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The co-occurrence of autistic and ADHD dimensions in adults: an etiological study in 17,770 twins.

ABSTRACT: Autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (ADHD) often occur together. To obtain more insight in potential causes for the co-occurrence, this study examined the genetic and environmental etiology of the association between specific ASD and ADHD disorder dimensions. Self-reported data on ASD dimensions social and communication difficulties (ASDsc), and repetitive and restricted behavior and interests (ASDr), and ADHD dimensions inattention (IA), and hyperactivity/impulsivity (HI) were assessed in a community sample of 17,770 adult Swedish twins. Phenotypic, genetic and environmental associations between disorder dimensions were examined in a multivariate model, accounting for sex differences. ASDr showed the strongest associations with IA and HI in both sexes (r(p) 0.33 to 0.40). ASDsc also correlated moderately with IA (females r(p) 0.29 and males r(p) 0.35) but only modestly with HI (females r(p) 0.17 and males r(p) 0.20). Genetic correlations ranged from 0.22 to 0.64 and were strongest between ASDr and IA and HI. Sex differences were virtually absent. The ASDr dimension (reflecting restricted, repetitive and stereotyped patterns of behavior, interests and activities) showed the strongest association with dimensions of ADHD, on a phenotypic, genetic and environmental level. This study opens new avenues for molecular genetic research. As our findings demonstrated that genetic overlap between disorders is dimension-specific, future gene-finding studies on psychiatric comorbidity should focus on carefully selected genetically related dimensions of disorders.

SUBMITTER: Polderman TJ

PROVIDER: S-EPMC4203013 | biostudies-literature | 2014 Sep

REPOSITORIES: biostudies-literature

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The co-occurrence of autistic and ADHD dimensions in adults: an etiological study in 17,770 twins.

Polderman T J C TJ Hoekstra R A RA Posthuma D D Larsson H H

Translational psychiatry 20140902

Autism spectrum disorder (ASD) and attention deficit/hyperactivity disorder (ADHD) often occur together. To obtain more insight in potential causes for the co-occurrence, this study examined the genetic and environmental etiology of the association between specific ASD and ADHD disorder dimensions. Self-reported data on ASD dimensions social and communication difficulties (ASDsc), and repetitive and restricted behavior and interests (ASDr), and ADHD dimensions inattention (IA), and hyperactivity ...[more]

PMID: 25180574

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Project description:BackgroundComorbidity between psychopathologies may be attributed to genetic and environmental differences between people as well as causal processes within individuals, where one pathology increases risk for another. Disentangling between-person (co)variance from within-person processes of psychopathology dimensions across childhood may shed light on developmental causes of comorbid mental health problems. Here, we aim to determine whether and to what extent directional relationships between psychopathology dimensions within-person, and between individuals within families, play a role in comorbidity.MethodsWe conducted random intercepts cross-lagged panel model (RI-CLPM) analyses to unravel the longitudinal co-occurrence of child psychopathology dimensions, jointly estimating between-person and within-person processes from childhood to early adolescence (age 7-12). We further developed an extension of the model to estimate sibling effects within-family (wf-RI-CLPM). Analyses were separately conducted in two large population-based cohorts, TEDS and NTR, including parent-rated measures of child problem behaviours based on the SDQ and CBCL scales respectively.ResultsWe found evidence for strong between-person effects underlying the positive intercorrelation between problem behaviours across time. Beyond these time-varying within-person processes accounted for an increasing amount of trait variance, within- and cross-trait, overtime in both cohorts. Lastly, by accommodating family level data, we found evidence for reciprocal directional influences within sib-pairs longitudinally.ConclusionsOur results indicate that within-person processes partly explain the co-occurrence of psychopathology dimensions across childhood, and within sib-pairs. Analyses provided substantive results on developmental processes underlying comorbidity in behavioural problems. Future studies should consider different developmental timeframes to shed more light on the processes contributing to developmental comorbidity.

Project description:Attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are childhood-onset disorders associated with functional and psychosocial impairments that may persist into adulthood, leading to serious personal and societal costs. This study aimed to examine the socio-economic difficulties, physical and mental comorbidities, and psycho-social vulnerabilities associated with ADHD, ASD, and their co-occurrence among young adults. 16 365 families with children born 1997-1999, were involved in the prospective population-based ABIS study (All Babies in Southeast Sweden). A total of 6 233 ABIS young adults answered the questionnaire at the 17-19-year follow-up and were included in this case-control study. Diagnoses of ADHD and ASD from birth up to 17 years of age were obtained from the Swedish National Diagnosis Register. N=182 individuals received a single diagnosis of ADHD, n=78 of ASD, and n=51 received both diagnoses and were considered the co-occurrence group. Multiple multinomial logistic regression analyses were performed. In the univariate analyses all three conditions were significantly associated with concentration difficulties, worse health quality, lower socio-economic status, lower faith in the future, less control over life, and lower social support. In the adjusted analyses, individuals with ADHD were almost three-times more likely to have less money compared with their friends (aOR 2.86; p < .001), experienced worse sleep quality (aOR 1.50; p = .043) and concentration difficulties (aOR 1.96; p < .001). ASD group were two-fold more likely to experience concentration difficulties (aOR 2.35; p = .002) and tended not to have faith in the future (aOR .63; p = .055), however, showed lesser risk-taking bahaviours (aOR .40; p < .001). Finally, the co-occurrence was significantly associated with unemployment (aOR 2.64; p = .007) and tended to have a higher risk of autoimmune disorders (aOR 2.41; p = .051), however, showed a 51% lower risk of stomach pain (aOR .49; p = .030). All these conditions significantly deteriorated several areas of life. ADHD/ASD co-occurrence is a heavy burden for health associated with several psychosocial vulnerabilities, that shared a similar morbidity pattern with ADHD although showed less risk cognitive and behavioral profile, similar to the ASD group. Long-term follow-up and support for individuals with these conditions over the life course are crucial.

