Effect of disease-associated SLC9A9 mutations on protein-protein interaction networks: implications for molecular mechanisms for ADHD and autism. ACTA ACUST UNITED AC 2019; 11:91-105. [PMID: 30927234 DOI: 10.1007/s12402-018-0281-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2018] [Accepted: 11/27/2018] [Indexed: 12/20/2022]
Abstract
Na+/H+ Exchanger 9 (NHE9) is an endosomal membrane protein encoded by the Solute Carrier 9A, member 9 gene (SLC9A9). SLC9A9 has been implicated in attention deficit hyperactivity disorder (ADHD), autism spectrum disorders (ASDs), epilepsy, multiple sclerosis and cancers. To better understand the function of NHE9 and the effects of disease-associated variants on protein-protein interactions, we conducted a quantitative analysis of the NHE9 interactome using co-immunoprecipitation and isobaric labeling-based quantitative mass spectrometry. We identified 100 proteins that interact with NHE9. These proteins were enriched in known functional pathways for NHE9: the endocytosis, protein ubiquitination and phagosome pathways, as well as some novel pathways including oxidative stress, mitochondrial dysfunction, mTOR signaling, cell death and RNA processing pathways. An ADHD-associated mutation (A409P) significantly altered NHE9's interactions with a subset of proteins involved in caveolae-mediated endocytosis and MAP2K2-mediated downstream signaling. An ASD nonsense mutation in SLC9A9, R423X, produced no-detectable amount of NHE9, suggesting the overall loss of NHE9 functional networks. In addition, seven of the NHE9 interactors are products of known autism candidate genes (Simons Foundation Autism Research Initiative, SFARI Gene) and 90% of the NHE9 interactome overlap with SFARI protein interaction network PIN (p < 0.0001), supporting the role of NHE9 interactome in ASDs molecular mechanisms. Our results provide a detailed understanding of the functions of protein NHE9 and its disrupted interactions, possibly underlying ADHD and ASDs. Furthermore, our methodological framework proved useful for functional characterization of disease-associated genetic variants and suggestion of druggable targets.
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Affiliation(s)
- Yanli Zhang-James
- Departments of Psychiatry, SUNY Upstate Medical University, 750 East Adams St., Syracuse, NY, 13210, USA
| | - Marc Vaudel
- Department of Clinical Science, University of Bergen, Bergen, Norway
| | - Olav Mjaavatten
- Department of Biomedicine, University of Bergen, Bergen, Norway
| | - Frode S Berven
- Department of Biomedicine, University of Bergen, Bergen, Norway
| | - Jan Haavik
- Department of Biomedicine, University of Bergen, Bergen, Norway.,K.G. Jebsen Centre for Research on Neuropsychiatric Disorders, University of Bergen, Bergen, Norway.,Division of Psychiatry, Haukeland University Hospital, Bergen, Norway
| | - Stephen V Faraone
- Departments of Psychiatry, SUNY Upstate Medical University, 750 East Adams St., Syracuse, NY, 13210, USA. .,Neuroscience and Physiology, SUNY Upstate Medical University, 750 East Adams St., Syracuse, NY, 13210, USA.
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19
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Ferrer M, García-Esteban R, Iñiguez C, Costa O, Fernández-Somoano A, Rodríguez-Delhi C, Ibarluzea J, Lertxundi A, Tonne C, Sunyer J, Julvez J. Head circumference and child ADHD symptoms and cognitive functioning: results from a large population-based cohort study. Eur Child Adolesc Psychiatry 2019; 28:377-388. [PMID: 30027417 DOI: 10.1007/s00787-018-1202-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2017] [Accepted: 07/16/2018] [Indexed: 12/24/2022]
Abstract
The aim of this study is to understand the association between prenatal, newborn and postnatal head circumference (HC) and preschool neurodevelopment in a large population-based birth cohort. The INMA project followed 1795 children from 12 weeks of pregnancy to preschool years. HC measurements were carried out prospectively, and following a standardized protocol during pregnancy (12, 20 and 34 weeks), birth, and child ages of 1-1.5 and 4 years old; and z-scores were further estimated. Prenatal head growth was assessed using conditional z-scores between weeks 12-20 and 20-34. Several neuropsychological tests [MSCA (cognition), CPT (attention)] and behavioral rating scales [DSM-IV-ADHD, CAST (autism), CPSCS (social competence)] were carried out during the last follow-up (5 years old). Multivariable models adjusted for family and child characteristics were applied to analyze associations between HC and neurodevelopment. In fully adjusted models, prenatal HC and head growth showed little or no associations with the neurodevelopment outcomes. Independent associations were observed between HC z-scores at birth, 1-1.5 years and 4 years and MSCA global cognitive scores and DSM-IV inattention symptoms. Specifically, z-score at birth was positively associated with general cognitive scores [β 1.22, 95% confidence interval (CI) 0.59, 1.85], and we observed a protective association with ADHD-DSM-IV total symptoms, mean ratio (MR) 0.85 (0.75, 0.96). Prenatal HC and head growth measurements gave little information about child cognitive abilities and behavior at preschool years. However, HC at birth and early childhood was positively associated with a range of neuropsychological outcomes, including protective associations with ADHD symptoms.
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Affiliation(s)
- Muriel Ferrer
- ISGlobal, Instituto de Salud Global de Barcelona-Campus MAR, PRBB, C. Doctor Aiguader 88, 08003, Barcelona, Catalonia, Spain
| | - Raquel García-Esteban
- ISGlobal, Instituto de Salud Global de Barcelona-Campus MAR, PRBB, C. Doctor Aiguader 88, 08003, Barcelona, Catalonia, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Catalonia, Spain.,CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain
| | - Carmen Iñiguez
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain.,Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat, Jaume I-Universitat de València, Av. Catalunya 21, 46020, Valencia, Spain
| | - Olga Costa
- Epidemiology and Environmental Health Joint Research Unit, FISABIO-Universitat, Jaume I-Universitat de València, Av. Catalunya 21, 46020, Valencia, Spain
| | - Ana Fernández-Somoano
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain.,Departamento de Medicina, Universidad de Oviedo, Oviedo, Asturias, Spain
| | | | - Jesús Ibarluzea
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain.,Public Health Division of Gipuzkoa, BioDonostia Research Institute, Gipuzkoa, San Sebastian, Spain.,Faculty of Psychology, University of the Basque Country (UPV/EHU), San Sebastian, Spain
| | - Aitana Lertxundi
- CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain.,Faculty of Psychology, University of the Basque Country (UPV/EHU), San Sebastian, Spain
| | - Cathryn Tonne
- ISGlobal, Instituto de Salud Global de Barcelona-Campus MAR, PRBB, C. Doctor Aiguader 88, 08003, Barcelona, Catalonia, Spain
| | - Jordi Sunyer
- ISGlobal, Instituto de Salud Global de Barcelona-Campus MAR, PRBB, C. Doctor Aiguader 88, 08003, Barcelona, Catalonia, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Catalonia, Spain.,CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain
| | - Jordi Julvez
- ISGlobal, Instituto de Salud Global de Barcelona-Campus MAR, PRBB, C. Doctor Aiguader 88, 08003, Barcelona, Catalonia, Spain. .,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Catalonia, Spain. .,CIBER Epidemiologia y Salud Pública (CIBERESP), Madrid, Spain. .,Universitat Pompeu Fabra (UPF), Barcelona, Catalonia, Spain.
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20
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Alebel A, Wagnew F, Tesema C, Gebrie A, Ketema DB, Asmare G, Kibret GD. Factors associated with low birth weight at Debre Markos Referral Hospital, Northwest Ethiopia: a hospital based cross-sectional study. BMC Res Notes 2019; 12:105. [PMID: 30813968 PMCID: PMC6391783 DOI: 10.1186/s13104-019-4143-1] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2018] [Accepted: 02/21/2019] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To assess the prevalence and associated factors of low birth weight among newborns delivered at Debre Markos Referral Hospital, Northwest Ethiopia. RESULTS From the total of 368 newborn baby/mother pairs planned to be participated, 338 agreed and involved in the study giving a response rate of 91.2%. In this study, the prevalence of low birth weight was 21.6 (95% CI 17.5, 26%). Being rural residence (AOR 2.0, 95% CI 1.0, 4.1), duration of pregnancy (AOR = 7.6, 95% CI 3.3, 17.4), and having complications during pregnancy (AOR 2.6, 95% CI 1.2, 5.7) were found to be factors significantly associated with low birth weight.
