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Voronin I, Ouellet‐Morin I, Petitclerc A, Morneau‐Vaillancourt G, Brendgen M, Dione G, Vitaro F, Boivin M. Intergenerational transmission of genetic risk for hyperactivity and inattention. Direct genetic transmission or genetic nurture? JCPP ADVANCES 2024; 4:e12222. [PMID: 38827976 PMCID: PMC11143957 DOI: 10.1002/jcv2.12222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2023] [Accepted: 01/03/2024] [Indexed: 06/05/2024] Open
Abstract
Background Hyperactivity and inattention, the symptoms of ADHD, are marked by high levels of heritability and intergenerational transmission. Two distinct pathways of genetic intergenerational transmission are distinguished: direct genetic transmission when parental genetic variants are passed to the child's genome and genetic nurture when the parental genetic background contributes to the child's outcomes through rearing environment. This study assessed genetic contributions to hyperactivity and inattention in childhood through these transmission pathways. Methods The sample included 415 families from the Quebec Newborn Twin Study. Twins' hyperactivity and inattention were assessed in early childhood by parents and in primary school by teachers. The polygenic scores for ADHD (ADHD-PGS) and educational attainment (EA-PGS) were computed from twins' and parents' genotypes. A model of intergenerational transmission was developed to estimate (1) the contributions of parents' and children's PGS to the twins' ADHD symptoms and (2) whether these variances were explained by genetic transmission and/or genetic nurture. Results ADHD-PGS explained up to 1.6% of the variance of hyperactivity and inattention in early childhood and primary school. EA-PGS predicted ADHD symptoms at both ages, explaining up to 1.6% of the variance in early childhood and up to 5.5% in primary school. Genetic transmission was the only significant transmission pathway of both PGS. The genetic nurture channeled through EA-PGS explained up to 3.2% of the variance of inattention in primary school but this association was non-significant. Conclusions Genetic propensities to ADHD and education predicted ADHD symptoms in childhood, especially in primary school. Its intergenerational transmission was driven primarily by genetic variants passed to the child, rather than by environmentally mediated parental genetic effects. The model developed in this study can be leveraged in future research to investigate genetic transmission and genetic nurture while accounting for parental assortative mating.
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Affiliation(s)
- Ivan Voronin
- École de psychologieUniversité LavalQuébecQuebecCanada
| | - Isabelle Ouellet‐Morin
- School of CriminologyUniversity of MontrealThe Research Center of the Montreal Mental Health University Institute and the Research Group on Child MaladjustmentMontréalQuebecCanada
| | | | - Geneviève Morneau‐Vaillancourt
- Social, Genetic & Developmental Psychiatry CentreInstitute of Psychiatry, Psychology & NeuroscienceKing's College LondonLondonUK
| | - Mara Brendgen
- Département de PsychologieUniversité du Québec à MontréalMontréalQuebecCanada
| | - Ginette Dione
- École de psychologieUniversité LavalQuébecQuebecCanada
| | - Frank Vitaro
- École de PsychoéducationUniversité de MontréalMontréalQuebecCanada
| | - Michel Boivin
- École de psychologieUniversité LavalQuébecQuebecCanada
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Kleppesto TH, Eilertsen EM, van Bergen E, Sunde HF, Zietsch B, Nordmo M, Eftedal NH, Havdahl A, Ystrom E, Torvik FA. Intergenerational transmission of ADHD behaviors: genetic and environmental pathways. Psychol Med 2024; 54:1309-1317. [PMID: 37920986 DOI: 10.1017/s003329172300315x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2023]
Abstract
BACKGROUND We investigate if covariation between parental and child attention-deficit hyperactivity disorder (ADHD) behaviors can be explained by environmental and/or genetic transmission. METHODS We employed a large children-of-twins-and-siblings sample (N = 22 276 parents and 11 566 8-year-old children) of the Norwegian Mother, Father and Child Cohort Study. This enabled us to disentangle intergenerational influences via parental genes and parental behaviors (i.e. genetic and environmental transmission, respectively). Fathers reported on their own symptoms and mothers on their own and their child's symptoms. RESULTS Child ADHD behaviors correlated with their mother's (0.24) and father's (0.10) ADHD behaviors. These correlations were largely due to additive genetic transmission. Variation in children's ADHD behaviors was explained by genetic factors active in both generations (11%) and genetic factors specific to the children (46%), giving a total heritability of 57%. There were small effects of parental ADHD behaviors (2% environmental transmission) and gene-environment correlation (3%). The remaining variability in ADHD behaviors was due to individual-specific environmental factors. CONCLUSIONS The intergenerational resemblance of ADHD behaviors is primarily due to genetic transmission, with little evidence for parental ADHD behaviors causing children's ADHD behaviors. This contradicts theories proposing environmental explanations of intergenerational transmission of ADHD, such as parenting theories or psychological life-history theory.
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Affiliation(s)
- Thomas H Kleppesto
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
- Department of Psychology, Norwegian University of Science and Technology, Trondheim, Norway
| | - Espen Moen Eilertsen
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Elsje van Bergen
- Department of Biological Psychology, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Research Institute LEARN!, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, Amsterdam, The Netherlands
| | - Hans Fredrik Sunde
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Brendan Zietsch
- Centre for Psychology and Evolution, School of Psychology, University of Queensland, Brisbane, Australia
| | - Magnus Nordmo
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
- Department of Educational Science, University of South-Eastern Norway, Notodden, Norway
| | - Nikolai Haahjem Eftedal
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
- Department of Psychology, University of Oslo, Oslo, Norway
| | - Alexandra Havdahl
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
- Nic Waals Institute, Spångbergveien 25, 0853 Oslo, Norway
- MRC Integrative Epidemiology Unit, University of Bristol, Bristol, UK
| | - Eivind Ystrom
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
- Department of Mental Disorders, Norwegian Institute of Public Health, Oslo, Norway
| | - Fartein Ask Torvik
- Centre for Fertility and Health, Norwegian Institute of Public Health, Oslo, Norway
- PROMENTA Research Center, Department of Psychology, University of Oslo, Oslo, Norway
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Peisch V, Li V, Arnett AB. Effortful Control Protects Against Familial Liability for ADHD: Longitudinal Results from the ABCD Study in the United States. Res Child Adolesc Psychopathol 2024; 52:595-604. [PMID: 37750998 DOI: 10.1007/s10802-023-01131-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2023] [Indexed: 09/27/2023]
Abstract
Effortful control, the ability to regulate complex and goal-directed behavior, may protect individuals from developing mental health symptoms. This study tested the potential for child effortful control and executive functioning to buffer the effects of familial liability for attention deficit hyperactivity disorder (ADHD) problems across a one-year timeframe. Data from the prospectively-collected Adolescent Brain Cognitive Development (ABCD)® study were used to examine whether caregiver-rated child effortful control and executive functioning moderated the association between familial ADHD risk and later ADHD symptoms in a sample of children (N = 6,133; ages 9-10 years at baseline). Two independent variables were considered to compare the predictive powers of specific (family ADHD) and broad (family psychopathology) risk factors. Two additional moderating variables (surgency, negative affect) were tested to examine specificity of effortful control and executive functioning as moderators. All variables of interest were measured on a continuum and via caregiver report. At high levels of effortful control and executive functioning, there was no association between familial liability for ADHD or broad psychopathology and later child ADHD problems. The moderator effects were specific to effortful control and executive functioning domains. Etiological models of heritable psychiatric disorders, such as ADHD, should consider the risk and protective contributions of individual traits, such as effortful control and executive functioning. Clinical prevention and intervention efforts may target self-regulation skills in children to buffer against familial liability for ADHD problems.
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Affiliation(s)
- Virginia Peisch
- Division of Developmental Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA.
| | - Vivian Li
- Division of Developmental Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA
| | - Anne B Arnett
- Division of Developmental Medicine, Boston Children's Hospital, 300 Longwood Ave, Boston, MA, 02115, USA
- Department of Pediatrics, Harvard Medical School, Boston, MA, USA
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Camerini L, Zurchimitten G, Bock B, Xavier J, Bastos CR, Martins E, Ardais AP, Dos Santos Motta JV, Pires AJ, de Matos MB, de Ávila Quevedo L, Pinheiro RT, Ghisleni G. Genetic Variations in Elements of the Oxytocinergic Pathway are Associated with Attention/Hyperactivity Problems and Anxiety Problems in Childhood. Child Psychiatry Hum Dev 2024; 55:552-563. [PMID: 36087156 DOI: 10.1007/s10578-022-01419-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/15/2022] [Revised: 08/03/2022] [Accepted: 08/17/2022] [Indexed: 11/28/2022]
Abstract
Genetic alterations related to oxytocin system seem to influence the neurobiology of attention-deficit hyperactivity disorder and anxiety problems leading to greater functional, social and emotional impairment. Here, we analyzed the association of OXTR rs2254298 and CD38 rs6449182 variants with attention/hyperactivity problems and anxiety problems in children. The study enrolled 292 children and adjusted regression model revealed OXTR rs2254298 AA genotype as a risk factor for attention deficit/hyperactivity problems (PR: 2.37; PadjFDR = 0.006), attention problems (PR: 2.71; PadjFDR = 0.003) and anxiety problems (PR: 1.92; PadjFDR = 0.018). CD38 rs6449182 G allele showed as a risk factor for attention deficit/hyperactivity problems (PR: 1.56; PadjFDR = 0.028). Moreover, in silico approach for regulatory roles found markers that influence chromatin accessibility and transcription capacity. Together, these data provide genetic information of oxytocin in developmental and behavioral disorders opening a range of opportunities for future studies that clarify their neurobiology in childhood.
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Affiliation(s)
- Laísa Camerini
- Postgraduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Gabriel Zurchimitten
- Postgraduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Bertha Bock
- Postgraduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Janaína Xavier
- Postgraduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Clarissa Ribeiro Bastos
- Department of Neurosciences, Federal University of Santa Catarina, Florianopolis, Santa Catarina, Brazil
| | - Evânia Martins
- Postgraduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Ana Paula Ardais
- Postgraduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | | | - Andressa Jacondino Pires
- Postgraduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Mariana Bonati de Matos
- Postgraduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Luciana de Ávila Quevedo
- Postgraduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Ricardo Tavares Pinheiro
- Postgraduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Rio Grande do Sul, Brazil
| | - Gabriele Ghisleni
- Postgraduate Program in Health and Behavior, Catholic University of Pelotas, Pelotas, Rio Grande do Sul, Brazil.
- Post-Graduation Program of Health and Behavior, Laboratory of Clinical Neuroscience, Catholic University of Pelotas - UCPel, Center of Health Science, Rua Gonçalves Chaves 373, sala 324, CEP 96010-280, Pelotas, RS, Brasil.
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Oginni OA, Ayorinde A, Ayodele KD, Opara OJ, Mapayi B, Mosaku K. The Challenges and Opportunities for Mental Health Twin Research in Nigeria. Behav Genet 2024; 54:42-50. [PMID: 37733122 PMCID: PMC10822790 DOI: 10.1007/s10519-023-10153-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2023] [Accepted: 08/23/2023] [Indexed: 09/22/2023]
Abstract
The recent interest in increasing diversity in genetic research can be useful in uncovering novel insights into the genetic architecture of mental health disorders - globally and in previously unexplored settings such as low- and middle-income settings like Nigeria. Genetic research into mental health is potentially promising in Nigeria and we reflect on the challenges and opportunities for twin research which may be particularly suited to Nigeria. The higher rates of twinning in Africa and Nigeria specifically, make the twin design an affordable and readily maintainable approach for genetic research in the country. Despite potential challenges with recruitment, data collection, data analysis and dissemination; the success of current efforts suggest that the twin design can tapped even further for greater impact in the country. We highlight some ways in which the scope of twin research can be increased and suggest some ways in which existing challenges can be overcome including recent Patient Participant Involve and Engagement activities.
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Affiliation(s)
- Olakunle Ayokunmi Oginni
- Department of Mental Health, Obafemi Awolowo University, Ile-Ife, Nigeria.
- Department of Mental Health, Obafemi Awolowo University Teaching Hospitals Complex, Ile- Ife, Nigeria.
- Social, Genetic and Developmental Psychiatry, King's College London, London, UK.
| | - Ayoyinka Ayorinde
- Department of Mental Health, Obafemi Awolowo University Teaching Hospitals Complex, Ile- Ife, Nigeria
| | - Kehinde Dorcas Ayodele
- Department of Mental Health, Obafemi Awolowo University Teaching Hospitals Complex, Ile- Ife, Nigeria
| | | | - Boladale Mapayi
- Department of Mental Health, Obafemi Awolowo University, Ile-Ife, Nigeria
- Department of Mental Health, Obafemi Awolowo University Teaching Hospitals Complex, Ile- Ife, Nigeria
| | - Kolawole Mosaku
- Department of Mental Health, Obafemi Awolowo University, Ile-Ife, Nigeria
- Department of Mental Health, Obafemi Awolowo University Teaching Hospitals Complex, Ile- Ife, Nigeria
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6
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Smolen C, Jensen M, Dyer L, Pizzo L, Tyryshkina A, Banerjee D, Rohan L, Huber E, El Khattabi L, Prontera P, Caberg JH, Van Dijck A, Schwartz C, Faivre L, Callier P, Mosca-Boidron AL, Lefebvre M, Pope K, Snell P, Lockhart PJ, Castiglia L, Galesi O, Avola E, Mattina T, Fichera M, Luana Mandarà GM, Bruccheri MG, Pichon O, Le Caignec C, Stoeva R, Cuinat S, Mercier S, Bénéteau C, Blesson S, Nordsletten A, Martin-Coignard D, Sistermans E, Kooy RF, Amor DJ, Romano C, Isidor B, Juusola J, Girirajan S. Assortative mating and parental genetic relatedness contribute to the pathogenicity of variably expressive variants. Am J Hum Genet 2023; 110:2015-2028. [PMID: 37979581 PMCID: PMC10716518 DOI: 10.1016/j.ajhg.2023.10.015] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/17/2023] [Revised: 10/25/2023] [Accepted: 10/27/2023] [Indexed: 11/20/2023] Open
Abstract
We examined more than 97,000 families from four neurodevelopmental disease cohorts and the UK Biobank to identify phenotypic and genetic patterns in parents contributing to neurodevelopmental disease risk in children. We identified within- and cross-disorder correlations between six phenotypes in parents and children, such as obsessive-compulsive disorder (R = 0.32-0.38, p < 10-126). We also found that measures of sub-clinical autism features in parents are associated with several autism severity measures in children, including biparental mean Social Responsiveness Scale scores and proband Repetitive Behaviors Scale scores (regression coefficient = 0.14, p = 3.38 × 10-4). We further describe patterns of phenotypic similarity between spouses, where spouses show correlations for six neurological and psychiatric phenotypes, including a within-disorder correlation for depression (R = 0.24-0.68, p < 0.001) and a cross-disorder correlation between anxiety and bipolar disorder (R = 0.09-0.22, p < 10-92). Using a simulated population, we also found that assortative mating can lead to increases in disease liability over generations and the appearance of "genetic anticipation" in families carrying rare variants. We identified several families in a neurodevelopmental disease cohort where the proband inherited multiple rare variants in disease-associated genes from each of their affected parents. We further identified parental relatedness as a risk factor for neurodevelopmental disorders through its inverse relationship with variant pathogenicity and propose that parental relatedness modulates disease risk by increasing genome-wide homozygosity in children (R = 0.05-0.26, p < 0.05). Our results highlight the utility of assessing parent phenotypes and genotypes toward predicting features in children who carry rare variably expressive variants and implicate assortative mating as a risk factor for increased disease severity in these families.
