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Tuan Y, Chen LC, Chen IC, Tsai SJ, Chen TJ, Chen MH. Effect of Parental Severe Mental Disorders on the Timing of Autism Diagnosis: A Family Linkage Study. J Autism Dev Disord 2024:10.1007/s10803-024-06518-9. [PMID: 39138805 DOI: 10.1007/s10803-024-06518-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/03/2024] [Indexed: 08/15/2024]
Abstract
The mean diagnosis age of autism was about 5 years in Taiwan. Whether the delayed diagnosis of autism (≥ 6 years) was associated with parental severe mental disorders remained unknown. The parents of 22,859 autistic individuals and 228,590 age- and sex-matched nonautistic individuals were assessed for the presence of severe mental disorders (schizophrenia, bipolar disorder, major depressive disorder, alcohol use disorder, and substance use disorder). The timing of autism diagnosis was classified into three age categories: < 6 years, 6-11 years, and ≥ 12 years. Logistic regression models were used to examine associations between parental severe mental disorders and these age categories of autism diagnosis. Parental schizophrenia and substance use disorders were associated with the delayed diagnosis of autism, both diagnosis at ≥ 12 years (odds ratio [OR]: 2.14; 1.57) and at 6-11 years (1.87; 1.38). Parental bipolar disorder and major depressive disorder were also associated with the delayed diagnosis of autism, especially diagnosis at 6-11 years (OR 1.98; 1.86). Our findings underscore the need for clinicians to monitor the neurodevelopmental conditions of offspring born to parents with severe mental disorders during the early stages of their life.
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Affiliation(s)
- Yu Tuan
- Department of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan
| | - Li-Chi Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Psychiatry, General Cheng Hsin Hospital, Taipei, Taiwan
| | - I-Chun Chen
- Department of Psychiatry, Taichung Veterans General Hospital, Taichung, Taiwan
- Rong Hsing Research Center for Translational Medicine, National Chung Hsing University, Taichung, Taiwan
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.
- Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
- Department of Medical Research, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei, 112, Taiwan.
| | - Tzeng-Ji Chen
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Hospital and Health Care Administration, National Yang Ming Chiao Tung University, Taipei, Taiwan
- Department of Family Medicine, Taipei Veterans General Hospital, Hsinchu Branch, Hsinchu, Taiwan
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.
- Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.
- Department of Medical Research, Taipei Veterans General Hospital, No. 201, Sec. 2, Shih-Pai Road, Taipei, 112, Taiwan.
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Stark I, Rast JE, Lundberg M, Döring N, Ohlis A, Idring Nordström S, Rai D, Magnusson C. Completion of Upper Secondary Mainstream School in Autistic Students in Sweden. J Autism Dev Disord 2024:10.1007/s10803-024-06470-8. [PMID: 39017805 DOI: 10.1007/s10803-024-06470-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2024] [Indexed: 07/18/2024]
Abstract
Higher education is an increasingly necessary achievement to attain employment. However, even in cases where a student has the academic skills to succeed, educational environments may not support students across all other domains necessary for education success, including social and communication needs. This is especially true for students with disabilities and autistic students, where the rate of completion of non-compulsory education is unknown. We used the Stockholm Youth Cohort (children aged 0-17 years from 2001 to 2011), a total population cohort (N = 736,180) including 3,918 autistic individuals, to investigate the association between autism without intellectual disability and completion of upper secondary education. We assessed the impact of sex and co-occurring Attention-Deficit/Hyperactivity Disorder (ADHD) on this association. By age 20 years (the expected age of completion), 68% of autistic students and 91% of non-autistic students admitted to upper secondary education had completed. In logistic regression models adjusted for student demographics, autistic students had almost five-fold higher odds of not completing secondary school (OR 4.90, 95% CI 4.56 5.26) compared to their non-autistic peers. Autistic students with ADHD had particularly high odds of non-completion of upper secondary school. Autistic students without intellectual disability attending mainstream education are substantially less likely to complete upper secondary education as compared to their peers. These findings have implications for the appraisal of how inclusive school policies serve autistic students' academic and social needs, ultimately addressing population health and independent living.
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Affiliation(s)
- Isidora Stark
- Department of Neurobiology, Care Sciences and Society, Karolinska Institutet, Stockholm, Sweden
| | - Jessica E Rast
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA, USA.
| | - Michael Lundberg
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Nora Döring
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Anna Ohlis
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Centre for Epidemiology and Community Medicine, Region Stockholm, Stockholm, Sweden
| | | | - Dheeraj Rai
- Centre for Academic Mental Health, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
- NIHR Biomedical Research Centre, University of Bristol, Bristol, UK
- Bristol Autism Spectrum Service, Avon and Wiltshire Partnership NHS Mental Health Trust, Bristol, UK
| | - Cecilia Magnusson
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Centre for Epidemiology and Community Medicine, Region Stockholm, Stockholm, Sweden
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Leone R, Zuglian C, Brambilla R, Morella I. Understanding copy number variations through their genes: a molecular view on 16p11.2 deletion and duplication syndromes. Front Pharmacol 2024; 15:1407865. [PMID: 38948459 PMCID: PMC11211608 DOI: 10.3389/fphar.2024.1407865] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2024] [Accepted: 05/16/2024] [Indexed: 07/02/2024] Open
Abstract
Neurodevelopmental disorders (NDDs) include a broad spectrum of pathological conditions that affect >4% of children worldwide, share common features and present a variegated genetic origin. They include clinically defined diseases, such as autism spectrum disorders (ASD), attention-deficit/hyperactivity disorder (ADHD), motor disorders such as Tics and Tourette's syndromes, but also much more heterogeneous conditions like intellectual disability (ID) and epilepsy. Schizophrenia (SCZ) has also recently been proposed to belong to NDDs. Relatively common causes of NDDs are copy number variations (CNVs), characterised by the gain or the loss of a portion of a chromosome. In this review, we focus on deletions and duplications at the 16p11.2 chromosomal region, associated with NDDs, ID, ASD but also epilepsy and SCZ. Some of the core phenotypes presented by human carriers could be recapitulated in animal and cellular models, which also highlighted prominent neurophysiological and signalling alterations underpinning 16p11.2 CNVs-associated phenotypes. In this review, we also provide an overview of the genes within the 16p11.2 locus, including those with partially known or unknown function as well as non-coding RNAs. A particularly interesting interplay was observed between MVP and MAPK3 in modulating some of the pathological phenotypes associated with the 16p11.2 deletion. Elucidating their role in intracellular signalling and their functional links will be a key step to devise novel therapeutic strategies for 16p11.2 CNVs-related syndromes.
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Affiliation(s)
- Roberta Leone
- Università di Pavia, Dipartimento di Biologia e Biotecnologie “Lazzaro Spallanzani”, Pavia, Italy
| | - Cecilia Zuglian
- Università di Pavia, Dipartimento di Biologia e Biotecnologie “Lazzaro Spallanzani”, Pavia, Italy
| | - Riccardo Brambilla
- Università di Pavia, Dipartimento di Biologia e Biotecnologie “Lazzaro Spallanzani”, Pavia, Italy
- Cardiff University, School of Biosciences, Neuroscience and Mental Health Innovation Institute, Cardiff, United Kingdom
| | - Ilaria Morella
- Cardiff University, School of Biosciences, Neuroscience and Mental Health Innovation Institute, Cardiff, United Kingdom
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Schendel D, Ejlskov L, Overgaard M, Jinwala Z, Kim V, Parner E, Kalkbrenner AE, Acosta CL, Fallin MD, Xie S, Mortensen PB, Lee BK. 3-generation family histories of mental, neurologic, cardiometabolic, birth defect, asthma, allergy, and autoimmune conditions associated with autism: an open-source catalogue of findings. MEDRXIV : THE PREPRINT SERVER FOR HEALTH SCIENCES 2024:2023.11.03.23298042. [PMID: 37961212 PMCID: PMC10635276 DOI: 10.1101/2023.11.03.23298042] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/15/2023]
Abstract
The relatively few conditions and family members investigated in autism family health history limits etiologic understanding. For more comprehensive understanding and hypothesis-generation we produced an open-source catalogue of autism associations with family histories of mental, neurologic, cardiometabolic, birth defect, asthma, allergy, and autoimmune conditions. All live births in Denmark, 1980-2012, of Denmark-born parents (1,697,231 births), and their 3-generation family members were followed through April 10, 2017 for each of 90 diagnoses (including autism), emigration or death. Adjusted hazard ratios (aHR) were estimated via Cox regression for each diagnosis-family member type combination, adjusting for birth year, sex, birth weight, gestational age, parental ages at birth, and number of family member types of index person; aHRs also calculated for sex-specific co-occurrence of each disorder. We obtained 6,462 individual family history aHRS across autism overall (26,840 autistic persons; 1.6% of births), by sex, and considering intellectual disability (ID); and 350 individual co-occurrence aHRS. Results are catalogued in interactive heat maps and down-loadable data files: https://ncrr-au.shinyapps.io/asd-riskatlas/ and interactive graphic summaries: https://public.tableau.com/views/ASDPlots_16918786403110/e-Figure5. While primarily for reference material or use in other studies (e.g., meta-analyses), results revealed considerable breadth and variation in magnitude of familial health history associations with autism by type of condition, family member type, sex of the family member, side of the family, sex of the index person, and ID status, indicative of diverse genetic, familial, and non-genetic autism etiologic pathways. Careful attention to sources of autism likelihood in family health history, aided by our open data resource, may accelerate understanding of factors underlying neurodiversity.
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Affiliation(s)
- Diana Schendel
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA, USA
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- National Centre for Register-Based Research, Aarhus BSS, Aarhus University, Aarhus, Denmark
| | - Linda Ejlskov
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- National Centre for Register-Based Research, Aarhus BSS, Aarhus University, Aarhus, Denmark
| | | | - Zeal Jinwala
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA, USA
- School of Biomedical Engineering, Science and Health Systems, Drexel University, Philadelphia, PA, USA
| | - Viktor Kim
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA, USA
| | - Erik Parner
- Department of Public Health, Aarhus University, Aarhus, Denmark
| | - Amy E Kalkbrenner
- University of Wisconsin Milwaukee, Joseph J Zilber College of Public Health, Milwaukee, WI, USA
| | - Christine Ladd Acosta
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - M Danielle Fallin
- Wendy Klag Center for Autism and Developmental Disabilities, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
- Current affiliation: Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA USA
| | - Sherlly Xie
- Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
- Medtronic, Mounds View, Minnesota, USA
| | - Preben Bo Mortensen
- The Lundbeck Foundation Initiative for Integrative Psychiatric Research, iPSYCH, Aarhus, Denmark
- National Centre for Register-Based Research, Aarhus BSS, Aarhus University, Aarhus, Denmark
- Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark
| | - Brian K Lee
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, PA, USA
- Dornsife School of Public Health, Drexel University, Philadelphia, PA, USA
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
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Yin W, Pulakka A, Reichenberg A, Kolevzon A, Ludvigsson JF, Risnes K, Lahti-Pulkkinen M, Persson M, Silverman ME, Åden U, Kajantie E, Sandin S. Association between parental psychiatric disorders and risk of offspring autism spectrum disorder: a Swedish and Finnish population-based cohort study. THE LANCET REGIONAL HEALTH. EUROPE 2024; 40:100902. [PMID: 38689608 PMCID: PMC11059471 DOI: 10.1016/j.lanepe.2024.100902] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 10/26/2023] [Revised: 03/25/2024] [Accepted: 03/26/2024] [Indexed: 05/02/2024]
Abstract
Background Roughly more than one in six adults worldwide suffer from psychiatric conditions. Sporadic studies have associated parental psychiatric disorders with autism spectrum disorder in offspring. Comprehensively examining the association between parental psychiatric disorders and offspring autism spectrum disorder is needed to guide health policies, and to inform etiologic studies. Methods We included all children born in Sweden and Finland 1997-2016. Diagnoses were clinically ascertained from National Registers through 2017. We calculated adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for autism spectrum disorder in offspring of fathers and mothers with psychiatric disorders, in both parents jointly and across co-occurring conditions. Findings Among 2,505,842 children, 33,612 were diagnosed with autism spectrum disorder, of which 20% had a parent with psychiatric disorders. The risk of autism spectrum disorder was increased across all psychiatric disorders in fathers (Sweden: aHR = 2.02, 95% CI = 1.92-2.12; Finland: aHR = 1.63, 95% CI = 1.50-1.77), mothers (Sweden: aHR = 2.34, 95% CI = 2.24-2.43; Finland aHR = 2.12, 95% CI = 1.92-2.28), or both parents (Sweden: aHR = 3.76, 95% CI = 3.48-4.07; Finland aHR = 3.61, 95% CI = 3.20-4.07), compared to neither parents. Co-occurrence of parental psychiatric disorders further increased risk (e.g., Sweden: for one, two or ≥three different diagnostic categories compared to no diagnosis, in fathers aHR = 1.81, 2.07, 2.52; in mothers aHR = 2.05, 2.63, 3.57). Interpretation Psychiatric disorders in both parents conveyed the highest risk of offspring autism spectrum disorder, followed by mothers and then fathers. The risk increased with number of co-occurring disorders. All parental psychiatric disorders were associated with increased the risk of autism spectrum disorder. To reliably assess the risk of autism spectrum disorder in children, a comprehensive history incorporating the full range of parental psychiatric disorders is needed beyond solely focusing on familial autism spectrum disorder. Funding Swedish-Research-Council-2021-0214.
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Affiliation(s)
- Weiyao Yin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
| | - Anna Pulakka
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland
- Research Unit of Population Health, Faculty of Medicine, University of Oulu, Oulu, Finland
| | - Abraham Reichenberg
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA
- Seaver Center for Autism Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Alexander Kolevzon
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA
- Seaver Center for Autism Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Jonas F. Ludvigsson
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Pediatrics, Örebro University Hospital, Örebro, Sweden
| | - Kari Risnes
- Department of Clinical and Molecular Medicine, NTNU, Trondheim, Norway
- Children’s Clinic, St Olav University Hospital, Trondheim, Norway
| | - Marius Lahti-Pulkkinen
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland
- Department of Psychology and Logopedics, Faculty of Medicine, University of Helsinki, Finland
| | - Martina Persson
- Department of Medicine, Clinical Epidemiological Unit, Karolinska Institutet, Stockholm, Sweden
- Department of Clinical Science and Education, Division of Pediatrics, Karolinska Institutet, Stockholm, Sweden
- Sachsska Childrens’ and Youth Hospital, Stockholm, Sweden
| | - Michael E. Silverman
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA
| | - Ulrika Åden
- Department of Women’s and Children’s Health, Karolinska Institutet, Stockholm, Sweden
- Department of Biomedical and Clinical Sciences, Linköping University, Sweden
| | - Eero Kajantie
- Population Health Unit, Finnish Institute for Health and Welfare, Helsinki and Oulu, Finland
- Department of Clinical and Molecular Medicine, NTNU, Trondheim, Norway
- Clinical Medicine Research Unit, MRC Oulu, Oulu University Hospital and University of Oulu, Oulu, Finland
| | - Sven Sandin
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, USA
- Seaver Center for Autism Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY, USA
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Rast JE, Fernandes SJ, Schott W, Shea LL. Disparities by Race and Ethnicity in Inpatient Hospitalizations Among Autistic Adults. J Autism Dev Disord 2024; 54:1672-1679. [PMID: 36757545 DOI: 10.1007/s10803-023-05911-0] [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: 01/20/2023] [Indexed: 02/10/2023]
Abstract
This study examined hospitalizations in a large, all-payer, nationally representative sample of inpatient hospitalizations in the US and identified differences in rates of hospitalization for conditions by race and ethnicity in autistic adults. Conditions examined included mood disorders, epilepsy, schizophrenia, and ambulatory care sensitive conditions (ACSCs). Compared to white, non-Hispanic autistic adults, Black, Hispanic, Asian or Pacific Islander (API), and autistic adults of another race had lower prevalence of admission for a principal diagnosis of a mood disorder. Conversely, Black, Hispanic, API, and autistic adults of another race had higher odds of admission for epilepsy than white autistic adults. Black and Hispanic autistic adults were more likely to have schizophrenia as a principal diagnosis compared to white autistic adults, but only Black autistic adults had increased odds for admission for an ACSCs compared to white autistic adults. Differences in diagnosis prevalence among hospitalized autistic adults may suggest differential access to comprehensive outpatient care that could prevent such hospitalizations, while also pointing to concerns of differential validity of diagnostic tools and treatment approaches. Insurance policy and programs should prioritize optimizing outpatient care to ensure access to care and emphasize the need for equitable treatment.