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Affiliation(s)
- Animut Alebel
- Department of Nursing, College of Health Science, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia.
| | - Fasil Wagnew
- Department of Nursing, College of Health Science, Debre Markos University, P.O. Box 269, Debre Markos, Ethiopia
| | - Cheru Tesema
- Department of Public Health, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Alemu Gebrie
- Department of Biomedical Science, School of Medicine, Debre Markos University, Debre Markos, Ethiopia
| | - Daniel Bekele Ketema
- Department of Public Health, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
| | - Getnet Asmare
- College of Health Science, Debre Tabor University, Debre Tabor, Ethiopia
| | - Getiye Dejenu Kibret
- Department of Public Health, College of Health Science, Debre Markos University, Debre Markos, Ethiopia
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21
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Lim KX, Liu C, Schoeler T, Cecil CA, Barker ED, Viding E, Greven CU, Pingault J. The role of birth weight on the causal pathway to child and adolescent ADHD symptomatology: a population-based twin differences longitudinal design. J Child Psychol Psychiatry 2018; 59:1036-1043. [PMID: 29999186 PMCID: PMC6175300 DOI: 10.1111/jcpp.12949] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/08/2018] [Indexed: 01/24/2023]
Abstract
BACKGROUND Available evidence points towards lower birth weight as a risk factor for the development of attention deficit/hyperactivity disorder (ADHD) symptoms. We probed the causal nature of this putative effect of birth weight on ADHD symptoms using the twin differences design, which accounts for genetic and shared environmental confounds. METHOD In a large population-based twin sample - 3,499 monozygotic (MZ) and 6,698 dizygotic (DZ) pairs - parents, teachers or twins rated the twins' ADHD symptoms at nine assessment waves (2-16 years). We implemented the twin differences design, which completely accounts for shared environmental and genetic confounding in MZ twins. We tested whether: (a) the lighter-born twins had elevated ADHD symptoms compared to the heavier-born twins, by regressing within-pair differences of ADHD symptoms on within-pair differences of birth weight among MZ twins; (b) the effect of birth weight on ADHD was moderated by gender, gestational age and low birth weight; (c) this effect changed with age at ADHD assessment using adapted latent growth curve models; and (d) results differed for inattention and hyperactivity/impulsivity. RESULTS Birth weight significantly predicted ADHD symptoms from early childhood to late adolescence. The lighter-born twin had more ADHD symptoms than the heavier-born cotwin among MZ twins across assessment waves and raters. No moderation effect was detected. The magnitude of the effect of birth weight decreased significantly across time for hyperactivity/impulsivity, but the decrease failed to reach significance for inattention. Estimates for inattention were significantly larger than for hyperactivity/impulsivity at each time point, implying stronger effect of birth weight on inattention symptoms. CONCLUSIONS Our findings provide stringent evidence for environmental effect of lower birth weight on the causal pathway to elevated ADHD symptoms. Effect of birth weight persists across a 14-year period from childhood into late adolescence, in particular for inattention symptoms.
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Affiliation(s)
- Kai Xiang Lim
- Social, Genetic, and Developmental Psychiatry CentreInstitute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK
| | - Chao‐Yu Liu
- Department of Clinical, Educational and Health PsychologyDivision of Psychology and Language SciencesUniversity College LondonLondonUK,School of MedicineNational Taiwan UniversityTaipei CityTaiwan
| | - Tabea Schoeler
- Department of Clinical, Educational and Health PsychologyDivision of Psychology and Language SciencesUniversity College LondonLondonUK
| | - Charlotte A.M. Cecil
- Department of PsychologyInstitute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
| | - Edward D. Barker
- Department of PsychologyInstitute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
| | - Essi Viding
- Department of Clinical, Educational and Health PsychologyDivision of Psychology and Language SciencesUniversity College LondonLondonUK
| | - Corina U. Greven
- Social, Genetic, and Developmental Psychiatry CentreInstitute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK,Department of Cognitive NeuroscienceDonders Institute for Brain, Cognition and BehaviourRadboud University Medical CentreNijmegenThe Netherlands,Karakter Child and Adolescent PsychiatryUniversity CenterNijmegenThe Netherlands
| | - Jean‐Baptiste Pingault
- Social, Genetic, and Developmental Psychiatry CentreInstitute of Psychiatry, Psychology and NeuroscienceKing's College LondonLondonUK,Department of Clinical, Educational and Health PsychologyDivision of Psychology and Language SciencesUniversity College LondonLondonUK
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22
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Şişmanlar Eyüboğlu T, Aslan AT, Ceylan A, Soysal AŞ, Budakoğlu Iİ, Ulukavak Çiftçi T, Köktürk O. Neurocognitive disorders and sleep in children with primary ciliary dyskinesia. Pediatr Pulmonol 2018; 53:1436-1441. [PMID: 29992786 DOI: 10.1002/ppul.24133] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2017] [Accepted: 06/20/2018] [Indexed: 11/12/2022]
Abstract
BACKGROUND Primary ciliary dyskinesia (PCD) patients have higher incidence of sleep disordered breathing which lead neurocognitive impairments such as attention-deficit/hyperactivity disorder (ADHD). It may effect academic performance of children and may cause impairment in emotional relationships. This study aim to evaluate hyperactivity and attention deficiency in PCD patients and investigate the relationship between sleep and hyperactivity and attention deficiency in PCD patients. METHOD Fifteen PCD patients aged 8-18 years and 31 age-matched healthy controls were compared. Ear, nose, and throat examination and home sleep testing were performed in PCD patients. Pediatric sleep questionnaire, Conners' Parents and Teacher scale and Stroop test were applied in both groups in order to investigate the relation between sleep disordered breathing and ADHD in PCD children. RESULTS PCD patients had chronic rhinosinusitis (100%), tonsillar hypertrophy (80%) and adenoidal hypertrophy (60%). FEF25-75 was low in pulmonary function test. Sixty percent of the PCD patients had mild obstructive sleep apnea syndrome in home sleep testing. Mean AHI was 1.54 ± 0.27. Compared with the controls PCD patients had higher PSQ scores. Hyperactivity scores on Conners' Parents scale and inattention findings in Stroop test were higher in PCD patients than the healthy controls (P < 0.05). CONCLUSION Most of PCD children had mild obstructive sleep apnea syndrome. Hyperactivity and inattention findings were higher in PCD patients. Sleep disordered breathing assessment should be a routine part of PCD patients management and these patients should be carefully monitored in terms of hyperactivity and inattention.
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Affiliation(s)
- Tuğba Şişmanlar Eyüboğlu
- Department of Pediatric Pulmonology, Dr Sami Ulus Maternity and Children Research and Training Hospital, Ankara, Turkey
| | - Ayşe Tana Aslan
- Department of Pediatric Pulmonology, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Alper Ceylan
- Department of ENT, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Azime Şebnem Soysal
- Department of Pediatrics, Gazi University Faculty of Medicine, Ankara, Turkey
| | - Işıl İrem Budakoğlu
- Department of Medical Education, Gazi University Faculty of Medicine, Ankara, Turkey
| | | | - Oğuz Köktürk
- Department of Chest Diseases, Gazi University Faculty of Medicine, Ankara, Turkey
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23
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Momany AM, Kamradt JM, Nikolas MA. A Meta-Analysis of the Association Between Birth Weight and Attention Deficit Hyperactivity Disorder. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2018; 46:1409-1426. [PMID: 29159441 PMCID: PMC5962386 DOI: 10.1007/s10802-017-0371-9] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
A large body of work has investigated the association between birth weight and ADHD and has resulted in mixed findings with regard to the direction and magnitude of this association. Despite the vast amount of research on this topic, a comprehensive and systematic quantification of the association between birth weight and ADHD has yet to be undertaken. A meta-analysis of 88 unique studies (N = 4,645,482) was conducted to quantify the overall effect size of birth weight on ADHD symptoms. Several variables were examined as moderators that may contribute to systematic variation in effect sizes. Overall, birth weight was found to have a small, but significant, association with ADHD symptoms such that individuals born at lower birth weights manifested greater symptoms of ADHD (r = -0.15). Sample type, mean birth weight of the sample, geographic region, the informant of ADHD symptoms, ADHD symptom measurement method, and race were all found to contribute significantly to heterogeneity in effect sizes. Notably, several early life risk factors previously found to be associated with both ADHD and birth weight, gestational age and prenatal smoking exposure, were not found to contribute to heterogeneity in effect sizes. The findings of the current analyses align with the growing recognition that early life adversity contributes to neurodevelopmental difficulties, and the findings highlight the importance of a better understanding of the mechanisms underlying the association between early life risk factors and adverse neurodevelopmental sequela, such as that observed in ADHD.