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Affiliation(s)
- Corrine Smolen
- Department of Biochemistry and Molecular Biology, Pennsylvania State University, University Park, PA 16802, USA; Bioinformatics and Genomics Graduate program, Pennsylvania State University, University Park, PA 16802, USA
| | - Matthew Jensen
- Department of Biochemistry and Molecular Biology, Pennsylvania State University, University Park, PA 16802, USA; Bioinformatics and Genomics Graduate program, Pennsylvania State University, University Park, PA 16802, USA
| | | | - Lucilla Pizzo
- Department of Biochemistry and Molecular Biology, Pennsylvania State University, University Park, PA 16802, USA
| | - Anastasia Tyryshkina
- Department of Biochemistry and Molecular Biology, Pennsylvania State University, University Park, PA 16802, USA; Neuroscience Graduate Program, Pennsylvania State University, University Park, PA 16802, USA
| | - Deepro Banerjee
- Department of Biochemistry and Molecular Biology, Pennsylvania State University, University Park, PA 16802, USA; Bioinformatics and Genomics Graduate program, Pennsylvania State University, University Park, PA 16802, USA
| | - Laura Rohan
- Department of Biochemistry and Molecular Biology, Pennsylvania State University, University Park, PA 16802, USA
| | - Emily Huber
- Department of Biochemistry and Molecular Biology, Pennsylvania State University, University Park, PA 16802, USA
| | - Laila El Khattabi
- Assistance Publique-Hôpitaux de Paris, Department of Medical Genetics, Armand Trousseau and Pitié-Salpêtrière Hospitals, Paris, France
| | - Paolo Prontera
- Medical Genetics Unit, Hospital "Santa Maria della Misericordia", Perugia, Italy
| | - Jean-Hubert Caberg
- Centre Hospitalier Universitaire de Liège. Domaine Universitaire du Sart Tilman, Liège, Belgium
| | - Anke Van Dijck
- Department of Medical Genetics, University and University Hospital Antwerp, Antwerp, Belgium
| | | | - Laurence Faivre
- Centre de Genetique et Cenre de Référence Anomalies du développement et syndromes malformatifs, Hôpital d'Enfants, CHU Dijon, Dijon, France; GAD INSERM UMR1231, FHU TRANSLAD, Université de Bourgogne Franche Comté, Dijon, France
| | - Patrick Callier
- Centre de Genetique et Cenre de Référence Anomalies du développement et syndromes malformatifs, Hôpital d'Enfants, CHU Dijon, Dijon, France; GAD INSERM UMR1231, FHU TRANSLAD, Université de Bourgogne Franche Comté, Dijon, France
| | | | - Mathilde Lefebvre
- GAD INSERM UMR1231, FHU TRANSLAD, Université de Bourgogne Franche Comté, Dijon, France
| | - Kate Pope
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Penny Snell
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia
| | - Paul J Lockhart
- Department of Paediatrics, University of Melbourne, Melbourne, VIC, Australia; Bruce Lefroy Center, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Lucia Castiglia
- Research Unit of Rare Diseases and Neurodevelopmental Disorders, Oasi Research Institute-IRCCS, 94018 Troina, Italy
| | - Ornella Galesi
- Research Unit of Rare Diseases and Neurodevelopmental Disorders, Oasi Research Institute-IRCCS, 94018 Troina, Italy
| | - Emanuela Avola
- Research Unit of Rare Diseases and Neurodevelopmental Disorders, Oasi Research Institute-IRCCS, 94018 Troina, Italy
| | - Teresa Mattina
- Medical Genetics, Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
| | - Marco Fichera
- Research Unit of Rare Diseases and Neurodevelopmental Disorders, Oasi Research Institute-IRCCS, 94018 Troina, Italy; Medical Genetics, Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
| | | | - Maria Grazia Bruccheri
- Research Unit of Rare Diseases and Neurodevelopmental Disorders, Oasi Research Institute-IRCCS, 94018 Troina, Italy
| | - Olivier Pichon
- CHU Nantes, Department of Medical Genetics, Nantes, France
| | - Cedric Le Caignec
- CHU Toulouse, Department of Medical Genetics, Toulouse, France; ToNIC, Toulouse Neuro Imaging, Center, Inserm, UPS, Université de Toulouse, Toulouse, France
| | - Radka Stoeva
- Service de Cytogenetique, CHU de Le Mans, Le Mans, France
| | | | - Sandra Mercier
- CHU Nantes, Department of Medical Genetics, Nantes, France
| | | | - Sophie Blesson
- Department of Genetics, Bretonneau University Hospital, Tours, France
| | | | | | - Erik Sistermans
- Department of Clinical Genetics, Amsterdam UMC, Amsterdam, the Netherlands
| | - R Frank Kooy
- Department of Medical Genetics, University and University Hospital Antwerp, Antwerp, Belgium
| | - David J Amor
- Bruce Lefroy Center, Murdoch Children's Research Institute, Melbourne, VIC, Australia
| | - Corrado Romano
- Medical Genetics, Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy; Medical Genetics, ASP Ragusa, Ragusa, Italy
| | | | | | - Santhosh Girirajan
- Department of Biochemistry and Molecular Biology, Pennsylvania State University, University Park, PA 16802, USA; Bioinformatics and Genomics Graduate program, Pennsylvania State University, University Park, PA 16802, USA; Neuroscience Graduate Program, Pennsylvania State University, University Park, PA 16802, USA; Department of Anthropology, Pennsylvania State University, University Park, PA 16802, USA.
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Almai AM, Salpekar JA. Healthcare utilisation in the United Arab Emirates for children with attention-deficit hyperactivity disorder and comorbidities. BJPsych Int 2023; 20:61-63. [PMID: 37531226 PMCID: PMC10387415 DOI: 10.1192/bji.2023.14] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2023] [Accepted: 05/23/2023] [Indexed: 08/04/2023] Open
Abstract
The prevalence of attention-deficit hyperactivity disorder is consistent worldwide. Psychiatric comorbidities are common, although less is known about how those comorbidities affect utilisation of healthcare services. Access to paediatric mental healthcare is a challenge in many regions. However, access to care in the United Arab Emirates (UAE) is supported by a well-established healthcare infrastructure with widely available primary care physicians. A review of diagnosis codes suggests that a clear correlation exists between the number of comorbidities and increased utilisation of available mental health services. Infrastructure in the UAE may represent a successful model for paediatric mental healthcare.
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Affiliation(s)
- Ahmad M Almai
- Consultant child and adolescent psychiatrist; Director of Residency Training, Department of Psychiatry, Johns Hopkins Aramco Health Center, Dhahran, Kingdom of Saudi Arabia. Email
| | - Jay A Salpekar
- Director of the Neuropsychiatry Center, Kennedy Krieger Institute, Baltimore, Maryland, USA; Associate Professor of Psychiatry and Neurology, Department of Psychiatry, Johns Hopkins University School of Medicine, Baltimore, Maryland, USA
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8
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Smolen C, Jensen M, Dyer L, Pizzo L, Tyryshkina A, Banerjee D, Rohan L, Huber E, El Khattabi L, Prontera P, Caberg JH, Van Dijck A, Schwartz C, Faivre L, Callier P, Mosca-Boidron AL, Lefebvre M, Pope K, Snell P, Lockhart PJ, Castiglia L, Galesi O, Avola E, Mattina T, Fichera M, Mandarà GML, Bruccheri MG, Pichon O, Le Caignec C, Stoeva R, Cuinat S, Mercier S, Bénéteau C, Blesson S, Nordsletten A, Martin-Coignard D, Sistermans E, Kooy RF, Amor DJ, Romano C, Isidor B, Juusola J, Girirajan S. Assortative mating and parental genetic relatedness drive the pathogenicity of variably expressive variants. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2023:2023.05.18.23290169. [PMID: 37292616 PMCID: PMC10246151 DOI: 10.1101/2023.05.18.23290169] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
We examined more than 38,000 spouse pairs from four neurodevelopmental disease cohorts and the UK Biobank to identify phenotypic and genetic patterns in parents associated with neurodevelopmental disease risk in children. We identified correlations between six phenotypes in parents and children, including correlations of clinical diagnoses such as obsessive-compulsive disorder (R=0.31-0.49, p<0.001), and two measures of sub-clinical autism features in parents affecting several autism severity measures in children, such as bi-parental mean Social Responsiveness Scale (SRS) scores affecting proband SRS scores (regression coefficient=0.11, p=0.003). We further describe patterns of phenotypic and genetic similarity between spouses, where spouses show both within- and cross-disorder correlations for seven neurological and psychiatric phenotypes, including a within-disorder correlation for depression (R=0.25-0.72, p<0.001) and a cross-disorder correlation between schizophrenia and personality disorder (R=0.20-0.57, p<0.001). Further, these spouses with similar phenotypes were significantly correlated for rare variant burden (R=0.07-0.57, p<0.0001). We propose that assortative mating on these features may drive the increases in genetic risk over generations and the appearance of "genetic anticipation" associated with many variably expressive variants. We further identified parental relatedness as a risk factor for neurodevelopmental disorders through its inverse correlations with burden and pathogenicity of rare variants and propose that parental relatedness drives disease risk by increasing genome-wide homozygosity in children (R=0.09-0.30, p<0.001). Our results highlight the utility of assessing parent phenotypes and genotypes in predicting features in children carrying variably expressive variants and counseling families carrying these variants.
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Affiliation(s)
- Corrine Smolen
- Department of Biochemistry and Molecular Biology, Pennsylvania State University, University Park, PA 16802, USA
- Bioinformatics and Genomics Graduate program, Pennsylvania State University, University Park, PA 16802, USA
| | - Matthew Jensen
- Department of Biochemistry and Molecular Biology, Pennsylvania State University, University Park, PA 16802, USA
- Bioinformatics and Genomics Graduate program, Pennsylvania State University, University Park, PA 16802, USA
| | | | - Lucilla Pizzo
- Department of Biochemistry and Molecular Biology, Pennsylvania State University, University Park, PA 16802, USA
| | - Anastasia Tyryshkina
- Department of Biochemistry and Molecular Biology, Pennsylvania State University, University Park, PA 16802, USA
- Neuroscience Graduate program, Pennsylvania State University, University Park, PA 16802
| | - Deepro Banerjee
- Department of Biochemistry and Molecular Biology, Pennsylvania State University, University Park, PA 16802, USA
- Bioinformatics and Genomics Graduate program, Pennsylvania State University, University Park, PA 16802, USA
| | - Laura Rohan
- Department of Biochemistry and Molecular Biology, Pennsylvania State University, University Park, PA 16802, USA
| | - Emily Huber
- Department of Biochemistry and Molecular Biology, Pennsylvania State University, University Park, PA 16802, USA
| | - Laila El Khattabi
- Assistance Publique–Hôpitaux de Paris, Department of Medical Genetics, Armand Trousseau and Pitié-Salpêtrière Hospitals, Paris, France
| | - Paolo Prontera
- Medical Genetics Unit, Hospital “Santa Maria della Misericordia”, Perugia, Italy
| | - Jean-Hubert Caberg
- Centre Hospitalier Universitaire de Liège. Domaine Universitaire du Sart Tilman, Liège, Belgium
| | - Anke Van Dijck
- Department of Medical Genetics, University and University Hospital Antwerp, Antwerp, Belgium
| | | | - Laurence Faivre
- Centre de Genetique et Cenre de Référence Anomalies du développement et syndromes malformatifs, Hôpital d’Enfants, CHU Dijon, Dijon, France
- GAD INSERM UMR1231, FHU TRANSLAD, Université de Bourgogne Franche Comté, Dijon, France
| | - Patrick Callier
- Centre de Genetique et Cenre de Référence Anomalies du développement et syndromes malformatifs, Hôpital d’Enfants, CHU Dijon, Dijon, France
- GAD INSERM UMR1231, FHU TRANSLAD, Université de Bourgogne Franche Comté, Dijon, France
| | | | - Mathilde Lefebvre
- GAD INSERM UMR1231, FHU TRANSLAD, Université de Bourgogne Franche Comté, Dijon, France
| | - Kate Pope
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Penny Snell
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
| | - Paul J. Lockhart
- Department of Paediatrics, University of Melbourne, Melbourne, Australia
- Bruce Lefroy Center, Murdoch Children’s Research Institute, Melbourne, Australia
| | - Lucia Castiglia
- Research Unit of Rare Diseases and Neurodevelopmental Disorders, Oasi Research Institute-IRCCS, 94018 Troina, Italy
| | - Ornella Galesi
- Research Unit of Rare Diseases and Neurodevelopmental Disorders, Oasi Research Institute-IRCCS, 94018 Troina, Italy
| | - Emanuela Avola
- Research Unit of Rare Diseases and Neurodevelopmental Disorders, Oasi Research Institute-IRCCS, 94018 Troina, Italy
| | - Teresa Mattina
- Medical Genetics, Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
| | - Marco Fichera
- Research Unit of Rare Diseases and Neurodevelopmental Disorders, Oasi Research Institute-IRCCS, 94018 Troina, Italy
- Medical Genetics, Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
| | | | - Maria Grazia Bruccheri
- Research Unit of Rare Diseases and Neurodevelopmental Disorders, Oasi Research Institute-IRCCS, 94018 Troina, Italy
| | - Olivier Pichon
- CHU Nantes, Department of Medical Genetics, Nantes, France
| | - Cedric Le Caignec
- CHU Toulouse, Department of Medical Genetics, Toulouse, France
- ToNIC, Toulouse Neuro Imaging, Center, Inserm, UPS, Université de Toulouse, Toulouse, France
| | - Radka Stoeva
- Service de Cytogenetique, CHU de Le Mans, Le Mans, France
| | | | - Sandra Mercier
- CHU Nantes, Department of Medical Genetics, Nantes, France
| | | | - Sophie Blesson
- Department of Genetics, Bretonneau University Hospital, Tours, France
| | | | | | - Erik Sistermans
- Department of Clinical Genetics, Amsterdam UMC, Amsterdam, The Netherlands
| | - R. Frank Kooy
- Department of Medical Genetics, University and University Hospital Antwerp, Antwerp, Belgium
| | - David J. Amor
- Bruce Lefroy Center, Murdoch Children’s Research Institute, Melbourne, Australia
| | - Corrado Romano
- Medical Genetics, Department of Biomedical and Biotechnological Sciences, University of Catania, 95123 Catania, Italy
- Medical Genetics, ASP Ragusa, Ragusa, Italy
| | | | | | - Santhosh Girirajan
- Department of Biochemistry and Molecular Biology, Pennsylvania State University, University Park, PA 16802, USA
- Bioinformatics and Genomics Graduate program, Pennsylvania State University, University Park, PA 16802, USA
- Neuroscience Graduate program, Pennsylvania State University, University Park, PA 16802
- Department of Anthropology, Pennsylvania State University, University Park, PA 16802, USA
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9
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Arpawong TE, Klopack ET, Kim JK, Crimmins EM. ADHD genetic burden associates with older epigenetic age: mediating roles of education, behavioral and sociodemographic factors among older adults. Clin Epigenetics 2023; 15:67. [PMID: 37101297 PMCID: PMC10131361 DOI: 10.1186/s13148-023-01484-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2022] [Accepted: 04/12/2023] [Indexed: 04/28/2023] Open
Abstract
BACKGROUND Shortened lifespans are associated with having Attention Deficit Hyperactivity Disorder (ADHD), which is likely mediated by related behavioral and sociodemographic factors that are also associated with accelerated physiological aging. Such factors include exhibiting more depressive symptoms, more cigarette smoking, higher body mass index, lower educational attainment, lower income in adulthood, and more challenges with cognitive processes compared to the general population. A higher polygenic score for ADHD (ADHD-PGS) is associated with having more characteristic features of ADHD. The degree to which (1) the ADHD-PGS associates with an epigenetic biomarker developed to predict accelerated aging and earlier mortality is unknown, as are whether (2) an association would be mediated by behavioral and sociodemographic correlates of ADHD, or (3) an association would be mediated first by educational attainment, then by behavioral and sociodemographic correlates. We evaluated these relationships in a population-based sample from the US Health and Retirement Study, among N = 2311 adults age 50 and older, of European-ancestry, with blood-based epigenetic and genetic data. The ADHD-PGS was calculated from a prior genomewide meta-analysis. Epigenome-wide DNA methylation levels that index biological aging and earlier age of mortality were quantified by a blood-based biomarker called GrimAge. We used a structural equation modeling approach to test associations with single and multi-mediation effects of behavioral and contextual indicators on GrimAge, adjusted for covariates. RESULTS The ADHD-PGS was significantly and directly associated with GrimAge when adjusting for covariates. In single mediation models, the effect of the ADHD-PGS on GrimAge was partially mediated via smoking, depressive symptoms, and education. In multi-mediation models, the effect of the ADHD-PGS on GrimAge was mediated first through education, then smoking, depressive symptoms, BMI, and income. CONCLUSIONS Findings have implications for geroscience research in elucidating lifecourse pathways through which ADHD genetic burden and symptoms can alter risks for accelerated aging and shortened lifespans, when indexed by an epigenetic biomarker. More education appears to play a central role in attenuating negative effects on epigenetic aging from behavioral and sociodemographic risk factors related to ADHD. We discuss implications for the potential behavioral and sociodemographic mediators that may attenuate negative biological system effects.