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Affiliation(s)
- Jessica E Rast
- A.J. Drexel Autism Institute, Drexel University, 3020 Market Street, Suite 560, Philadelphia, PA, 19104, USA.
| | - Sherira J Fernandes
- A.J. Drexel Autism Institute, Drexel University, 3020 Market Street, Suite 560, Philadelphia, PA, 19104, USA
| | - Whitney Schott
- A.J. Drexel Autism Institute, Drexel University, 3020 Market Street, Suite 560, Philadelphia, PA, 19104, USA
| | - Lindsay L Shea
- A.J. Drexel Autism Institute, Drexel University, 3020 Market Street, Suite 560, Philadelphia, PA, 19104, USA
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Kendler KS, Ohlsson H, Sundquist J, Sundquist K. The genetic epidemiology of schizotypal personality disorder. Psychol Med 2024:1-8. [PMID: 38362845 DOI: 10.1017/s0033291724000230] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/17/2024]
Abstract
BACKGROUND The concept of schizotypal personality disorder (SPD) emerged from observations of personality characteristics common in relatives of schizophrenic patients. While often studied in family designs, few studies and none with genetic measures, have examined SPD in epidemiological samples. METHODS We studied individuals born in Sweden 1940-2000 with an ICD-10 diagnosis of SPD with no prior schizophrenia (SZ) diagnosis (n = 2292). Demographic features, patterns of comorbidity, and Family Genetic Risk Scores (FGRS) were assessed from multiple Swedish registries. Prediction of progression to SZ was assessed by Cox models. RESULTS SPD was rare, with a prevalence of 0.044%, and had high levels of comorbidity with autism spectrum disorder (ASD), OCD, ADHD, and major depression (MD), and increased rates of being single, unemployed and in receipt of welfare. Affected individuals had elevated levels of FGRS for SZ (+0.42), ASD (+0.30), MD (+0.29), and ADHD (+0.20). Compared to cases of schizophrenia, they had significantly lower rates of FGRSSZ, but significantly elevated rates of genetic risk for ASD, MD, and ADHD. Over a mean follow-up of 8.7 years, 14.6% of SPD cases received a first diagnosis of SZ, the risk for which was significantly increased by levels of FGRSSZ, male sex, young age at SPD diagnosis and an in-patient SPD diagnosis and significantly decreased by comorbidity with MD, ASD, and ADHD. CONCLUSIONS Our results not only support the designation of SPD as a schizophrenia spectrum disorder but also suggest potentially important etiologic links between SPD and ASD and, to a lesser extent, ADHD, OCD, and MD.
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Affiliation(s)
- Kenneth S Kendler
- Department of Psychiatry, Virginia Institute for Psychiatric and Behavioral Genetics, Virginia Commonwealth University, Richmond, VA, USA
- Department of Psychiatry, Virginia Commonwealth University, Richmond, VA, USA
| | - Henrik Ohlsson
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
| | - Jan Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
- University Clinic Primary Care Skane, Sweden
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, NY, USA
| | - Kristina Sundquist
- Center for Primary Health Care Research, Lund University, Malmö, Sweden
- University Clinic Primary Care Skane, Sweden
- Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, NY, USA
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May T, Williams K. Mother and child mental health over time in children with Autism and/or ADHD in the Longitudinal Study of Australian Children. Dev Psychopathol 2024; 36:170-180. [PMID: 36345845 DOI: 10.1017/s0954579422001067] [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] [Indexed: 11/11/2022]
Abstract
This study utilised a longitudinal population-based study to explore mother and child mental health trajectories over time from child age 0 to 14 years, between children with ASD, ADHD, or ASD + ADHD. It explored whether a bidirectional relationship between mother psychological distress and child emotional and behavioural problems (EBPs) existed. The birth cohort from the Longitudinal Study of Australian Children was used. Child EBPs were assessed using the Strengths and Difficulties Questionnaire; and mother emotional distress using the Kessler K6. Generalised estimating equations and structured equation modelling was used to understand changes over time, differences between groups and bidirectional relationships. As expected, children with ASD, ADHD or ASD + ADHD had higher EBPs than children without, and their mothers had higher levels of psychological distress across most time points, but with differing trajectories. Mothers of children with ASD (with or without ADHD) showed increasing psychological distress over time, while mothers of children with ADHD had reducing distress. The bidirectional relationship between mother and child mental health found in children without diagnoses was only partially present in children with ASD/ADHD. Findings highlight support needs and discuss implications for transactional models of parent/child emotional problems in children with neurodevelopmental disorders.
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Affiliation(s)
- Tamara May
- School of Psychology, Charles Sturt University, Bathurst, NSW, Australia
- Department of Paediatrics, Monash University, Clayton, VIC, Australia
- Murdoch Childrens Research Institute, Parkville, VIC, Australia
| | - Katrina Williams
- Department of Paediatrics, Monash University, Clayton, VIC, Australia
- Murdoch Childrens Research Institute, Parkville, VIC, Australia
- Department of Paediatrics, Melbourne University, Parkville, VIC, Australia
- Developmental Paediatrics, Monash Children's Hospital, Clayton, VIC, Australia
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Volgyesi-Molnar M, Gyori M, Eapen V, Borsos Z, Havasi A, Jakab Z, Janoch L, Nemeth V, Oszi T, Szekeres A, Stefanik K. Quality of Life in Hungarian Parents of Autistic Individuals. J Autism Dev Disord 2024:10.1007/s10803-024-06243-3. [PMID: 38280137 DOI: 10.1007/s10803-024-06243-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/08/2024] [Indexed: 01/29/2024]
Abstract
PURPOSE Parents of autistic individuals have been known to have a lower overall quality of life (QQL) than those of typically developing children. We present the first Hungarian large-sample study whose objective was to explore the differences in QOL between parents of autistic individuals (AS) and those of neurotypical (NT) persons. METHODS Based on the ABCX model we developed a questionnaire comprising standardized scales to characterize the life of parents involved. Our data came from parents of 842 individuals (ASD = 521, NT = 321) between 0 and 49 years. Battery deployed standardized instruments to examine quality of life (WHO-QQL BREF and Quality of Life in Autism questionnaire, QOLA). We assessed the families' socio-economic/demographic characteristics, parents' psychological well-being, the autistic/neurotypical individuals' characteristics, and the interventions. RESULTS Our data showed significantly lower QOL in parents of autistic individuals in all domains of questionnaires. We analyzed 20 relevant factors to uncover the predictors of parental QOL. We confirmed the existence of most but not all predictors present in earlier literature and identified intervention-related predictors. CONCLUSION Our study confirms the importance of supporting parents in their role, and of providing health and social supports that focus on quality of life, in addition to child care.
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Affiliation(s)
- Marta Volgyesi-Molnar
- Hungarian Academy of Sciences - ELTE University 'Autism in Education' Research Group, Budapest, Hungary.
- Faculty of Special Education, Institute of Special Needs Education for People with Atypical Behaviour and Cognition, ELTE University, Budapest, Hungary.
| | - Miklos Gyori
- Hungarian Academy of Sciences - ELTE University 'Autism in Education' Research Group, Budapest, Hungary
| | - Valsamma Eapen
- Discipline of Psychiatry and Mental Health, School of Clinical Medicine, Faculty of Medicine and Health, University of New South Wales, Sydney, NSW, Australia
- Academic Unit of Infant, Child and Adolescent Psychiatry Services (AUCS), South Western Sydney Local Health District & Ingham Institute, Liverpool, Australia
| | - Zsofia Borsos
- Hungarian Academy of Sciences - ELTE University 'Autism in Education' Research Group, Budapest, Hungary
- Faculty of Special Education, Institute for the Psychology of Special Needs, ELTE University, Budapest, Hungary
| | - Agnes Havasi
- Hungarian Academy of Sciences - ELTE University 'Autism in Education' Research Group, Budapest, Hungary
- Faculty of Special Education, Institute of Special Needs Education for People with Atypical Behaviour and Cognition, ELTE University, Budapest, Hungary
| | - Zoltan Jakab
- Hungarian Academy of Sciences - ELTE University 'Autism in Education' Research Group, Budapest, Hungary
- Faculty of Special Education, Institute for the Psychology of Special Needs, ELTE University, Budapest, Hungary
| | - Laszlone Janoch
- Hungarian Academy of Sciences - ELTE University 'Autism in Education' Research Group, Budapest, Hungary
- Faculty of Special Education, Institute of Special Needs Education for People with Atypical Behaviour and Cognition, ELTE University, Budapest, Hungary
| | - Vivien Nemeth
- Hungarian Academy of Sciences - ELTE University 'Autism in Education' Research Group, Budapest, Hungary
- Faculty of Special Education, Institute of Special Needs Education for People with Atypical Behaviour and Cognition, ELTE University, Budapest, Hungary
- Faculty of Education and Psychology, Doctoral School of Education, ELTE University, Budapest, Hungary
| | - Tamasne Oszi
- Hungarian Academy of Sciences - ELTE University 'Autism in Education' Research Group, Budapest, Hungary
- Faculty of Special Education, Institute of Special Needs Education for People with Atypical Behaviour and Cognition, ELTE University, Budapest, Hungary
| | - Agota Szekeres
- Hungarian Academy of Sciences - ELTE University 'Autism in Education' Research Group, Budapest, Hungary
- Faculty of Special Education, Institute of Special Needs Education for People with Atypical Behaviour and Cognition, ELTE University, Budapest, Hungary
- Hungarian University of Agriculture and Life Sciences, Institute of Education, Kaposvar, Hungary
| | - Krisztina Stefanik
- Hungarian Academy of Sciences - ELTE University 'Autism in Education' Research Group, Budapest, Hungary
- Faculty of Special Education, Institute of Special Needs Education for People with Atypical Behaviour and Cognition, ELTE University, Budapest, Hungary
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10
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Roubinov D, Don B, Blades R, Epel E. Is it me or my child? The association between maternal depression and children's behavior problems in mothers and their children with or without autism. FAMILY PROCESS 2023; 62:737-753. [PMID: 36017571 DOI: 10.1111/famp.12810] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/20/2021] [Revised: 07/20/2022] [Accepted: 07/21/2022] [Indexed: 06/08/2023]
Abstract
Bidirectional associations between maternal depression and child behavior problems have been reported in prior research, however, few studies examine these relations across varied family contexts. This study examined parenting stress and child diagnosis of autism spectrum disorder (ASD) as moderators of bidirectional associations between maternal depression and child behavior problems over time. Our sample included 86 mother-child dyads who reported maternal depressive symptoms, child behavior problems, and parenting stress at three time points over more than 1 year. Approximately half were mothers of children with ASD (n = 41) and half were mothers of neurotypical children (n = 45). We tested the bidirectional associations between maternal depressive symptoms and children's behavior problems and the potential moderating role of parental stress or child ASD diagnosis on these bidirectional associations using aggregated, lagged, and linear mixed models. Even after controlling for lagged maternal depressive symptoms, child behavior problems were associated with greater subsequent maternal depression at the between-person level, but not at the within-person level. The converse relation of prior maternal depressive symptoms on subsequent child behavior problems was not significant. Neither parenting stress nor child ASD diagnosis moderated bidirectional associations between maternal depressive symptoms and children's behavior problems. Child behavior predicted maternal depression, but the converse was not true, regardless of parenting stress levels or child's ASD diagnosis. For mothers experiencing elevated parenting stress and those with children with ASD, this may help alleviate elevated feelings of guilt related to their children's behavior problems.
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Affiliation(s)
- Danielle Roubinov
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, California, USA
| | - Brian Don
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, California, USA
| | - Robin Blades
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, California, USA
| | - Elissa Epel
- Department of Psychiatry and Behavioral Sciences, University of California, San Francisco, California, USA
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11
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赵 亚, 范 慧, 王 翔, 罗 雅, 张 嵘, 郑 晓. [Early death and causes of death of patients with autism spectrum disorders: A systematic review]. BEIJING DA XUE XUE BAO. YI XUE BAN = JOURNAL OF PEKING UNIVERSITY. HEALTH SCIENCES 2023; 55:375-383. [PMID: 37042154 PMCID: PMC10091241 DOI: 10.19723/j.issn.1671-167x.2023.02.027] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/03/2022] [Indexed: 06/20/2023]
Abstract
To study of premature/early death of autistic patients from the perspective of life course can help families, medical institutions and policy makers better deal with the adverse effects of autism. Several studies have shown that autistic patients have a high risk of death, however, the results are still inconsistent. To assess the risk of mortality among the autistic patients, we undertook a comprehensive search of MEDLINE, Web of Science and EMBASE databases. This paper reviewed the studies on the negative disease outcomes of autism spectrum disorders, including the risk of death, causes of death and several research hotspots in this field. Strict inclusion/exclusion criteria were used. Information was extracted from selected papers, tabulated and synthesized. In the study, 15 studies were included, with a total of 216 045 individuals. The main outcome was all-cause mortality in association with autism and the secondary outcome was cause-specific mortality. The results showed that all-cause mortality was higher for the autistic patients (RR=2.32, 95%CI: 1.98-2.72, I2=87.1%, P < 0.001). Risk ratio showed a greater inequality for female than male (male: RR=2.00, 95%CI: 1.57-2.55, I2=93.2%, P < 0.001; female: RR=4.66, 95%CI: 3.30-6.58, I2=92.0%, P < 0.001). Compared with the unnatural death, the risk of natural death was higher (RR=3.44, 95%CI: 1.27-9.26, I2=80.2%, P=0.025). As autism had many comorbidities, which would bring more health risks and natural deaths possibilities. There were some structural differences in unnatural death. Accidental injury death and suicide were two kinds of causes. Lacking social skills would weaken the ability to ask for help when encountering injuries. This paper put forward some suggestions for futures. First, to well study the comorbidity can reduce the risk of death from a medical point of view. Second, the scientists and policymakers should pay attention to the social environment and provide a safer environment for the autistic patients. Third, for women and for adolescents without cognitive impairment, due to their high risk of suicide, the society should provide them with more supportive social networks and improve their life satisfaction. Fourth, it is necessary to balance the rehabilitation resources in various regions in China and provide more high-quality lifelong rehabilitation monitoring and care services.