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Affiliation(s)
- Allison M Momany
- Department of Psychological and Brain Sciences, University of Iowa, E11 Seashore Hall, Iowa City, IA, 52242, USA.
| | - Jaclyn M Kamradt
- Department of Psychological and Brain Sciences, University of Iowa, E11 Seashore Hall, Iowa City, IA, 52242, USA
| | - Molly A Nikolas
- Department of Psychological and Brain Sciences, University of Iowa, E11 Seashore Hall, Iowa City, IA, 52242, USA
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24
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Furuse T, Wakana S. [Does Malnutrition during Fetal Life Have a Potential to Be a Precipitating Factor for Developmental Disorders?]. Nihon Eiseigaku Zasshi 2018; 73:97-100. [PMID: 29848880 DOI: 10.1265/jjh.73.97] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
OBJECTIVES The developmental origins of health and disease paradigm (DOHaD) is a concept that fetal environmental factors affect adult phenotypes. We performed experiments to evaluate the DOHaD theory in developmental disorders using mouse models. METHODS In vitro fertilization and embryo transfer techniques were used for mouse production. The AIN93G-control diet, which contains 20% protein (CD), 5% protein-restricted diet (PR), and PR with supplemental folic acid (FA) were provided as experimental diets to mothers. The body weights (BWs) of mothers and offspring, and the blood-clinical biochemistry results of mothers were examined. In addition, gene expression and genomic methylation in the brain of adult offspring and behavioral phenotypes of adult offspring were examined. RESULTS Pregnant mothers that consumed the protein-restricted diets, namely, PR and FA, exhibited reduction in BW. The values of protein-related parameters determined by blood-clinical biochemistry decreased in the PR fed groups. The BWs of neonates and adult offspring did not change. The offspring exposed to maternal hyponutrition exhibited increased activity in the home cage and enhanced fear and anxiety-like behavior. The adult offspring of the PR-fed group and FA-fed groups exhibited different patterns of mRNA expression and genomic methylation in the brain. CONCLUSIONS The maternal PR diet affected the progenies' behavioral phenotypes and epigenetic outcomes in the brain. However, the behavioral changes induced by maternal protein restriction were very slight. Hence, interactions between several genetic factors and environmental exposures such as maternal malnutrition may cause developmental and psychiatric disorders.
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Affiliation(s)
- Tamio Furuse
- Technology and Development Team for Mouse Phenotype Analysis, RIKEN BRC
| | - Shigeharu Wakana
- Technology and Development Team for Mouse Phenotype Analysis, RIKEN BRC
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25
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Lin B, Ostlund BD, Conradt E, Lagasse LL, Lester BM. Testing the programming of temperament and psychopathology in two independent samples of children with prenatal substance exposure. Dev Psychopathol 2018; 30:1023-1040. [PMID: 30068412 PMCID: PMC6074047 DOI: 10.1017/s0954579418000391] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
Abstract
Prenatal programming models have rarely been applied to research on children with prenatal substance exposure, despite evidence suggesting that prenatal drug exposure is a form of stress that impacts neurodevelopmental outcomes and risk for psychopathology. Utilizing data from two longitudinal multisite studies comprising children prenatally exposed to substances as well as a nonexposed comparison group (Maternal Lifestyle Study, n = 1,388; Infant Development, Environment, and Lifestyle study, n = 412), we tested whether early phenotypic indicators of hypothesized programming effects, indexed by growth parameters at birth and infant temperament, served as a link between prenatal substance exposure and internalizing and externalizing behavior at age 5. Latent profile analysis indicated that individual differences in reactivity and regulation for infants prenatally exposed to substances was best characterized by four temperament profiles. These profiles were virtually identical across two independent samples, and demonstrated unique associations with adjustment difficulties nearly 5 years later. Results of path analysis using structural equation modeling also showed that increased prenatal substance exposure was linked to poorer growth parameters at birth, profiles of temperamental reactivity in infancy, and internalizing and externalizing behavior at age 5. This pathway was partially replicated across samples. This study was among the first to link known individual-level correlates of prenatal substance exposure into a specific pathway to childhood problem behavior. Implications for the developmental origins of a child's susceptibility to psychopathology as a result of intrauterine substance exposure are discussed.
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26
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Hanć T, Cortese S. Attention deficit/hyperactivity-disorder and obesity: A review and model of current hypotheses explaining their comorbidity. Neurosci Biobehav Rev 2018; 92:16-28. [PMID: 29772309 DOI: 10.1016/j.neubiorev.2018.05.017] [Citation(s) in RCA: 56] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2018] [Revised: 04/29/2018] [Accepted: 05/14/2018] [Indexed: 01/10/2023]
Abstract
Available meta-analyses point to a significant association between attention-deficit/hyperactivity disorder (ADHD) and obesity. The possible mechanisms underlying this relationship are unclear. Here, we overview the studies aimed at identifying the factors contributing to the comorbidity between ADHD and obesity, including genetic factors, fetal programming, executive dysfunctions, psychosocial stress, factors directly related to energy balance, and sleep patterns alterations. The bulk of current research has focused on reduced physical activity and abnormal eating patterns as possible causes of weight gain in individuals with ADHD. Further research is needed to explore the specific role of executive dysfunctions. None of the available published studies have evaluated physiological mechanisms such as hormonal and metabolic disorders or inappropriate neurobiological regulation of appetite. Research exploring the genetic basis for the coexistence of ADHD and obesity and epigenetic mechanisms, with particular emphasis on stress, both pre- and postnatal, seems particularly promising. Here, we propose a biopsychosocial model to integrate current findings and move the field forward to gain insight into the ADHD-obesity relationship.
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Affiliation(s)
- Tomasz Hanć
- Department of Human Biological Development, Institute of Anthropology, Faculty of Biology, Adam Mickiewicz University, Ul. Umultowska 89, 61-614, Poznan, Poland.
| | - Samuele Cortese
- Center for Innovation in Mental Health, Academic Unit of Psychology, University of Southampton, SO17 1BJ, UK; Clinical and Experimental Sciences (CNS and Psychiatry), Faculty of Medicine, University of Southampton, SO17 1BJ, UK; Solent NHS Trust, Southampton, SO19 8BR, UK; New York University Child Study Center, New York, NY, 10016, USA; Division of Psychiatry and Applied Psychology, School of Medicine, University of Nottingham, Nottingham, NG7 2UH, UK
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27
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Brander G, Rydell M, Kuja-Halkola R, Fernández de la Cruz L, Lichtenstein P, Serlachius E, Rück C, Almqvist C, D'Onofrio BM, Larsson H, Mataix-Cols D. Perinatal risk factors in Tourette's and chronic tic disorders: a total population sibling comparison study. Mol Psychiatry 2018; 23:1189-1197. [PMID: 28348386 PMCID: PMC5984087 DOI: 10.1038/mp.2017.31] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2016] [Revised: 12/15/2016] [Accepted: 01/09/2017] [Indexed: 12/19/2022]
Abstract
Adverse perinatal events may increase the risk of Tourette's and chronic tic disorders (TD/CTD), but previous studies have been unable to control for unmeasured environmental and genetic confounding. We aimed to prospectively investigate potential perinatal risk factors for TD/CTD, taking unmeasured factors shared between full siblings into account. A population-based birth cohort, consisting of all singletons born in Sweden in 1973-2003, was followed until December 2013. A total of 3 026 861 individuals were identified, 5597 of which had a registered TD/CTD diagnosis. We then studied differentially exposed full siblings from 947 942 families; of these, 3563 families included siblings that were discordant for TD/CTD. Perinatal data were collected from the Medical Birth Register and TD/CTD diagnoses were collected from the National Patient Register, using a previously validated algorithm. In the fully adjusted models, impaired fetal growth, preterm birth, breech presentation and cesarean section were associated with a higher risk of TD/CTD, largely independent from shared family confounders and measured covariates. Maternal smoking during pregnancy was associated with risk of TD/CTD in a dose-response manner but the association was no longer statistically significant in the sibling comparison models or after the exclusion of comorbid attention-deficit/hyperactivity disorder. A dose-response relationship between the number of adverse perinatal events and increased risk for TD/CTD was also observed, with hazard ratios ranging from 1.41 (95% confidence interval (CI): 1.33-1.50) for one event to 2.42 (95% CI: 1.65-3.53) for five or more events. These results pave the way for future gene by environment interaction and epigenetic studies in TD/CTD.