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Affiliation(s)
- Thalida E Arpawong
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA.
| | - Eric T Klopack
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Jung Ki Kim
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
| | - Eileen M Crimmins
- Leonard Davis School of Gerontology, University of Southern California, Los Angeles, CA, USA
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10
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Liljenwall H, Lean RE, Smyser TA, Smyser CD, Rogers CE. Parental ADHD and ASD symptoms and contributions of psychosocial risk to childhood ADHD and ASD symptoms in children born very preterm. J Perinatol 2023; 43:458-464. [PMID: 35840709 PMCID: PMC9840718 DOI: 10.1038/s41372-022-01463-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2022] [Revised: 05/02/2022] [Accepted: 07/06/2022] [Indexed: 01/18/2023]
Abstract
OBJECTIVES Examine maternal and paternal ADHD and ASD symptoms in relation to very preterm (VPT) and full-term (FT) children's ADHD and ASD symptoms. STUDY DESIGN In this longitudinal study, maternal- and teacher-report of child ADHD and ASD symptoms were obtained for 119 children (VPT = 79, FT = 40) at age 5-years using the Conner's Rating Scale-Revised (CRS-R) and Social Responsiveness Scale-2 (SRS-2). A biological parent completed self- and observer-report CRS-R and SRS-2, and measures of mood/affect, stress, and social support to assess psychosocial distress. Data were analyzed using mixed-effect models adjusted for covariates. RESULTS Child ADHD symptoms were associated with VPT birth, maternal distress, and maternal ADHD symptoms (p ≤ 0.02), and paternal ADHD symptoms (p < 0.001). Regarding ASD, VPT birth and parental ASD symptoms were associated with child ASD symptoms (p ≤ 0.009). Parental symptoms and birth group had no interaction. CONCLUSIONS VPT birth and parental psychopathology represent independent risks for ADHD and ASD.
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Affiliation(s)
- Helen Liljenwall
- Medical Education, Washington University School of Medicine, St Louis, MO, USA
| | - Rachel E Lean
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
| | - Tara A Smyser
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA
| | - Christopher D Smyser
- Department of Neurology, Washington University School of Medicine, St Louis, MO, USA
- Department of Radiology, Washington University School of Medicine, St Louis, MO, USA
- Department of Pediatrics, Washington University School of Medicine, St Louis, MO, USA
| | - Cynthia E Rogers
- Department of Psychiatry, Washington University School of Medicine, St Louis, MO, USA.
- Department of Pediatrics, Washington University School of Medicine, St Louis, MO, USA.
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11
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Meng X, Zheng JL, Sun ML, Lai HY, Wang BJ, Yao J, Wang H. Association between MTHFR (677C>T and 1298A>C) polymorphisms and psychiatric disorder: A meta-analysis. PLoS One 2022; 17:e0271170. [PMID: 35834596 PMCID: PMC9282595 DOI: 10.1371/journal.pone.0271170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 06/25/2022] [Indexed: 11/30/2022] Open
Abstract
Recent studies showed that genetic polymorphism of 5,10-methylenetetrahydrofolate reductase (MTHFR) is related to attention-deficit hyperactivity disorder (ADHD), bipolar disorder (BD) and schizophrenia (SCZ). However, no consistent conclusion has been determined. This meta-analysis aims to interrogate the relationship between MTHFR gene polymorphisms (677C>T and 1298A>C) and the occurrence of ADHD, BD and SCZ. We retrieved case-control studies that met the inclusion criteria from the PubMed database. Associations between MTHFR polymorphisms (677C>T and 1298A>C) and ADHD, BD and SCZ were measured by means of odds ratios (ORs) using a random effects model and 95% confidence intervals (CIs). Additionally, sensitivity analysis and publication bias were performed. After inclusion criteria were met, a total of five studies with ADHD including 434 cases and 670 controls, 18 studies with BD including 4167 cases and 5901 controls and 44 studies with SCZ including 16,098 cases and 19913 controls were finally included in our meta-analysis. Overall, our meta-analytical results provided evidence that the MTHFR 677C>T was associated with occurrence of BD and SCZ, while the 1298A>C polymorphism was related to ADHD and BD, and additionally the sensitivity analysis indicated these results were stable and reliable. This may provide useful information for relevant studies on the etiology of psychiatric disorders.
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Affiliation(s)
- Xinyao Meng
- School of Basic Medicine, Shenyang Medical College, Shenyang, P.R. China
| | - Ji-long Zheng
- Department of Forensic Medicine, China Criminal Police College, Shenyang, P.R. China
| | - Mao-ling Sun
- School of Forensic Medicine, China Medical University, Shenyang, P.R. China
| | - Hai-yun Lai
- School of Forensic Medicine, China Medical University, Shenyang, P.R. China
| | - Bao-jie Wang
- School of Forensic Medicine, China Medical University, Shenyang, P.R. China
| | - Jun Yao
- School of Forensic Medicine, China Medical University, Shenyang, P.R. China
| | - Hongbo Wang
- School of Basic Medicine, Shenyang Medical College, Shenyang, P.R. China
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12
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Steele CM, Wymbs BT, Capps RE. Birds of a Feather: An Examination of ADHD Symptoms and Associated Concerns in Partners of Adults with ADHD. J Atten Disord 2022; 26:296-306. [PMID: 33322995 DOI: 10.1177/1087054720978553] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE Adults often select romantic partners who behave like they do (i.e. assortative mating). However, little is known about whether assortative mating is common among adults with attention-deficit/hyperactivity disorder (ADHD) and whether it is related to associated problems. METHOD About 94 adults without ADHD, 43 adults with childhood ADHD histories but without current symptoms or impairment (ADHD-Desist), 27 adults with childhood ADHD histories and elevated current symptoms and impairment (ADHD-Persist) rated their partners' ADHD symptoms and their own associated problems (e.g., intimate partner violence, financial difficulties). RESULTS The ADHD-Persist group reported that their partners exhibited more ADHD symptoms than the ADHD-Desist group and those without ADHD. Adults in the ADHD-Persist group who had partners with elevated ADHD symptoms endorsed high intimate partner violence and financial difficulties. CONCLUSION Assortative mating appears to be common among adults with ADHD, especially those with persistent symptoms, and to increase risk of additional problems.
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13
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Jallow J, Halt AH, Öhman H, Hurtig T. Prenatal inflammation does not increase the risk for symptoms of attention deficit hyperactivity disorder (ADHD) in offspring. Eur Child Adolesc Psychiatry 2021; 30:1825-1828. [PMID: 32583074 DOI: 10.1007/s00787-020-01580-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/03/2020] [Accepted: 06/17/2020] [Indexed: 10/24/2022]
Affiliation(s)
- Jandeh Jallow
- Research Unit of Clinical Neuroscience, Department of Psychiatry, Faculty of Medicine, University of Oulu, Oulu, Finland.
| | - Anu-Helmi Halt
- Research Unit of Clinical Neuroscience, Department of Psychiatry, Faculty of Medicine, University of Oulu, Oulu, Finland.,Department of Psychiatry, Oulu University Hospital, Oulu, Finland
| | - Hanna Öhman
- Biobank Borealis of Northern Finland, Oulu University Hospital, Oulu, Finland.,Faculty of Medicine, Medical Research Center, University of Oulu, Oulu, Finland
| | - Tuula Hurtig
- Research Unit of Clinical Neuroscience, Department of Psychiatry, Faculty of Medicine, University of Oulu, Oulu, Finland.,PEDEGO Research Unit, Child Psychiatry, University of Oulu, Oulu, Finland.,Clinic of Child Psychiatry, Oulu University Hospital, Oulu, Finland
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14
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Wymbs BT, Canu WH, Sacchetti GM, Ranson LM. Adult ADHD and romantic relationships: What we know and what we can do to help. JOURNAL OF MARITAL AND FAMILY THERAPY 2021; 47:664-681. [PMID: 33421168 DOI: 10.1111/jmft.12475] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Revised: 11/15/2020] [Accepted: 11/22/2020] [Indexed: 05/27/2023]
Abstract
It has been widely maintained that enduring and healthy romantic relationships are critical to quality of life in adulthood, and can buffer the impact of adversity, including psychological disorder. Unfortunately, much research points toward adults with attention-deficit hyperactivity disorder (ADHD) having short-lived and discordant romantic relationships. Despite this ample evidence, relatively little research has focused on identifying specific factors that may strengthen or explain their relational difficulties, which would have obvious relationship distress prevention and intervention implications. The current study reviews the state of the literature on romantic relationships in adults with ADHD, including differences that have been established between ADHD and non-ADHD populations as well as distal and proximal factors that appear to increase risk of relationship distress of adults with ADHD. Finally, notable gaps in the literature are identified and implications are raised with regards to prevention and intervention efforts designed to address functional impairment in adults with ADHD.
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Affiliation(s)
- Brian T Wymbs
- Department of Psychology, Ohio University, Athens, OH, USA
| | - Will H Canu
- Department of Psychology, Appalachian State University, Boone, NC, USA
| | | | - Loren M Ranson
- Department of Psychology, Appalachian State University, Boone, NC, USA
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15
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Twin Study of the Relationship between Childhood Negative Emotionality and Hyperactivity/Inattention Problems. Twin Res Hum Genet 2021; 24:7-13. [PMID: 33766178 DOI: 10.1017/thg.2021.5] [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: 11/07/2022]
Abstract
The present study aimed to determine the genetic and environmental etiology of the association between childhood negative emotionality (NE) and hyperactivity/inattention problems (HIP) using South Korean elementary school twins (mean age = 10.19 years, SD = 1.79 years). Telephone interviews were given to mothers of 919 twins (229 monozygotic males: 112 pairs and 5 individuals; 148 dizygotic males: 73 pairs and 2 individuals; 180 monozygotic females: 87 pairs and 6 individuals; 103 dizygotic females: 50 pairs and 3 individuals; 259 opposite-sex dizygotic twins: 127 pairs and 5 individuals) to assess their children's NE and HIP. Consistent with prior studies, the phenotypic correlation between NE and the HIP was moderate (r = .29; 95% CI = .24, .34). Model-fitting analysis revealed that additive genetic and nonshared environmental influences on NE were .45 (95% CI [.34, .54]) and .55 (95% CI [.46, .66]), respectively, and that additive and nonadditive genetic, and nonshared environmental influences on HIP were .08 (95% CI [.03, .26]), .41 (95% CI [.21, .51]) and .51 (95% CI = .42, .61), respectively. In addition, the additive genetic correlation between NE and HIP was 1.0 (95% CI [.52, 1.00]), indicating that additive genetic factors are entirely shared between the two phenotypes. Nonadditive genetic influences were unique to HIP and not responsible for the NE-HIP association. Nonshared environmental correlation was significant but modest (re = .18, 95% CI [.06, .30]).
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16
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de Zeeuw EL, Hottenga JJ, Ouwens KG, Dolan CV, Ehli EA, Davies GE, Boomsma DI, van Bergen E. Intergenerational Transmission of Education and ADHD: Effects of Parental Genotypes. Behav Genet 2020; 50:221-232. [PMID: 32026073 PMCID: PMC7355279 DOI: 10.1007/s10519-020-09992-w] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2019] [Accepted: 01/08/2020] [Indexed: 11/30/2022]
Abstract
It remains a challenge to determine whether children resemble their parents due to nature, nurture, or a mixture of both. Here we used a design that exploits the distinction between transmitted and non-transmitted alleles in genetic transmission from parent to offspring. Two separate polygenic scores (PGS) were calculated on the basis of the transmitted and non-transmitted alleles. The effect of the non-transmitted PGS is necessarily mediated by parental phenotypes, insofar as they contribute to the rearing environment of the offspring (genetic nurturing). We calculated transmitted and non-transmitted PGSs associated with adult educational attainment (EA) and PGSs associated with childhood ADHD in a general population sample of trios, i.e. child or adult offspring and their parents (N = 1120-2518). We tested if the EA and ADHD (non-)transmitted PGSs were associated with childhood academic achievement and ADHD in offspring. Based on the earlier findings for shared environment, we hypothesized to find genetic nurturing for academic achievement, but not for ADHD. In adults, both transmitted (R2 = 7.6%) and non-transmitted (R2 = 1.7%) EA PGSs were associated with offspring EA, evidencing genetic nurturing. In children around age 12, academic achievement was associated with the transmitted EA PGSs (R2 = 5.7%), but we found no support for genetic nurturing (R2 ~ 0.1%). The ADHD PGSs were not significantly associated with academic achievement (R2 ~ 0.6%). ADHD symptoms in children were only associated with transmitted EA PGSs and ADHD PGSs (R2 = 1-2%). Based on these results, we conclude that the associations between parent characteristics and offspring outcomes in childhood are mainly to be attributable to the effects of genes that are shared by parents and children.
