Sex Differences in Comorbidity Patterns of Attention-Deficit/Hyperactivity Disorder
To investigate sex differences in associations between attention-deficit/hyperactivity disorder (ADHD) and a spectrum of comorbid disorders. The study population included all children born in Denmark from 1981 through 2013 (N = 1,665,729). Data were merged from Danish registers and information was o...
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| Veröffentlicht in: | Journal of the American Academy of Child and Adolescent Psychiatry 2019-04, Vol.58 (4), p.412-422.e3 |
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| container_title | Journal of the American Academy of Child and Adolescent Psychiatry |
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| creator | Ottosen, Cæcilie Larsen, Janne Tidselbak Faraone, Stephen V Chen, Qi Hartman, Catharina Larsson, Henrik Petersen, Liselotte Dalsgaard, Søren |
| description | To investigate sex differences in associations between attention-deficit/hyperactivity disorder (ADHD) and a spectrum of comorbid disorders.
The study population included all children born in Denmark from 1981 through 2013 (N = 1,665,729). Data were merged from Danish registers and information was obtained on birth characteristics, socioeconomic status, familial psychiatric history, and diagnoses of ADHD (n = 32,308) and comorbid disorders. To estimate absolute and relative risks of comorbid disorders, incidence rates and adjusted hazard ratios (HRs) with 95% CIs were calculated for female and male individuals. In addition, interactions between ADHD and sex in association with comorbid disorders were estimated as HR ratios (HRRs) in female and male individuals (95% CIs).
Individuals diagnosed with ADHD had significantly increased absolute and relative risks of all 12 comorbid psychiatric disorders investigated. ADHD-sex interactions were found for some comorbid disorders. Compared with male individuals, ADHD in female individuals showed a stronger association with autism spectrum disorder (HRR 1.86, 95% CI 1.62-2.14), oppositional defiant/conduct disorder (HRR 1.97, 95% CI 1.68-2.30), intellectual disability (HRR 1.79, 95% CI 1.54-2.09), personality disorders (HRR 1.23, 95% CI 1.06-1.43), schizophrenia (HRR 1.21, 95% CI 1.02-1.43), substance use disorders (HRR 1.21, 95% CI 1.07-1.38), and suicidal behavior (1.28, 95% CI 1.12-1.47). The remaining disorders showed no significant sex differences in association with ADHD.
This study indicates that the association between ADHD and several comorbid disorders is stronger in female than in male individuals. These important findings add to the literature on sex differences in ADHD and suggest that female individuals diagnosed with ADHD are a more vulnerable group of patients. |
| doi_str_mv | 10.1016/j.jaac.2018.07.910 |
| format | Article |
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The study population included all children born in Denmark from 1981 through 2013 (N = 1,665,729). Data were merged from Danish registers and information was obtained on birth characteristics, socioeconomic status, familial psychiatric history, and diagnoses of ADHD (n = 32,308) and comorbid disorders. To estimate absolute and relative risks of comorbid disorders, incidence rates and adjusted hazard ratios (HRs) with 95% CIs were calculated for female and male individuals. In addition, interactions between ADHD and sex in association with comorbid disorders were estimated as HR ratios (HRRs) in female and male individuals (95% CIs).
Individuals diagnosed with ADHD had significantly increased absolute and relative risks of all 12 comorbid psychiatric disorders investigated. ADHD-sex interactions were found for some comorbid disorders. Compared with male individuals, ADHD in female individuals showed a stronger association with autism spectrum disorder (HRR 1.86, 95% CI 1.62-2.14), oppositional defiant/conduct disorder (HRR 1.97, 95% CI 1.68-2.30), intellectual disability (HRR 1.79, 95% CI 1.54-2.09), personality disorders (HRR 1.23, 95% CI 1.06-1.43), schizophrenia (HRR 1.21, 95% CI 1.02-1.43), substance use disorders (HRR 1.21, 95% CI 1.07-1.38), and suicidal behavior (1.28, 95% CI 1.12-1.47). The remaining disorders showed no significant sex differences in association with ADHD.