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Affiliation(s)
- G Brander
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden,Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Gävlegatan 22B, Stockholm 113 30, Sweden. E-mail:
| | - M Rydell
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - R Kuja-Halkola
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - L Fernández de la Cruz
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden
| | - P Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - E Serlachius
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden,Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - C Rück
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden,Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
| | - C Almqvist
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden,Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - B M D'Onofrio
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA
| | - H Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden,Department of Medical Sciences, Örebro University, Örebro, Sweden
| | - D Mataix-Cols
- Department of Clinical Neuroscience, Centre for Psychiatry Research, Karolinska Institutet, Stockholm, Sweden,Stockholm Health Care Services, Stockholm County Council, Stockholm, Sweden
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28
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Serati M, Barkin JL, Orsenigo G, Altamura AC, Buoli M. Research Review: The role of obstetric and neonatal complications in childhood attention deficit and hyperactivity disorder - a systematic review. J Child Psychol Psychiatry 2017; 58:1290-1300. [PMID: 28714195 DOI: 10.1111/jcpp.12779] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/22/2017] [Indexed: 12/14/2022]
Abstract
BACKGROUND Attention deficit and hyperactivity disorder (ADHD) is a developmental disorder characterized by an inability to sustain attention, activity levels and impulse control, and, according to the latest studies, the prevalence is about 8% and in some countries less than 1%. Currently, it is well-known that complications during the perinatal period have significant implications on child's physical and mental health. Purpose of the present paper is to review the literature about the association between perinatal complications and future risk of an ADHD diagnosis. METHODS A research in the main database sources has been conducted to obtain a systematic review on the perinatal risk factors of ADHD. RESULTS Among perinatal complications, available data indicate low birth weight (LBW) (Cohen's d effect size range: 0.31-1.64-small effect size) and preterm birth (PB) (range d: 0.41-0.68) as the most important factors associated with a future diagnosis of ADHD. CONCLUSIONS PB and LBW children should be carefully monitored for an early diagnosis of ADHD limiting the impact of the disease in life span. A systematic review focusing on these risk factors have not been published until now, in the next future preventive strategies should be developed in order to minimize ADHD onset.
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Affiliation(s)
- Marta Serati
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Jennifer L Barkin
- Department of Community Medicine, Mercer University School of Medicine, Macon, GA, USA
| | - Giulia Orsenigo
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Alfredo Carlo Altamura
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
| | - Massimiliano Buoli
- Department of Psychiatry, University of Milan, Fondazione IRCCS Ca'Granda Ospedale Maggiore Policlinico, Milan, Italy
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29
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Pohlabeln H, Rach S, De Henauw S, Eiben G, Gwozdz W, Hadjigeorgiou C, Molnár D, Moreno LA, Russo P, Veidebaum T, Pigeot I. Further evidence for the role of pregnancy-induced hypertension and other early life influences in the development of ADHD: results from the IDEFICS study. Eur Child Adolesc Psychiatry 2017; 26:957-967. [PMID: 28258320 DOI: 10.1007/s00787-017-0966-2] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/26/2016] [Accepted: 02/21/2017] [Indexed: 12/25/2022]
Abstract
The aim of this study is to investigate whether in addition to established early risk factors other, less studied pre-, peri-, and postnatal influences, like gestational hypertension or neonatal respiratory disorders and infections, may increase a child's risk of developing attention-deficit/hyperactivity disorders (ADHD). In the IDEFICS study more than 18,000 children, aged 2-11.9 years, underwent extensive medical examinations supplemented by parental questionnaires on pregnancy and early childhood. The present analyses are restricted to children whose parents also completed a supplementary medical questionnaire (n = 15,577), including the question whether or not the child was ever diagnosed with ADHD. Multilevel multivariable logistic regression was used to assess the association between early life influences and the risk of ADHD. Our study confirms the well-known association between maternal smoking during pregnancy and a child's risk of ADHD. In addition, our study showed that children born to mothers younger than 20 years old were 3-4 times more likely to develop ADHD as compared to children born to mothers aged 25 years and older. Moreover, we found that children whose mothers suffered from pregnancy-induced hypertension had an approximately twofold risk of ADHD (OR 1.95; 95% CI 1.09-3.48). This also holds true for infections during the first 4 weeks after birth (OR 2.06; 95% CI 1.05-4.04). In addition, although not statistically significant, we observed a noticeable elevated risk estimate for neonatal respiratory disorders (OR 1.76; 95% CI 0.91-3.41). Hence, we recommend that these less often studied pre-, peri, and postnatal influences should get more attention when considering early indicators or predictors for ADHD in children. However, special study designs such as genetically sensitive designs may be needed to derive causal conclusions.
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Affiliation(s)
- Hermann Pohlabeln
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Achterstrasse 30, 28359, Bremen, Germany.
| | - Stefan Rach
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Achterstrasse 30, 28359, Bremen, Germany
| | - Stefaan De Henauw
- Department of Public Health, Faculty of Medicine and Health Sciences, Ghent University, Ghent, Belgium
| | - Gabriele Eiben
- Section for Epidemiology and Social Medicine, Institute of Medicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden
| | - Wencke Gwozdz
- Department of Intercultural Communication and Management, Centre for Corporate Social Responsibility, Copenhagen Business School, Copenhagen, Denmark
| | | | - Dénes Molnár
- Department of Paediatrics, Medical Faculty, University of Pécs, Pecs, Hungary
| | - Luis A Moreno
- GENUD (Growth, Exercise, Nutrition and Development) Research Group, Instituto Agroalimentario de Aragón (IA2), Instituto de Investigación Sanitaria Aragón (IIS Aragón), Centro de Investigación Biomédica en Red Fisiopatología de la Obesidad y Nutrición (CIBERObn), University of Zaragoza, Saragossa, Spain
| | - Paola Russo
- Unit of Epidemiology & Population Genetics, Institute of Food Sciences, National Research Council, Avellino, Italy
| | | | - Iris Pigeot
- Leibniz Institute for Prevention Research and Epidemiology-BIPS, Achterstrasse 30, 28359, Bremen, Germany
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30
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The Prevalence and Risk Factors for Low Birth Weight among Term Newborns in Adwa General Hospital, Northern Ethiopia. Obstet Gynecol Int 2017; 2017:2149156. [PMID: 28744313 PMCID: PMC5514323 DOI: 10.1155/2017/2149156] [Citation(s) in RCA: 43] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2017] [Revised: 04/06/2017] [Accepted: 04/27/2017] [Indexed: 11/29/2022] Open
Abstract
Background. World health organization estimates that 25 million LBW babies are born annually worldwide and 95% occur in developing countries. Objective. To assess the prevalence and associated factors of low birth weight among term neonates delivered in Adwa Hospital, Northern Ethiopia. Methods. A cross-sectional study was conducted among neonates delivered in Adwa Hospital. All live births delivered from July 1, 2014, to June 30, 2016, were included in this study. The study participants were selected through systematic sampling technique and the data was collected using a structured questionnaire. Data was entered to Epi Data version 3.1 and analyzed using SPSS version 20 software. To identify independent predictors, bivariate and multivariable binary logistic regressions were employed. Adjusted odds ratio and 95% confidence interval were used to determine the strength of association. Results. The prevalence of term low birth weight was 10%. The risk factors were mothers aged less than 20 years, mothers whose pregnancy was desired, mothers with a history of abortion, and mothers with normal hemoglobin, iron with folic acid, and HIV status. Conclusion. The burden of LBW obtained in this study was in the same range as in some other countries.
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31
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Components of the folate metabolic pathway and ADHD core traits: an exploration in eastern Indian probands. J Hum Genet 2017; 62:687-695. [PMID: 28250422 DOI: 10.1038/jhg.2017.23] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 01/30/2017] [Accepted: 01/31/2017] [Indexed: 01/11/2023]
Abstract
We investigated role of the folate-homocysteine metabolic pathway in the etiology of attention-deficit hyperactivity disorder (ADHD) due to its importance in maintaining DNA integrity as well as neurotransmission. Functional gene variants in MTR (rs1805087), CBS (rs5742905), MTHFR (rs1801133 &rs1801131), MTHFD (rs2236225), RFC1 (rs1051266), plasma vitamin B12, folate and homocysteine were analyzed. rs1805087 'A' showed strong association with ADHD. Vitamin B12 deficiency of ADHD probands (P=0.01) correlated with rs1801133 'T' and rs1805087'GG'. Mild hyperhomocysteinemia (P=0.05) in the probands was associated with rs1805087 'AA'. Probands having rs1805087 'GG' and rs1051266 'G' was more inattentive. Hyperactivity-impulsivity score revealed association with rs5742905 'TT' and rs2236225 'CC', while rs1801133 'CC' showed association with inattentiveness and hyperactivity-impulsivity. rs1801131 exhibited strong synergistic interaction with rs1051266 and rs2236225. This indicated that the folate-homocysteine pathway gene variants may affect ADHD etiology through mild hyperhomocysteinemia and vitamin B12 deficiency, factors known to be associated with cognitive deficit.