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Affiliation(s)
- Eveline L de Zeeuw
- Department of Biological Psychology, Vrije Universiteit, Van der Boechorststraat 7-9, 1081 BT, Amsterdam, The Netherlands.
- Amsterdam Public Health Research Institute, VUmc, Amsterdam, The Netherlands.
| | - Jouke-Jan Hottenga
- Department of Biological Psychology, Vrije Universiteit, Van der Boechorststraat 7-9, 1081 BT, Amsterdam, The Netherlands
| | - Klaasjan G Ouwens
- Department of Biological Psychology, Vrije Universiteit, Van der Boechorststraat 7-9, 1081 BT, Amsterdam, The Netherlands
| | - Conor V Dolan
- Department of Biological Psychology, Vrije Universiteit, Van der Boechorststraat 7-9, 1081 BT, Amsterdam, The Netherlands
| | - Erik A Ehli
- Avera Institute for Human Genetics, Avera McKennan Hospital & University Health Center, Sioux Falls, SD, USA
| | - Gareth E Davies
- Avera Institute for Human Genetics, Avera McKennan Hospital & University Health Center, Sioux Falls, SD, USA
| | - Dorret I Boomsma
- Department of Biological Psychology, Vrije Universiteit, Van der Boechorststraat 7-9, 1081 BT, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, VUmc, Amsterdam, The Netherlands
| | - Elsje van Bergen
- Department of Biological Psychology, Vrije Universiteit, Van der Boechorststraat 7-9, 1081 BT, Amsterdam, The Netherlands
- Amsterdam Public Health Research Institute, VUmc, Amsterdam, The Netherlands
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17
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Merikangas AK, Almasy L. Using the tools of genetic epidemiology to understand sex differences in neuropsychiatric disorders. GENES BRAIN AND BEHAVIOR 2020; 19:e12660. [PMID: 32348611 PMCID: PMC7507200 DOI: 10.1111/gbb.12660] [Citation(s) in RCA: 37] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/11/2019] [Revised: 03/01/2020] [Accepted: 04/24/2020] [Indexed: 02/06/2023]
Abstract
Many neuropsychiatric disorders exhibit differences in prevalence, age of onset, symptoms or course of illness between males and females. For the most part, the origins of these differences are not well understood. In this article, we provide an overview of sex differences in psychiatric disorders including autism spectrum disorder (ASD), attention deficit/hyperactivity disorder (ADHD), anxiety, depression, alcohol and substance abuse, schizophrenia, eating disorders and risk of suicide. We discuss both genetic and nongenetic mechanisms that have been hypothesized to underlie these differences, including ascertainment bias, environmental stressors, X‐ or Y‐linked risk loci, and differential liability thresholds in males and females. We then review the use of twin, family and genome‐wide association approaches to study potential genetic mechanisms of sex differences and the extent to which these designs have been employed in studies of psychiatric disorders. We describe the utility of genetic epidemiologic study designs, including classical twin and family studies, large‐scale studies of population registries, derived recurrence risks, and molecular genetic analyses of genome‐wide variation that may enhance our understanding sex differences in neuropsychiatric disorders.
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Affiliation(s)
- Alison K Merikangas
- Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Penn-CHOP Lifespan Brain Institute, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Laura Almasy
- Department of Biomedical and Health Informatics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.,Penn-CHOP Lifespan Brain Institute, University of Pennsylvania, Philadelphia, Pennsylvania, USA.,Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
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18
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The (Broad-Sense) Genetic Correlations Among Four Measures of Inattention and Hyperactivity in 12 Year Olds. Behav Genet 2020; 50:273-288. [PMID: 32529491 PMCID: PMC7355270 DOI: 10.1007/s10519-020-10002-2] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2019] [Accepted: 05/28/2020] [Indexed: 10/26/2022]
Abstract
We estimated the genetic covariance matrix among four inattention (INATT) and four hyperactivity (HYP) measures in the classical twin design. Data on INATT and HYP symptom counts were obtained in mono- and dizygotic twin pairs (N = 1593) with an average age of 12.2 years (sd = .51). We analyzed maternal ratings of INATT and HYP based on the Conners' Parent Rating Scale (CPRS), the Strengths and Weaknesses of ADHD-symptoms and Normal-behavior (SWAN), and teacher ratings based on the Conners' Teacher rating scale (CTRS) and the ASEBA Teacher Rating Form (TRF). Broad-sense heritabilities, corrected for the main effects of sex and for random teacher rater effects, were large (ranging from .658 to .912). The results reveal pervasive and strong broad-sense genetic effects on INATT and HYP phenotypes with the phenotypic covariance among the phenotypes largely due to correlated genetic effects. Specifically between 79.9 and 99.9% of the phenotypic covariance among the HYP measures, and between 81.0 and 93.5% of the INATT measures are attributable to broad-sense genetic effects. Overall, the present results, pertaining to the broad-sense heritabilities and shared genetic effects, support the current genome-wide association meta-analytic approach to identifying pleiotropic genetic variants.
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19
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Miranda P, Cox CD, Alexander M, Danev S, Lakey JRT. In Quest of Pathognomonic/Endophenotypic Markers of Attention Deficit Hyperactivity Disorder (ADHD): Potential of EEG-Based Frequency Analysis and ERPs to Better Detect, Prevent and Manage ADHD. MEDICAL DEVICES-EVIDENCE AND RESEARCH 2020; 13:115-137. [PMID: 32547262 PMCID: PMC7250294 DOI: 10.2147/mder.s241205] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2019] [Accepted: 04/16/2020] [Indexed: 11/23/2022] Open
Abstract
Attention deficit hyperactivity disorder (ADHD) is a chronic heritable developmental delay psychiatric disorder requiring chronic management, characterized by inattention, hyperactivity, hyperkinectivity and impulsivity. Subjective clinical evaluation still remains crucial in its diagnosis. Discussed are two key aspects in the “characterizing ADHD” and on the quest for objective “pathognomonic/endophenotypic diagnostic markers of ADHD”. The first aspect briefly revolves around issues related to identification of pathognomonic/endophenotypic diagnostic markers in ADHD. Issues discussed include changes in ADHD definition, remission/persistence and overlapping-symptoms cum shared-heritability with its co-morbid cross-border mental disorders. The second aspect discussed is neurobiological and EEG-based studies on ADHD. Given the neurobiological and temporal aspects of ADHD symptoms the electroencephalograph (EEG) like NeuralScan by Medeia appears as an appropriate tool. The EEGs appropriateness is further enhanced when coupled with suitable behavior/cognitive/motor/psychological tasks/paradigms yielding EEG-based markers like event-related-potential (ERPs like P3 amplitudes and latency), reaction time variability (RTV), Theta:Beta ratio (TBR) and sensorimotor rhythm (SMR). At present, these markers could potentially help in the neurobiological characterization of ADHD and either help in identifying or lay the groundwork for identifying pathognomonic and/or endophenotypic EEG-based markers enabling its diagnosis, treatment and management.
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Affiliation(s)
- Priya Miranda
- Department of Surgery and Biomedical Engineering, University of California Irvine, Irvine, California, USA
| | - Christopher D Cox
- Department of Neurology, David Geffen School of Medicine, University of California, Los Angeles, California, USA
| | - Michael Alexander
- Department of Surgery and Biomedical Engineering, University of California Irvine, Irvine, California, USA
| | | | - Jonathan R T Lakey
- Department of Surgery and Biomedical Engineering, University of California Irvine, Irvine, California, USA
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20
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DRD4 48 bp multiallelic variants as age-population-specific biomarkers in attention-deficit/hyperactivity disorder. Transl Psychiatry 2020; 10:70. [PMID: 32075956 PMCID: PMC7031506 DOI: 10.1038/s41398-020-0755-4] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2019] [Revised: 12/10/2019] [Accepted: 12/20/2019] [Indexed: 01/09/2023] Open
Abstract
The identification of biomarkers to support the diagnosis and prediction of treatment response for attention-deficit/hyperactivity disorder (ADHD) is still a challenge. Our previous works highlighted the DRD4 (dopamine receptor D4) as the best potential genetic marker for childhood diagnosis and methylphenidate (MPH) response. Here, we aimed to provide additional evidence on biomarkers for ADHD diagnosis and treatment response, by using more specific approaches such as meta-analytic and bioinformatics tools. Via meta-analytic approaches including over 3000 cases and 16,000 controls, we demonstrated that, among the different variants studied in DRD4 gene, the 48-base pair, Variable Tandem Repeat Polymorphism, VNTR in exon 3 showed an age/population-specificity and an allelic heterogeneity. In particular, the 7R/"long" allele was identified as an ADHD risk factor in European-Caucasian populations (d = 1.31, 95%CI: 1.17-1.47, Z = 4.70/d = 1.36, 95%CI: 1.20-1.55, Z = 4.78, respectively), also, from the results of last meta-analysis, linked to the poor MPH efficacy. The 4R/"short" allele was a protective factor in European-Caucasian and South American populations (d = 0.83, 95%CI: 0.75-0.92, Z = 3.58), and was also associated to positive MPH response. These results refer to children with ADHD. No evidence of such associations was detected for adults with persistent ADHD (data from the last meta-analysis). Moreover, we found evidence that the 4R allele leads to higher receptor expression and increased sensitivity to dopamine, as compared with the 7R allele (d = 1.20, 95%CI: 0.71-1.69, Z = 4.81), and this is consistent with the ADHD protection/susceptibility effects of the respective alleles. Using bioinformatics tools, based on the latest genome-wide association (GWAS) meta-analysis of the Psychiatry Genomic Consortium (PGC), we demonstrated that the 48 bp VNTR is not in Linkage Disequilibrium with the DRD4 SNPs (Single Nucleotide Polymorphisms), which were not found to be associated with ADHD. Moreover, a DRD4 expression downregulation was found in ADHD specific brain regions (Putamen, Z score = -3.02, P = 0.00252). Overall, our results suggest that DRD4 48 bp VNTR variants should be considered as biomarkers to support the diagnosis of ADHD and to predict MPH response, although the accuracy of such a biomarker remains to be further elucidated.
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Identification of ADHD risk genes in extended pedigrees by combining linkage analysis and whole-exome sequencing. Mol Psychiatry 2020; 25:2047-2057. [PMID: 30116028 PMCID: PMC7473839 DOI: 10.1038/s41380-018-0210-6] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2017] [Revised: 05/01/2018] [Accepted: 06/18/2018] [Indexed: 12/23/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder with a complex genetic background, hampering identification of underlying genetic risk factors. We hypothesized that combining linkage analysis and whole-exome sequencing (WES) in multi-generation pedigrees with multiple affected individuals can point toward novel ADHD genes. Three families with multiple ADHD-affected members (Ntotal = 70) and apparent dominant inheritance pattern were included in this study. Genotyping was performed in 37 family members, and WES was additionally carried out in 10 of those. Linkage analysis was performed using multi-point analysis in Superlink Online SNP 1.1. From prioritized linkage regions with a LOD score ≥ 2, a total of 24 genes harboring rare variants were selected. Those genes were taken forward and were jointly analyzed in gene-set analyses of exome-chip data using the MAGMA software in an independent sample of patients with persistent ADHD and healthy controls (N = 9365). The gene-set including all 24 genes together, and particularly the gene-set from one of the three families (12 genes), were significantly associated with persistent ADHD in this sample. Among the latter, gene-wide analysis for the AAED1 gene reached significance. A rare variant (rs151326868) within AAED1 segregated with ADHD in one of the families. The analytic strategy followed here is an effective approach for identifying novel ADHD risk genes. Additionally, this study suggests that both rare and more frequent variants in multiple genes act together in contributing to ADHD risk, even in individual multi-case families.
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Bahn GH, Lee YS, Yoo HK, Kim EJ, Park S, Han DH, Hong M, Kim B, Lee SI, Bhang SY, Lee SY, Hong JP, Joung YS. Development of the Korean Practice Parameter for Adult Attention-Deficit/Hyperactivity Disorder. Soa Chongsonyon Chongsin Uihak 2020; 31:5-25. [PMID: 32612409 PMCID: PMC7324844 DOI: 10.5765/jkacap.190030] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 09/18/2019] [Accepted: 09/19/2019] [Indexed: 01/03/2023] Open
Abstract
OBJECTIVES Adult attention-deficit/hyperactivity disorder (ADHD) is an important mental health problem that needs resolution, especially considering the high rates of ADHD continuation from childhood to adolescence/adulthood and the high prevalence of ADHD in adults. Adults with ADHD have lifelong negative impacts and require close monitoring with long-term follow-up. Hence, the establishment of a Korean practice parameter for adult ADHD is necessary to minimize discontinuation of treatment and enable information sharing among Korean mental health professionals. METHODS The Korean practice parameter was developed using an evidence-based approach consisting of expert consensus survey coupled with literature review. RESULTS According to the expert consensus survey, the most commonly used diagnostic methods were clinical psychiatric interview (20.66%) and self-report scales (19.25%) followed by attention (14.71%) and psychological tests (14.24%). Key evaluation instruments currently available in Korea are the World Health Organization Adult ADHD Self-Report Rating Scale, Korean Adult ADHD Rating Scale, Diagnostic Interview for ADHD in Adults, Barkley Deficits in Executive Functioning Scale for adults, Comprehensive Attention Test, Conners' Continuous Performance Test, and the subtests of Wechsler Adult Intelligence Scale, Digit Span and Letter-Number Sequencing. Although pharmacotherapy is recommended as the first-line of treatment for adult ADHD, we recommend that it be followed by a multimodal and multidisciplinary approach including psychoeducation, pharmacotherapy, cognitive behavior therapy and coaching. CONCLUSION The Korean practice parameter introduces not only general information for the diagnosis and treatment of adult ADHD on a global scale, but also the process of diagnosis and treatment options tailored to the Korean population.
