Early-Life Injuries and the Development of Attention-Deficit/Hyperactivity Disorder
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Early-Life Injuries and the Development of Attention-Deficit/Hyperactivity Disorder. / Wimberley, Theresa; Brikell, Isabell; Pedersen, Emil M.; Agerbo, Esben; Vilhjálmsson, Bjarni J.; Albiñana, Clara; Privé, Florian; Thapar, Anita; Langley, Kate; Riglin, Lucy; Simonsen, Marianne; Nielsen, Helena S.; Børglum, Anders D.; Nordentoft, Merete; Mortensen, Preben B.; Dalsgaard, Søren.
In: Journal of Clinical Psychiatry, Vol. 83, No. 1, 21m14033, 2022.Research output: Contribution to journal › Journal article › Research › peer-review
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TY - JOUR
T1 - Early-Life Injuries and the Development of Attention-Deficit/Hyperactivity Disorder
AU - Wimberley, Theresa
AU - Brikell, Isabell
AU - Pedersen, Emil M.
AU - Agerbo, Esben
AU - Vilhjálmsson, Bjarni J.
AU - Albiñana, Clara
AU - Privé, Florian
AU - Thapar, Anita
AU - Langley, Kate
AU - Riglin, Lucy
AU - Simonsen, Marianne
AU - Nielsen, Helena S.
AU - Børglum, Anders D.
AU - Nordentoft, Merete
AU - Mortensen, Preben B.
AU - Dalsgaard, Søren
N1 - Publisher Copyright: © Copyright 2022 Physicians Postgraduate Press, Inc.
PY - 2022
Y1 - 2022
N2 - Objective: To estimate phenotypic and familial association between early-life injuries and attention-deficit/hyperactivity disorder (ADHD) and the genetic contribution to the association using polygenic risk score for ADHD (PRS-ADHD) and genetic correlation analyses. Methods: Children born in Denmark between 1995–2010 (n = 786,543) were followed from age 5 years until a median age of 14 years (interquartile range: 10–18 years). Using ICD-10 diagnoses, we estimated hazard ratios (HRs) and absolute risks of ADHD by number of hospital/emergency ward–treated injuries by age 5. In a subset of ADHD cases and controls born 1995 to 2005 who had genetic data available (n = 16,580), we estimated incidence rate ratios (IRRs) for the association between PRS-ADHD and number of injuries before age 5 and the genetic correlation between ADHD and any injury before age 5. Results: Injuries were associated with ADHD (HR = 1.61; 95% CI, 1.55–1.66) in males (HR = 1.59; 1.53–1.65) and females (HR = 1.65; 1.54–1.77), with a dose-response relationship with number of injuries. The absolute ADHD risk by age 15 was 8.4% (3+ injuries) vs 3.1% (no injuries). ADHD was also associated with injuries in relatives, with a stronger association in first- than second-degree relatives. PRS-ADHD was marginally associated with the number of injuries in the general population (IRR = 1.06; 1.00–1.14), with a genetic correlation of 0.53 (0.21–0.85). Conclusions: Early-life injuries in individuals and their relatives were associated with a diagnosis of ADHD. However, even in children with the most injuries, more than 90% were not diagnosed with ADHD by age 15. Despite a low positive predictive value and that the impact of unmeasured factors such as parental behavior remains unclear, results indicate that the association is partly explained by genetics, suggesting that early-life injuries may represent or herald early behavioral manifestations of ADHD.
AB - Objective: To estimate phenotypic and familial association between early-life injuries and attention-deficit/hyperactivity disorder (ADHD) and the genetic contribution to the association using polygenic risk score for ADHD (PRS-ADHD) and genetic correlation analyses. Methods: Children born in Denmark between 1995–2010 (n = 786,543) were followed from age 5 years until a median age of 14 years (interquartile range: 10–18 years). Using ICD-10 diagnoses, we estimated hazard ratios (HRs) and absolute risks of ADHD by number of hospital/emergency ward–treated injuries by age 5. In a subset of ADHD cases and controls born 1995 to 2005 who had genetic data available (n = 16,580), we estimated incidence rate ratios (IRRs) for the association between PRS-ADHD and number of injuries before age 5 and the genetic correlation between ADHD and any injury before age 5. Results: Injuries were associated with ADHD (HR = 1.61; 95% CI, 1.55–1.66) in males (HR = 1.59; 1.53–1.65) and females (HR = 1.65; 1.54–1.77), with a dose-response relationship with number of injuries. The absolute ADHD risk by age 15 was 8.4% (3+ injuries) vs 3.1% (no injuries). ADHD was also associated with injuries in relatives, with a stronger association in first- than second-degree relatives. PRS-ADHD was marginally associated with the number of injuries in the general population (IRR = 1.06; 1.00–1.14), with a genetic correlation of 0.53 (0.21–0.85). Conclusions: Early-life injuries in individuals and their relatives were associated with a diagnosis of ADHD. However, even in children with the most injuries, more than 90% were not diagnosed with ADHD by age 15. Despite a low positive predictive value and that the impact of unmeasured factors such as parental behavior remains unclear, results indicate that the association is partly explained by genetics, suggesting that early-life injuries may represent or herald early behavioral manifestations of ADHD.
U2 - 10.4088/JCP.21m14033
DO - 10.4088/JCP.21m14033
M3 - Journal article
C2 - 34985833
AN - SCOPUS:85136543088
VL - 83
JO - Journal of Clinical Psychiatry
JF - Journal of Clinical Psychiatry
SN - 0160-6689
IS - 1
M1 - 21m14033
ER -
ID: 328478038