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32
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Momany AM, Kamradt JM, Ullsperger JM, Elmore AL, Nigg JT, Nikolas MA. Sex moderates the impact of birth weight on child externalizing psychopathology. JOURNAL OF ABNORMAL PSYCHOLOGY 2017; 126:244-256. [PMID: 27868421 PMCID: PMC5305621 DOI: 10.1037/abn0000238] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
Low birth weight (LBW) has consistently been associated with childhood attention deficit/hyperactivity disorder (ADHD), and a similar association has been found for childhood externalizing disorders, such as oppositional defiant disorder (ODD) and conduct disorder (CD), albeit to a lesser degree. Although the association between LBW and these disorders has been robustly replicated, few studies have adequately controlled for confounding variables, such as parental age at birth and prenatal tobacco use, examined the specificity of the risk of LBW for ADHD symptoms, or investigated potential nonlinear (i.e., quadratic) effects of birth weight (BW). Additionally, the extent to which LBW confers risk for these disorders depending on childhood sex has rarely been examined. The current study examined associations between BW and ADHD, ODD, and CD symptom dimensions as well as the extent to which such associations are moderated by child sex, while also controlling for confounding variables. Significant interactions between sex and BW emerged across all analyses predicting ADHD and externalizing psychopathology, such that associations were stronger in males relative to females. Results remained when controlling for a number of confounds, including parental age, prenatal tobacco use, comorbid psychopathology, as well as other indicators of maternal and child health during the pre- and perinatal period. Both linear and quadratic associations emerged between BW and both hyperactivity and CD symptoms, whereas BW predicted inattention and ODD symptoms in a linear fashion. Future research should continue to investigate the impact of BW on ADHD and externalizing psychopathology, in particular, the biological mechanisms underlying this association. (PsycINFO Database Record
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Affiliation(s)
- Allison M Momany
- Department of Psychological and Brain Sciences, University of Iowa
| | - Jaclyn M Kamradt
- Department of Psychological and Brain Sciences, University of Iowa
| | | | - Alexis L Elmore
- Department of Psychological and Brain Sciences, University of Iowa
| | - Joel T Nigg
- Department of Psychiatry, Oregon Health and Sciences University
| | - Molly A Nikolas
- Department of Psychological and Brain Sciences, University of Iowa
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Schechter JC, Kollins SH. Prenatal Smoke Exposure and ADHD: Advancing the Field. Pediatrics 2017; 139:e20163481. [PMID: 28138004 PMCID: PMC5260156 DOI: 10.1542/peds.2016-3481] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 11/15/2016] [Indexed: 11/24/2022] Open
Affiliation(s)
- Julia C Schechter
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina
| | - Scott H Kollins
- Department of Psychiatry and Behavioral Sciences, Duke University School of Medicine, Durham, North Carolina
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García-Contreras C, Valent D, Vázquez-Gómez M, Arroyo L, Isabel B, Astiz S, Bassols A, Gonzalez-Bulnes A. Fetal growth-retardation and brain-sparing by malnutrition are associated to changes in neurotransmitters profile. Int J Dev Neurosci 2017; 57:72-76. [PMID: 28104460 DOI: 10.1016/j.ijdevneu.2017.01.005] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2016] [Revised: 12/01/2016] [Accepted: 01/11/2017] [Indexed: 10/20/2022] Open
Abstract
The present study assesses possible changes in the levels of different neurotransmitters (catecholamines and indoleamines) in fetuses affected by nutrient shortage. Hence, we determined the concentration of catecholamines and indoleamines at the hypothalamus of 56 swine fetuses obtained at both 70 and 90days of pregnancy (n=33 and 23 fetuses, respectively). The degree of fetal development and the fetal sex affected the neurotransmitters profile at both stages. At Day 70, there were found higher mean concentrations of l-DOPA in both female and male fetuses with severe IUGR; male fetuses with severe IUGR also showed higher concentrations of TRP than normal male littermates. At Day 90 of pregnancy, the differences between sexes were more evident. There were no significant effects from either severe IUGR on the neurotransmitter profile in male fetuses. However, in the females, a lower body-weight was related to lower concentrations of l-DOPA and TRP and those female fetuses affected by severe IUGR evidenced lower HVA concentration. In conclusion, the fetal synthesis and use of neurotransmitters increase with time of pregnancy but, in case of IUGR, both catecholamines and indoleamines pathways are affected by sex-related effects.
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Affiliation(s)
| | - D Valent
- Faculty of Veterinary, UAB, Barcelona, Spain
| | | | - L Arroyo
- Faculty of Veterinary, UAB, Barcelona, Spain
| | - B Isabel
- Faculty of Veterinary, UCM, Madrid, Spain
| | | | - A Bassols
- Faculty of Veterinary, UAB, Barcelona, Spain
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Taylor MJ, Lichtenstein P, Larsson H, Anckarsäter H, Greven CU, Ronald A. Is There a Female Protective Effect Against Attention-Deficit/Hyperactivity Disorder? Evidence From Two Representative Twin Samples. J Am Acad Child Adolesc Psychiatry 2016; 55:504-512.e2. [PMID: 27238069 PMCID: PMC4896985 DOI: 10.1016/j.jaac.2016.04.004] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/06/2015] [Revised: 02/23/2016] [Accepted: 04/01/2016] [Indexed: 02/07/2023]
Abstract
OBJECTIVE Attention-deficit/hyperactivity disorder (ADHD) is more frequent in males than in females. The "female protective effect" posits that females undergo greater exposure to etiological factors than males in order to develop ADHD, leading to the prediction that relatives of females with ADHD will display more ADHD behaviors. We thus tested whether cotwins of females displaying extreme ADHD traits would display more ADHD traits than cotwins of males displaying extreme ADHD traits. METHOD Parents of approximately 7,000 pairs of nonidentical twins in Sweden, and approximately 4,000 pairs of twins in England and Wales, completed dimensional assessments of ADHD traits. Probands were selected on the basis of scoring within the highest 10% of the distribution in each sample. Dimensional scores of cotwins of probands, as well as the categorical recurrence rate, were investigated by proband sex. RESULTS Cotwins of female probands displayed higher mean ADHD trait scores (mean = 0.62-0.79) than cotwins of male probands (mean = 0.38-0.55) in both samples. This trend was significant in the Swedish sample (p < .01) and when the 2 samples were merged into a single, larger sample (p < .001). When the samples were merged, there was also a significant association between proband sex and cotwin's categorical status, with more cotwins of female probands also being probands than cotwins of male probands. CONCLUSION These findings support a female protective effect against ADHD behaviors, suggesting that females require greater exposure to genetic and environmental factors associated with ADHD in order to develop the condition.
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Affiliation(s)
| | | | | | - Henrik Anckarsäter
- Centre for Ethics, Law and Mental Health (CELAM), University of Gothenburg, Gothenburg, Sweden
| | - Corina U. Greven
- Radboud University Medical Center, Donders Institute for Brain, Cognition and Behaviour, Nijmegen, The Netherlands; Karakter Child and Adolescent Psychiatry Center, Nijmegen; and King’s College London, Medical Research Council Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, London
| | - Angelica Ronald
- Centre for Brain and Cognitive Development, Birkbeck, University of London.