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Affiliation(s)
- 亚楠 赵
- 中国医学科学院, 北京协和医学院群医学与公共卫生学院, 北京 100730School of Population Medicine and Public Health, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100730, China
- 北京大学中国卫生发展研究中心, 北京 100191China Center for Health Development Studies, Peking University, Beijing 100191, China
- 北京大学亚太经合组织健康科学研究院, 北京 100871Peking University Asia Pacific Economic Cooperation Health Sciences Academy, Beijing 100871, China
| | - 慧芸 范
- 北京大学亚太经合组织健康科学研究院, 北京 100871Peking University Asia Pacific Economic Cooperation Health Sciences Academy, Beijing 100871, China
- 北京大学人口研究所, 北京 100871Institute of Population Research, Peking University, Beijing 100871, China
| | - 翔宇 王
- 北京大学亚太经合组织健康科学研究院, 北京 100871Peking University Asia Pacific Economic Cooperation Health Sciences Academy, Beijing 100871, China
- 北京大学人口研究所, 北京 100871Institute of Population Research, Peking University, Beijing 100871, China
| | - 雅楠 罗
- 北京大学亚太经合组织健康科学研究院, 北京 100871Peking University Asia Pacific Economic Cooperation Health Sciences Academy, Beijing 100871, China
- 北京大学公共卫生学院全球卫生学系, 北京 100191Department of Global Health, Peking University School of Public Health, Beijing 100191, China
| | - 嵘 张
- 北京大学神经科学研究所, 北京大学基础医学院神经生物学系, 神经科学教育部重点实验室, 卫生部神经科学重点实验室, 北京 100191Neuroscience Research Institute, Peking University; Department of Neurobiology, Peking University School of Basic Medical Sciences; Key Laboratory for Neuroscience of the Ministry of Education; Key Laboratory for Neuroscience of the Ministry of National Health Commission; Beijing 100191, China
- 北京大学医学部孤独症研究中心, 北京 100191Autism Research Centre, Peking University Health Science Centre, Beijing 100191, China
| | - 晓瑛 郑
- 中国医学科学院, 北京协和医学院群医学与公共卫生学院, 北京 100730School of Population Medicine and Public Health, Chinese Academy of Medical Sciences, Peking Union Medical College, Beijing 100730, China
- 北京大学亚太经合组织健康科学研究院, 北京 100871Peking University Asia Pacific Economic Cooperation Health Sciences Academy, Beijing 100871, China
- 北京大学医学部孤独症研究中心, 北京 100191Autism Research Centre, Peking University Health Science Centre, Beijing 100191, China
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12
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Shayestehfar M, Nakhostin-Ansari A, Memari A, Hosseini Asl SH, Faghihi F. Risk of autism spectrum disorder in offspring with parental schizophrenia: a systematic review and meta-analysis. Nord J Psychiatry 2023; 77:127-136. [PMID: 35507890 DOI: 10.1080/08039488.2022.2070664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
BACKGROUND The effect of parental schizophrenia on the risk of Autism Spectrum Disorders (ASD) in offspring has been evaluated in previous studies. However, to our knowledge, no systematic review and meta-analysis have assessed this association. In this study, we aimed to evaluate the risk of ASD in offspring with parental schizophrenia. METHODS The electronic databases EMBASE, PubMed, and Scopus were systematically searched. We administered the Newcastle Ottawa quality assessment scale (NOS) to assess the quality of all selected studies. Combined effect values, as well as their 95% confidence intervals (CI), were calculated. We evaluated heterogeneity using Q and I2 statistics. The publication bias was evaluated by funnel plot and Egger's regression test. In addition, a leave-one-out sensitivity analysis was performed to assess the robustness of the finding. RESULTS A total of 12 observational studies (10 cohorts and two case-control) were included. Our study found a high risk of ASD in offspring exposed to parental schizophrenia [RR = 2.38 (CI%95 2.0-2.83)]. Subgroup and sensitivity analysis confirmed the robustness of our main analysis. CONCLUSION The risk of ASD is considerably higher in offspring with parental schizophrenia. Our findings may suggest a shared pathologic pathway between schizophrenia and ASD.
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Affiliation(s)
- Monir Shayestehfar
- Neuroscience Department, School of Advanced Technologies in Medicine, Iran University of Medical Sciences, Tehran Iran
| | - Amin Nakhostin-Ansari
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Amirhossein Memari
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Seyed Hossein Hosseini Asl
- Sports Medicine Research Center, Neuroscience Institute, Tehran University of Medical Sciences, Tehran, Iran.,Students' Scientific Research center, Exceptional Talents Development Center, Tehran University of Medical Sciences, Tehran, Iran
| | - Faezeh Faghihi
- Cellular and Molecular Research Center, Iran University of Medical Sciences, Tehran, Iran
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13
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Hsu TW, Chu CS, Tsai SJ, Hsu JW, Huang KL, Cheng CM, Su TP, Chen TJ, Bai YM, Liang CS, Chen MH. Diagnostic progression to schizophrenia: A nationwide cohort study of 11 170 adolescents and young adults with autism spectrum disorder. Psychiatry Clin Neurosci 2022; 76:644-651. [PMID: 36057134 DOI: 10.1111/pcn.13468] [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] [Received: 11/15/2021] [Revised: 08/24/2022] [Accepted: 08/25/2022] [Indexed: 11/29/2022]
Abstract
AIMS Previous studies have suggested an increased risk of developing schizophrenia later in life in children with autism spectrum disorder (ASD). This study aims to investigate the diagnosis stability and the potential predictors for progression to schizophrenia in ASD. METHODS We recruited 11 170 adolescents (10-19 years) and young adults (20-29 years) with ASD between 2001 and 2010. They were followed up to the end of 2011 to identify newly diagnosed schizophrenia. The Kaplan-Meier method and Cox regression with age as a time scale were employed to estimate incidence rates and the significance of candidate predictors. RESULTS The progression rate from ASD to schizophrenia was 10.26% for 10 years of follow-up. Among 860 progressors, 580 (67.44%) occurred within the first 3 years after a diagnosis of ASD. The identified predictors were age (reported as hazard ratio with 95% confidence interval: 1.13; 1.11-1.15), depressive disorder (1.36; 1.09-1.69), alcohol use disorder (3.05; 2.14-4.35), substance use disorder (1.91; 1.18-3.09), cluster A personality disorder (2.95; 1.79-4.84), cluster B personality disorder (1.86; 1.05-3.28), and a family history of schizophrenia (2.12; 1.65-2.74). CONCLUSION More than two-thirds of the progressors developed schizophrenia within the first 3 years. Demographic characteristics, physical and psychiatric comorbidities, and psychiatric family history were significant predictors of progression.
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Affiliation(s)
- Tien-Wei Hsu
- Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Che-Sheng Chu
- Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Ju-Wei Hsu
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Kai-Lin Huang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chih-Ming Cheng
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Psychiatry, General Cheng Hsin Hospital, Taipei, Taiwan
| | - Tzeng-Ji Chen
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.,Institute of Hospital and Health Care Administration, National Yang Ming Chiao Tung University, Taipei, Taiwan.,Department of Family Medicine, Taipei Veterans General Hospital, Hsinchu Branch, Hsinchu, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
| | - Chih-Sung Liang
- Department of Psychiatry, Beitou Branch, Tri-Service General Hospital, National Defense Medical Center, Taipei, Taiwan.,Graduate Institute of Medical Sciences, National Defense Medical Center, Taipei, Taiwan
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan.,Department of Psychiatry, College of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan
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14
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Chien YL, Wu CS, Chang YC, Cheong ML, Yao TC, Tsai HJ. Associations between parental psychiatric disorders and autism spectrum disorder in the offspring. Autism Res 2022; 15:2409-2419. [PMID: 36250255 DOI: 10.1002/aur.2835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Accepted: 10/06/2022] [Indexed: 12/15/2022]
Abstract
Whether parental psychiatric disorders are associated with autism spectrum disorder (ASD) in offspring has remained inconclusive. We examined the associations of parental psychiatric disorders with ASD in offspring. This population-based case-control study used Taiwan's National Health Insurance Research Database to identify a cohort of children born from 2004 to 2017 and their parents. A total of 24,279 children with ASD (diagnostic ICD-9-CM code: 299.x or ICD-10 code F84.x) and 97,715 matched controls were included. Parental psychiatric disorders, including depressive disorders, bipolar spectrum disorders, anxiety disorders, obsessive-compulsive disorder, schizophrenia, substance use disorders, autism spectrum disorder, attention-deficit hyperactivity disorder (ADHD), and adjustment disorders were identified. Conditional logistic regressions with covariate adjustment were performed. The results suggest that parental diagnosis with any of the psychiatric disorders is associated with ASD in offspring (adjusted odds ratio [AOR] = 1.45, 95%CI: 1.40-1.51 for mothers; and AOR = 1.12, 95%CI: 1.08-1.17 for fathers). ASD in offspring was associated with schizophrenia, depressive disorders, obsessive-compulsive disorder, adjustment disorders, ADHD and ASD in both parents. The relationship between parental psychiatric disorders and the timing of the child's birth and ASD diagnosis varied across the different psychiatric disorders. The present study provides supportive evidence that parental psychiatric disorders are associated with autistic children. Furthermore, because the associations between parental psychiatric disorders and the timing of child's birth and ASD diagnosis varied across psychiatric disorders, the observed relationships may be affected by both genetic and environmental factors. Future studies are needed to disentangle the potential influence of genetic and environmental factors on the observed associations.
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Affiliation(s)
- Yi-Ling Chien
- Department of Psychiatry, National Taiwan University Hospital, Taipei, Taiwan
| | - Chi-Shin Wu
- National Center for Geriatrics and Welfare Research, National Health Research Institutes, Zhunan, Taiwan.,Department of Psychiatry, National Taiwan University Hospital, Douliu, Taiwan
| | - Yen-Chen Chang
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan
| | - Mei-Leng Cheong
- Department of Obstetrics and Gynecology, Cathay General Hospital, Taipei, Taiwan.,School of Medicine, National Tsing Hua University, Hsinchu, Taiwan
| | - Tsung-Chieh Yao
- Division of Allergy, Asthma, and Rheumatology, Department of Pediatrics, Chang Gung Memorial Hospital, Taoyuan, Taiwan.,School of Medicine, Chang Gung University College of Medicine, Taoyuan, Taiwan
| | - Hui-Ju Tsai
- Institute of Population Health Sciences, National Health Research Institutes, Miaoli, Taiwan.,College of Life Science, National Tsing-Hua University, Hsinchu, Taiwan
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15
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Yu T, Chang KC, Kuo PL. Paternal and maternal psychiatric disorders associated with offspring autism spectrum disorders: A case-control study. J Psychiatr Res 2022; 151:469-475. [PMID: 35609363 DOI: 10.1016/j.jpsychires.2022.05.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Revised: 03/28/2022] [Accepted: 05/09/2022] [Indexed: 10/18/2022]
Abstract
A family history of psychiatric diseases was suggested as one risk factor for autism spectrum disorders (ASD). Our aim was to assess the association of paternal and maternal diagnosis of psychiatric disorders with the risk of ASD in offspring in Taiwan. We conducted a population-based case-control study. Using several linked national databases, we obtained 1,000,939 singleton birth records born between 2004 and 2008. We followed these children up to 2015 for cases of ASD, using diagnostic codes in the National Health Insurance databases. There were 8,933 ASD cases and each case was matched to ten controls by sex and year of birth. We extracted their parental diagnosis of psychiatric disorders and performed conditional logistic regression models to assess the association of interest. Our sample included 8,933 cases and 89,330 controls. Eighty-six percent of the sample were boys. After adjustment for parental age, family income, and urbanization, we found that parental psychiatric diseases were significantly associated with ASD, including schizophrenic and psychotic disorders, mood, anxiety and personality disorders, with adjusted odds ratios ranging from 1.32 to 2.39. Notably, the effect estimates were all larger for maternal diagnosis than paternal diagnosis when stratified by mothers or fathers. Cases of ASD are more likely to be born to parents with psychiatric disorders than their counterparts. Maternal psychiatric diagnosis seems to have a larger influence than paternal diagnosis. Both genetics and maternal environmental factors may contribute to the association observed between parental psychiatric diseases and child ASD.
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Affiliation(s)
- Tsung Yu
- Department of Public Health, College of Medicine, National Cheng Kung University, 1 University Rd., East Dist, Tainan, 701401, Taiwan
| | - Kun-Chia Chang
- Jianan Psychiatric Center, Ministry of Health and Welfare, 539 Yuzhong Rd, Rende Dist., Tainan, 717204, Taiwan; Department of Natural Biotechnology, Nan Hua University, 55, Sec. 1, Nanhua Rd, Dalin Township, Chiayi, 622301, Taiwan.
| | - Pao-Lin Kuo
- Department of Obstetrics and Gynecology, College of Medicine, National Cheng Kung University, 1 University Rd., East Dist, Tainan, 701401, Taiwan
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16
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McKenzie R, Dallos R, Vassallo T, Myhill C, Gude A, Bond N. Family Experience of Safe: A New Intervention for Families of Children with a Diagnosis of Autism Spectrum Disorder. CONTEMPORARY FAMILY THERAPY 2022. [DOI: 10.1007/s10591-021-09568-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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17
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Wang HE, Cheng CM, Bai YM, Hsu JW, Huang KL, Su TP, Tsai SJ, Li CT, Chen TJ, Leventhal BL, Chen MH. Familial coaggregation of major psychiatric disorders in first-degree relatives of individuals with autism spectrum disorder: a nationwide population-based study. Psychol Med 2022; 52:1437-1447. [PMID: 32914742 DOI: 10.1017/s0033291720003207] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
BACKGROUND Family coaggregation of attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), bipolar disorder (BD), major depressive disorder (MDD) and schizophrenia have been presented in previous studies. The shared genetic and environmental factors among psychiatric disorders remain elusive. METHODS This nationwide population-based study examined familial coaggregation of major psychiatric disorders in first-degree relatives (FDRs) of individuals with ASD. Taiwan's National Health Insurance Research Database was used to identify 26 667 individuals with ASD and 67 998 FDRs of individuals with ASD. The cohort was matched in 1:4 ratio to 271 992 controls. The relative risks (RRs) and 95% confidence intervals (CI) of ADHD, ASD, BD, MDD and schizophrenia were assessed among FDRs of individuals with ASD and ASD with intellectual disability (ASD-ID). RESULTS FDRs of individuals with ASD have higher RRs of major psychiatric disorders compared with controls: ASD 17.46 (CI 15.50-19.67), ADHD 3.94 (CI 3.72-4.17), schizophrenia 3.05 (CI 2.74-3.40), BD 2.22 (CI 1.98-2.48) and MDD 1.88 (CI 1.76-2.00). Higher RRs of schizophrenia (4.47, CI 3.95-5.06) and ASD (18.54, CI 16.18-21.23) were observed in FDRs of individuals with both ASD-ID, compared with ASD only. CONCLUSIONS The risk for major psychiatric disorders was consistently elevated across all types of FDRs of individuals with ASD. FDRs of individuals with ASD-ID are at further higher risk for ASD and schizophrenia. Our results provide leads for future investigation of shared etiologic pathways of ASD, ID and major psychiatric disorders and highlight the importance of mental health care delivered to at-risk families for early diagnoses and interventions.
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Affiliation(s)
- Hohui E Wang
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Chih-Ming Cheng
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ya-Mei Bai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Ju-Wei Hsu
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Kai-Lin Huang
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Tung-Ping Su
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
- Department of Psychiatry, General Cheng Hsin Hospital, Taipei, Taiwan
| | - Shih-Jen Tsai
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Cheng-Ta Li
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
| | - Tzeng-Ji Chen
- Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan
- Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan
| | - Bennett L Leventhal
- Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Mu-Hong Chen
- Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan
- Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
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18
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Nakahara K, Michikawa T, Morokuma S, Hamada N, Ogawa M, Kato K, Sanefuji M, Shibata E, Tsuji M, Shimono M, Kawamoto T, Ohga S, Kusuhara K, Kamijima M, Yamazaki S, Ohya Y, Kishi R, Yaegashi N, Hashimoto K, Mori C, Ito S, Yamagata Z, Inadera H, Nakayama T, Iso H, Shima M, Kurozawa Y, Suganuma N, Katoh T. Association of physical activity and sleep habits during pregnancy with autistic spectrum disorder in 3-year-old infants. COMMUNICATIONS MEDICINE 2022; 2:35. [PMID: 35603288 PMCID: PMC9053216 DOI: 10.1038/s43856-022-00101-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2021] [Accepted: 03/11/2022] [Indexed: 12/19/2022] Open
Abstract
Background: We hypothesized that maternal lifestyle factors, such as physical activity and sleep habits, may be associated with autism spectrum disorder (ASD) in infants. This study aimed to investigate the association between maternal physical activity and sleep before and during pregnancy with infant ASD diagnosed by the age of 3 years. Methods: We used the data from the Japan Environment and Children’s Study between 2011 and 2014. The study included 103,060 pregnant women, among which, 69,969 women were analyzed. Participants were asked about their physical activity and sleep before and during pregnancy using questionnaires during pregnancy. Maternal physical activity was estimated using the international physical activity questionnaire. Based on the levels of physical activity before or during pregnancy, the participants were divided into five groups. Maternal sleep was analyzed based on sleep duration and bedtime. The outcome was diagnosis of ASD in 3-year-old infants. Results: In mothers with higher physical activity levels during pregnancy, the risk ratios (RR) for ASD in their 3-year-old infants were lower (RR = 0.61, 95% confidence interval (CI) = 0.42–0.90). In contrast, too short (<6 h) and too long (>10 h) sleep durations during pregnancy were associated with higher risk ratios for ASD than 7–8 h sleep duration (too short: RR = 1.87, 95% CI = 1.21–2.90; too long: RR = 1.56, 95% CI = 1.00–2.48). These associations were not observed before pregnancy. Conclusion: Maternal physical activity and sleep duration during pregnancy may be associated with ASD in infants. Children with autism spectrum disorder (ASD) have difficulties with communication and can have problematic behavior. It is unclear whether lifestyle habits before and during pregnancy influence the chances of having a child with ASD. We investigated whether maternal physical activity and particular sleep habits before and during pregnancy increased the likelihood of 3-year-old infants having ASD. Mothers completed questionnaires asking about their physical activity, sleep habits, and any diagnosis of ASD in their child. The children of mothers with high levels of physical activity during pregnancy were less likely to have ASD. The children of mothers who had slept for less than 6 h or longer than 10 h a night were more likely to have ASD. Thus, improving sleep and increasing exercise during pregnancy might reduce the risk of ASD in their children. Nakahara, Michikawa et al determined the physical activity and sleep habits of women before and during pregnancy and compared these with diagnoses of autism spectrum disorder in their offspring. Abnormal sleep and reduced physical activity during pregnancy were associated with a diagnosis of autism spectrum disorder.