This study indicates that the association between ADHD and several comorbid disorders is stronger in female than in male individuals. These important findings add to the literature on sex differences in ADHD and suggest that female individuals diagnosed with ADHD are a more vulnerable group of patients.</description><identifier>ISSN: 0890-8567</identifier><identifier>ISSN: 1527-5418</identifier><identifier>EISSN: 1527-5418</identifier><identifier>DOI: 10.1016/j.jaac.2018.07.910</identifier><identifier>PMID: 30768399</identifier><language>eng</language><publisher>United States: Elsevier BV</publisher><subject>ADHD ; Attention deficit hyperactivity disorder ; Autism ; Autism Spectrum Disorders ; Autistic children ; Child & adolescent psychiatry ; comorbid disorders ; Comorbidity ; Conduct disorder ; Females ; Gender differences ; Hyperactivity ; Learning disabilities ; Males ; Mental disorders ; Oppositional defiant disorder ; Personality disorders ; Personality Problems ; Population studies ; Psychiatry ; Risk assessment ; Risk factors ; Schizophrenia ; Sex differences ; Socioeconomic status ; Substance use disorder ; Suicide</subject><ispartof>Journal of the American Academy of Child and Adolescent Psychiatry, 2019-04, Vol.58 (4), p.412-422.e3</ispartof><rights>Copyright © 2019 American Academy of Child and Adolescent Psychiatry. Published by Elsevier Inc. All rights reserved.</rights><rights>Copyright Lippincott Williams & Wilkins Ovid Technologies Apr 2019</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c516t-26b54df0fb630120b00076acf559ada2f3b402c15ad267aca16d3d0232e87df63</citedby><cites>FETCH-LOGICAL-c516t-26b54df0fb630120b00076acf559ada2f3b402c15ad267aca16d3d0232e87df63</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,550,776,780,881,27901,27902,30976</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/30768399$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-73543$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttp://kipublications.ki.se/Default.aspx?queryparsed=id:141129378$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><creatorcontrib>Ottosen, Cæcilie</creatorcontrib><creatorcontrib>Larsen, Janne Tidselbak</creatorcontrib><creatorcontrib>Faraone, Stephen V</creatorcontrib><creatorcontrib>Chen, Qi</creatorcontrib><creatorcontrib>Hartman, Catharina</creatorcontrib><creatorcontrib>Larsson, Henrik</creatorcontrib><creatorcontrib>Petersen, Liselotte</creatorcontrib><creatorcontrib>Dalsgaard, Søren</creatorcontrib><title>Sex Differences in Comorbidity Patterns of Attention-Deficit/Hyperactivity Disorder</title><title>Journal of the American Academy of Child and Adolescent Psychiatry</title><addtitle>J Am Acad Child Adolesc Psychiatry</addtitle><description>To investigate sex differences in associations between attention-deficit/hyperactivity disorder (ADHD) and a spectrum of comorbid disorders.
The study population included all children born in Denmark from 1981 through 2013 (N = 1,665,729). Data were merged from Danish registers and information was obtained on birth characteristics, socioeconomic status, familial psychiatric history, and diagnoses of ADHD (n = 32,308) and comorbid disorders. To estimate absolute and relative risks of comorbid disorders, incidence rates and adjusted hazard ratios (HRs) with 95% CIs were calculated for female and male individuals. In addition, interactions between ADHD and sex in association with comorbid disorders were estimated as HR ratios (HRRs) in female and male individuals (95% CIs).
Individuals diagnosed with ADHD had significantly increased absolute and relative risks of all 12 comorbid psychiatric disorders investigated. ADHD-sex interactions were found for some comorbid disorders. Compared with male individuals, ADHD in female individuals showed a stronger association with autism spectrum disorder (HRR 1.86, 95% CI 1.62-2.14), oppositional defiant/conduct disorder (HRR 1.97, 95% CI 1.68-2.30), intellectual disability (HRR 1.79, 95% CI 1.54-2.09), personality disorders (HRR 1.23, 95% CI 1.06-1.43), schizophrenia (HRR 1.21, 95% CI 1.02-1.43), substance use disorders (HRR 1.21, 95% CI 1.07-1.38), and suicidal behavior (1.28, 95% CI 1.12-1.47). The remaining disorders showed no significant sex differences in association with ADHD.
