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Associations Between Attention-Deficit/Hyperactivity Disorder and Various Eating Disorders: A Swedish Nationwide Population Study Using Multiple Genetically Informative Approaches.

Shuyang Yao,Ralf Kuja-Halkola,Joanna Martin,Yi Lu,Paul Lichtenstein,Claes Norring,Andreas Birgegard,Zeynep Yilmaz,Christopher Hubel,Hunna Watson,Jessica Baker,Catarina Almqvist,Laura M. Thornton,Patrik K. Magnusson,Cynthia M. Bulik,Henrik Larsson,Roger Adan,Tetsuya Ando,Andrew Bergen, Wade Berrettini,Claudette Boni,Vesna Boraska Perica,Harry Brandt,Roland Burghardt,Matteo Cassina, Carolyn Cesta, Maurizio Clementi, Joni Coleman,Roger Cone,Philippe Courtet,Steven Crawford,Scott Crow,James Crowley,Unna Danner,Oliver Davis, Martina de Zwaan,George Dedoussis,Daniela Degortes,Janiece DeSocio, Danielle Dick,Dimitris Dikeos,Monika Dmitrzak-Weglarz,Elisa Docampo,Karin Egberts,Stefan Ehrlich,Georgia Escaramis,Tonu Esko,Xavier Estivill,Angela Favaro,Fernando Fernandez-Aranda,Manfred Fichter,Chris Finan,Krista Fischer,Manuel Focker,Lenka Foretova,Monica Forzan,Christopher Franklin,Helena Gaspar,Fragiskos Gonidakis,Philip Gorwood,Monica Gratacos,Sebastien Guillaume,Yiran Guo, Hakon Hakonarson,Katherine Halmi,Konstantinos Hatzikotoulas,Joanna Hauser,Johannes Hebebrand,Sietske Helder,Judith Hendriks,Beate Herpertz-Dahlmann,Wolfgang Herzog, Christopher Hilliard,Anke Hinney,Laura Huckins, James Hudson,Julia Huemer,Hartmut Imgart,Hidetoshi Inoko, Susana Jimenez-Murcia,Craig Johnson,Jenny Jordan,Anders Jureus,Gursharan Kalsi, Debora Kaminska,Allan Kaplan, Jaakko Kaprio,Leila Karhunen,Andreas Karwautz,Martien Kas, Walter Kaye, James Kennedy,Martin Kennedy,Anna Keski-Rahkonen,Kirsty Kiezebrink,Youl-Ri Kim,Kelly Klump,Gun Peggy Knudsen,Bobby Koeleman,Doris Koubek,Maria La Via, Mikael Landen,Robert Levitan, Dong Li,Lisa Lilenfeld, Jolanta Lissowska,Pierre Magistretti,Mario Maj,Katrin Mannik, Nicholas Martin,Sara McDevitt,Peter McGuffin,Elisabeth Merl,Andres Metspalu,Ingrid Meulenbelt,Nadia Micali,James Mitchell,Karen Mitchell,Palmiero Monteleone,Alessio Maria Monteleone,Preben Mortensen,Melissa Munn-Chernoff,Benedetta Nacmias, Ida Nilsson,Ioanna Ntalla,Julie O'Toole,Jacques Pantel,Hana Papezova, Richard Parker,Raquel Rabionet,Anu Raevuori,Andrzej Rajewski,Nicolas Ramoz,N. William Rayner,Ted Reichborn-Kjennerud,Valdo Ricca,Stephan Ripke,Franziska Ritschel,Marion Roberts,Alessandro Rotondo,Filip Rybakowski, Paolo Santonastaso, Ulrike Schmidt,Nicholas Schork,Alexandra Schosser,Jochen Seitz,Lenka Slachtova, P. Eline Slagboom,Margarita Slof-Op't Landt, Agnieszka Slopien,Tosha Smith,Sandro Sorbi, Eric Strengman,Michael Strober, Patrick Sullivan,Jin Szatkiewicz, Neonila Szeszenia-Dabrowska,Ioanna Tachmazidou,Elena Tenconi,Laura Thornton, Alfonso Tortorella,Federica Tozzi, Janet Treasure,Artemis Tsitsika,Konstantinos Tziouvas,Annemarie van Elburg,Eric van Furth,Tracey Wade,Gudrun Wagner,Esther Walton, D. Blake Woodside, Elefthena Zeggini,Stephanie Zerwas,Stephan Zipfel,Lars Alfredsson,Ole Andreassen,Harald Aschauer,Jeffrey Barrett, Vladimir Bencko,Laura Carlberg,Sven Cichon,Sarah Cohen-Woods,Christian Dina, Bo Ding,Thomas Espeseth,James Floyd,Steven Gallinger, Giovanni Gambaro,Ina Giegling,Stefan Herms,Vladimir Janout,Antonio Julia,Lars Klareskog,Stephanie Le Hellard,Marion Leboyer, Asti Lundervold,Sara Marsal,Morten Mattingsdal,Marie Navratilova,Roel Ophoff, Aamo Palotie,Dalila Pinto, Samuli Ripatti,Dan Rujescu, Stephen Scherer, Laura Scott, Robert Sladek, Nicole Soranzo,Lorraine Southam,Vidar Steen,H-Erich Wichmann, Elisabeth Widen,Gerome Breen,Cynthia Bulik

Biological psychiatry(2019)

Cited 35|Views46
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Abstract
BACKGROUND: Although attention-deficit/hyperactivity disorder (ADHD) and eating disorders (EDs) frequently cooccur, little is known about the shared etiology. In this study, we comprehensively investigated the genetic association between ADHD and various EDs, including anorexia nervosa (AN) and other EDs such as bulimia nervosa. METHODS: We applied different genetically informative designs to register-based information of a Swedish nationwide population (N = 3,550,118). We first examined the familial coaggregation of clinically diagnosed ADHD and EDs across multiple types of relatives. We then applied quantitative genetic modeling in full-sisters and maternal half-sisters to estimate the genetic correlations between ADHD and EDs. We further tested the associations between ADHD polygenic risk scores and ED symptoms, and between AN polygenic risk scores and ADHD symptoms, in a genotyped population-based sample (N = 13,472). RESULTS: Increased risk of all types of EDs was found in individuals with ADHD (any ED: odds ratio [OR] = 3.97, 95% confidence interval [CI] = 3.81, 4.14; AN: OR = 2.68, 95% CI = 2.15, 2.86; other EDs: OR = 4.66, 95% CI = 4.47, 4.87; bulimia nervosa: OR = 5.01, 95% CI = 4.63, 5.41) and their relatives compared with individuals without ADHD and their relatives. The magnitude of the associations decreased as the degree of relatedness decreased, suggesting shared familial liability between ADHD and EDs. Quantitative genetic models revealed stronger genetic correlation of ADHD with other EDs (.37, 95% CI = .31, .42) than with AN (.14, 95% CI = .05, .22). ADHD polygenic risk scores correlated positively with ED symptom measures overall and with the subscales Drive for Thinness and Body Dissatisfaction despite small effect sizes. CONCLUSIONS: We observed stronger genetic association with ADHD for non-AN EDs than for AN, highlighting specific genetic correlation beyond a general genetic factor across psychiatric disorders.
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Key words
ADHD,Anorexia nervosa,Bulimia nervosa,Eating disorders,Genetic epidemiology,Polygenic risk score
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