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19
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Guan J, Blanchard A, DiGuiseppi CG, Chihuri S, Li G. Homicide Incidents Involving Children with Autism Spectrum Disorder as Victims Reported in the US News Media, 2000-2019. J Autism Dev Disord 2022; 52:1673-1677. [PMID: 33983521 PMCID: PMC10124270 DOI: 10.1007/s10803-021-05065-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/02/2021] [Indexed: 10/21/2022]
Abstract
Recent research indicates that children with autism are at increased risk of maltreatment. We examined news media reports on homicide incidents involving children with autism as victims in the United States between 2000 and 2019. Of the 52 victims studied, 47 (90.4%) were male. Age of victims ranged from 2 to 20 years (mean = 10.4 ± 5.3 years). Parents and other caregivers accounted for 63.5% and 13.5% of the perpetrators, respectively. The leading injury mechanism was gunshot wounds (23.1%), followed by drowning (19.2%), and suffocation, strangulation, or asphyxiation (19.2%). The most commonly cited contributing factor (47.1%) was overwhelming stress from caring for the autistic child. These results underscore the importance of supporting services for caregivers of children with autism.
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Affiliation(s)
| | - Ashley Blanchard
- Department of Emergency Medicine, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | | | - Stanford Chihuri
- Department of Anesthesiology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA
| | - Guohua Li
- Department of Anesthesiology, Columbia University Vagelos College of Physicians and Surgeons, New York, NY, USA.
- Department of Epidemiology, Columbia University Mailman School of Public Health, New York, NY, USA.
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20
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Prats C, Fatjó-Vilas M, Penzol MJ, Kebir O, Pina-Camacho L, Demontis D, Crespo-Facorro B, Peralta V, González-Pinto A, Pomarol-Clotet E, Papiol S, Parellada M, Krebs MO, Fañanás L. Association and epistatic analysis of white matter related genes across the continuum schizophrenia and autism spectrum disorders: The joint effect of NRG1-ErbB genes. World J Biol Psychiatry 2022; 23:208-218. [PMID: 34338147 DOI: 10.1080/15622975.2021.1939155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Abstract
BACKGROUND Schizophrenia-spectrum disorders (SSD) and Autism spectrum disorders (ASD) are neurodevelopmental disorders that share clinical, cognitive, and genetic characteristics, as well as particular white matter (WM) abnormalities. In this study, we aimed to investigate the role of a set of oligodendrocyte/myelin-related (OMR) genes and their epistatic effect on the risk for SSD and ASD. METHODS We examined 108 SNPs in a set of 22 OMR genes in 1749 subjects divided into three independent samples (187 SSD trios, 915 SSD cases/control, and 91 ASD trios). Genetic association and gene-gene interaction analyses were conducted with PLINK and MB-MDR, and permutation procedures were implemented in both. RESULTS Some OMR genes showed an association trend with SSD, while after correction, the ones that remained significantly associated were MBP, ERBB3, and AKT1. Significant gene-gene interactions were found between (i) NRG1*MBP (perm p-value = 0.002) in the SSD trios sample, (ii) ERBB3*AKT1 (perm p-value = 0.001) in the SSD case-control sample, and (iii) ERBB3*QKI (perm p-value = 0.0006) in the ASD trios sample. DISCUSSION Our results suggest the implication of OMR genes in the risk for both SSD and ASD and highlight the role of NRG1 and ERBB genes. These findings are in line with the previous evidence and may suggest pathophysiological mechanisms related to NRG1/ERBBs signalling in these disorders.
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Affiliation(s)
- C Prats
- Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals, Facultat de Biologia, Universitat de Barcelona, Spain; Institut de Biomedicina de la Universitat de Barcelona (IBUB), Barcelona, Spain.,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Institut d'Investigació Biomèdica de Bellvitge, Hospital Duran i Reynals, L'Hospitalet de Llobregat, Barcelona, Spain
| | - M Fatjó-Vilas
- Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals, Facultat de Biologia, Universitat de Barcelona, Spain; Institut de Biomedicina de la Universitat de Barcelona (IBUB), Barcelona, Spain.,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
| | - M J Penzol
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, Madrid, Spain
| | - O Kebir
- INSERM, U1266, Laboratory "Pathophysiology of psychiatric disorders", Institute of psychiatry and neurosciences of Paris, Paris, France.,GHU Psychiatrie et Neurosciences de Paris, Paris, France
| | - L Pina-Camacho
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, Madrid, Spain
| | - D Demontis
- Department of Biomedicine, Aarhus University, Aarhus, Denmark; The Lundbeck Foundation Initiative for Integrative Psychiatric Research iPSYCH, Aarhus, Denmark
| | - B Crespo-Facorro
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,University Hospital Virgen del Rocio, IbiS Department of Psychiatry, School of Medicine, University of Sevilla, Sevilla, Spain
| | - V Peralta
- Gerencia de Salud Mental, Servicio Navarro de Salud-Osasunbidea, Pamplona, Navarra, Spain.,Instituto de Investigación Sanitaria de Navarra (IdiSNa), Pamplona, Navarra, Spain
| | - A González-Pinto
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Psychiatry Service, University Hospital of Alava-Santiago, EMBREC, EHU/UPV University of the Basque Country, Kronikgune, Vitoria, Spain
| | - E Pomarol-Clotet
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,FIDMAG Germanes Hospitalàries Research Foundation, Barcelona, Spain
| | - S Papiol
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Institute of Psychiatric Phenomics and Genomics (IPPG), University Hospital, LMU Munich, Munich, Germany.,Department of Psychiatry, University Hospital, Ludwig Maximilian University, Munich, Germany
| | - M Parellada
- Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain.,Department of Child and Adolescent Psychiatry, Institute of Psychiatry and Mental Health, Hospital General Universitario Gregorio Marañón, School of Medicine, Universidad Complutense, IiSGM, Madrid, Spain
| | - M O Krebs
- INSERM, U1266, Laboratory "Pathophysiology of psychiatric disorders", Institute of psychiatry and neurosciences of Paris, Paris, France.,University Paris Descartes, Sorbonne Paris Cité, Faculté de Médecine Paris Descartes, Service Hospitalo-Universitaire, Centre Hospitalier Sainte-Anne, Paris, France
| | - L Fañanás
- Departament de Biologia Evolutiva, Ecologia i Ciències Ambientals, Facultat de Biologia, Universitat de Barcelona, Spain; Institut de Biomedicina de la Universitat de Barcelona (IBUB), Barcelona, Spain.,Instituto de Salud Carlos III, Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, Spain
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21
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Ozbaran B, Kose S, Barankoglu I, Dogan N. Inpatient Care Unit in Children and Adolescents With Autism Spectrum Disorder: Benefits, Difficulties, and Conditions of Hospitalization. J Nerv Ment Dis 2022; 210:206-211. [PMID: 34643184 DOI: 10.1097/nmd.0000000000001429] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
ABSTRACT Autism spectrum disorder (ASD) is a complex neurodevelopmental disorder that affects social interactions and behavior. The number of children and adolescents with ASD treated in mental health services has been growing in recent years. Knowing clinical and familial characteristics of hospitalized patients with ASD and multidisciplinary approach are crucial for children and adolescents mental health professionals. In this study, 253 Turkish children and adolescents, with and without ASD, treated in psychiatry inpatient care unit were examined. Applied approaches such as medical consultation areas, psychiatric management of mothers, and pharmacological treatment during hospitalization, were studied. In addition to familial and clinical characteristics of patients with ASD, the benefits and the hospitalization conditions were evaluated. Patients with ASD showed a higher tendency on having relatives with a psychiatric disorder than the patients without ASD. A significant difference was found in terms of age, sex, and intellectual functioning, whereas length of stay did not differ drastically. Also, suicide attempts were significantly higher in patients without ASD than in patients with ASD. This study eases the management of hospitalized ASD patients with giving important information of clinical and familial characteristics.
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Affiliation(s)
- Burcu Ozbaran
- Department of Child and Adolescent Psychiatry, Faculty of Medicine, Ege University, Izmir, Turkey
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22
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Jutla A, Foss-Feig J, Veenstra-VanderWeele J. Autism spectrum disorder and schizophrenia: An updated conceptual review. Autism Res 2022; 15:384-412. [PMID: 34967130 PMCID: PMC8931527 DOI: 10.1002/aur.2659] [Citation(s) in RCA: 23] [Impact Index Per Article: 11.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2021] [Revised: 11/08/2021] [Accepted: 12/12/2021] [Indexed: 12/19/2022]
Abstract
Autism spectrum disorder (ASD) and schizophrenia (SCZ) are separate disorders, with distinct clinical profiles and natural histories. ASD, typically diagnosed in childhood, is characterized by restricted or repetitive interests or behaviors and impaired social communication, and it tends to have a stable course. SCZ, typically diagnosed in adolescence or adulthood, is characterized by hallucinations and delusions, and tends to be associated with declining function. However, youth with ASD are three to six times more likely to develop SCZ than their neurotypical counterparts, and increasingly, research has shown that ASD and SCZ converge at several levels. We conducted a systematic review of studies since 2013 relevant to understanding this convergence, and present here a narrative synthesis of key findings, which we have organized into four broad categories: symptoms and behavior, perception and cognition, biomarkers, and genetic and environmental risk. We then discuss opportunities for future research into the phenomenology and neurobiology of overlap between ASD and SCZ. Understanding this overlap will allow for researchers, and eventually clinicians, to understand the factors that may make a child with ASD vulnerable to developing SCZ. LAY SUMMARY: Autism spectrum disorder and schizophrenia are distinct diagnoses, but people with autism and people with schizophrena share several characteristics. We review recent studies that have examined these areas of overlap, and discuss the kinds of studies we will need to better understand how these disorders are related. Understanding this will be important to help us identify which autistic children are at risk of developing schizophrenia.
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Affiliation(s)
- Amandeep Jutla
- Columbia University Vagelos College of Physicians and
Surgeons, 630 W 168th St, New York, NY 10032, United States
- New York State Psychiatric Institute, 1051 Riverside
Drive, Mail Unit 78, New York, NY 10032, United States
| | - Jennifer Foss-Feig
- Seaver Autism Center for Research and Treatment, Icahn
School of Medicine at Mount Sinai, Department of Psychiatry, 1 Gustave L. Levy
Place, Box 1230, New York, NY 10029, United States
| | - Jeremy Veenstra-VanderWeele
- Columbia University Vagelos College of Physicians and
Surgeons, 630 W 168th St, New York, NY 10032, United States
- New York State Psychiatric Institute, 1051 Riverside
Drive, Mail Unit 78, New York, NY 10032, United States
- Center for Autism and the Developing Brain, New
York-Presbyterian Westchester Behavioral Health Center, 21 Bloomingdale Road, White
Plains, NY 10605, United States
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23
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Hall HA, Speyer LG, Murray AL, Auyeung B. Prenatal Maternal Infections and Children's Neurodevelopment in the UK Millennium Cohort Study: A Focus on ASD and ADHD. J Atten Disord 2022; 26:616-628. [PMID: 34009046 DOI: 10.1177/10870547211015422] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE No clear answer has yet been attained as to the influence of prenatal exposure to infection on autism spectrum disorder (ASD) and attention-deficit/hyperactivity disorder (ADHD), either alone or as co-occurring issues. The current study examined links between hospital-recorded and maternal-reported prenatal infections and ASD, ADHD, and co-occurring ASD and ADHD. METHODS Participants were n = 15,462 children and mother pairs from the Millennium Cohort Study (MCS), a population-representative UK sample. RESULTS Findings show associations between maternal-reported infections and ASD, and some evidence of links with ADHD and co-occurring ASD and ADHD. Hospital-recorded infections were not found to be associated with ASD, ADHD, or their co-occurrence. Agreement between hospital-recorded and maternal-reported infections was low, which may explain the discrepant findings. CONCLUSION Prenatal maternal infections may be associated with increased odds of ASD and ADHD. Findings point to the importance of drawing on multiple sources of information when ascertaining prenatal infection status.
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Affiliation(s)
| | | | | | - Bonnie Auyeung
- University of Edinburgh, UK.,University of Cambridge, UK
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24
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Pacheco M, Deliz L, Martínez I, Morales L. Epidemiological Profile of Children with Neurodevelopmental Disorders in a Diagnostic Center in Southern Puerto Rico, 2006-2017. Epidemiology 2022; 7:3-10. [PMID: 35419502 PMCID: PMC9005062] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE This study has the purpose of developing an epidemiological profile of children with neurodevelopmental disorders in southern Puerto Rico. METHODS This is an exploratory study with a mixed design that was carried out in a diagnostic center located in Ponce, Puerto Rico. The population under study were children within 0-18-years-old of both sexes diagnosed with a neurodevelopmental disorder using the diagnostic and statistical manual of mental disorders (DSM-4) and DSM-5 criteria. The sample under investigation were all the children in the secondary database of children who received health services in the diagnostic center during 2016-2017. Additionally, to the data from the secondary database, a hand-writing record review was performed to obtain data related to comorbidities and family history. The bivariate and multivariate analysis evaluated the association between each neurodevelopmental disorder, and each disease reported in the family history of diseases. Also bivariate, and multivariate analysis assessed the association between each neurodevelopmental disorder, and each comorbidity reported. RESULTS AND CONCLUSION The mean age and standard deviation of the sample were 5.2±3.20, and 80.5% were males. Most of the children lived in Ponce, Puerto Rico. The sample size did not have normal distribution because the sample size was too small and selected by non-probabilistic methods. Furthermore, 88.2% of the children received a previous evaluation related to the problem, and 70.5% received treatment for the symptoms. The results revealed that neurodevelopmental disorders frequently co-occurred. Also, other comorbidities commonly co-occurred with these disorders. Mental disorders were commonly reported with autism, attention deficit and hyperactivity disorder (ADHD) and communication disorders. Autism was also linked to a family history of mental disorders.