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Affiliation(s)
- Geon Ho Bahn
- Department of Psychiatry, Kyung Hee University School of Medicine, Seoul, Korea
| | - Young Sik Lee
- Department of Psychiatry, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
| | | | - Eui-Jung Kim
- Department of Psychiatry, College of Medicine, Ewha Womans University, Seoul, Korea
| | - Subin Park
- Department of Research Planning, Mental Health Research Institute, National Center for Mental Health, Seoul, Korea
| | - Doug Hyun Han
- Department of Psychiatry, Chung-Ang University Hospital, Chung-Ang University College of Medicine, Seoul, Korea
| | - Minha Hong
- Department of Psychiatry, Myongji Hospital, Hanyang University College of Medicine, Seoul, Korea
| | - Bongseog Kim
- Department of Psychiatry, Inje University College of Medicine, Seoul, Korea
| | - Soyoung Irene Lee
- Department of Psychiatry, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Buchun, Korea
| | - Soo Young Bhang
- Department of Psychiatry, Eulji University School of Medicine, Seoul, Korea
| | - Seung Yup Lee
- Department of Psychiatry, Kyung Hee University School of Medicine, Seoul, Korea
| | - Jin Pyo Hong
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
| | - Yoo-Sook Joung
- Department of Psychiatry, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea
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van Dongen J, Zilhão NR, Sugden K, Hannon EJ, Mill J, Caspi A, Agnew-Blais J, Arseneault L, Corcoran DL, Moffitt TE, Poulton R, Franke B, Boomsma DI. Epigenome-wide Association Study of Attention-Deficit/Hyperactivity Disorder Symptoms in Adults. Biol Psychiatry 2019; 86:599-607. [PMID: 31003786 PMCID: PMC6717697 DOI: 10.1016/j.biopsych.2019.02.016] [Citation(s) in RCA: 35] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/08/2018] [Revised: 02/07/2019] [Accepted: 02/08/2019] [Indexed: 11/29/2022]
Abstract
BACKGROUND Previous studies have reported associations between attention-deficit/hyperactivity disorder symptoms and DNA methylation in children. We report the first epigenome-wide association study meta-analysis of adult attention-deficit/hyperactivity disorder symptoms, based on peripheral blood DNA methylation (Infinium HumanMethylation450K array) in three population-based adult cohorts. METHODS An epigenome-wide association study was performed in the Netherlands Twin Register (N = 2258, mean age 37 years), Dunedin Multidisciplinary Health and Development Study (N = 800, age 38 years), and Environmental Risk Longitudinal Twin Study (N = 1631, age 18 years), and results were combined through meta-analysis (total sample size N = 4689). Region-based analyses accounting for the correlation between nearby methylation sites were also performed. RESULTS One epigenome-wide significant differentially methylated position was detected in the Dunedin study, but meta-analysis did not detect differentially methylated positions that were robustly associated across cohorts. In region-based analyses, six significant differentially methylation regions (DMRs) were identified in the Netherlands Twin Register, 19 in the Dunedin study, and none in the Environmental Risk Longitudinal Twin Study. Of these DMRs, 92% were associated with methylation quantitative trait loci, and 68% showed moderate to large blood-brain correlations for DNA methylation levels. DMRs included six nonoverlapping DMRs (three in the Netherlands Twin Register, three in the Dunedin study) in the major histocompatibility complex, which were associated with expression of genes in the major histocompatibility complex, including C4A and C4B, previously implicated in schizophrenia. CONCLUSIONS Our findings point at new candidate loci involved in immune and neuronal functions that await further replication. Our work also illustrates the need for further research to examine to what extent epigenetic associations with psychiatric traits depend on characteristics such as age, comorbidities, exposures, and genetic background.
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Affiliation(s)
- Jenny van Dongen
- Department of Biological Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam.
| | - Nuno R Zilhão
- Department of Biological Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam
| | - Karen Sugden
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina; Center for Genomic and Computational Biology, Duke University, Durham, North Carolina
| | - Eilis J Hannon
- University of Exeter Medical School, University of Exeter, Exeter, United Kingdom
| | - Jonathan Mill
- University of Exeter Medical School, University of Exeter, Exeter, United Kingdom
| | - Avshalom Caspi
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina; Center for Genomic and Computational Biology, Duke University, Durham, North Carolina; Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Jessica Agnew-Blais
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Louise Arseneault
- Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - David L Corcoran
- Center for Genomic and Computational Biology, Duke University, Durham, North Carolina
| | - Terrie E Moffitt
- Department of Psychology and Neuroscience, Duke University, Durham, North Carolina; Center for Genomic and Computational Biology, Duke University, Durham, North Carolina; Social, Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, United Kingdom
| | - Richie Poulton
- Dunedin Multidisciplinary Health and Development Research Unit, Department of Psychology, University of Otago, Dunedin, New Zealand
| | - Barbara Franke
- Department of Human Genetics, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands; Department of Psychiatry, Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Dorret I Boomsma
- Department of Biological Psychology, Amsterdam Public Health Research Institute, Vrije Universiteit Amsterdam, Amsterdam
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Capusan AJ, Bendtsen P, Marteinsdottir I, Larsson H. Comorbidity of Adult ADHD and Its Subtypes With Substance Use Disorder in a Large Population-Based Epidemiological Study. J Atten Disord 2019; 23:1416-1426. [PMID: 26838558 DOI: 10.1177/1087054715626511] [Citation(s) in RCA: 62] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Objective: The objective of the study is to explore the role and possible substance preference in ADHD and subtypes in substance use disorder (SUD). Method: Using self-report data on ADHD Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) symptoms and SUD (alcohol, illicit drugs, and nicotine) in 18,167 Swedish twins, aged 20 to 45 years, we obtained odds ratios (OR) from mixed effect logistic regression, controlling for age, sex, education, and nonindependence of twin data. Results: Increased ADHD symptoms were significantly associated with increased odds for all SUD. ORs ranged between 1.33 for regular nicotine (95% confidence interval [CI] = [1.12, 1.59]); 2.54 for multiple drug use (95% CI = [2.00, 3.23]), and 3.58 for alcohol dependence (95% CI = [2.86, 4.49]). Conclusion: ADHD symptoms and subtypes in the population are associated with increased risks for all SUD outcomes, with no difference between ADHD subtypes, no substance preference, and no sex differences for the comorbidity. Clinicians need to consider ADHD evaluation and treatment as part of management of SUD in adults.
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Affiliation(s)
- Andrea J Capusan
- 1 Department of Psychiatry and Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Preben Bendtsen
- 2 Department of Medical Specialist and Department of Medicine and Health Sciences, Linköping University, Motala, Sweden
| | - Ina Marteinsdottir
- 3 Centre for Social and Affective Neuroscience, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
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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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Genetic risk factors and gene–environment interactions in adult and childhood attention-deficit/hyperactivity disorder. Psychiatr Genet 2019; 29:63-78. [DOI: 10.1097/ypg.0000000000000220] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
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Faraone SV, Larsson H. Genetics of attention deficit hyperactivity disorder. Mol Psychiatry 2019; 24:562-575. [PMID: 29892054 PMCID: PMC6477889 DOI: 10.1038/s41380-018-0070-0] [Citation(s) in RCA: 477] [Impact Index Per Article: 95.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 01/31/2018] [Accepted: 02/19/2018] [Indexed: 02/07/2023]
Abstract
Decades of research show that genes play an vital role in the etiology of attention deficit hyperactivity disorder (ADHD) and its comorbidity with other disorders. Family, twin, and adoption studies show that ADHD runs in families. ADHD's high heritability of 74% motivated the search for ADHD susceptibility genes. Genetic linkage studies show that the effects of DNA risk variants on ADHD must, individually, be very small. Genome-wide association studies (GWAS) have implicated several genetic loci at the genome-wide level of statistical significance. These studies also show that about a third of ADHD's heritability is due to a polygenic component comprising many common variants each having small effects. From studies of copy number variants we have also learned that the rare insertions or deletions account for part of ADHD's heritability. These findings have implicated new biological pathways that may eventually have implications for treatment development.
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Affiliation(s)
- Stephen V Faraone
- Departments of Psychiatry and of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, 13210, USA.
| | - Henrik Larsson
- School of Medical Sciences, Örebro University, Örebro, Sweden
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
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Updated European Consensus Statement on diagnosis and treatment of adult ADHD. Eur Psychiatry 2018; 56:14-34. [DOI: 10.1016/j.eurpsy.2018.11.001] [Citation(s) in RCA: 201] [Impact Index Per Article: 33.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/09/2018] [Revised: 11/02/2018] [Accepted: 11/03/2018] [Indexed: 12/17/2022] Open
Abstract
AbstractBackground Attention-deficit/hyperactivity disorder (ADHD) is among the most common psychiatric disorders of childhood that often persists into adulthood and old age. Yet ADHD is currently underdiagnosed and undertreated in many European countries, leading to chronicity of symptoms and impairment, due to lack of, or ineffective treatment, and higher costs of illness.Methods The European Network Adult ADHD and the Section for Neurodevelopmental Disorders Across the Lifespan (NDAL) of the European Psychiatric Association (EPA), aim to increase awareness and knowledge of adult ADHD in and outside Europe. This Updated European Consensus Statement aims to support clinicians with research evidence and clinical experience from 63 experts of European and other countries in which ADHD in adults is recognized and treated.Results Besides reviewing the latest research on prevalence, persistence, genetics and neurobiology of ADHD, three major questions are addressed: (1) What is the clinical picture of ADHD in adults? (2) How should ADHD be properly diagnosed in adults? (3) How should adult ADHDbe effectively treated?Conclusions ADHD often presents as a lifelong impairing condition. The stigma surrounding ADHD, mainly due to lack of knowledge, increases the suffering of patients. Education on the lifespan perspective, diagnostic assessment, and treatment of ADHD must increase for students of general and mental health, and for psychiatry professionals. Instruments for screening and diagnosis of ADHD in adults are available, as are effective evidence-based treatments for ADHD and its negative outcomes. More research is needed on gender differences, and in older adults with ADHD.
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Pagani LS, Fitzpatrick C. Children's Early Disruptive Behavior Predicts Later Coercive Behavior and Binge Drinking by Mothers. J Pediatr Nurs 2018. [PMID: 29525211 DOI: 10.1016/j.pedn.2017.12.011] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Abstract
PURPOSE We examined the prospective influence of early child problematic behavior on later coercive interactions and binge drinking by mothers. DESIGN AND METHODS Canadian participants are from the Quebec Longitudinal Study of Child Development, born between spring 1997 and 1998, which allowed a longitudinal birth cohort design. At the 41months, 628 parents reported on children's oppositional, aggressive, turbulent, and inattentive/hyperactive behavior. Mothers then reported on their own coercive and binge drinking behavior at the 60month follow-up. RESULTS We estimated a series of ordinary least-squares regressions to examine the relationship between early child behavior problems and later parental coercion and binge drinking, above and beyond many key pre-existing/concurrent confounding factors including prior parenting stress and binge alcohol use. Oppositional, aggressive, and turbulent child behaviors at 41months predicted harsh, negative parenting at 60months. Early inattentive/hyperactive child behavior also forecasted later binge alcohol use by mothers within the same time frame. CONCLUSION Negative preschool behavior predicted harsh, negative maternal behavior kindergarten entry. Early inattentive/hyperactive behavior also forecasted later binge alcohol use by mothers. Coercive parenting and alcohol use are clinically signs of adult distress. Such parents might use alcohol excessively because of its perceived stress-dampening effects and mental evasion from their life difficulties and frustration experiences. PRACTICE IMPLICATIONS Problematic preschool behavior can lead to less effective child-rearing and unhealthy parental behavior. Such at-risk mothers would benefit from professional caring practices. Practitioners can inspire change, especially using interaction interventions which encourage positive parent-child relations that, in turn, diminish parental distress.
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Affiliation(s)
- Linda S Pagani
- School of Psycho-Education, Sainte-Justine's Hospital Research Center, Brain Health Division, University of Montreal, Canada.
| | - Caroline Fitzpatrick
- School of Psycho-Education, Sainte-Justine's Hospital Research Center, Brain Health Division, University of Montreal, Canada; Université Sainte-Anne, Church Point, Canada; PERFORM Centre, Concordia University, Montreal, Canada
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Bonvicini C, Faraone SV, Scassellati C. Common and specific genes and peripheral biomarkers in children and adults with attention-deficit/hyperactivity disorder. World J Biol Psychiatry 2018; 19:80-100. [PMID: 28097908 PMCID: PMC5568996 DOI: 10.1080/15622975.2017.1282175] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Abstract
OBJECTIVES Elucidating the biological mechanisms involved in attention-deficit/hyperactivity disorder (ADHD) has been challenging. Relatively unexplored is the fact that these mechanisms can differ with age. METHODS We present an overview on the major differences between children and adults with ADHD, describing several studies from genomics to metabolomics performed in ADHD children and in adults (cADHD and aADHD, respectively). A systematic search (up until February 2016) was conducted. RESULTS From a PRISMA flow-chart, a total of 350 and 91 genomics and metabolomics studies were found to be elligible for cADHD and aADHD, respectively. For children, associations were found for genes belonging to dopaminergic (SLC6A3, DRD4 and MAOA) and neurodevelopmental (LPHN3 and DIRAS2) systems and OPRM1 (Yates corrected P = 0.016; OR = 2.27 95%CI: 1.15-4.47). Studies of adults have implicated circadian rhythms genes, HTR2A, MAOB and a more generic neurodevelopmental/neurite outgrowth network (BCHE, SNAP25, BAIAP2, NOS1/NO, KCNIP4 and SPOCK3; Yates corrected P = 0.007; OR = 3.30 95%CI: 1.33-8.29). In common among cADHD and aADHD, the most significant findings are for oxidative stress proteins (MAD, SOD, PON1, ARES, TOS, TAS and OSI), and, in the second level, DISC1, DBH, DDC, microRNA and adiponectin. CONCLUSIONS Through a convergent functional genomics, this review contributes to clarification of which genetic/biological mechanisms differ with age. The effects of some genes do not change throughout the lifetime, whereas others are linked to age-specific stages. Additional research and further studies are needed to generate firmer conclusions that might someday be useful for predicting the remission and persistence of the disorder. Despite the limitations, some of these genes/proteins could be potential useful biomarkers to discriminate cADHD from aADHD.
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Affiliation(s)
- Cristian Bonvicini
- Genetics Unit, IRCCS “Centro S. Giovanni di Dio” Fatebenefratelli, Brescia, Italy
| | - Stephen V. Faraone
- Departments of Psychiatry and of Neuroscience and Physiology, SUNY Upstate Medical University, Syracuse, NY, USA; K.G. Jebsen Centre for Research on Neuropsychiatric Disorders, Department of Biomedicine, University of Bergen, Bergen, Norway
| | - Catia Scassellati
- Genetics Unit, IRCCS “Centro S. Giovanni di Dio” Fatebenefratelli, Brescia, Italy
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Capusan AJ, Yao S, Kuja-Halkola R, Bulik CM, Thornton LM, Bendtsen P, Marteinsdottir I, Thorsell A, Larsson H. Genetic and environmental aspects in the association between attention-deficit hyperactivity disorder symptoms and binge-eating behavior in adults: a twin study. Psychol Med 2017; 47:2866-2878. [PMID: 28578734 DOI: 10.1017/s0033291717001416] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
BACKGROUND Prior research demonstrated that attention-deficit hyperactivity disorder (ADHD) is associated with binge-eating behavior, binge-eating disorder (BED), and bulimia nervosa (BN). The aim of this study was to investigate these associations in an adult twin population, and to determine the extent to which ADHD symptoms and binge-eating behavior share genetic and environmental factors. METHODS We used self-reports of current ADHD symptoms and lifetime binge-eating behavior and associated characteristics from a sample of over 18 000 adult twins aged 20-46 years, from the population-based Swedish Twin Registry. Mixed-effects logistic regression was used to examine the association between ADHD and lifetime binge-eating behavior, BED, and BN. Structural equation modeling was used in 13 773 female twins to determine the relative contribution of genetic and environmental factors to the association between ADHD symptoms and binge-eating behavior in female adult twins. RESULTS ADHD symptoms were significantly associated with lifetime binge-eating behavior, BED, and BN. The heritability estimate for current ADHD symptoms was 0.42 [95% confidence interval (CI) 0.41-0.44], and for lifetime binge-eating behavior 0.65 (95% CI 0.54-0.74). The genetic correlation was estimated as 0.35 (95% CI 0.25-0.46) and the covariance between ADHD and binge-eating behavior was primarily explained by genetic factors (91%). Non-shared environmental factors explained the remaining part of the covariance. CONCLUSIONS The association between adult ADHD symptoms and binge-eating behavior in females is largely explained by shared genetic risk factors.