This study indicates that the association between ADHD and several comorbid disorders is stronger in female than in male individuals. These important findings add to the literature on sex differences in ADHD and suggest that female individuals diagnosed with ADHD are a more vulnerable group of patients.</description><subject>ADHD</subject><subject>Attention deficit hyperactivity disorder</subject><subject>Autism</subject><subject>Autism Spectrum Disorders</subject><subject>Autistic children</subject><subject>Child & adolescent psychiatry</subject><subject>comorbid disorders</subject><subject>Comorbidity</subject><subject>Conduct disorder</subject><subject>Females</subject><subject>Gender differences</subject><subject>Hyperactivity</subject><subject>Learning disabilities</subject><subject>Males</subject><subject>Mental disorders</subject><subject>Oppositional defiant disorder</subject><subject>Personality disorders</subject><subject>Personality Problems</subject><subject>Population studies</subject><subject>Psychiatry</subject><subject>Risk assessment</subject><subject>Risk factors</subject><subject>Schizophrenia</subject><subject>Sex differences</subject><subject>Socioeconomic status</subject><subject>Substance use disorder</subject><subject>Suicide</subject><issn>0890-8567</issn><issn>1527-5418</issn><issn>1527-5418</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>7QJ</sourceid><sourceid>D8T</sourceid><recordid>eNp1kc1uEzEUhS1ERdPCC7BAI7Fh0Zle2-OfWUYJbZEqFanA1vL4B3lIxsGeAfL2OCR0gcTC8pX13aNjfQi9xtBgwPx6aAatTUMAywZE02F4hhaYEVGzFsvnaAGyg1oyLs7RRc4DAGAh5Qt0TkFwSbtugR4f3a9qHbx3yY3G5SqM1SpuY-qDDdO--qinyaUxV9FXyzKOU4hjvXY-mDBd3-13LmkzhR8Hdh1yTNall-jM6012r073Jfp88_7T6q6-f7j9sFre14ZhPtWE96y1HnzPKWACfeknuDaesU5bTTztWyAGM20JF9pozC21QChxUljP6SWqj7n5p9vNvdqlsNVpr6IO6vT0rUxOtRJ3rSj81X_5dfiyVDF9LWdWgrKWFvzdEd-l-H12eVLbkI3bbPTo4pwVIaWvAPkn-e0_6BDnNJbPF4qQjlDMcaHIkTIp5pycf2qAQR2MqkEdjKqDUQVCFaNl6c0peu63zj6t_FVIfwOYy530</recordid><startdate>20190401</startdate><enddate>20190401</enddate><creator>Ottosen, Cæcilie</creator><creator>Larsen, Janne Tidselbak</creator><creator>Faraone, Stephen V</creator><creator>Chen, Qi</creator><creator>Hartman, Catharina</creator><creator>Larsson, Henrik</creator><creator>Petersen, Liselotte</creator><creator>Dalsgaard, Søren</creator><general>Elsevier BV</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QJ</scope><scope>7TK</scope><scope>K9.</scope><scope>7X8</scope><scope>ADTPV</scope><scope>AOWAS</scope><scope>D91</scope><scope>D8T</scope><scope>ZZAVC</scope></search><sort><creationdate>20190401</creationdate><title>Sex Differences in Comorbidity Patterns of Attention-Deficit/Hyperactivity Disorder</title><author>Ottosen, Cæcilie ; Larsen, Janne Tidselbak ; Faraone, Stephen V ; Chen, Qi ; Hartman, Catharina ; Larsson, Henrik ; Petersen, Liselotte ; Dalsgaard, Søren</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c516t-26b54df0fb630120b00076acf559ada2f3b402c15ad267aca16d3d0232e87df63</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>ADHD</topic><topic>Attention deficit hyperactivity disorder</topic><topic>Autism</topic><topic>Autism Spectrum Disorders</topic><topic>Autistic children</topic><topic>Child & adolescent psychiatry</topic><topic>comorbid disorders</topic><topic>Comorbidity</topic><topic>Conduct disorder</topic><topic>Females</topic><topic>Gender differences</topic><topic>Hyperactivity</topic><topic>Learning disabilities</topic><topic>Males</topic><topic>Mental disorders</topic><topic>Oppositional defiant disorder</topic><topic>Personality disorders</topic><topic>Personality Problems</topic><topic>Population studies</topic><topic>Psychiatry</topic><topic>Risk assessment</topic><topic>Risk factors</topic><topic>Schizophrenia</topic><topic>Sex differences</topic><topic>Socioeconomic status</topic><topic>Substance use disorder</topic><topic>Suicide</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Ottosen, Cæcilie</creatorcontrib><creatorcontrib>Larsen, Janne Tidselbak</creatorcontrib><creatorcontrib>Faraone, Stephen V</creatorcontrib><creatorcontrib>Chen, Qi</creatorcontrib><creatorcontrib>Hartman, Catharina</creatorcontrib><creatorcontrib>Larsson, Henrik</creatorcontrib><creatorcontrib>Petersen, Liselotte</creatorcontrib><creatorcontrib>Dalsgaard, Søren</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Applied