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Affiliation(s)
- María Pacheco
- Public Health Program, Ponce Health Sciences University, P. O. Box 7004, Ponce, Puerto Rico
| | - Laura Deliz
- School of Behavioral and Brain Sciences, Ponce Health Sciences University, P. O. Box 7004, Ponce, Puerto Rico
| | - Iris Martínez
- Public Health Program, Ponce Health Sciences University, P. O. Box 7004, Ponce, Puerto Rico
| | - Luisa Morales
- Public Health Program, Ponce Health Sciences University, P. O. Box 7004, Ponce, Puerto Rico
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25
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Sipsock D, Tokadjian H, Righi G, Morrow EM, Sheinkopf SJ. Autism severity aggregates with family psychiatric history in a community-based autism sample. Autism Res 2021; 14:2524-2532. [PMID: 34652072 DOI: 10.1002/aur.2625] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 09/01/2021] [Accepted: 09/18/2021] [Indexed: 01/04/2023]
Abstract
The purpose of this study was to examine family psychiatric history in individuals with autism spectrum disorder (ASD) and its association with clinical presentation. Participants were 798 individuals with a clinical diagnosis of ASD, confirmed by the Autism Diagnostic Observation Schedule, Second Edition (ADOS-2), enrolled in Rhode Island Consortium for Autism Research and Treatment, a statewide research registry. Prior research suggests a specific behavioral phenotype in individuals with ASD who have family members with psychiatric diagnoses, including higher IQ and less severe language impairment. However, studies have not specifically investigated autism severity. We hypothesized that increased psychiatric family history would be associated with increased autism severity symptoms. Results show a strong association of increased burden of first-degree family psychiatric history with higher autism symptom severity as measured by Social Responsiveness Scale, Second Edition (SRS-2), but not with ADOS-2 severity scores, IQ, or adaptive functioning. These findings support the importance of investigating the contribution of psychiatric family history toward clinical ASD presentation. LAY SUMMARY: This study explored how family psychiatric history is related to clinical presentation of Autism Spectrum Disorder (ASD). Higher amounts of first-degree family psychiatric history was associated with higher autism symptom severity as measured by the Social Responsiveness Scale, Second Edition (SRS-2). The contribution of psychiatric family history requires ongoing investigation.
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Affiliation(s)
- Danielle Sipsock
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Emma Pendleton Bradley Hospital, East Providence, Rhode Island, USA.,Brown Center for the Study of Children at Risk, Women & Infants Hospital, Providence, Rhode Island, USA
| | - Hasmik Tokadjian
- Brown Center for the Study of Children at Risk, Women & Infants Hospital, Providence, Rhode Island, USA
| | - Giulia Righi
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Emma Pendleton Bradley Hospital, East Providence, Rhode Island, USA.,Brown Center for the Study of Children at Risk, Women & Infants Hospital, Providence, Rhode Island, USA
| | - Eric M Morrow
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Emma Pendleton Bradley Hospital, East Providence, Rhode Island, USA.,Hassenfeld Child Health Innovation Institute, Brown University, Providence, Rhode Island, USA.,Department of Molecular Biology, Cell Biology and Biochemistry, Brown University, Providence, Rhode Island, USA.,Center for Translational Neuroscience, Robert J. and Nancy D. Carney Institute for Brain Science and Brown Institute for Translational Science, Brown University, Providence, Rhode Island, USA
| | - Stephen J Sheinkopf
- Department of Psychiatry and Human Behavior, Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Emma Pendleton Bradley Hospital, East Providence, Rhode Island, USA.,Brown Center for the Study of Children at Risk, Women & Infants Hospital, Providence, Rhode Island, USA.,Hassenfeld Child Health Innovation Institute, Brown University, Providence, Rhode Island, USA.,Department of Pediatrics, Alpert Medical School of Brown University, Providence, Rhode Island, USA
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26
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Wang Z, Chan AYL, Coghill D, Ip P, Lau WCY, Simonoff E, Brauer R, Wei L, Wong ICK, Man KKC. Association Between Prenatal Exposure to Antipsychotics and Attention-Deficit/Hyperactivity Disorder, Autism Spectrum Disorder, Preterm Birth, and Small for Gestational Age. JAMA Intern Med 2021; 181:1332-1340. [PMID: 34398171 PMCID: PMC8369381 DOI: 10.1001/jamainternmed.2021.4571] [Citation(s) in RCA: 36] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE The risk of birth and neurodevelopmental complications with prenatal exposure to antipsychotics is unclear. OBJECTIVE To evaluate the association between prenatal antipsychotics exposure and the risk of birth and neurodevelopmental problems. DESIGN, SETTING, AND PARTICIPANTS This population-based cohort study included children born between January 2001 and January 2015 with follow-up to December 2019 who were identified by the Hong Kong Clinical Data Analysis and Reporting System. Pregnancies with maternal antidepressant/lithium exposure were removed. Primary analyses compared gestationally exposed and gestationally nonexposed individuals with propensity score fine stratification. Additional analyses included gestationally exposed individuals vs those with past exposure and a sibling-matched analysis to evaluate the effect of confounding by indication. EXPOSURES Prenatal antipsychotic exposure. MAIN OUTCOMES AND MEASURES Preterm birth (<37 gestational weeks), small for gestational age (birth weight <2 standard deviations below the mean for gestational age), and first diagnosis of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) in children. RESULTS The cohorts included 333 749 mother-child pairs for ADHD (mean [SD] maternal age at delivery, 31.46 [5.03] years) and 411 251 pairs for ASD, preterm birth, and small for gestational age analyses (mean [SD] maternal age at delivery, 31.56 [5.01] years). There were 13 196 children (3.95%) with a diagnosis of ADHD, 8715 (2.12%) with ASD, 33 891 (8.24%) preterm, and 7009 (1.70%) who were small for gestational age. The weighted hazard ratio (wHR) was 1.16 (95% CI, 0.83-1.61) for ADHD and 1.06 (95% CI, 0.70-1.60) for ASD, while the weighted odds ratio (wOR) was 1.40 (95% CI, 1.13-1.75) for preterm birth and 1.36 (95% CI, 0.86-2.14) for small for gestational age when comparing gestationally exposed with gestationally nonexposed individuals. Additional analyses showed no association when comparing gestationally exposed individuals with those with past exposure (ADHD: wHR, 0.99; 95% CI, 0.60-1.61; ASD: wHR, 1.10; 95% CI, 0.58-2.08; preterm birth: wOR, 0.93; 95% CI, 0.70-1.24; small for gestational age: wOR, 1.21; 95% CI, 0.66-2.20) and in a sibling-matched analysis (ADHD: wHR, 0.41; 95% CI, 0.04-4.93; ASD: wHR, 0.90; 95% CI, 0.40-2.01; preterm birth: wOR, 1.25; 95% CI, 0.85-1.82; small for gestational age: wOR, 0.86, 95% CI, 0.32-2.31). CONCLUSIONS AND RELEVANCE In this cohort study, the findings did not suggest that prenatal antipsychotics exposure increased the risk of ADHD, ASD, or small for gestational age. In the primary analysis, there was a small increased risk of preterm birth, but additional analyses comparing gestationally exposed individuals with those with past exposure and comparing gestationally exposed with gestationally nonexposed siblings did not support an increased risk. Given the benefits of treating psychosis during pregnancy, our findings do not support a recommendation for women to discontinue receipt of their regular antipsychotic treatment during pregnancy.
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Affiliation(s)
- Zixuan Wang
- Research Department of Practice and Policy, UCL School of Pharmacy, London, England
| | - Adrienne Y L Chan
- Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.,Laboratory of Data Discovery for Health, Hong Kong Science Park, Hong Kong Special Administrative Region, China.,Groningen Research Institute of Pharmacy, Unit of PharmacoTherapy, Epidemiology and Economics, University of Groningen, Groningen, the Netherlands
| | - David Coghill
- Department of Paediatrics and Psychiatry, Faculty of Medicine, Dentistry and Health Sciences, University of Melbourne, Melbourne, Australia.,Murdoch Children's Research Institute, Melbourne, Australia
| | - Patrick Ip
- Department of Paediatrics and Adolescent Medicine, Li Ka Shing Faculty of Medicine, University of Hong Kong, Hong Kong, China
| | - Wallis C Y Lau
- Research Department of Practice and Policy, UCL School of Pharmacy, London, England.,Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China
| | - Emily Simonoff
- Department of Child and Adolescent Psychiatry, King's College London, Institute of Psychiatry, Psychology and Neuroscience, London, England
| | - Ruth Brauer
- Research Department of Practice and Policy, UCL School of Pharmacy, London, England
| | - Li Wei
- Research Department of Practice and Policy, UCL School of Pharmacy, London, England
| | - Ian C K Wong
- Research Department of Practice and Policy, UCL School of Pharmacy, London, England.,Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.,Laboratory of Data Discovery for Health, Hong Kong Science Park, Hong Kong Special Administrative Region, China
| | - Kenneth K C Man
- Research Department of Practice and Policy, UCL School of Pharmacy, London, England.,Department of Pharmacology and Pharmacy, Li Ka Shing Faculty of Medicine, The University of Hong Kong, Hong Kong, China.,Laboratory of Data Discovery for Health, Hong Kong Science Park, Hong Kong Special Administrative Region, China
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27
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Neri de Souza Reis V, Tahira AC, Daguano Gastaldi V, Mari P, Portolese J, Feio dos Santos AC, Lisboa B, Mari J, Caetano SC, Brunoni D, Bordini D, Silvestre de Paula C, Vêncio RZN, Quackenbush J, Brentani H. Environmental Influences Measured by Epigenetic Clock and Vulnerability Components at Birth Impact Clinical ASD Heterogeneity. Genes (Basel) 2021; 12:genes12091433. [PMID: 34573415 PMCID: PMC8467464 DOI: 10.3390/genes12091433] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 09/03/2021] [Accepted: 09/08/2021] [Indexed: 11/16/2022] Open
Abstract
Although Autism Spectrum Disorders (ASD) is recognized as being heavily influenced by genetic factors, the role of epigenetic and environmental factors is still being established. This study aimed to identify ASD vulnerability components based on familial history and intrauterine environmental stress exposure, explore possible vulnerability subgroups, access DNA methylation age acceleration (AA) as a proxy of stress exposure during life, and evaluate the association of ASD vulnerability components and AA to phenotypic severity measures. Principal Component Analysis (PCA) was used to search the vulnerability components from 67 mothers of autistic children. We found that PC1 had a higher correlation with psychosocial stress (maternal stress, maternal education, and social class), and PC2 had a higher correlation with biological factors (psychiatric family history and gestational complications). Comparing the methylome between above and below PC1 average subgroups we found 11,879 statistically significant differentially methylated probes (DMPs, p < 0.05). DMPs CpG sites were enriched in variably methylated regions (VMRs), most showing environmental and genetic influences. Hypermethylated probes presented higher rates in different regulatory regions associated with functional SNPs, indicating that the subgroups may have different affected regulatory regions and their liability to disease explained by common variations. Vulnerability components score moderated by epigenetic clock AA was associated with Vineland Total score (p = 0.0036, adjR2 = 0.31), suggesting risk factors with stress burden can influence ASD phenotype.
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Affiliation(s)
- Viviane Neri de Souza Reis
- Departamento & Instituto de Psiquiatria, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo 05403-903, SP, Brazil; (V.N.d.S.R.); (A.C.T.); (V.D.G.); (P.M.); (J.P.); (A.C.F.d.S.); (B.L.)
| | - Ana Carolina Tahira
- Departamento & Instituto de Psiquiatria, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo 05403-903, SP, Brazil; (V.N.d.S.R.); (A.C.T.); (V.D.G.); (P.M.); (J.P.); (A.C.F.d.S.); (B.L.)
- Instituto Butantan, São Paulo 05503-900, SP, Brazil
| | - Vinícius Daguano Gastaldi
- Departamento & Instituto de Psiquiatria, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo 05403-903, SP, Brazil; (V.N.d.S.R.); (A.C.T.); (V.D.G.); (P.M.); (J.P.); (A.C.F.d.S.); (B.L.)
| | - Paula Mari
- Departamento & Instituto de Psiquiatria, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo 05403-903, SP, Brazil; (V.N.d.S.R.); (A.C.T.); (V.D.G.); (P.M.); (J.P.); (A.C.F.d.S.); (B.L.)
| | - Joana Portolese
- Departamento & Instituto de Psiquiatria, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo 05403-903, SP, Brazil; (V.N.d.S.R.); (A.C.T.); (V.D.G.); (P.M.); (J.P.); (A.C.F.d.S.); (B.L.)
| | - Ana Cecilia Feio dos Santos
- Departamento & Instituto de Psiquiatria, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo 05403-903, SP, Brazil; (V.N.d.S.R.); (A.C.T.); (V.D.G.); (P.M.); (J.P.); (A.C.F.d.S.); (B.L.)
- Laboratório de Pesquisas Básicas em Malária—Entomologia, Seção de Parasitologia—Instituto Evandro Chagas/SVS/MS, Ananindeua 66093-020, PA, Brazil
| | - Bianca Lisboa
- Departamento & Instituto de Psiquiatria, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo 05403-903, SP, Brazil; (V.N.d.S.R.); (A.C.T.); (V.D.G.); (P.M.); (J.P.); (A.C.F.d.S.); (B.L.)
| | - Jair Mari
- Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo 04023-062, SP, Brazil; (J.M.); (S.C.C.); (D.B.); (C.S.d.P.)
| | - Sheila C. Caetano
- Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo 04023-062, SP, Brazil; (J.M.); (S.C.C.); (D.B.); (C.S.d.P.)
| | - Décio Brunoni
- Centro de Ciências Biológicas e da Saúde, Universidade Presbiteriana Mackenzie (UPM), São Paulo 01302-907, SP, Brazil;
| | - Daniela Bordini
- Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo 04023-062, SP, Brazil; (J.M.); (S.C.C.); (D.B.); (C.S.d.P.)
| | - Cristiane Silvestre de Paula
- Departamento de Psiquiatria, Universidade Federal de São Paulo (UNIFESP), São Paulo 04023-062, SP, Brazil; (J.M.); (S.C.C.); (D.B.); (C.S.d.P.)
- Centro de Ciências Biológicas e da Saúde, Universidade Presbiteriana Mackenzie (UPM), São Paulo 01302-907, SP, Brazil;
| | - Ricardo Z. N. Vêncio
- Departamento de Computação e Matemática FFCLRP-USP, Universidade de São Paulo, Ribeirão Preto 14040-901, SP, Brazil;
| | - John Quackenbush
- Center for Cancer Computational Biology, Department of Biostatistics and Computational Biology, Dana-Farber Cancer Institute, Boston, MA 02115, USA; or
- Department of Biostatistics, Harvard T. H. Chan School of Public Health, Boston, MA 02115, USA
| | - Helena Brentani
- Departamento & Instituto de Psiquiatria, Faculdade de Medicina FMUSP, Universidade de São Paulo, São Paulo 05403-903, SP, Brazil; (V.N.d.S.R.); (A.C.T.); (V.D.G.); (P.M.); (J.P.); (A.C.F.d.S.); (B.L.)
- Correspondence: ; Tel.: +55-(11)-99-931-4349
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Ames JL, Ladd-Acosta C, Fallin MD, Qian Y, Schieve LA, DiGuiseppi C, Lee LC, Kasten EP, Zhou G, Pinto-Martin J, Howerton E, Eaton CL, Croen LA. Maternal Psychiatric Conditions, Treatment With Selective Serotonin Reuptake Inhibitors, and Neurodevelopmental Disorders. Biol Psychiatry 2021; 90:253-262. [PMID: 34116791 PMCID: PMC8504533 DOI: 10.1016/j.biopsych.2021.04.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/19/2021] [Revised: 04/06/2021] [Accepted: 04/07/2021] [Indexed: 12/16/2022]
Abstract
BACKGROUND This study aims to clarify relationships of maternal psychiatric conditions and selective serotonin reuptake inhibitor (SSRI) use during preconception and pregnancy with risk of neurodevelopmental disorders in offspring. METHODS We used data from the Study to Explore Early Development, a multisite case-control study conducted in the United States among children born between 2003 and 2011. Final study group classifications of autism spectrum disorder (ASD) (n = 1367), developmental delays or disorders (DDs) (n = 1750), and general population controls (n = 1671) were determined by an in-person standardized developmental assessment. Maternal psychiatric conditions and SSRI use during pregnancy were ascertained from both self-report and medical records. We used logistic regression to evaluate associations of ASD and DDs (vs. population controls) with maternal psychiatric conditions and SSRI treatment in pregnancy. To reduce confounding by indication, we also examined SSRI associations in analyses restricted to mothers with psychiatric conditions during pregnancy. RESULTS Psychiatric conditions and SSRI use during pregnancy were significantly more common among mothers of children with either ASD or DDs than among population controls. Odds of ASD were similarly elevated among mothers with psychiatric conditions who did not use SSRIs during pregnancy (adjusted odds ratio 1.81, 95% confidence interval 1.44-2.27) as in mothers who did use SSRIs (adjusted odds ratio 2.05, 95% confidence interval 1.50-2.80). Among mothers with psychiatric conditions, SSRI use was not significantly associated with ASD in offspring (adjusted odds ratio 1.14, 95% confidence interval 0.80-1.62). Primary findings for DDs exhibited similar relationships to those observed with ASD. CONCLUSIONS Maternal psychiatric conditions but not use of SSRIs during pregnancy were associated with increased risk of neurodevelopmental disorders in offspring.