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Affiliation(s)
- A J Capusan
- Department of Psychiatry and Department of Clinical and Experimental Medicine,Linköping University,Sweden
| | - S Yao
- Department of Medical Epidemiology and Biostatistics,Karolinska Institutet,Stockholm,Sweden
| | - R Kuja-Halkola
- Department of Medical Epidemiology and Biostatistics,Karolinska Institutet,Stockholm,Sweden
| | - C M Bulik
- Department of Medical Epidemiology and Biostatistics,Karolinska Institutet,Stockholm,Sweden
| | - L M Thornton
- Department of Psychiatry,University of North Carolina at Chapel Hill,Chapel Hill,USA
| | - P Bendtsen
- Department of Medical Specialist and Department of Medical and Health Sciences,Linköping University,Motala,Sweden
| | - I Marteinsdottir
- Department of Clinical and Experimental Medicine,Center for Social and Affective Neuroscience (CSAN), Linköping University,Linköping,Sweden
| | - A Thorsell
- Department of Clinical and Experimental Medicine,Center for Social and Affective Neuroscience (CSAN), Linköping University,Linköping,Sweden
| | - H Larsson
- Department of Medical Epidemiology and Biostatistics,Karolinska Institutet,Stockholm,Sweden
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Abstract
ADHD symptoms "run in families". However, relatively little is known about the ways in which parents' symptoms might additively and interactively work with the parenting environment, to influence (and be influenced by) the developmental trajectory of symptoms in children and adolescents. In this commentary on the special section addressing this gap in knowledge, emphasis is placed on the importance of replicating and extending family-wide studies of ADHD symptoms and etiology. The current papers exemplify the leading-edge of such efforts, demonstrating the feasibility and rigor with which studies are being conducted, utilizing longitudinal and experimental designs. Families and parenting environments operate as a system in which individuals influence each other's symptoms and functioning. In so doing, parents produce tremendous variability within (as well as between) each family in individuals' ADHD symptoms from childhood through adulthood, via gene-environment transactions that may even begin during prenatal development.
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Neuroticism and the Overlap Between Autistic and ADHD Traits: Findings From a Population Sample of Young Adult Australian Twins. Twin Res Hum Genet 2017; 20:319-329. [DOI: 10.1017/thg.2017.38] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
Neuroticism, a ‘Big Five’ personality trait, has been associated with sub-clinical traits of both autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD). The objective of the current study was to examine whether causal overlap between ASD and ADHD traits can be accounted for by genetic and environmental risk factors that are shared with neuroticism. We performed twin-based structural equation modeling using self-report data from 12 items of the Neo Five-Factor Inventory Neuroticism domain, 11 Social Responsiveness Scale items, and 12 Adult ADHD Self-Report Scale items obtained from 3,170 young adult Australian individual twins (1,081 complete pairs). Univariate analysis for neuroticism, ASD, and ADHD traits suggested that the most parsimonious models were those with additive genetic and unique environmental components, without sex limitation effects. Heritability of neuroticism, ASD, and ADHD traits, as measured by these methods, was moderate (between 40% and 45% for each respective trait). In a trivariate model, we observed moderate phenotypic (between 0.45 and 0.62), genetic (between 0.56 and 0.71), and unique environmental correlations (between 0.37and 0.55) among neuroticism, ASD, and ADHD traits, with the highest value for the shared genetic influence between neuroticism and self-reported ASD traits (rg = 0.71). Together, our results suggest that in young adults, genetic, and unique environmental risk factors indexed by neuroticism overlap with those that are shared by ASD and ADHD.
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Bidwell LC, Gray JC, Weafer J, Palmer AA, de Wit H, MacKillop J. Genetic influences on ADHD symptom dimensions: Examination of a priori candidates, gene-based tests, genome-wide variation, and SNP heritability. Am J Med Genet B Neuropsychiatr Genet 2017; 174:458-466. [PMID: 28512748 PMCID: PMC5690554 DOI: 10.1002/ajmg.b.32535] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 02/03/2017] [Accepted: 02/10/2017] [Indexed: 01/26/2023]
Abstract
Although the heritability of ADHD is estimated to be high, identifying specific genetic markers remains challenging. Most studies to date have examined the genetic basis of ADHD by employing dichotomous diagnostic phenotypes, but, as ADHD symptoms tend to be phenotypically dimensional, an alternative and potentially informative approach is to examine continuous indices of inattention and hyperactivity-impulsivity symptoms. The current study aimed to identify genetic effects on dimensionally-focused adult ADHD-related phenotypes in 990 individuals of European ancestry with intentionally low levels of substance misuse to avoid confounding. The study used four complementary approaches: (1) analysis of a priori candidate loci identified in prior meta-analytic work; (2) gene-based analysis; (3) hypothesis-free genome-wide association testing; and (4) single nucleotide polymorphism (SNP) heritability via genomic-relatedness-matrix restricted maximum likelihood analysis (GREML). The GREML analysis included a bivariate model to test whether the ADHD symptom dimensions index the same genetic liability. The results revealed significant differential associations between two a priori loci and ADHD phenotypes, rs6296 in HTR1B with inattention and rs3746544 in SNAP-25 with hyperactivity-impulsivity. No significant gene-based or genome-wide associations were detected, but SNP heritability revealed that a large portion of genetic variance was accounted for by common SNPs (44%, 55%, and 59% for inattention, hyperactivity-impulsivity, and total ADHD, respectively) and substantial shared genetic variance across inattention and hyperactivity-impulsivity (86%). These findings reveal both unique and common patterns of genetic influences across dimensional ADHD-related phenotypes. More broadly, these findings reveal the value in using multiple methods to understand the genetic etiology of ADHD.
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Affiliation(s)
- L Cinnamon Bidwell
- Institute of Cognitive Science, University of Colorado at Boulder, Boulder, Colorado
| | - Joshua C Gray
- Department of Psychology, University of Georgia, Athens, Georgia
- Department of Psychiatry and Human Behavior, Brown University, Providence, Rhode Island
| | - Jessica Weafer
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois
| | - Abraham A Palmer
- Department of Psychiatry, University of California San Diego, San Diego, California
- Institute for Genomic Medicine, University of California San Diego, La Jolla, California
| | - Harriet de Wit
- Department of Psychiatry and Behavioral Neuroscience, University of Chicago, Chicago, Illinois
| | - James MacKillop
- Peter Boris Centre for Addictions Research, McMaster University/St. Joseph's Healthcare Hamilton, Hamilton, Canada
- Homewood Research Institute, Homewood Health Centre, Guelph, Canada
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Kim EJ, Kim Y, Seo WS, Lee SH, Park EJ, Bae SM, Shin D. The Revised Korean Practice Parameter for the Treatment of Attention-Deficit Hyperactivity Disorder (I) - Clinical Presentation and Comorbidity -. Soa Chongsonyon Chongsin Uihak 2017. [DOI: 10.5765/jkacap.2017.28.2.46] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022] Open
Affiliation(s)
- Eun Jin Kim
- Department of Psychiatry, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Korea
| | - Yunsin Kim
- Department of Psychiatry, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Korea
| | - Wan Seok Seo
- Department of Psychiatry, Yeungnam University School of Medicine, Daegu, Korea
| | - So Hee Lee
- Department of Psychiatry, National Medical Center, Seoul, Korea
| | - Eun Jin Park
- Department of Psychiatry, Inje University School of Medicine, Ilsan Paik Hospital, Goyang, Korea
| | - Seung-Min Bae
- Department of Psychiatry, Gachon University College of Medicine, Gil Medical Center, Incheon, Korea
| | - Dongwon Shin
- Department of Psychiatry, Sungkyunkwan University School of Medicine, Kangbuk Samsung Hospital, Seoul, Korea
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Jacob CP, Gross-Lesch S, Reichert S, Geissler J, Jans T, Kittel-Schneider S, Nguyen TT, Romanos M, Reif A, Dempfle A, Lesch KP. Sex- and Subtype-Related Differences of Personality Disorders (Axis II) and Personality Traits in Persistent ADHD. J Atten Disord 2016; 20:1056-1065. [PMID: 24510476 DOI: 10.1177/1087054714521293] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/24/2023]
Abstract
OBJECTIVE Despite growing awareness of adult ADHD and its comorbidity with personality disorders (PDs), little is known about sex- and subtype-related differences. METHOD In all, 910 patients (452 females, 458 males) affected with persistent adult ADHD were assessed for comorbid PDs with the Structured Clinical Interview of DSM-IV and for personality traits with the revised NEO personality inventory, and the Tridimensional Personality Questionnaire. RESULTS The most prevalent PDs were narcissistic PD in males and histrionic PD in females. Affected females showed higher Neuroticism, Openness to Experience, and Agreeableness scores as well as Harm Avoidance and Reward Dependence scores. Narcissistic PD and antisocial PD have the highest prevalence in the H-type, while Borderline PD is more frequent in the C-type. CONCLUSION Sex- and subtype-related differences in Axis II disorder comorbidity as well as impairment-modifying personality traits have to be taken into account in epidemiological studies of persistent ADHD.
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Affiliation(s)
- Christian P Jacob
- Department of Psychiatry, Psychsomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Silke Gross-Lesch
- Department of Psychiatry, Psychsomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Susanne Reichert
- Department of Psychiatry, Psychsomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Julia Geissler
- Department of Psychiatry, Psychsomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Thomas Jans
- Department of Psychiatry, Psychsomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Sarah Kittel-Schneider
- Department of Psychiatry, Psychsomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Trang T Nguyen
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Marcel Romanos
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Andreas Reif
- Department of Psychiatry, Psychsomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Astrid Dempfle
- Department of Child and Adolescent Psychiatry and Psychotherapy, University of Würzburg, Würzburg, Germany
| | - Klaus-Peter Lesch
- Department of Psychiatry, Psychsomatics and Psychotherapy, University of Würzburg, Würzburg, Germany
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Groß-Lesch S, Dempfle A, Reichert S, Jans T, Geissler J, Kittel-Schneider S, Nguyen TT, Reif A, Lesch KP, Jacob CP. Sex- and Subtype-Related Differences in the Comorbidity of Adult ADHDs. J Atten Disord 2016; 20:855-66. [PMID: 24196345 DOI: 10.1177/1087054713510353] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE Comorbidity in adult ADHD (aADHD) has been investigated in a large number of studies using varying research approaches with divergent results. In contrast, there is limited information about sex- or subtype-related differences from studies with small sample size. METHOD A large sample of 910 individuals (458 males, 452 females) affected with aADHD was recruited at a tertiary referral center. All probands underwent a four-step procedure for diagnosing aADHD, including the Structured Clinical Interview of Diagnostic and Statistical Manual of Mental Disorders (4th ed.; DSM-IV) Axis I disorders to assess comorbidity. This study will provide additional information regarding the co-morbidity of Axis I disorders in the currently largest clinical referral sample. However, the main objective of this study is to gain information about sex- or subtype-related differences. RESULTS Affected females show higher rates of mood (61% vs. 49%), anxiety (32% vs. 22%), and eating disorders (16% vs. 1%) than affected males, while substance use disorders were more frequent in affected males (45% vs. 29%), which mirrors sex differences in prevalence in the general population. There were hardly any relevant differences in comorbidities between subtypes, with the exception of the inattentive subtype having an especially low prevalence of panic disorder. Comorbidity in general and substance use disorders in particular, but not sex or subtype, were highly predictive of lower psychosocial status. CONCLUSION Sex-related differences in the comorbidity of aADHD are more pronounced than subtype-related differences.
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Sherlock JM, Verweij KJH, Murphy SC, Heath AC, Martin NG, Zietsch BP. The Role of Genes and Environment in Degree of Partner Self-Similarity. Behav Genet 2016; 47:25-35. [PMID: 27590902 DOI: 10.1007/s10519-016-9808-0] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2015] [Accepted: 08/18/2016] [Indexed: 12/14/2022]
Abstract
Choice of romantic partner is an enormously important component of human life, impacting almost every facet of day-to-day existence, however; the processes underlying this choice are remarkably complex and have so far been largely resistant to scientific explanation. One consistent finding is that, on average, members of romantic dyads tend to be more alike than would be expected by chance. Selecting for self-similarity is at least partially driven by phenotypic matching wherein couples share similar phenotypes, and preferences for a number of these traits are partly genetically influenced (e.g., education, height, social attitudes and religiosity). This suggests that genetically influenced preferences for self-similarity might contribute to phenotypic matching (and thus assortative mating), but it has never been studied in actual couples. In the present study, we use a large sample of twins to model sources of variation in self-similarity between partners. Biometrical modelling revealed that very little of the variation in the tendency to assortatively mate across 14 traits was due to genetic effects (7 %) or the shared environment of twins (0 %).
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Affiliation(s)
- James M Sherlock
- School of Psychology, The University of Queensland, St Lucia, QLD, Australia.
| | - Karin J H Verweij
- School of Psychology, The University of Queensland, St Lucia, QLD, Australia.,Department of Biological Psychology, VU University, Amsterdam, The Netherlands
| | - Sean C Murphy
- Melbourne School of Psychological Sciences, The University of Melbourne, Parkville, VIC, 3010, Australia
| | - Andrew C Heath
- Department of Psychiatry, Washington University School of Medicine, St. Louis, MO, USA
| | - Nicholas G Martin
- Genetic Epidemiology, QIMR Berghofer Medical Research Institute, Herston, Brisbane, QLD, Australia
| | - Brendan P Zietsch
- School of Psychology, The University of Queensland, St Lucia, QLD, Australia. .,Genetic Epidemiology, QIMR Berghofer Medical Research Institute, Herston, Brisbane, QLD, Australia.