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Estimating the Roles of Genetic Risk, Perinatal Risk, and Marital Hostility on Early Childhood Adjustment: Medical Records and Self-Reports. Behav Genet 2016; 46:334-52. [PMID: 27075497 DOI: 10.1007/s10519-016-9788-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2015] [Accepted: 03/19/2016] [Indexed: 11/26/2022]
Abstract
A wide variety of perinatal risk factors have been linked to later developmental outcomes in children. Much of this work has relied on either birth/medical records or mothers' self-reports collected after delivery, and there has been an ongoing debate about which strategy provides the most accurate and reliable data. This report uses a parent-offspring adoption design (N = 561 families) to (1) examine the correspondence between medical record data and self-report data, (2) examine how perinatal risk factors may influence child internalizing and externalizing behavior at age 4.5 years, and (3) explore interactions among genetic, perinatal risk, and rearing environment on child internalizing and externalizing behavior during early childhood. The agreement of self-reports and medical records data was relatively high (51-100 %), although there was some variation based on the construct. There were few main effects of perinatal risk on child outcomes; however, there were several 2- and 3-way interactions suggesting that the combined influences of genetic, perinatal, and rearing environmental risks are important, particularly for predicting whether children exhibit internalizing versus externalizing symptoms at age 4.5 years.
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Pre- and Perinatal Ischemia-Hypoxia, the Ischemia-Hypoxia Response Pathway, and ADHD Risk. Behav Genet 2016; 46:467-77. [DOI: 10.1007/s10519-016-9784-4] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2015] [Accepted: 02/10/2016] [Indexed: 02/06/2023]
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Nationwide Twin Birth Weight Percentiles by Gestational Age in Taiwan. Pediatr Neonatol 2015; 56:294-300. [PMID: 25797652 DOI: 10.1016/j.pedneo.2014.12.004] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/15/2014] [Revised: 10/30/2014] [Accepted: 12/03/2014] [Indexed: 11/21/2022] Open
Abstract
BACKGROUND Nationwide birth weight norms for twins have been reported in several countries across different ethnicities, but such data have not been established in Taiwan. The purpose of this study was to develop reference growth charts that are population-based and contain the information of birth weight percentiles by gestational age for twin neonates in Taiwan. METHODS In this study, we collected nationwide birth weight data for twins by sex and gestational age through the Taiwan Birth Registry. Percentiles, means, and standard deviations of birth weight for each 1-week increment of gestational age from 21 weeks of gestation were estimated and smoothed using weighted polynomial models. RESULTS The 10(th), 50(th), and 90(th) percentiles of birth weight born at the 37(th) gestational week were 2174 g, 2580 g, and 3125 g for male twins, respectively, and they were 2100 g, 2500 g, and 3000 g for female twins, respectively. The 10(th), 50(th), and 90(th) percentiles of birth weight born at the 40(th) gestational week were 2326, 3285, and 3790 g for male twins, respectively, and they were 2200 g, 2770 g, and 3690 g for female twins, respectively. CONCLUSION This is the first nationwide birth weight norm for twins in Taiwan, which is particularly useful for investigation into the predictors and outcomes of altered fetal growth through twin studies in the Taiwanese population.
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Sucksdorff M, Lehtonen L, Chudal R, Suominen A, Joelsson P, Gissler M, Sourander A. Preterm Birth and Poor Fetal Growth as Risk Factors of Attention-Deficit/ Hyperactivity Disorder. Pediatrics 2015; 136:e599-608. [PMID: 26304830 DOI: 10.1542/peds.2015-1043] [Citation(s) in RCA: 143] [Impact Index Per Article: 15.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Previous studies have shown an association between prematurity and attention- abstract deficit/hyperactivity disorder (ADHD). Results concerning late preterm infants are controversial, and studies examining fetal growth represented by weight for gestational age are scarce. Our objective was to examine the association between gestational age by each week of fetal maturity, weight for gestational age, and ADHD. METHODS In this population-based study, 10 321 patients with ADHD, diagnosed according to the International Classification of Diseases and 38 355 controls individually matched for gender, date and place of birth, were identified from Finnish nationwide registers. Perinatal data were obtained from the Finnish Medical Birth Register. Conditional logistic regression was used to examine the association between gestational age, weight for gestational age, and ADHD after controlling for confounding factors. RESULTS The risk of ADHD increased by each declining week of gestation. The associations were robust after adjusting for confounders. An elevated risk also was seen among late preterm and early term infants. As for fetal growth, the odds ratio showed a U-shaped curve with an increased risk seen when the weight for gestational age was 1 SD below and 2 SD above the mean. CONCLUSIONS Our findings suggest that each gestational week has significance for child's subsequent neurodevelopment and risk for ADHD. We also showed that poor fetal growth increased the risk of ADHD. This highlights the importance of taking into account both prematurity and poor fetal growth when planning the timing of birth as well as later follow-up and support policies.
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Affiliation(s)
- Minna Sucksdorff
- Departments of Child Psychiatry, and
- Departments of Pediatrics, and
| | - Liisa Lehtonen
- Departments of Pediatrics, and
- Pediatrics, University of Turku, Turku, Finland
| | | | | | | | - Mika Gissler
- National Institute for Health and Welfare, Helsinki, Finland; and
- Nordic School of Public Health, Gothenburg, Sweden
| | - Andre Sourander
- Departments of Child Psychiatry, and
- Child Psychiatry, Turku University Hospital, Turku, Finland
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Jackson DB, Beaver KM. Sibling differences in low birth weight, dopaminergic polymorphisms, and ADHD symptomatology: evidence of GxE. Psychiatry Res 2015; 226:467-73. [PMID: 25704081 DOI: 10.1016/j.psychres.2015.01.025] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2014] [Revised: 01/28/2015] [Accepted: 01/30/2015] [Indexed: 11/16/2022]
Abstract
Low birth weight has been found to increase the risk of attention-deficit hyperactivity disorder (ADHD) in children. However, few studies adequately control for shared environmental influences (e.g., concentrated disadvantage, family structure) or examine whether interactions between birth weight and genetic factors predict ADHD. The present study addresses these limitations in prior research by examining a) whether sibling differences in low birth weight status are significantly predictive of sibling differences in behaviors symptomatic of ADHD and b) whether sibling differences in dopaminergic genes interact with sibling differences in low birth weight status to predict sibling differences in ADHD symptomatology. The results suggest that low birth weight siblings are at significantly greater risk of exhibiting symptoms of ADHD during childhood relative to their normal birth weight siblings. Moreover, possessing greater genetic risk on three dopaminergic genes (DAT1, DRD2, and DRD4) relative to a sibling appears to exacerbate the link between sibling differences in birth weight and sibling differences in ADHD symptomatology. Limitations and directions for future research are discussed.
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Affiliation(s)
| | - Kevin M Beaver
- Florida State University, USA; King Abdulaziz University, Saudi Arabia
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Low and high birth weight and the risk of child attention problems. J Pediatr 2015; 166:862-9.e1-3. [PMID: 25681197 DOI: 10.1016/j.jpeds.2014.12.075] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/18/2014] [Revised: 11/03/2014] [Accepted: 12/30/2014] [Indexed: 02/04/2023]
Abstract
OBJECTIVE To study the prospective association between birth weight and attention problems and to explore the role of maternal body mass index (BMI) in this association. STUDY DESIGN In 6015 children of a population-based cohort (Rotterdam, The Netherlands, 2001-2005), information on birth weight was collected and gestational age-adjusted SDS were calculated. At age 6 years, parents assessed attention problems with the Child Behavior Checklist. We used linear regression to study the association of birth weight with attention problem score and examined the modification of this association by maternal early pregnancy BMI. RESULTS The observed association between birth weight and attention problem score was curvilinear (adjusted β per birth weight SDS(2): 0.02, 95% CI 0.00; 0.03, P = .008); the turning point equals 3.6 kg at term. In analyses of the extreme tails of the birth weight distribution, the associations with attention problem score disappeared after adjustment for socioeconomic confounders. Maternal early pregnancy BMI moderated the association of child birth weight with attention problem score (P interaction = .007, with curvilinear term in model). CONCLUSIONS Higher birth weight was related to less attention problems but from a birth weight of about 3.6 kg or more, a higher birth weight did not reduce the risk of attention problems any further. However, in children of obese mothers (BMI >30 kg/m(2)), high birth weight may increase the risk of attention problems.