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Affiliation(s)
| | - Christine Ladd-Acosta
- Wendy Klag Center for Autism and Developmental Disabilities, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - M. Daniele Fallin
- Wendy Klag Center for Autism and Developmental Disabilities, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Yinge Qian
- Division of Research, Kaiser Permanente, Oakland, CA
| | | | - Carolyn DiGuiseppi
- Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, CO
| | - Li-Ching Lee
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Eric P. Kasten
- Clinical and Translational Sciences Institute, Michigan State University, East Lansing, MI
| | - Guoli Zhou
- Clinical and Translational Sciences Institute, Michigan State University, East Lansing, MI
| | - Jennifer Pinto-Martin
- School of Nursing and Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA
| | - Ellen Howerton
- Wendy Klag Center for Autism and Developmental Disabilities, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD
| | - Christopher L. Eaton
- The Permanente Medical Group, Kaiser Permanente Medical Center, San Francisco, CA
| | - Lisa A. Croen
- Division of Research, Kaiser Permanente, Oakland, CA
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Torres A, Lecusay D, Valdez D, Rosoli A, Garrido G, Cukier S, Paula CS, Garcia R, Rattazzi A, Montiel-Nava C. Use of allied-health services and medication among adults with ASD in Latin America. Autism Res 2021; 14:2200-2211. [PMID: 34338424 DOI: 10.1002/aur.2583] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 07/04/2021] [Accepted: 07/17/2021] [Indexed: 11/10/2022]
Abstract
ASD is a neurodevelopmental disorder that affects people across the entire lifespan, yet most of the research identifying the health and medical needs for autistic individuals have been among minors. As individuals with ASD transition to emerging adulthood, the services, already limited, become less available. This study aimed to identify the use of services for Latin American adults on the spectrum. We surveyed 295 caregivers of adults with ASD from six Latin American countries. Comparing the results for all the possible services observed in this study, the adults in our sample were primarily underserved: 84.4%-95.9% were receiving zero hours per week, 3.7%-12.9% 1%-10 h, 0%-1.7% 11-20, and only 0%-1% above 20 h of services. Almost half of the sample used medication, and neurologists were the most consulted health providers. Next to inexistent health care usage in Latin American adults with ASD highlights socioeconomic and health disparities in service provision for ASD in the region. The lack of services places adults with ASD in Latin America at a higher risk of worse symptom severity than autistic adults from regions with broader access to services. LAY SUMMARY: This study aimed to identify the quantity of services received by adults with autism in Latin America. Most of our sample was not receiving health services yet almost half had access to medication. This could mean that adults with autism in Latin America are at higher risk for poorer health.
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Affiliation(s)
- Andy Torres
- Department of Psychological Sciences, University of Texas Rio Grande Valley, Edinburg, Texas, USA
| | - Denise Lecusay
- Department of Psychological Sciences, University of Texas Rio Grande Valley, Edinburg, Texas, USA
| | - Daniel Valdez
- Universidad de Buenos Aires, Buenos Aires, Argentina
| | - Analía Rosoli
- Organización Estados Iberoamericanos para la Educación la Ciencia y la Cultura (OEI), Santo Domingo, Dominican Republic
| | | | - Sebastián Cukier
- Programa Argentino para Niños, Adolescentes y Adultos con Condiciones del Espectro Autista, Buenos Aires, Argentina
| | - Cristiane Silvestre Paula
- Programa de Pós-Graduação em Distúrbios do Desenvolvimento Universidade Presbiteriana Mackenzie (UPM), São Paulo, SP, Brazil
| | | | - Alexia Rattazzi
- Programa Argentino para Niños, Adolescentes y Adultos con Condiciones del Espectro Autista, Buenos Aires, Argentina
| | - Cecilia Montiel-Nava
- Department of Psychological Sciences, University of Texas Rio Grande Valley, Edinburg, Texas, USA
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30
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Ejlskov L, Wulff JN, Kalkbrenner A, Ladd-Acosta C, Fallin MD, Agerbo E, Mortensen PB, Lee BK, Schendel D. Prediction of Autism Risk From Family Medical History Data Using Machine Learning: A National Cohort Study From Denmark. BIOLOGICAL PSYCHIATRY GLOBAL OPEN SCIENCE 2021; 1:156-164. [PMID: 36324994 PMCID: PMC9616292 DOI: 10.1016/j.bpsgos.2021.04.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/09/2021] [Accepted: 04/18/2021] [Indexed: 11/15/2022] Open
Abstract
Background A family history of specific disorders (e.g., autism, depression, epilepsy) has been linked to risk for autism spectrum disorder (ASD). This study examines whether family history data could be used for ASD risk prediction. Methods We followed all Danish live births, from 1980 to 2012, of Denmark-born parents for an ASD diagnosis through April 10, 2017 (N = 1,697,231 births; 26,840 ASD cases). Linking each birth to three-generation family members, we identified 438 morbidity indicators, comprising 73 disorders reported prospectively for each family member. We tested various models using a machine learning approach. From the best-performing model, we calculated a family history risk score and estimated odds ratios and 95% confidence intervals for the risk of ASD. Results The best-performing model comprised 41 indicators: eight mental conditions (e.g., ASD, attention-deficit/hyperactivity disorder, neurotic/stress disorders) and nine nonmental conditions (e.g., obesity, hypertension, asthma) across six family member types; model performance was similar in training and test subsamples. The highest risk score group had 17.0% ASD prevalence and a 15.3-fold (95% confidence interval, 14.0-17.1) increased ASD risk compared with the lowest score group, which had 0.6% ASD prevalence. In contrast, individuals with a full sibling with ASD had 9.5% ASD prevalence and a 6.1-fold (95% confidence interval, 5.9-6.4) higher risk than individuals without an affected sibling. Conclusions Family history of multiple mental and nonmental conditions can identify more individuals at highest risk for ASD than only considering the immediate family history of ASD. A comprehensive family history may be critical for a clinically relevant ASD risk prediction framework in the future.
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Affiliation(s)
- Linda Ejlskov
- Department of Economics and Business, National Center for Register-based Research, Aarhus University, Aarhus, Denmark
- Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
| | - Jesper N. Wulff
- Department of Econometrics and Business Analytics, Aarhus University, Aarhus, Denmark
| | - Amy Kalkbrenner
- Joseph J Zilber School of Public Health, University of Wisconsin-Milwaukee, Milwaukee, Wisconsin
| | - Christine Ladd-Acosta
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - M. Danielle Fallin
- Department of Mental Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
- Wendy Klag Center for Autism and Developmental Disabilities, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Esben Agerbo
- Department of Economics and Business, National Center for Register-based Research, Aarhus University, Aarhus, Denmark
- Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark
- Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
| | - Preben Bo Mortensen
- Department of Economics and Business, National Center for Register-based Research, Aarhus University, Aarhus, Denmark
- Centre for Integrated Register-based Research, Aarhus University, Aarhus, Denmark
- Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
| | - Brian K. Lee
- Department of Epidemiology and Biostatistics, Drexel University, Philadelphia, Pennsylvania
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania
| | - Diana Schendel
- Department of Economics and Business, National Center for Register-based Research, Aarhus University, Aarhus, Denmark
- Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Aarhus, Denmark
- A.J. Drexel Autism Institute, Drexel University, Philadelphia, Pennsylvania
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Finkelman MD, Wei T, Lowe SR. Computer-Based Testing to Shorten the Social Communication Questionnaire (SCQ): a Proof- of-Principle Study of the Lifetime and Current Forms. JOURNAL OF PSYCHOPATHOLOGY AND BEHAVIORAL ASSESSMENT 2021. [DOI: 10.1007/s10862-020-09853-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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32
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Amin SI, Salah EL-Deen GM. Autistic traits in offspring of schizophrenic patients in comparison to those of normal population: a case-control study. MIDDLE EAST CURRENT PSYCHIATRY 2021. [DOI: 10.1186/s43045-021-00100-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Abstract
Background
Autism is not a discreet condition and those families members with autistic propend are more likely to display autistic symptoms with a wide range of severity, even below the threshold for diagnosis of autism spectrum disorders. Even with a parental history of schizophrenia, the likelihood of autistic spectrum disorder was found to be 3-fold greater. The aim of this study is to assess autistic traits among offspring of schizophrenic patients in the age group from 4 to 11 years and compare it in the offspring of normal individuals, and its association with the sociodemographic data. To determine whether schizophrenic parents are a risk factor to autistic traits in their children.
Results
There was a statistically significant (P < 0.05*) increase in Autism Quotient Child scores of the case group where 47.2% had a score equal or more than the cutoff point (76), while only 17 19.4% of the control group had the same score with odds = 3.71 indicating that children of schizophrenic parents 18 were three times likely to have Autism Quotient-Child score greater than or equal to the cutoff point (76) than 19 children of healthy parents. No statistically significant association (P ≥ 0.05) was found between all 20 sociodemographic characteristics and Autism Quotient-Child scores among the case group except for family 21 income and social class where there was a statistically significant association (P < 0.05) between insufficient income 22 and low social class and higher Autism Quotient-Child score (≥ 76).
Conclusions
Children of schizophrenic parents are at high risk to have autistic traits than children of normal parents.
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Rotem RS, Nguyen VT, Chodick G, Davidovitch M, Shalev V, Hauser R, Coull BA, Bellavia A, Weisskopf MG. Associations of Maternal Androgen-Related Conditions With Risk of Autism Spectrum Disorder in Progeny and Mediation by Cardiovascular, Metabolic, and Fertility Factors. Am J Epidemiol 2021; 190:600-610. [PMID: 33521821 PMCID: PMC8024051 DOI: 10.1093/aje/kwaa219] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 10/02/2020] [Accepted: 10/07/2020] [Indexed: 12/14/2022] Open
Abstract
Fetal exposure to elevated androgens is thought to contribute to autism spectrum disorder (ASD) risk. However, data rely heavily on in utero androgens measurements, which also reflect fetal secretions. Thus, in utero hyperandrogenemia might indicate adverse autism-related neurogenesis that has already occurred affecting fetal androgen homeostasis, rather than being a cause of the disorder. Associations between maternal androgen-related conditions and ASD could more directly implicate androgens' etiological role. We examined the association between maternal hyperandrogenemia-related conditions, focusing primarily on polycystic ovarian syndrome (PCOS), and progeny ASD, in an Israeli cohort of 437,222 children born in 1999-2013. Odds ratios and 95% confidence intervals were estimated using generalized estimating equations. Multiple mediation analyses using natural effect models were conducted to evaluate combined mediation of the PCOS effect by androgen-related cardiovascular, metabolic, and fertility factors. Results indicated that children of mothers with PCOS had higher ASD odds compared with children of mothers without PCOS (odds ratio = 1.42, 95% confidence interval: 1.24,1.64), and this effect was only partly mediated by the factors considered. Elevated odds were also observed for other hyperandrogenemia-related conditions. Findings provide support for direct involvement of maternal hyperandrogenemia in ASD etiology. Alternatively, findings might reflect shared genetic and/or environmental factors independently affecting maternal androgen homeostasis and fetal neurodevelopment.
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Affiliation(s)
- Ran S Rotem
- Correspondence to Dr. Ran S. Rotem, Department of Environmental Health, Harvard T. H. Chan School of Public Health, 665 Huntington Avenue, Boston, MA 02115 (e-mail: )
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McKenzie R, Dallos R, Stedmon J, Hancocks H, Vickery PJ, Barton A, Vassallo T, Myhill C, Chynoweth J, Ewings P. SAFE, a new therapeutic intervention for families of children with autism: a randomised controlled feasibility trial. BMJ Open 2020; 10:e038411. [PMID: 33384385 PMCID: PMC7780715 DOI: 10.1136/bmjopen-2020-038411] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 11/30/2020] [Accepted: 12/17/2020] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVES To establish the feasibility of a definitive randomised controlled trial of Systemic Autism-related Family Enabling (SAFE), an intervention for families of children with autism. DESIGN A randomised, controlled, multicentred feasibility study. SETTING Participants were identified from three National Health Service (NHS) diagnosing centres in Plymouth and Cornwall and a community pathway. PARTICIPANTS 34 families of a child with a diagnosis of autism severity level 1 or 2 between 3 and 16 years. Four families were lost to follow-up. INTERVENTIONS SAFE is a manualised five-session family therapy-based intervention delivered over 16 weeks and designed for families of children with autism. SAFE involves families attending five 3-hour sessions led by systemic practitioners. PRIMARY AND SECONDARY OUTCOME MEASURES The proposed primary outcome measure was the Systemic CORE 15 (SCORE-15). Proposed secondary outcome measures: Patient Health Questionnaire-Somatic Anxiety Depressive Symptoms, the Coding of Attachment-Related Parenting for use with children with Autism, the Child Behaviour Checklist (CBCL), the Reflective Functioning Questionnaire (RFQ) and the Caregiving Helplessness Questionnaire. Outcome measures were collected at baseline and 24 weeks post randomisation. RESULTS All primary caregivers retained in the study completed the SCORE-15 at both time points. 34 of the target of 36 families were recruited and 88% of families were retained. Training for therapists was effective. Feedback revealed willingness to undergo randomisation. There was 100% attendance at appropriate sessions for core family members. The SCORE-15 showed reduction in scores for families receiving SAFE compared with controls suggesting positive change. Qualitative data also revealed that families found the study acceptable and families receiving SAFE experienced positive change. Feedback indicated that the SCORE-15 should be retained as a primary measure in a future trial, but secondary measures should be reduced. CONCLUSIONS This study indicates that a larger trial of SAFE is feasible. Findings suggest that SAFE can address current gaps in recommended care, can be confidently delivered by NHS staff and has potential as a beneficial treatment. TRIAL REGISTRATION NUMBERS ISCTRN83964946 and IRAS213527.
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Affiliation(s)
| | - Rudi Dallos
- Department of Clinical Psychology, University of Plymouth, Plymouth, UK
| | - Jacqui Stedmon
- Department of Clinical Psychology, University of Plymouth, Plymouth, UK
| | - Helen Hancocks
- Peninsula Clinical Trials Unit, University of Plymouth, Plymouth, UK
| | | | - Andy Barton
- South West Research Design Service, Plymouth, UK
| | - Tara Vassallo
- Institute of Education, University of Plymouth, Plymouth, UK
| | - Craig Myhill
- Institute of Education, University of Plymouth, Plymouth, UK
| | - Jade Chynoweth
- Medical Statistics, University of Plymouth, Plymouth, UK
| | - Paul Ewings
- Research Office, Research Design Service, Taunton, UK
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Stark I, Liao P, Magnusson C, Lundberg M, Rai D, Lager A, Idring Nordström S. Qualification for upper secondary education in individuals with autism without intellectual disability: Total population study, Stockholm, Sweden. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2020; 25:1036-1046. [PMID: 33246359 PMCID: PMC8111225 DOI: 10.1177/1362361320975929] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
This study used the Stockholm Youth Cohort, a total population cohort (N = 364,957), to describe patterns and predictors of qualification for upper secondary education, defined by passing graduation grades in core compulsory school subjects in contemporary young individuals diagnosed with autism spectrum disorders without intellectual disability (n = 6138). At the expected age for graduation, 16 years, 29% (adjusted rate difference 95% confidence interval (28.0–30.0)) fewer autistic than non-autistic individuals were qualified for upper secondary education (57% and 86%, respectively). Comorbid attention-deficit hyperactivity disorder further increased this difference. Within the group of autistic students without intellectual disability, female sex and lower family income were associated with non-qualification for upper secondary education. The proportion of students with autism without intellectual disability who qualified for upper secondary education increased at age 20. These findings underline the need for improved support for students with a diagnosis of autism without intellectual disability in mainstream education.