Project description:Multiple forms of drug abuse/dependence frequently co-occur with problem/pathological gambling (PPG). The current study examines the extent to which genetic and environmental factors contribute to their co-occurrence.Bivariate models investigated the magnitude and correlation of genetic and environmental contributions to problem/pathological gambling and its co-occurrence with nicotine dependence, cannabis abuse/dependence and stimulant abuse/dependence.Computer-assisted telephone interviews in the community.Participants were 7869 male twins in the Vietnam Era Twin Registry, a USA-based national twin registry.Life-time DSM-III-R diagnoses for problem/pathological gambling, nicotine dependence, cannabis abuse/dependence and stimulant abuse/dependence were determined using the Diagnostic Interview Schedule.All drug-use disorders displayed additive genetic and non-shared environmental contributions, with cannabis abuse/dependence also displaying shared environmental contributions. Both genetic [genetic correlation rA ?=?0.22; 95% confidence interval (CI)?=?0.10-0.34] and non-shared environmental components (environmental correlation rE ?=?0.24; 95% CI?=?0.10-0.37) contributed to the co-occurrence of problem/pathological gambling and nicotine dependence. This pattern was shared by cannabis abuse/dependence (rA ?=?0.32; 95% CI?=?0.05-1.0; rE ?=?0.36; 95% CI?=?0.16-0.55) but not stimulant abuse/dependence (SAD), which showed only genetic contributions to the co-occurrence with problem/pathological gambling (rA ?=?0.58; 95% CI?=?0.45-0.73).Strong links between gambling and stimulant-use disorders may relate to the neurochemical properties of stimulants or the illicit nature of using 'hard' drugs such as cocaine. The greater contribution of environmental factors to the co-occurrence between problem/pathological gambling and 'softer' forms of drug abuse/dependence (cannabis, tobacco) suggest that environmental interventions (perhaps relating to availability and legality) may help to diminish the relationship between problem/pathological gambling and tobacco- and cannabis-use disorders.

Project description:BackgroundAttention-deficit/hyperactivity disorder (ADHD) is a common neurodevelopmental disorder. Many previous studies have shown that the comorbid status of disruptive behaviour disorders (DBD) was a predictor for ADHD persistence into adulthood. However, the brain mechanisms underlying such a relationship remain unclear. Thus, we aim to investigate whether the brain functional alteration in adults with ADHD could also be detected in children with ADHD co-occurring with disruptive behaviours from both quantitative and categorical dimensions.MethodsA total of 172 children with ADHD (cADHD), 98 adults with ADHD (aADHD), 77 healthy control children (cHC) and 40 healthy control adults (aHC) were recruited. The whole-brain spontaneous fluctuations in brain activity of each participant were recorded using functional near-infrared spectroscopy (fNIRS), and the functional connectivities (FCs) were calculated. We first compared the FC differences between aADHD and aHC. Then, for the regions with significantly abnormal FCs in aADHD, we further compared these features between cADHD and cHC. In addition, the correlation between these FCs and the conduct disorder (CD)/oppositional defiant disorder (ODD) symptoms were analysed in cADHD. Moreover, to render the results readily interpretable, we compared the FC differences among ADHDCD-, subthreshold ADHDCD+ and cHC groups, and among ADHDODD-, ADHDODD+ and cHC groups. Finally, we repeated the above analysis after controlling for other comorbidities and core symptoms to diminish the potential confounding effects.ResultsWe found that compared with aHC, aADHD showed significantly increased FCs in the VN, DMN, SMN, and DAN. The aforementioned abnormal FCs were also detected in cADHD, however, in an opposite orientation. Notably, these abnormal FCs were positively correlated with CD symptoms. Finally, the subthreshold ADHDCD+ group even exhibited a tendency of adult-like increased FCs compared with the cHC. The results held after controlling for other comorbidities and core symptoms.ConclusionThis study provides functional neuroimaging evidence that CD might be a risk factor for ADHD persistence into adulthood. Our work highlights the importance of differentiating ADHDCD+ from ADHD and inspiring further understanding of brain development in ADHD.

Dataset Information

The co-occurrence of autistic and ADHD dimensions in adults: an etiological study in 17,770 twins.

Publications

The co-occurrence of autistic and ADHD dimensions in adults: an etiological study in 17,770 twins.

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