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Pettersson E, Sjölander A, Almqvist C, Anckarsäter H, D’Onofrio BM, Lichtenstein P, Larsson H. Birth weight as an independent predictor of ADHD symptoms: a within-twin pair analysis. J Child Psychol Psychiatry 2015; 56:453-9. [PMID: 25040291 PMCID: PMC4295006 DOI: 10.1111/jcpp.12299] [Citation(s) in RCA: 70] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/16/2014] [Indexed: 12/16/2022]
Abstract
BACKGROUND Studies have found an association between low birth weight and ADHD, but the nature of this relation is unclear. First, it is uncertain whether birth weight is associated with both of the ADHD dimensions, inattentiveness and hyperactivity-impulsivity. Second, it remains uncertain whether the association between birth weight and ADHD symptom severity is confounded by familial factors. METHOD Parents of all Swedish 9- and 12-year-old twins born between 1992 and 2000 were interviewed for DSM-IV inattentive and hyperactive-impulsive ADHD symptoms by the Autism - Tics, AD/HD and other Comorbidities (A-TAC) inventory (N = 21,775 twins). Birth weight was collected prospectively through the Medical Birth Registry. We used a within-twin pair design to control for genetic and shared environmental factors. RESULTS Reduced birth weight was significantly associated with a mean increase in total ADHD (β = -.42; 95% CI: -.53, -.30), inattentive (β = -.26; 95% CI: -.33, -.19), and hyperactive-impulsive (β = -.16; 95% CI: -.22, -.10) symptom severity. These results imply that a change of one kilogram of birth weight corresponded to parents rating their child nearly one unit higher (going from "no" to "yes, to some extent" on a given symptom) on the total ADHD scale. These associations remained within pairs of MZ and DZ twins, and were also present when restricting the analyses to full term births. CONCLUSIONS There is an independent association between low birth weight and all forms of ADHD symptoms, even after controlling for all environmental and genetic confounds shared within twin pairs. These results indicate that fetal growth restriction (as reflected in birth weight differences within twin pairs) and/or the environmental factors which influence it is in the casual pathway leading to ADHD.
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Affiliation(s)
- Erik Pettersson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Arvid Sjölander
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Catarina Almqvist
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
,Astrid Lindgren Children’s Hospital, Lung and Allergy Unit, Karolinska University Hospital, Stockholm Sweden
| | - Henrik Anckarsäter
- Forensic Psychiatry, Institute of Neuroscience and Physiology, Sahlgren’s Academy, University of Gothenburg, Sweden
| | - Brian M. D’Onofrio
- Department of Psychological and Brain Sciences, Indiana University, Bloomington, IN, USA
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Multifactorial Origin of Neurodevelopmental Disorders: Approaches to Understanding Complex Etiologies. TOXICS 2015; 3:89-129. [PMID: 29056653 PMCID: PMC5634696 DOI: 10.3390/toxics3010089] [Citation(s) in RCA: 55] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/29/2014] [Revised: 03/06/2015] [Accepted: 03/18/2015] [Indexed: 12/12/2022]
Abstract
A significant body of evidence supports the multifactorial etiology of neurodevelopmental disorders (NDDs) affecting children. The present review focuses on early exposure to environmental chemicals as a risk factor for neurodevelopment, and presents the major lines of evidence derived from epidemiological studies, underlying key uncertainties and research needs in this field. We introduce the exposome concept that, encompassing the totality of human environmental exposures to multiple risk factors, aims at explaining individual vulnerability and resilience to early chemical exposure. In this framework, we synthetically review the role of variable gene backgrounds, the involvement of epigenetic mechanisms as well as the function played by potential effect modifiers such as socioeconomic status. We describe laboratory rodent studies where the neurodevelopmental effects of environmental chemicals are assessed in the presence of either a “vulnerable” gene background or adverse pregnancy conditions (i.e., maternal stress). Finally, we discuss the need for more descriptive and “lifelike” experimental models of NDDs, to identify candidate biomarkers and pinpoint susceptible groups or life stages to be translated to large prospective studies within the exposome framework.
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Butwicka A, Lichtenstein P, Landén M, Nordenvall AS, Nordenström A, Nordenskjöld A, Frisén L. Hypospadias and increased risk for neurodevelopmental disorders. J Child Psychol Psychiatry 2015; 56:155-61. [PMID: 25048198 DOI: 10.1111/jcpp.12290] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/25/2014] [Indexed: 01/27/2023]
Abstract
BACKGROUND Hypospadias (aberrant opening of the urethra on the underside of the penis) occurs in 1 per 300 newborn boys. It has been previously unknown whether this common malformation is associated with increased psychiatric morbidity later in life. Studies of individuals with hypospadias also provide an opportunity to examine whether difference in androgen signaling is related to neurodevelopmental disorders. To elucidate the mechanisms behind a possible association, we also studied psychiatric outcomes among brothers of the hypospadias patients. METHODS Registry study within a national cohort of all 9,262 males with hypospadias and their 4,936 healthy brothers born in Sweden between 1973 and 2009. Patients with hypospadias and their brothers were matched with controls by year of birth and county. The following outcomes were evaluated (1) any psychiatric (2) psychotic, (3) mood, (4) anxiety, (5) eating, and (6) personality disorders, (7) substance misuse, (8) attention-deficit hyperactivity disorder (ADHD), (9) autism spectrum disorders (ASD), (10) intellectual disability, and (11) other behavioral/emotional disorders with onset in childhood. RESULTS Patients with hypospadias were more likely to be diagnosed with intellectual disability (OR 3.2; 95% CI 2.8-3.8), ASD (1.4; 1.2-1.7), ADHD (1.5; 1.3-1.9), and behavioral/emotional disorders (1.4; 1.2-1.6) compared with the controls. Brothers of patients with hypospadias had an increased risk of ASD (1.6; 1.3-2.1) and other behavioral/emotional disorders with onset in childhood (1.2; 0.9-1.5) in comparison to siblings of healthy individuals. A slightly higher, although not statistically significant, risk was found for intellectual disability (1.3; 1.0-1.9). No relation between other psychiatric diagnosis and hypospadias was found. CONCLUSIONS This is the first study to identify an increased risk for neurodevelopmental disorders in patients with hypospadias, as well as an increased risk for ASD in their brothers, suggesting a common familial (genetic and/or environmental) liability.
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Affiliation(s)
- Agnieszka Butwicka
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden; Department of Child Psychiatry, Medical University of Warsaw, Warsaw, Poland
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Hanć T, Słopień A, Wolańczyk T, Dmitrzak-Węglarz M, Szwed A, Czapla Z, Durda M, Ratajczak J, Cieślik J. ADHD and overweight in boys: cross-sectional study with birth weight as a controlled factor. Eur Child Adolesc Psychiatry 2015; 24:41-53. [PMID: 24633695 PMCID: PMC4291509 DOI: 10.1007/s00787-014-0531-1] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/13/2013] [Accepted: 02/23/2014] [Indexed: 12/23/2022]
Abstract
Population studies indicate a strong relationship between birth weight (BW) and body size in later life. However, BW as a variable was never accounted for in studies on the relationship between attention-deficit/hyperactivity disorder (ADHD) and overweight. This study aims to assess the relationship between ADHD and overweight with control of birth weight and other confounding factors. Prevalence of overweight was compared in clinical sample of 219 boys with ADHD and 396 boys without ADHD, aged 6-18 years. The following factors were controlled: BW, parents income and education level, place of residence, ADHD type, selected comorbid disorders and stimulant treatment. Overweight and obesity were diagnosed according to the criteria proposed by the International Obesity Task Force. Logistic regression analysis was used to estimate the association between ADHD and the prevalence of overweight and obesity. Boys with ADHD differed significantly from the control group in distribution of low BW (8.2 vs. 3.0 %, χ (2) = 8.23, p = 0.02). Low BW was associated with a lower prevalence of overweight than normal and high BW (0 vs. 12.14 %, χ (2) = 4.12, p = 0.04). Overweight was observed significantly more often in boys with ADHD (17.3 vs. 8.3 %, χ (2) = 11.23, p < 0.001) even after adjustment for BW and other variables (OR = 2.44, 95 % CI 1.38-4.29, p = 0.002) and after controlling for ADHD type, stimulant treatment and selected comorbid disorders. Independently to applied analysis, obesity was not associated with ADHD. Lower birth weight is over twice more often observed in boys with ADHD than in control group. Although this phenomenon may reduce the rate of overweight in the studied group, ADHD remains strongly associated with increased prevalence of overweight.