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Affiliation(s)
| | - Peiwen Liao
- Karolinska Institutet, Sweden.,University of New South Wales (UNSW), Australia
| | | | | | | | - Anton Lager
- Karolinska Institutet, Sweden.,Stockholm County Council, Sweden
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36
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Koukouriki E, Soulis SG, Andreoulakis E. Depressive symptoms of autism spectrum disorder children's siblings in Greece: Associations with parental anxiety and social support. AUTISM : THE INTERNATIONAL JOURNAL OF RESEARCH AND PRACTICE 2020; 25:529-544. [PMID: 33086862 DOI: 10.1177/1362361320966847] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
LAY ABSTRACT Typically developing siblings of children with autism spectrum disorders are often found to exhibit elevated levels of stress and depressive symptoms compared to siblings of typically developing children or siblings of children with other disabilities. Besides the behavioral problems of the child with autism and certain demographic characteristics that have been recognized as factors associated with typically developing siblings' psychological distress, the role of parental mental health and the social support from the family has not been studied sufficiently. The goal of this study is to assess depressive symptoms in 85 Greek school-aged typically developing siblings of children with autism and to investigate for any associations between siblings' depressive symptoms on one hand and demographics, parental mental health, and perceived social support on the other hand. It was found that typically developing siblings had higher levels of depressive symptoms compared to children from a general population sample. In addition, parental anxiety and social support from the family as perceived by the parents themselves were identified as independently associated with typically developing siblings' depressive symptoms. Of note, perceived social support failed to attenuate the association between parental anxiety and siblings' depressive symptoms. These results highlight the importance of assessing both parental and typically developing siblings' psychological state to implement interventions addressed to the needs of all family members.
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Affiliation(s)
- Evangelia Koukouriki
- University of Ioannina, Greece.,Hellenic Ministry of Education and Religious Affairs, Greece
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37
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Barrionuevo BA, Chowdhury AR, Lee JM, Dueker ND, Martin ER, Pericak-Vance MA, Cuccaro M. Family History of Eating Disorder and the Broad Autism Phenotype in Autism. Autism Res 2020; 13:1573-1581. [PMID: 32888262 DOI: 10.1002/aur.2378] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2019] [Revised: 07/22/2020] [Accepted: 07/23/2020] [Indexed: 11/07/2022]
Abstract
Autism features occur frequently among individuals with eating disorders (ED). This co-occurrence is not well understood but there is speculation that select traits (e.g., rigidity) are common to both autism and ED. To explore the co-occurrence of autistic traits and ED features, we used the Simons Simplex Collection (SSC; N = 2,623 families) to test whether first-degree relatives of individuals with autism with a history of ED features had more autism traits, as measured by the Broad Autism Phenotype Questionnaire (BAP-Q), compared to relatives with no history of ED. The frequency of individuals with ED features was 2.2% (N = 57) among mothers, <1% in siblings, and not present in fathers. We restricted our analyses to mothers. Compared to mothers with no history of ED, those with a history of ED had significantly higher scores on the BAP-Q Total Score and each of the three BAP-Q domains. More importantly, when the BAP-Q was used as a classification tool, we found that when compared to mothers with no history of ED, those with a history of ED were most likely to fall into the clinically significant range on the BAP-Q Rigid domain. Our results suggest that a history of ED features among mothers of individuals with autism is associated with the presence of autistic traits. This extends previous work showing a relationship between autism and ED and expands the range of neuropsychiatric traits that have relevance to the BAP among family members of individuals with autism. LAY SUMMARY: Using information from the Simons Simplex Collection we tested whether mothers of individuals with autism with a history of eating disorder had more autism traits (i.e., similar to those in autism but milder) compared to mothers with no history of eating disorder. The most striking difference between the groups was the presence of rigidity in mothers with a history of eating disorder. This extends previous work showing a relationship between autism and eating disorders and suggests the utility of studying eating disorders in future family studies of autism. Autism Res 2020, 13: 1573-1581. © 2020 International Society for Autism Research, Wiley Periodicals, Inc.
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Affiliation(s)
| | | | - Joycelyn M Lee
- University of Miami Miller School of Medicine, Miami, FL, USA.,John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Nicole D Dueker
- University of Miami Miller School of Medicine, Miami, FL, USA.,John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Eden R Martin
- University of Miami Miller School of Medicine, Miami, FL, USA.,John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Margaret A Pericak-Vance
- University of Miami Miller School of Medicine, Miami, FL, USA.,John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
| | - Michael Cuccaro
- University of Miami Miller School of Medicine, Miami, FL, USA.,John P. Hussman Institute for Human Genomics, University of Miami Miller School of Medicine, Miami, FL, USA
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Wiggins LD, Rubenstein E, Daniels J, DiGuiseppi C, Yeargin-Allsopp M, Schieve LA, Tian LH, Sabourin K, Moody E, Pinto-Martin J, Reyes N, Levy SE. A Phenotype of Childhood Autism Is Associated with Preexisting Maternal Anxiety and Depression. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2020; 47:731-740. [PMID: 30128718 DOI: 10.1007/s10802-018-0469-8] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
This study explored whether ASD phenotypes in the child were associated with a history of anxiety or depression in the mother. We hypothesized that an ASD profile in children characterized by mild delays and increased rates of dysregulation would be associated with preexisting maternal anxiety or depression. Participants were 672 preschool children with ASD and their mothers. Children were classified as ASD after a comprehensive developmental evaluation. Mothers reported whether a healthcare provider ever diagnosed them with anxiety or depression before the birth of their child. Four child ASD phenotypes were derived from latent class analysis: Mild Language Delay with Cognitive Rigidity (Type 1), Significant Developmental Delay with Repetitive Motor Behaviors (Type 2), General Developmental Delay (Type 3), and Mild Language and Motor Delay with Dysregulation (i.e., aggression, anxiety, depression, emotional reactivity, inattention, somatic complaints, and sleep problems) (Type 4). Type 2 ASD served as the referent category in statistical analyses. Results showed that 22.6% of mothers reported a diagnosis of anxiety or depression before the birth of their child. Maternal anxiety or depression was associated with 2.7 times the odds (95% confidence interval: 1.4, 5.3) of Type 4 or Dysregulated ASD in the child; maternal anxiety and depression was associated with 4.4 times the odds (95% confidence interval: 1.4, 14.0) of Type 4 or Dysregulated ASD in the child. Our findings suggest an association between Dysregulated ASD in the child and anxiety and depression in the mother. These findings can enhance screening methods and inform future research efforts.
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Affiliation(s)
- Lisa D Wiggins
- NCBDDD, Centers for Disease Control and Prevention, 4770 Buford Highway MS E-86, Atlanta, GA, 30341, USA.
| | | | | | | | - Marshalyn Yeargin-Allsopp
- NCBDDD, Centers for Disease Control and Prevention, 4770 Buford Highway MS E-86, Atlanta, GA, 30341, USA
| | - Laura A Schieve
- NCBDDD, Centers for Disease Control and Prevention, 4770 Buford Highway MS E-86, Atlanta, GA, 30341, USA
| | - Lin H Tian
- NCBDDD, Centers for Disease Control and Prevention, 4770 Buford Highway MS E-86, Atlanta, GA, 30341, USA
| | | | - Eric Moody
- University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
| | | | - Nuri Reyes
- University of Colorado-Anschutz Medical Campus, Aurora, CO, USA
| | - Susan E Levy
- Center for Autism Research, Children's Hospital of Philadelphia, Philadelphia, PA, USA
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Characterization and Prediction of Anxiety in Adolescents with Autism Spectrum Disorder: A Longitudinal Study. JOURNAL OF ABNORMAL CHILD PSYCHOLOGY 2020; 48:1239-1249. [PMID: 32617732 DOI: 10.1007/s10802-020-00673-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Anxiety is one of the most common comorbidities in youth with autism spectrum disorder (ASD). The current study's aims were: To examine the frequency of elevated anxiety symptoms in adolescents diagnosed with ASD in toddlerhood; To explore the impact of comorbid anxiety in adolescents on clinical presentation; To evaluate variables in toddlerhood that associate with anxiety symptom severity in adolescence. The study included 61 adolescents (mean age = 13:8y) diagnosed with ASD in toddlerhood (T1). Participants underwent a comprehensive assessment of cognitive ability, adaptive skills and autism severity at T1 and again as adolescents (T2), and an evaluation of anxiety symptoms at T2. For the first aim, the most prevalent anxiety subtypes noted in adolescence were separation (39.3%), social (27.9%) and generalized anxiety (18.0%). For the second aim, cognitive ability, autism severity and adaptive skills in adolescents with and without elevated anxiety symptoms scores of any type did not differ significantly. For the third aim, younger age at adolescence was associated with more severe separation and generalized anxiety symptoms. Higher cognitive ability and adaptive skills in toddlerhood were associated with elevated generalized anxiety symptoms in adolescence. Lower adaptive behaviors and repetitive behaviors (RRBs) correlated with elevated social anxiety symptoms. Lower cognitive abilities and more severe RRBs in toddlerhood predicted separation anxiety in adolescence. The study sheds light on early characteristics in ASD that associate with anxiety symptom severity in adolescence. The type of elevated anxiety symptoms presented in adolescence associated with the level of cognitive ability, adaptive skills and RRBs in toddlerhood.
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Hickey EJ, Hartley SL, Papp L. Psychological Well-Being and Parent-Child Relationship Quality in Relation to Child Autism: An Actor-Partner Modeling Approach. FAMILY PROCESS 2020; 59:636-650. [PMID: 30844091 PMCID: PMC6732055 DOI: 10.1111/famp.12432] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Parents of children with autism spectrum disorder (ASD) often report poor psychological well-being, including a high level of parenting stress and depressive symptoms. Little is known about the extent to which poor parent psychological well-being alters the emotional quality of the parent-child relationship in a context of child ASD. This study examined the association between actor (one's own) and partner (one's partner's) level of parenting stress and depressive symptoms and the emotional quality of the parent-child relationship using a Five Minute Speech Sample (FMSS) in 150 families of children with ASD, aged 5-12 years (85.7% male). Mothers and fathers were aged 38.69 (SD = 5.62) and 40.76 (SD = 6.19), respectively; 76% of mothers and 68% of fathers had a college degree. Structural equation modeling, using Analysis of Moment Structures software, was used to test Actor-Partner Interdependence Models. Results indicated that mother's level of parenting stress and depressive symptoms were associated with her own FMSS Warmth and Criticism toward the child with ASD 12 months later in negative and positive directions. Mother's level of parenting stress was also negatively associated with father's FMSS Warmth toward the child with ASD 12 months later. Finally, father's level of parenting stress was positively associated with his FMSS Criticism toward the child with ASD. Overall, findings indicate that the mother-child and father-child relationship are both impacted by parent psychological well-being in families of children with ASD; however, actor effects are stronger for mothers and partner effects were only found for fathers. Implications for interventions are discussed.
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Affiliation(s)
- Emily J Hickey
- Human Development and Family Studies Department, University of Wisconsin-Madison, Madison, WI
| | - Sigan L Hartley
- Human Development and Family Studies Department, University of Wisconsin-Madison, Madison, WI
| | - Lauren Papp
- Human Development and Family Studies Department, University of Wisconsin-Madison, Madison, WI
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Magdalena H, Beata K, Justyna P, Agnieszka KG, Szczepara-Fabian M, Buczek A, Ewa EW. Preconception Risk Factors for Autism Spectrum Disorder - A Pilot Study. Brain Sci 2020; 10:E293. [PMID: 32423096 PMCID: PMC7288185 DOI: 10.3390/brainsci10050293] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Revised: 05/10/2020] [Accepted: 05/12/2020] [Indexed: 12/22/2022] Open
Abstract
Autism spectrum disorder (ASD) is a neurodevelopmental disorder of multifactorial etiology. Preconception risk factors are still poorly understood. A survey on preconception risk factors for ASD was conducted among parents of 121 ASD patients aged 3-12 years and parents of 100 healthy children aged 3-12 years. The exclusion criteria were as follows: the presence of associated problems such as intellectual disability, epilepsy or other genetic and neurological diseases. Thirteen parameters were considered, a few among which were conception problems, conception with assisted reproductive techniques, the use and duration of oral contraception, the number of previous pregnancies and miscarriages, time since the previous pregnancy (in months), the history of mental illness in the family (including ASD), other chronic diseases in the mother or father and maternal and paternal treatment in specialist outpatient clinics. Three factors statistically significantly increased the risk of developing ASD: mental illness in the mother/mother's family (35.54% vs. 16.0%, p = 0.0002), maternal thyroid disease (16.67% vs. 5.0%, p = 0.009) and maternal oral contraception (46.28% vs. 29.0%, p = 0.01). Children of mothers with thyroid disorders or with mental illness in relatives should be closely monitored for ASD. Further studies are warranted to assess a potential effect of oral contraception on the development of offspring.
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Affiliation(s)
- Hankus Magdalena
- Department of Pediatric Neurology, Faculty of Medical Science in Katowice, Medical University of Silesia, 42-600 Katowice, Poland; (H.M.); (E.-W.E.)
| | - Kazek Beata
- Persevere—Child Development Support Center, 42-600 Katowice, Poland;
| | - Paprocka Justyna
- Department of Pediatric Neurology, Faculty of Medical Science in Katowice, Medical University of Silesia, 42-600 Katowice, Poland; (H.M.); (E.-W.E.)
| | | | | | - Agata Buczek
- Department of Neurological Rehabilitation, John Paul II Upper Silesian Child Health Centre, 42-600 Katowice, Poland;
| | - Emich-Widera Ewa
- Department of Pediatric Neurology, Faculty of Medical Science in Katowice, Medical University of Silesia, 42-600 Katowice, Poland; (H.M.); (E.-W.E.)
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42
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Stewart GR, Corbett A, Ballard C, Creese B, Aarsland D, Hampshire A, Charlton RA, Happé F. The Mental and Physical Health of Older Adults With a Genetic Predisposition for Autism. Autism Res 2020; 13:641-654. [PMID: 32045138 DOI: 10.1002/aur.2277] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 12/23/2019] [Accepted: 01/24/2020] [Indexed: 12/28/2022]
Abstract
Autism commonly aggregates in families, with twin studies estimating heritability to be around 80%. Subclinical autism-like characteristics have also been found at elevated rates in relatives of autistic probands. Physical and psychiatric conditions have been reported at elevated rates in autistic children and adults, and also in their relatives. However, to date, there has been no exploration of how aging may affect this pattern. This study examined cross-sectional data from the ongoing online PROTECT study. A total of 20,220 adults aged 50 years and older reported whether they have an autistic first-degree relative. In total, 739 older adults reported having an autistic first-degree relative (AFDR group) and 11,666 were identified as having no family history of any neurodevelopmental disorder (NFD group). The AFDR group demonstrated significantly higher frequencies of self-reported psychiatric diagnoses and a greater total number of co-occurring psychiatric diagnoses than the NFD group. Furthermore, the AFDR group reported elevated current self-report symptoms of depression, anxiety, traumatic experience, and post-traumatic stress than the NFD group. By contrast, few differences between AFDR and NFD groups were observed in physical health conditions, and no differences were observed in the total number of co-occurring physical health diagnoses. These findings suggest that adults who have an AFDR may be at greater risk of poor mental, but not physical, health in later life. Older adults with autistic relatives may benefit from close monitoring to mitigate this susceptibility and to provide timely intervention. Autism Res 2020, 13: 641-654. © 2020 The Authors. Autism Research published by International Society for Autism Research published by Wiley Periodicals, Inc. LAY SUMMARY: Children and adults with an autistic relative have been found to experience more psychiatric difficulties than those with no family links to autism. However, a few studies have explored what happens when these individuals get older. Examining over 20,000 adults age 50+, we found that older adults with an autistic relative experienced elevated rates of most psychiatric conditions but not physical conditions. Older adults with autistic relatives may benefit from close monitoring to mitigate this susceptibility and to provide timely intervention.