Social Sciences Index & Abstracts (ASSIA)</collection><collection>Neurosciences Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>MEDLINE - Academic</collection><collection>SwePub</collection><collection>SwePub Articles</collection><collection>SWEPUB Örebro universitet</collection><collection>SWEPUB Freely available online</collection><collection>SwePub Articles full text</collection><jtitle>Journal of the American Academy of Child and Adolescent Psychiatry</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Ottosen, Cæcilie</au><au>Larsen, Janne Tidselbak</au><au>Faraone, Stephen V</au><au>Chen, Qi</au><au>Hartman, Catharina</au><au>Larsson, Henrik</au><au>Petersen, Liselotte</au><au>Dalsgaard, Søren</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Sex Differences in Comorbidity Patterns of Attention-Deficit/Hyperactivity Disorder</atitle><jtitle>Journal of the American Academy of Child and Adolescent Psychiatry</jtitle><addtitle>J Am Acad Child Adolesc Psychiatry</addtitle><date>2019-04-01</date><risdate>2019</risdate><volume>58</volume><issue>4</issue><spage>412</spage><epage>422.e3</epage><pages>412-422.e3</pages><issn>0890-8567</issn><issn>1527-5418</issn><eissn>1527-5418</eissn><abstract>To investigate sex differences in associations between attention-deficit/hyperactivity disorder (ADHD) and a spectrum of comorbid disorders.
The study population included all children born in Denmark from 1981 through 2013 (N = 1,665,729). Data were merged from Danish registers and information was obtained on birth characteristics, socioeconomic status, familial psychiatric history, and diagnoses of ADHD (n = 32,308) and comorbid disorders. To estimate absolute and relative risks of comorbid disorders, incidence rates and adjusted hazard ratios (HRs) with 95% CIs were calculated for female and male individuals. In addition, interactions between ADHD and sex in association with comorbid disorders were estimated as HR ratios (HRRs) in female and male individuals (95% CIs).
Individuals diagnosed with ADHD had significantly increased absolute and relative risks of all 12 comorbid psychiatric disorders investigated. ADHD-sex interactions were found for some comorbid disorders. Compared with male individuals, ADHD in female individuals showed a stronger association with autism spectrum disorder (HRR 1.86, 95% CI 1.62-2.14), oppositional defiant/conduct disorder (HRR 1.97, 95% CI 1.68-2.30), intellectual disability (HRR 1.79, 95% CI 1.54-2.09), personality disorders (HRR 1.23, 95% CI 1.06-1.43), schizophrenia (HRR 1.21, 95% CI 1.02-1.43), substance use disorders (HRR 1.21, 95% CI 1.07-1.38), and suicidal behavior (1.28, 95% CI 1.12-1.47). The remaining disorders showed no significant sex differences in association with ADHD.
This study indicates that the association between ADHD and several comorbid disorders is stronger in female than in male individuals. These important findings add to the literature on sex differences in ADHD and suggest that female individuals diagnosed with ADHD are a more vulnerable group of patients.</abstract><cop>United States</cop><pub>Elsevier BV</pub><pmid>30768399</pmid><doi>10.1016/j.jaac.2018.07.910</doi><oa>free_for_read</oa></addata></record> |
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| source | Applied Social Sciences Index & Abstracts (ASSIA); Elsevier ScienceDirect Journals Complete; SWEPUB Freely available online |
| subjects | ADHD Attention deficit hyperactivity disorder Autism Autism Spectrum Disorders Autistic children Child & adolescent psychiatry comorbid disorders Comorbidity Conduct disorder Females Gender differences Hyperactivity Learning disabilities Males Mental disorders Oppositional defiant disorder Personality disorders Personality Problems Population studies Psychiatry Risk assessment Risk factors Schizophrenia Sex differences Socioeconomic status Substance use disorder Suicide |
| title | Sex Differences in Comorbidity Patterns of Attention-Deficit/Hyperactivity Disorder |
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