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Affiliation(s)
- Tomasz Hanć
- Department of Human Biological Development, Faculty of Biology, Institute of Anthropology, Adam Mickiewicz University, Umultowska 89, 61-614, Poznan, Poland,
| | - Agnieszka Słopień
- Department of Child and Adolescent Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Tomasz Wolańczyk
- Department of Child Psychiatry, Medical University of Warsaw, Warsaw, Poland
| | - Monika Dmitrzak-Węglarz
- Laboratory of Psychiatric Genetics, Department of Psychiatry, Poznan University of Medical Sciences, Poznan, Poland
| | - Anita Szwed
- Department of Human Biological Development, Faculty of Biology, Institute of Anthropology, Adam Mickiewicz University, Umultowska 89, 61-614 Poznan, Poland
| | - Zbigniew Czapla
- Department of Human Biological Development, Faculty of Biology, Institute of Anthropology, Adam Mickiewicz University, Umultowska 89, 61-614 Poznan, Poland
| | - Magdalena Durda
- Department of Human Biological Development, Faculty of Biology, Institute of Anthropology, Adam Mickiewicz University, Umultowska 89, 61-614 Poznan, Poland
| | - Joanna Ratajczak
- Department of Human Biological Development, Faculty of Biology, Institute of Anthropology, Adam Mickiewicz University, Umultowska 89, 61-614 Poznan, Poland
| | - Joachim Cieślik
- Department of Human Biological Development, Faculty of Biology, Institute of Anthropology, Adam Mickiewicz University, Umultowska 89, 61-614 Poznan, Poland
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Chatterji P, Lahiri K, Kim D. Fetal growth and neurobehavioral outcomes in childhood. ECONOMICS AND HUMAN BIOLOGY 2014; 15:187-200. [PMID: 25464342 PMCID: PMC4293286 DOI: 10.1016/j.ehb.2014.09.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/24/2014] [Revised: 09/11/2014] [Accepted: 09/15/2014] [Indexed: 06/04/2023]
Abstract
Using a sample of sibling pairs from a nationally representative U.S. survey, we examine the effects of the fetal growth rate on a set of neurobehavioral outcomes in childhood measured by parent-reported diagnosed developmental disabilities and behavior problems. Based on models that include mother fixed effects, we find that the fetal growth rate, a marker for the fetal environment, is negatively associated with lifetime diagnosis of developmental delay. We also find that the fetal growth rate is negatively associated with disruptive behaviors among male children. These results suggest that developmental disabilities and problem behaviors may play a role in explaining the well-documented association between birth weight and human capital outcomes measured in adulthood.
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Class QA, Rickert ME, Larsson H, Lichtenstein P, D’Onofrio BM. Fetal growth and psychiatric and socioeconomic problems: population-based sibling comparison. Br J Psychiatry 2014; 205:355-61. [PMID: 25257067 PMCID: PMC4217026 DOI: 10.1192/bjp.bp.113.143693] [Citation(s) in RCA: 56] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
BACKGROUND It is unclear whether associations between fetal growth and psychiatric and socioeconomic problems are consistent with causal mechanisms. AIMS To estimate the extent to which associations are a result of unmeasured confounding factors using a sibling-comparison approach. METHOD We predicted outcomes from continuously measured birth weight in a Swedish population cohort (n = 3 291 773), while controlling for measured and unmeasured confounding. RESULTS In the population, lower birth weight (⩽ 2500 g) increased the risk of all outcomes. Sibling-comparison models indicated that lower birth weight independently predicted increased risk for autism spectrum disorder (hazard ratio for low birth weight = 2.44, 95% CI 1.99-2.97) and attention-deficit hyperactivity disorder. Although attenuated, associations remained for psychotic or bipolar disorder and educational problems. Associations with suicide attempt, substance use problems and social welfare receipt, however, were fully attenuated in sibling comparisons. CONCLUSIONS Results suggest that fetal growth, and factors that influence it, contribute to psychiatric and socioeconomic problems.
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Tarver J, Daley D, Sayal K. Attention-deficit hyperactivity disorder (ADHD): an updated review of the essential facts. Child Care Health Dev 2014; 40:762-74. [PMID: 24725022 DOI: 10.1111/cch.12139] [Citation(s) in RCA: 146] [Impact Index Per Article: 14.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 03/06/2014] [Indexed: 02/07/2023]
Abstract
Attention-deficit hyperactivity disorder (ADHD) is a complex disorder that can affect individuals across the lifespan. It is associated with substantial heterogeneity in terms of aetiology, clinical presentation and treatment outcome and is the subject of extensive research. Because of this, it can be difficult for clinicians to stay up to date with the most relevant findings and know how best to respond to parents' questions and concerns about the disorder and interventions. This is a narrative review that aims to summarize key findings from recent research into ADHD and its treatment that clinicians can share with families in order to increase their knowledge about ADHD and intervention options. ADHD develops as a result of complex interplay between interdependent genetic and non-genetic factors. The disorder is associated with substantial impairments in functioning and poor long-term outcomes. Pharmacological and non-pharmacological treatment options are available for symptom management and to improve function, but functioning outcomes often fail to normalize in children with ADHD. Despite extensive advances in understanding this complex disorder, it is clear that there is still a long way to go. In particular, we address the need for future non-pharmacological interventions to be more specifically targeted for ADHD symptoms and its commonly associated functioning deficits in order to ensure the best long-term outcomes for children with ADHD.
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Affiliation(s)
- J Tarver
- Division of Psychiatry and Applied Psychology, University of Nottingham, Nottingham, UK; Centre for ADHD and Neurodevelopmental Disorders Across the Lifespan (CANDAL), University of Nottingham, Nottingham, UK
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Wang H, Leung GM, Schooling CM. Life course adiposity and adolescent depressive symptoms among Hong Kong adolescents. J Adolesc Health 2014; 55:408-14. [PMID: 24794052 DOI: 10.1016/j.jadohealth.2014.03.009] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2013] [Revised: 02/10/2014] [Accepted: 03/05/2014] [Indexed: 10/25/2022]
Abstract
PURPOSE Depression is a public health issue, which often emerges in adolescence. Adiposity may be a factor in this emergence; however, in Western settings, both adiposity and depression tend to be socially patterned, making it unclear whether any association is biologically based or contextually specific. METHODS Multivariable analysis was used to assess the adjusted association of birth weight and life course body mass index (BMI) z score (at 3 and 9 months and 3, 7, 9, 11, and 12 years of age) and changes in BMI z score with adolescent depressive symptoms score at ∼14 years of age, assessed from Patient Health Questionnaire-9 (PHQ-9) in a population-representative Chinese study, Hong Kong's "Children of 1997" birth cohort, which has little social patterning of birth weight or BMI. We also assessed whether associations varied with sex. RESULTS PHQ-9 was available for 5,797 term births (73% follow-up). Birth weight z score, BMI z scores at 3 and 9 months and at 3, 7, 9, 11, and 12 years of age, and successive BMI z score changes had little association with PHQ-9 at ∼14 years of age, adjusted for socioeconomic position, parental depressive symptoms, and survey mode. CONCLUSIONS In a developed non-Western setting, life course adiposity does not appear to be a factor in the development of depressive symptoms in adolescence, suggesting that observed associations to date may be contextually specific rather than biologically based.
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Affiliation(s)
- Hui Wang
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - Gabriel M Leung
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, People's Republic of China
| | - C Mary Schooling
- School of Public Health, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong SAR, People's Republic of China; City University of New York School of Public Health and Hunter College, New York, New York.
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D'Onofrio BM, Class QA, Lahey BB, Larsson H. Testing the Developmental Origins of Health and Disease Hypothesis for Psychopathology Using Family-Based Quasi-Experimental Designs. CHILD DEVELOPMENT PERSPECTIVES 2014; 8:151-157. [PMID: 25364377 DOI: 10.1111/cdep.12078] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
The Developmental Origin of Health and Disease (DOHaD) hypothesis is a broad theoretical framework that emphasizes how early risk factors have a causal influence on psychopathology. Researchers have raised concerns about the causal interpretation of statistical associations between early risk factors and later psychopathology because most existing studies have been unable to rule out the possibility of environmental and genetic confounding. In this paper we illustrate how family-based quasi-experimental designs can test the DOHaD hypothesis by ruling out alternative hypotheses. We review the logic underlying sibling-comparison, co-twin control, offspring of siblings/twins, adoption, and in vitro fertilization designs. We then present results from studies using these designs focused on broad indices of fetal development (low birth weight and gestational age) and a particular teratogen, smoking during pregnancy. The results provide mixed support for the DOHaD hypothesis for psychopathology, illustrating the critical need to use design features that rule out unmeasured confounding.
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Affiliation(s)
- Brian M D'Onofrio
- Indiana University-Bloomington, Department of Psychological and Brain Sciences
| | - Quetzal A Class
- Indiana University-Bloomington, Department of Psychological and Brain Sciences
| | | | - Henrik Larsson
- Karolinska Institutet, Department of Medical Epidemiology and Biostatistics
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