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Affiliation(s)
- Gavin R Stewart
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Anne Corbett
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Clive Ballard
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Byron Creese
- College of Medicine and Health, University of Exeter, Exeter, UK
| | - Dag Aarsland
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
| | - Adam Hampshire
- Department of Medicine, Imperial College London, London, UK
| | | | - Francesca Happé
- Institute of Psychiatry, Psychology and Neuroscience, King's College London, London, UK
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Lanillos P, Oliva D, Philippsen A, Yamashita Y, Nagai Y, Cheng G. A review on neural network models of schizophrenia and autism spectrum disorder. Neural Netw 2020; 122:338-363. [DOI: 10.1016/j.neunet.2019.10.014] [Citation(s) in RCA: 56] [Impact Index Per Article: 14.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2019] [Revised: 09/18/2019] [Accepted: 10/23/2019] [Indexed: 02/07/2023]
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Blacher J, Baker BL. Collateral Effects of Youth Disruptive Behavior Disorders on Mothers' Psychological Distress: Adolescents with Autism Spectrum Disorder, Intellectual Disability, or Typical Development. J Autism Dev Disord 2019; 49:2810-2821. [PMID: 29071563 DOI: 10.1007/s10803-017-3347-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Disruptive behavior disorders were assessed in 160 youth aged 13 years, with Autism Spectrum Disorder (ASD, n = 48), intellectual disability (ID, n = 28), or typical development (TD, n = 84). Mothers' reported collateral effects on their psychological adjustment were related to both youth disability status and clinical level behavior disorders. More youth with ASD or ID had clinical level behavior disorders than their TD peers, and their mothers reported significantly higher personal stress and psychological symptoms, as well as lower positive impact of the youth on the family. The youth's clinical level behavior disorders accounted for these differences more than the diagnostic status. Mothers high in dispositional optimism reported the lowest stress and psychological symptoms in relationship to youth behavior challenges.
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Affiliation(s)
- Jan Blacher
- Graduate School of Education, University of California, UCR, Sproul Hall, Riverside, CA, 92521, USA.
| | - Bruce L Baker
- Department of Psychology, University of California, Los Angeles (UCLA), Franz Hall, Los Angeles, CA, 90095, USA
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45
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Prevalence of Non-Affective Psychoses in Individuals with Autism Spectrum Disorders: A Systematic Review. J Clin Med 2019; 8:jcm8091304. [PMID: 31450601 PMCID: PMC6780908 DOI: 10.3390/jcm8091304] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2019] [Revised: 08/13/2019] [Accepted: 08/20/2019] [Indexed: 12/27/2022] Open
Abstract
Autism spectrum disorders (ASD) and non-affective psychoses such as schizophrenia are commonly acknowledged as discrete entities. Previous research has revealed evidence of high comorbidity between these conditions, but their differential diagnosis proves difficult in routine clinical practice due to the similarities between core symptoms of each disorder. The prevalence of comorbid non-affective psychoses in individuals with ASD is uncertain, with studies reporting rates ranging from 0% to 61.5%. We therefore performed a systematic review and pooled analysis of the available studies reporting the prevalence of non-affective psychosis in ASD. Fourteen studies, including a total of 1708 participants, were included, with a weighted pooled prevalence assessed at 9.5% (95% CI 2.6 to 16.0). In view of significant heterogeneity amongst the studies, subgroup analyses were conducted. We observed higher prevalence of non-affective psychoses among ASD inpatients versus outpatients, when operationalised criteria were used, and in studies with smaller sample sizes, whereas the figures were comparable between children and adults with ASD. Our results suggest that future studies involving larger samples should implement both operationalized criteria and specific scales for the assessment of psychotic symptoms in individuals with ASD. A deeper understanding of both differential and comorbid features of ASD and non-affective psychosis will be required for the development of optimized clinical management protocols.
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46
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Foss-Feig JH, Velthorst E, Smith L, Reichenberg A, Addington J, Cadenhead KS, Cornblatt BA, Mathalon DH, McGlashan TH, Perkins DO, Seidman LJ, Stone WS, Keshavan M, Tsuang MT, Walker EF, Woods SW, Cannon TD, Bearden CE. Clinical Profiles and Conversion Rates Among Young Individuals With Autism Spectrum Disorder Who Present to Clinical High Risk for Psychosis Services. J Am Acad Child Adolesc Psychiatry 2019; 58:582-588. [PMID: 30797038 PMCID: PMC7781438 DOI: 10.1016/j.jaac.2018.09.446] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/06/2018] [Revised: 08/31/2018] [Accepted: 09/14/2018] [Indexed: 01/06/2023]
Abstract
OBJECTIVE The overlap versus independence of autism spectrum disorder (ASD) and schizophrenia is a topic that has garnered the attention of generations of clinicians and scientists. Although high rates of psychotic symptoms have been identified in individuals with ASD, the nature, prevalence, and prognostic significance of subclinical psychotic experiences in ASD remain poorly understood. METHOD This study sought to compare baseline characteristics, clinical profiles, and conversion outcomes between young individuals at clinical high risk for psychosis (CHR) who presented with or without a prior ASD diagnosis during the second phase of the North American Prodrome Longitudinal Study (NAPLS, N = 764). RESULTS Patients with CHR and ASD (CHR/ASD+, n = 26) tended to exhibit greater social and social cognitive difficulties, but expressed relatively levels of core psychosis symptoms similar to those of to patients with CHR but no ASD (CHR/ASD-). Risk for conversion to co-occurring psychosis (18.2% CHR/ASD+ versus 16.8% CHR/ASD-) was equivalent between CHR/ASD+ and CHR/ASD- groups, and the NAPLS2 Psychosis Risk Calculator predicted conversion to psychosis equally well across groups. CONCLUSION These results suggest that baseline psychosis symptoms, predictors of risk for conversion, and ultimate conversion rates are similar in patients with CHR with and without ASD. They further suggest that ASD must not be considered a mutually exclusive diagnosis when such youth present in CHR settings. Future research is needed to better track trajectories in larger cohorts of individuals with CHR and comorbid ASD and to understand whether treatment recommendations effective in the broader CHR population are useful for this particular population as well.
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Affiliation(s)
- Jennifer H Foss-Feig
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY.
| | - Eva Velthorst
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Lauren Smith
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY
| | - Abraham Reichenberg
- Seaver Autism Center for Research and Treatment, Icahn School of Medicine at Mount Sinai, New York, NY
| | | | | | | | - Daniel H Mathalon
- University of California, San Francisco, CA; VA San Francisco Healthcare System, San Francisco, CA
| | | | | | | | | | | | | | | | - Scott W Woods
- Connecticut Mental Health Center, Yale University, New Haven, CT
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McKenzie R, Dallos R, Stedmon J, Hancocks H, Vickery PJ, Ewings P, Barton A, Vassallo T, Myhill C. SAFE, a new therapeutic intervention for families of children with autism: study protocol for a feasibility randomised controlled trial. BMJ Open 2019; 9:e025006. [PMID: 31133577 PMCID: PMC6549626 DOI: 10.1136/bmjopen-2018-025006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/25/2018] [Revised: 03/07/2019] [Accepted: 03/27/2019] [Indexed: 11/17/2022] Open
Abstract
INTRODUCTION Incidence of autistic traits, mental health problems, stress and poor coping is high among family members of children with autism. These problems are coupled with challenging behaviour among children with autism. Current treatment for these families is disjointed and costly. The need for whole family support is supported by the National Institute for Health and Care Excellence recommendations, developments regarding children's service provision, research and requests by families of children with autism. Despite evidence that family therapies can provide benefits to these families, efficacy has not been subject to a randomised controlled trial. Systemic Autism-related Family Enabling (SAFE) is a new family therapy intervention designed specifically for families of children with autism. We aim to establish the feasibility of running a fully powered randomised controlled trial to evaluate SAFE. METHODS AND ANALYSIS Families of children with autism aged 3-16 years will be invited to participate. Consenting participants will be randomised 2:1 to either SAFE+support as usual or support as usual alone. The proposed primary outcome measure for the main trial will be the Systemic CORE 15. Participants will also complete proposed secondary outcome measures, indexing changes in child behaviour, child-parent attachment, anxiety and depression. Generic health economic outcome measures (EuroQol 5 dimensions and Child Health Utility 9 Dimensions) will also provide data on the feasibility of cost-effectiveness analysis. Questionnaires will be completed at baseline and 32 weeks post-allocation. Data on ability to identify, recruit, randomise, retain and collect data from families, acceptability of outcome measures, adherence of therapists and families to the intervention, appropriateness of resource use questionnaires and effectiveness of training will be collected for feasibility analysis. Qualitative data will also explore acceptability of SAFE and reasons for declining and withdrawing from the study. ETHICS AND DISSEMINATION The current trial protocol received ethical approval from the South West-Exeter Research Ethics Committee (Ref: 17/SW/0192). The findings of the trial will be disseminated in collaboration with our Family Consultation Group and other partners. Findings will be shared locally, nationally and internationally through events, conferences and published papers. TRIAL REGISTRATION NUMBER ISCTRN83964946 (Pre-results) IRAS 213527.
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Affiliation(s)
| | - Rudi Dallos
- Department of Clinical Psychology, University of Plymouth, Plymouth, UK
| | - Jacqui Stedmon
- Department of Clinical Psychology, University of Plymouth, Plymouth, UK
| | - Helen Hancocks
- Peninsula Clinical Trials Unit, University of Plymouth, Plymouth, UK
| | | | - Paul Ewings
- Research Office, Research Design Service, Taunton, UK
| | - Andy Barton
- South West Research Design Service, Plymouth, UK
| | - Tara Vassallo
- Institute of Education, University of Plymouth, Plymouth, UK
| | - Craig Myhill
- Institute of Education, University of Plymouth, Plymouth, UK
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Breadon C, Kulkarni J. An update on medication management of women with schizophrenia in pregnancy. Expert Opin Pharmacother 2019; 20:1365-1376. [DOI: 10.1080/14656566.2019.1612876] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022]
Affiliation(s)
- Carolyn Breadon
- Monash Alfred Psychiatry Research Centre, Monash University, Melbourne, Australia
| | - Jayashri Kulkarni
- Monash Alfred Psychiatry Research Centre, Monash University, Melbourne, Australia
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49
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Bowers K, Khoury J, Sucharew H, Xu Y, Chen A, Lanphear B, Yolton K. Early Infant Attention as a Predictor of Social and Communicative Behavior in Childhood. INTERNATIONAL JOURNAL OF BEHAVIORAL DEVELOPMENT 2019; 43:204-211. [PMID: 37736344 PMCID: PMC10512366 DOI: 10.1177/0165025418797001] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/23/2023]
Abstract
Background The objective was to determine whether infant neurobehavior measured at five post-gestational weeks could predict social and communicative behavior (SCB) through five and eight years. Methods Infant neurobehavior was assessed using the Neonatal Intensive Care Unit Network Neurobehavioral Scale, and SCB was measured using the Social Responsiveness Scale (SRS). Adjusted linear regression with generalized estimating equations were employed to estimate the association between infant neurobehavior and SCB. Interaction terms and stratification were used to identify potential effect modification by autism spectrum disorder risk factors. Results The analyses include n = 214 and n = 227 participants who were examined at 5 weeks and followed to 4/5 and 8 years, respectively. Adjusting for maternal age, race, parity, and education as well as gestational age, only the Neonatal Intensive Care Unit Network Neurobehavioral Scale summary score of "attention" (measured at mean 43.9 gestational weeks) was inversely associated with total SRS T-score through 5 years. However, in analyses stratified by maternal age, the inverse association between "attention" and SCB was significant, but only among offspring of women of advanced maternal age (≥35 y); in addition, higher scores of "excitability," "lethargy," and "arousal" were associated with increased total SRS T scores among women of advanced maternal age. The associations were no longer statistically significant at 8 years. Conclusions Newborns with lower scores on the attention subscale (determined by an ability to localize and track animate and inanimate objects) were more likely to demonstrate deficits in SCB. In addition, infants with increased excitability, lethargy, or increased arousal were more likely to have impaired SCB that persisted through 5 years, but not at 8 years of age. Further work is necessary to identify specific aspects of infant neurobehavior that may affect childhood SCBs.
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Affiliation(s)
- Katherine Bowers
- Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, USA
| | - Jane Khoury
- Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, USA
| | - Heidi Sucharew
- Division of Biostatistics and Epidemiology, Cincinnati Children’s Hospital Medical Center, USA
| | - Yingying Xu
- Division of General and Community Pediatrics, Cincinnati Children’s Hospital Medical Center, USA
| | - Aimin Chen
- Department of Environmental Health, University of Cincinnati, USA
| | - Bruce Lanphear
- Faculty of Health Sciences, Simon Fraser University, Canada
| | - Kimberly Yolton
- Division of General and Community Pediatrics, Cincinnati Children’s Hospital Medical Center, USA
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50
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Miller M, Iosif AM, Young GS, Bell LJ, Schwichtenberg A, Hutman T, Ozonoff S. The dysregulation profile in preschoolers with and without a family history of autism spectrum disorder. J Child Psychol Psychiatry 2019; 60:516-523. [PMID: 30506566 PMCID: PMC6458078 DOI: 10.1111/jcpp.13003] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 10/11/2018] [Indexed: 12/20/2022]
Abstract
BACKGROUND The 'dysregulation profile' (DP) is a measure of emotional and behavioral dysregulation that may cut across diagnostic boundaries. Siblings of children with autism spectrum disorder (ASD) who do not develop ASD themselves are at risk for atypical outcomes including behavioral challenges and therefore may be a useful population in which to investigate the structure of the DP in preschoolers. METHODS We sought to examine the factor structure and predictors of the DP in a sample enriched for a wide range of phenotypic variation-36-month-olds with and without family histories of ASD-and to determine whether children with genetic liability for ASD are at risk for a phenotype characterized by elevated dysregulation. Data were collected from 415 children with (n = 253) and without (n = 162) an older sibling with ASD, all without ASD themselves, at 18, 24, and 36 months of age. RESULTS Our findings replicate prior reports, conducted in predominantly clinically referred and older samples, supporting the superiority of a bifactor model of the DP in the preschool period compared to the second-order and one-factor models. Examiner ratings were longitudinally and concurrently associated with the DP at 36 months of age. Family history of ASD was associated with higher dysregulation in the Anxious/Depressed dimension. CONCLUSIONS These findings support the relevance of examining the structure of psychopathology in preschoolers and suggest that examiner observations as early as 18 months of age, particularly of overactivity, may help identify risk for later DP-related concerns. Non-ASD preschoolers with family histories of ASD may be at risk for a phenotype characterized by elevated dysregulation particularly in the Anxious/Depressed dimension by age 3.
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Affiliation(s)
- Meghan Miller
- Department of Psychiatry & Behavioral Sciences and MIND Institute, University of California, Davis
| | - Ana-Maria Iosif
- Department of Public Health Sciences, University of California, Davis
| | - Gregory S. Young
- Department of Psychiatry & Behavioral Sciences and MIND Institute, University of California, Davis
| | - Laura J. Bell
- Department of Psychiatry & Behavioral Sciences and MIND Institute, University of California, Davis
| | - A.J. Schwichtenberg
- Departments of Human Development and Family Studies, Psychological Sciences, and Speech, Language, and Hearing Sciences, Purdue University
| | - Ted Hutman
- Department of Psychiatry, University of California, Los Angeles
| | - Sally Ozonoff
- Department of Psychiatry & Behavioral Sciences and MIND Institute, University of California, Davis
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