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Attention-deficit hyperactivity disorder in adults: A systematic review and meta-analysis of genetic, pharmacogenetic and biochemical studies. Mol Psychiatry 2016; 21:872-84. [PMID: 27217152 PMCID: PMC5414093 DOI: 10.1038/mp.2016.74] [Citation(s) in RCA: 119] [Impact Index Per Article: 14.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2015] [Revised: 02/09/2016] [Accepted: 04/01/2016] [Indexed: 01/16/2023]
Abstract
The adult form of attention-deficit/hyperactivity disorder has a prevalence of up to 5% and is the most severe long-term outcome of this common disorder. Family studies in clinical samples as well as twin studies suggest a familial liability and consequently different genes were investigated in association studies. Pharmacotherapy with methylphenidate (MPH) seems to be the first-line treatment of choice in adults with attention-deficit hyperactive disorder (ADHD) and some studies were conducted on the genes influencing the response to this drug. Finally some peripheral biomarkers were identified in ADHD adult patients. We believe this work is the first systematic review and meta-analysis of candidate gene association studies, pharmacogenetic and biochemical (metabolomics) studies performed in adults with ADHD to identify potential genetic, predictive and peripheral markers linked specifically to ADHD in adults. After screening 5129 records, we selected 87 studies of which 61 were available for candidate gene association studies, 5 for pharmacogenetics and 21 for biochemical studies. Of these, 15 genetic, 2 pharmacogenetic and 6 biochemical studies were included in the meta-analyses. We obtained an association between adult ADHD and the gene BAIAP2 (brain-specific angiogenesis inhibitor 1-associated protein 2), even after Bonferroni correction, with any heterogeneity in effect size and no publication bias. If we did not apply the Bonferroni correction, a trend was found for the carriers allele 9R of dopamine transporter SLC6A3 40 bp variable tandem repeat polymorphism (VNTR) and for 6/6 homozygotes of SLC6A3 30 bp VNTR. Negative results were obtained for the 9-6 haplotype, the dopamine receptor DRD4 48 bp VNTR, and the enzyme COMT SNP rs4680. Concerning pharmacogenetic studies, no association was found for the SLC6A3 40 bp and response to MPH with only two studies selected. For the metabolomics studies, no differences between ADHD adults and controls were found for salivary cortisol, whereas lower serum docosahexaenoic acid (DHA) levels were found in ADHD adults. This last association was significant even after Bonferroni correction and in absence of heterogeneity. Other polyunsaturated fatty acids (PUFAs) such as AA (arachidonic acid), EPA (eicosapentaenoic acid) and DyLA (dihomogammalinolenic acid) levels were not different between patients and controls. No publication biases were observed for these markers. Genes linked to dopaminergic, serotoninergic and noradrenergic signaling, metabolism (DBH, TPH1, TPH2, DDC, MAOA, MAOB, BCHE and TH), neurodevelopment (BDNF and others), the SNARE system and other forty genes/proteins related to different pathways were not meta-analyzed due to insufficient data. In conclusion, we found that there were not enough genetic, pharmacogenetic and biochemical studies of ADHD in adults and that more investigations are needed. Moreover we confirmed a significant role of BAIAP2 and DHA in the etiology of ADHD exclusively in adults. Future research should be focused on the replication of these findings and to assess their specificity for ADHD.
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40
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Nordsletten AE, Larsson H, Crowley JJ, Almqvist C, Lichtenstein P, Mataix-Cols D. Patterns of Nonrandom Mating Within and Across 11 Major Psychiatric Disorders. JAMA Psychiatry 2016; 73:354-61. [PMID: 26913486 PMCID: PMC5082975 DOI: 10.1001/jamapsychiatry.2015.3192] [Citation(s) in RCA: 136] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Psychiatric disorders are heritable, polygenic traits, which often share risk alleles and for which nonrandom mating has been suggested. However, despite the potential etiological implications, the scale of nonrandom mating within and across major psychiatric conditions remains unclear. OBJECTIVE To quantify the nature and extent of nonrandom mating within and across a broad range of psychiatric conditions at the population level. DESIGN, SETTING, AND PARTICIPANTS Population-based cohort using Swedish population registers. Participants were all Swedish residents with a psychiatric diagnosis of interest (attention-deficit/hyperactivity disorder, autism spectrum disorder, schizophrenia, bipolar disorder, major depression, generalized anxiety disorder, agoraphobia, social phobia, obsessive-compulsive disorder, anorexia, or substance abuse), along with their mates. Individuals with select nonpsychiatric disorders (Crohn's disease, type 1 and type 2 diabetes mellitus, multiple sclerosis, or rheumatoid arthritis) were included for comparison. General population samples were also derived and matched 1:5 with each case proband. Inpatient and outpatient diagnostic data were derived from the Swedish National Patient Register (1973-2009), with analyses conducted between June 2014 and May 2015. MAIN OUTCOMES AND MEASURES Correlation in the diagnostic status of mates both within and across disorders. Conditional logistic regression was used to quantify the odds of each diagnosis in the mates of cases relative to matched population controls. RESULTS Across cohorts, data corresponded to 707 263 unique case individuals, with women constituting 45.7% of the full population. Positive correlations in diagnostic status were evident between mates. Within-disorder correlations were marginally higher (range, 0.11-0.48) than cross-disorder correlations (range, 0.01-0.42). Relative to matched populations, the odds of psychiatric case probands having an affected mate were significantly elevated. Differences in the magnitude of observed relationships were apparent by disorder (odds ratio range, 0.8-11.4). The number of comorbidities in a case proband was associated with the proportion of affected mates. These relationships were not apparent or weaker in magnitude among nonpsychiatric conditions (correlation range, -0.03 to 0.17). CONCLUSIONS AND RELEVANCE Nonrandom mating is evident in psychiatric populations both within specific disorders and across the spectrum of psychiatric conditions. This phenomenon may hold important implications for how we understand the familial transmission of these disorders and for psychiatric genetic research.
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Affiliation(s)
| | - Henrik Larsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - James J. Crowley
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden3Department of Genetics, University of North Carolina at Chapel Hill
| | - Catarina Almqvist
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden4Astrid Lindgren Children’s Hospital, Karolinska University Hospital, Stockholm, Sweden
| | - Paul Lichtenstein
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - David Mataix-Cols
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
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Wesseldijk LW, Dieleman GC, Lindauer RJL, Bartels M, Willemsen G, Hudziak JJ, Boomsma DI, Middeldorp CM. Spousal resemblance in psychopathology: A comparison of parents of children with and without psychopathology. Eur Psychiatry 2016; 34:49-55. [PMID: 26928346 DOI: 10.1016/j.eurpsy.2016.01.2423] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2015] [Revised: 01/20/2016] [Accepted: 01/20/2016] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Spouses resemble each other for psychopathology, but data regarding spousal resemblance in externalizing psychopathology, and data regarding spousal resemblance across different syndromes (e.g. anxiety in wives and attention deficit/hyperactivity disorder [ADHD] in husbands) are limited. Moreover, knowledge is lacking regarding spousal resemblance in parents of children with psychiatric disorders. We investigated and compared spousal resemblance within and across internalizing and externalizing symptom domains in parents of children with and without psychopathology. METHODS Symptoms of depression, anxiety, avoidant personality, ADHD, and antisocial personality were assessed with the Adult Self Report in 728 mothers and 544 fathers of 778 children seen in child and adolescent psychiatric outpatient clinics and in 2075 mothers and 1623 fathers of 2784 children from a population-based sample. Differences in symptom scores and spousal correlations between the samples were tested. RESULTS Parents in the clinical sample had higher symptom scores than in the population-based sample. In both samples, correlations within and across internalizing and externalizing domains of psychopathology were significant. Importantly, correlations were significantly higher in the clinical sample (P=0.03). Correlations, within and across symptoms, ranged from 0.14 to 0.30 in the clinical sample and from 0.05 to 0.23 in the population-based sample. CONCLUSIONS This large study shows that spousal resemblance is not only present within but also across symptom domains. Especially in the clinical sample, ADHD symptoms in fathers and antisocial personality symptoms in mothers were correlated with a range of psychiatric symptoms in their spouses. Clinicians need to be alert of these multiple affected families.
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Affiliation(s)
- L W Wesseldijk
- Department of Biological Psychology, VU University Amsterdam, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands; EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands.
| | - G C Dieleman
- Department of Child and Adolescent Psychiatry/Psychology, Erasmus Medical Center Rotterdam/Sophia Children's Hospital, Wytemaweg 80, 3015 CN Rotterdam, The Netherlands
| | - R J L Lindauer
- Department of Child and Adolescent Psychiatry, Academic Medical Center, Meibergdreef 5, 1105 AZ Amsterdam, The Netherlands; De Bascule, Academic Center for Child and Adolescent Psychiatry, Amsterdam, The Netherlands
| | - M Bartels
- Department of Biological Psychology, VU University Amsterdam, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands; EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands; Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
| | - G Willemsen
- Department of Biological Psychology, VU University Amsterdam, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands; EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands
| | - J J Hudziak
- Department of Psychiatry and Medicine (Division of Human Genetics), Center for Children, Youth and Families, University of Vermont, B229 Given B, Burlington, VT 05405, USA
| | - D I Boomsma
- Department of Biological Psychology, VU University Amsterdam, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands; EMGO+ Institute for Health and Care Research, VU University Medical Centre, Amsterdam, The Netherlands; Neuroscience Campus Amsterdam, Amsterdam, The Netherlands
| | - C M Middeldorp
- Department of Biological Psychology, VU University Amsterdam, Van der Boechorststraat 1, 1081 BT Amsterdam, The Netherlands; Neuroscience Campus Amsterdam, Amsterdam, The Netherlands; Department of Child and Adolescent Psychiatry, GGZ inGeest/VU University Medical Center, Amsterdam, The Netherlands
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Peyrot WJ, Boomsma DI, Penninx BWJH, Wray NR. Disease and Polygenic Architecture: Avoid Trio Design and Appropriately Account for Unscreened Control Subjects for Common Disease. Am J Hum Genet 2016; 98:382-91. [PMID: 26849113 DOI: 10.1016/j.ajhg.2015.12.017] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2015] [Accepted: 12/17/2015] [Indexed: 01/17/2023] Open
Abstract
Genome-wide association studies (GWASs) are an optimal design for discovery of disease risk loci for diseases whose underlying genetic architecture includes many common causal loci of small effect (a polygenic architecture). We consider two designs that deserve careful consideration if the true underlying genetic architecture of the trait is polygenic: parent-offspring trios and unscreened control subjects. We assess these designs in terms of quantification of the total contribution of genome-wide genetic markers to disease risk (SNP heritability) and power to detect an associated risk allele. First, we show that trio designs should be avoided when: (1) the disease has a lifetime risk > 1%; (2) trio probands are ascertained from families with more than one affected sibling under which scenario the SNP heritability can drop by more than 50% and power can drop as much as from 0.9 to 0.15 for a sample of 20,000 subjects; or (3) assortative mating occurs (spouse correlation of the underlying liability to the disorder), which decreases the SNP heritability but not the power to detect a single locus in the trio design. Some studies use unscreened rather than screened control subjects because these can be easier to collect; we show that the estimated SNP heritability should then be scaled by dividing by (1 - K × u)(2) for disorders with population prevalence K and proportion of unscreened control subjects u. When omitting to scale appropriately, the SNP heritability of, for example, major depressive disorder (K = 0.15) would be underestimated by 28% when none of the control subjects are screened.
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Affiliation(s)
- Wouter J Peyrot
- Department of Psychiatry, VU University Medical Center & GGZ inGeest, Amsterdam 1081 HL, the Netherlands; Queensland Brain Institute, University of Queensland, Brisbane 4072, Australia.
| | - Dorret I Boomsma
- Department of Biological Psychology, VU University Amsterdam, Amsterdam 1081 BT, the Netherlands
| | - Brenda W J H Penninx
- Department of Psychiatry, VU University Medical Center & GGZ inGeest, Amsterdam 1081 HL, the Netherlands
| | - Naomi R Wray
- Queensland Brain Institute, University of Queensland, Brisbane 4072, Australia.
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Lubke GH, Ouwens KG, de Moor MH, Trull TJ, Boomsma DI. Population heterogeneity of trait anger and differential associations of trait anger facets with borderline personality features, neuroticism, depression, Attention Deficit Hyperactivity Disorder (ADHD), and alcohol problems. Psychiatry Res 2015; 230:553-60. [PMID: 26454404 PMCID: PMC4655156 DOI: 10.1016/j.psychres.2015.10.003] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Revised: 09/15/2015] [Accepted: 10/01/2015] [Indexed: 10/22/2022]
Abstract
Anger is an emotion consisting of feelings of variable intensity ranging from mild irritation to intense fury. High levels of trait anger are associated with a range of psychiatric, interpersonal, and health problems. The objectives of this study were to explore heterogeneity of anger as measured by the Spielberger Trait Anger Scale (STAS), and to assess the association of the different anger facets with a selection of psychiatric disorders covering externalizing and internalizing problems, personality disorders, and substance use. Factor mixture models differentiated between a high and low scoring class (28% vs. 72%), and between three factors (anger-temperament, anger-reaction, and immediacy of an anger response). Whereas all psychiatric scales correlated significantly with the STAS total score, regressing the three STAS factors on psychiatric behaviors model showed a more detailed pattern. Only borderline affect instability and depression were significantly associated with all three factors in both classes whereas other problem behaviors were associated only with 1 or 2 of the factors. Alcohol problems were associated with immediacy only in the high scoring class, indicating a non-linear relation in the total sample. Taking into account these more specific associations is likely to be beneficial when investigating differential treatment strategies.
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Affiliation(s)
- Gitta H. Lubke
- Department of Psychology, University of Notre Dame, USA,Biological Psychology, VU University Amsterdam, The Netherlands
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Treur JL, Willemsen G, Bartels M, Geels LM, van Beek JHDA, Huppertz C, van Beijsterveldt CEM, Boomsma DI, Vink JM. Smoking During Adolescence as a Risk Factor for Attention Problems. Biol Psychiatry 2015; 78:656-63. [PMID: 25092631 DOI: 10.1016/j.biopsych.2014.06.019] [Citation(s) in RCA: 47] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/15/2014] [Revised: 06/23/2014] [Accepted: 06/25/2014] [Indexed: 12/22/2022]
Abstract
BACKGROUND Cigarette smoking and attention-deficit/hyperactivity disorder (ADHD) are highly comorbid. One explanation is that individuals with ADHD use cigarettes as "self-medication" to alleviate their attention problems. However, animal studies reported that exposure to nicotine during adolescence influences the developing brain and negatively affects attention. This is the first human study exploring the effects of smoking during adolescence on attention problems. METHODS Longitudinal data on smoking and attention problems were available for 1987 adult and 648 adolescent monozygotic twin pairs from the Netherlands Twin Register. Twin pairs were classified as concordant/discordant for smoking and compared on attention problems. Within adult discordant pairs, the difference in attention problems between the smoking and never-smoking twins was first assessed cross-sectionally. In longitudinal analyses, the increase in attention problems from adolescence, when neither twin smoked, to adulthood was compared within discordant pairs. In subgroups with longitudinal data from childhood and adolescence, changes in smoking concordance and subsequent changes in attention problems were explored. RESULTS Adult twins who ever smoked reported significantly more attention problems than their never-smoking co-twin. Longitudinal analyses showed a larger increase in attention problems from adolescence to adulthood in smoking twins than their never-smoking co-twin (p < .05). In childhood and adolescence, smoking twins had more attention problems than their never-smoking co-twin, whereas scores were similar before smoking was initiated or after both twins started smoking (not significant in all groups). CONCLUSIONS Results from this genetically informative study suggest smoking during adolescence leads to higher attention problem scores, lasting into adulthood.
