Background
Attention-deficit hyperactivity disorder (ADHD) is associated
with bipolar disorder and schizophrenia, and it has been
suggested that combined bipolar disorder and ADHD is
aetiologically distinct from the pure disorders.
Aims
To clarify whether ADHD shares genetic and environmental
factors with bipolar disorder and schizophrenia.
Method
By linking longitudinal Swedish national registers, we
identified 61 187 persons with ADHD (the proband group)
and their first- and second-degree relatives, and matched
them with a control group of people without ADHD and
their corresponding relatives. Conditional logistic regression
was used to determine the risks of bipolar disorder and
schizophrenia in the relatives of the two groups.
Results
First-degree relatives of the ADHD proband group were
at increased risk of both bipolar disorder (odds ratio
(OR) = 1.84–2.54 for parents, offspring and full siblings) and
schizophrenia (OR = 1.71–2.22 for parents, offspring and full
siblings). The risks of bipolar disorder and schizophrenia
among second-degree relatives were substantially lower than
among full siblings.
Conclusions
These findings suggest that the co-occurrence of ADHD and
bipolar disorder as well as ADHD and schizophrenia is due to
shared genetic factors, rather than representing completely
aetiologically distinct subsyndromes.
Declaration of interest
None.
BackgroundAttention-deficit hyperactivity disorder (ADHD) is associatedwith bipolar disorder and schizophrenia, and it has beensuggested that combined bipolar disorder and ADHD isaetiologically distinct from the pure disorders.AimsTo clarify whether ADHD shares genetic and environmentalfactors with bipolar disorder and schizophrenia.MethodBy linking longitudinal Swedish national registers, weidentified 61 187 persons with ADHD (the proband group)and their first- and second-degree relatives, and matchedthem with a control group of people without ADHD andtheir corresponding relatives. Conditional logistic regressionwas used to determine the risks of bipolar disorder andschizophrenia in the relatives of the two groups.ResultsFirst-degree relatives of the ADHD proband group wereat increased risk of both bipolar disorder (odds ratio(OR) = 1.84–2.54 for parents, offspring and full siblings) andschizophrenia (OR = 1.71–2.22 for parents, offspring and fullsiblings). The risks of bipolar disorder and schizophreniaamong second-degree relatives were substantially lower thanamong full siblings.ConclusionsThese findings suggest that the co-occurrence of ADHD andbipolar disorder as well as ADHD and schizophrenia is due toshared genetic factors, rather than representing completelyaetiologically distinct subsyndromes.Declaration of interestNone.
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