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Affiliation(s)
- Jorien L Treur
- Department of Biological Psychology, VU University Amsterdam, The Netherlands; EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands.
| | - Gonneke Willemsen
- Department of Biological Psychology, VU University Amsterdam, The Netherlands; EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands; Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Meike Bartels
- Department of Biological Psychology, VU University Amsterdam, The Netherlands; EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands; Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Lot M Geels
- Department of Biological Psychology, VU University Amsterdam, The Netherlands; EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Jenny H D A van Beek
- Department of Biological Psychology, VU University Amsterdam, The Netherlands; EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Charlotte Huppertz
- Department of Biological Psychology, VU University Amsterdam, The Netherlands; EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands
| | - Catharina E M van Beijsterveldt
- Department of Biological Psychology, VU University Amsterdam, The Netherlands; EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands; Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Dorret I Boomsma
- Department of Biological Psychology, VU University Amsterdam, The Netherlands; EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands; Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
| | - Jacqueline M Vink
- Department of Biological Psychology, VU University Amsterdam, The Netherlands; EMGO+ Institute for Health and Care Research, VU University Medical Center, Amsterdam, The Netherlands; Neuroscience Campus Amsterdam, VU University Medical Center, Amsterdam, The Netherlands
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45
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Capusan AJ, Bendtsen P, Marteinsdottir I, Kuja-Halkola R, Larsson H. Genetic and environmental contributions to the association between attention deficit hyperactivity disorder and alcohol dependence in adulthood: A large population-based twin study. Am J Med Genet B Neuropsychiatr Genet 2015; 168:414-422. [PMID: 25711682 DOI: 10.1002/ajmg.b.32300] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2014] [Accepted: 01/18/2014] [Indexed: 02/03/2023]
Abstract
Previous research indicates that attention deficit hyperactivity disorder (ADHD) frequently co-occurs with alcohol dependence; however, the extent to which shared genetic risk factors underpin this association remains unclear. The aim of this study is to investigate the relative importance of genetic, shared, and nonshared environmental factors for the overlap between ADHD and alcohol dependence in adults. Almost 18,000 adult twins aged 20-45 years, from more than 12,000 twin pairs (5,420 complete pairs), from the population-representative Swedish Twin Registry, were included. Self-ratings were used to assess symptoms of ADHD and alcohol dependence. Twin analysis was used to determine the role of additive genetic (A), shared (C), and nonshared environmental (E) factors. As a result, we found a significant association between ADHD and alcohol dependence (odds ratio 3.58; 95% confidence interval, 2.85-4.49). Twin analysis suggested that shared genetic risk factors explained 64% of the overlap between ADHD and alcohol dependence. Nonshared environmental factors accounted for the remaining 36%, whereas the contribution of shared environmental factors was minimal. We found no support for statistically significant sex differences in the overlap between ADHD and alcohol dependence. In conclusion the overlap between ADHD and alcohol dependence in adulthood was largely explained by shared genetic risk factors. This is an important step toward understanding the underlying nature of the risk of alcohol dependence in patients with ADHD and suggests that individuals with ADHD and their family members are important targets for alcohol prevention and treatment. © 2015 Wiley Periodicals, Inc.
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Affiliation(s)
- Andrea J Capusan
- Division of Psychiatry, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Preben Bendtsen
- Department of Specialist Medicine, Motala and Department of Medical and Health Sciences, Division of Community Medicine Linköping University, Linköping
| | - Ina Marteinsdottir
- Division of Psychiatry, Department of Clinical and Experimental Medicine, Linköping University, Linköping, Sweden
| | - Ralf Kuja-Halkola
- 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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46
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Alemany S, Ribasés M, Vilor-Tejedor N, Bustamante M, Sánchez-Mora C, Bosch R, Richarte V, Cormand B, Casas M, Ramos-Quiroga JA, Sunyer J. New suggestive genetic loci and biological pathways for attention function in adult attention-deficit/hyperactivity disorder. Am J Med Genet B Neuropsychiatr Genet 2015; 168:459-470. [PMID: 26174813 DOI: 10.1002/ajmg.b.32341] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/31/2014] [Accepted: 06/22/2015] [Indexed: 11/09/2022]
Abstract
Attention deficit is one of the core symptoms of the attention-deficit/hyperactivity disorder (ADHD). However, the specific genetic variants that may be associated with attention function in adult ADHD remain largely unknown. The present study aimed to identifying SNPs associated with attention function in adult ADHD and tested whether these associations were enriched for specific biological pathways. Commissions, hit-reaction time (HRT), the standard error of HRT (HRTSE), and intraindividual coefficient variability (ICV) of the Conners Continuous Performance Test (CPT-II) were assessed in 479 unmedicated adult ADHD individuals. A Genome-Wide Association Study (GWAS) was conducted for each outcome and, subsequently, gene set enrichment analyses were performed. Although no SNPs reached genome-wide significance (P < 5E-08), 27 loci showed suggestive evidence of association with the CPT outcomes (P < E-05). The most relevant associated SNP was located in the SORCS2 gene (P = 3.65E-07), previously associated with bipolar disorder (BP), Alzheimer disease (AD), and brain structure in elderly individuals. We detected other genes suggested to be involved in synaptic plasticity, cognitive function, neurological and neuropsychiatric disorders, and smoking behavior such as NUAK1, FGF20, NETO1, BTBD9, DLG2, TOP3B, and CHRNB4. Also, several of the pathways nominally associated with the CPT outcomes are relevant for ADHD such as the ubiquitin proteasome, neurodegenerative disorders, axon guidance, and AD amyloid secretase pathways. To our knowledge, this is the first GWAS and pathway analysis of attention function in patients with persistent ADHD. Overall, our findings reinforce the conceptualization of attention function as a potential endophenotype for studying the molecular basis of adult ADHD. © 2015 Wiley Periodicals, Inc.
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Affiliation(s)
- Silvia Alemany
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Marta Ribasés
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain.,Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Natàlia Vilor-Tejedor
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain
| | - Mariona Bustamante
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain.,Center for Genomic Regulation (CRG), Barcelona, Spain
| | - Cristina Sánchez-Mora
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain.,Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Rosa Bosch
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain
| | - Vanesa Richarte
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain.,Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Bru Cormand
- Facultat de Biologia, Departament de Genètica, Universitat de Barcelona, Catalonia, Spain.,Centro de Investigación Biomédica en Red de Enfermedades Raras (CIBERER), Madrid, Spain.,Institut de Biomedicina de la Universitat de Barcelona (IBUB), Catalonia, Spain
| | - Miguel Casas
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain.,Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Josep A Ramos-Quiroga
- Department of Psychiatry, Hospital Universitari Vall d'Hebron, Barcelona, Spain.,Biomedical Network Research Centre on Mental Health (CIBERSAM), Barcelona, Spain.,Psychiatric Genetics Unit, Vall d'Hebron Research Institute (VHIR), Universitat Autònoma de Barcelona, Barcelona, Spain.,Department of Psychiatry and Legal Medicine, Universitat Autònoma de Barcelona, Barcelona, Spain
| | - Jordi Sunyer
- Centre for Research in Environmental Epidemiology (CREAL), Barcelona, Spain.,Universitat Pompeu Fabra (UPF), Barcelona, Spain.,CIBER Epidemiology and Public Health (CIBERESP), Madrid, Spain.,IMIM (Hospital del Mar Medical Research Institute), Barcelona, Spain
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Brikell I, Kuja-Halkola R, Larsson H. Heritability of attention-deficit hyperactivity disorder in adults. Am J Med Genet B Neuropsychiatr Genet 2015; 168:406-413. [PMID: 26129777 DOI: 10.1002/ajmg.b.32335] [Citation(s) in RCA: 84] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/18/2014] [Accepted: 06/15/2015] [Indexed: 11/07/2022]
Abstract
Attention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder. Symptoms often persist into adulthood, with a prevalence of 2.5-5% in adult populations. Twin studies in childhood consistently report high heritabilities of 70-80%, while studies in adult samples show only moderate heritability of 30-40% when estimated from self-ratings. This review summarizes the available research on the heritability of ADHD in adults. Three key findings are outlined: (i) self-ratings lead to relatively low heritability estimates of ADHD, independent of age and whether ratings refer to current or retrospective symptoms; (ii) studies relying on different informants to rate each twin within a pair (i.e., self-ratings and different parents/teachers rating each twin in a pair) consistently yield lower heritability estimates than studies relying on ratings from a single informant; (iii) studies using cross-informant data via either combined parent and self-ratings or clinical diagnoses information suggest that the heritability of ADHD in adults could be as high as 70-80%. Together, the reviewed studies suggest that the previously reported low heritability of ADHD in adults is unlikely to reflect a true developmental change. Instead, the drop in heritability is better explained by rater effects related to a switch from using one rater for both twins in a pair (parent/teacher) in childhood, to relying on self-ratings (where each twin rates themselves) of ADHD symptoms in adulthood. When rater effects are addressed using cross-informant approaches, the heritability of ADHD in adults appears to be comparable to the heritability of ADHD in childhood. © 2015 Wiley Periodicals, Inc.
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Affiliation(s)
- Isabell Brikell
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Ralf Kuja-Halkola
- 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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48
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Lesch KP. Editorial: Attention-deficit/hyperactivity disorder: a continuing challenge to researchers, practitioners and carers. J Child Psychol Psychiatry 2015; 56:595-7. [PMID: 25968452 DOI: 10.1111/jcpp.12429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
This editorial introduces a collection of research papers and a review on ADHD, highlighting the continuing challenge that ADHD poses in research and practice. The articles include a Practitioner Review providing a comprehensive review focusing on current knowledge about barriers and facilitators operating at the individual, organisational and societal level; a study reporting a randomised controlled trial of parent training for ADHD pre-schoolers; an empirical paper on sex differences in ADHD symptom severity; a study of the co-development of ADHD and externalizing behaviour across the lifespan; a study of the genetic architecture of neurocognitive abilities in the general population; and finally a study examining the differential association among three behavioural dimensions leading to early-onset conduct problems.
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49
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Tong JHS, Cummins TDR, Johnson BP, McKinley LA, Pickering HE, Fanning P, Stefanac NR, Newman DP, Hawi Z, Bellgrove MA. An association between a dopamine transporter gene (SLC6A3) haplotype and ADHD symptom measures in nonclinical adults. Am J Med Genet B Neuropsychiatr Genet 2015; 168B:89-96. [PMID: 25656223 DOI: 10.1002/ajmg.b.32283] [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: 10/06/2014] [Indexed: 01/07/2023]
Abstract
Previous genetic studies have postulated that attention deficit hyperactivity disorder (ADHD) should be regarded as the extreme end of a set of behavioural traits that can be continuously measured in the general population. The current study adopted a quantitative trait approach to examine the relationship between dopamine gene variants and self-reported ADHD symptoms in 517 nonclinical adults. Although genetic associations with variants of both the dopamine transporter (DAT1; SLC6A3) and D4 receptor (DRD4) genes have been reliably reported in children, results in adults are less consistent. We probed two potentially functional variable number of tandem repeat (VNTR) polymorphisms in the 3'UTR and intron 8 of DAT1, the 10-repeat and 6-repeat alleles of which respectively form a haplotype (10/6 DAT1 haplotype) that is associated with childhood ADHD. We also genotyped the exon 3 VNTR of DRD4, the 7-repeat allele of which is also an established risk factor for childhood ADHD. Permutation analysis showed an influence of the 10/6 DAT1 haplotype on both CAARS-G and CAARS-H (DSM-IV ADHD Symptoms Total and ADHD Index respectively), such that ADHD symptom scores increased with each additional copy of the 10/6 DAT1 haplotype. This result survived corrections for multiple comparisons both at the level of genotype and phenotype. A nominal association with CAARS-G was also found for the 7-repeat allele of the DRD4 VNTR however this did not survive multiple comparison correction. Our results provide further support for the influence of variation in the 10/6 DAT1 haplotype and individual differences in ADHD symptoms in adults.
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Affiliation(s)
- Janette H S Tong
- Monash University, School of Psychological Sciences, Melbourne, Victoria, Australia
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50
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Davis C, Cohen A, Davids M, Rabindranath A. Attention-deficit/hyperactivity disorder in relation to addictive behaviors: a moderated-mediation analysis of personality-risk factors and sex. Front Psychiatry 2015; 6:47. [PMID: 25941494 PMCID: PMC4403287 DOI: 10.3389/fpsyt.2015.00047] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2015] [Accepted: 03/23/2015] [Indexed: 11/13/2022] Open
Abstract
INTRODUCTION Research has shown that those with attention-deficit/hyperactivity disorder (ADHD) have an increased risk for addiction disorders like alcoholism and substance abuse. What is less clear is the mechanism(s) whereby ADHD gives rise to increased engagement in addictive behaviors, and whether there are sex differences in the ADHD-addiction propensity. Both ADHD and addictions have also been associated with personality traits such as impulsivity, reward seeking, anxiousness, and negative affect. In this study, we tested a moderator-mediation model, which predicted that both sex and ADHD-symptom status would make independent contributions to the variance in personality risk and in addictive behaviors, with males, and those with diagnosed ADHD, scoring higher on both dependent variables. Our model also predicted that the effect of sex and ADHD-symptom status on addictive behaviors would be via the mediating or intervening influence of personality-risk factors. METHODS A community-based sample of young men and women took part in the study. Among these individuals, 46 had received a lifetime diagnosis of ADHD. The non-diagnosed participants were dichotomized into a high-ADHD-symptom group (n = 83) and a low-symptom group (n = 84). RESULTS We found that a high-risk personality profile may, in part, account for the relationship between ADHD symptomatology and the use/abuse of a broad range of addictive behaviors. However, we found no sex differences in personality risk for addiction or in the use of addictive behaviors; nor did sex moderate the relationships we assessed. CONCLUSION While ADHD status showed a strong relationship with both dependent variables in the model, we found no difference between those who had been diagnosed with ADHD and treated with stimulants, and their high-symptom non-diagnosed/non-treated counterparts. These results add support to claims that the treatment of ADHD with stimulant medication neither protects nor fosters the risk for substance abuse disorders.
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Affiliation(s)
- Caroline Davis
- Kinesiology and Health Sciences, York University , Toronto, ON , Canada
| | - Alina Cohen
- Kinesiology and Health Sciences, York University , Toronto, ON , Canada
| | - Mark Davids
- Kinesiology and Health Sciences, York University , Toronto, ON , Canada
| | - Alex Rabindranath
- Kinesiology and Health Sciences, York University , Toronto, ON , Canada
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