Ronald Angelica, Simonoff Emily, Kuntsi Jonna, Asherson Philip, Plomin Robert
Social Genetic and Developmental Psychiatry Centre, Institute of Psychiatry, London, UK.
J Child Psychol Psychiatry. 2008 May;49(5):535-42. doi: 10.1111/j.1469-7610.2007.01857.x. Epub 2008 Jan 21.
High levels of clinical comorbidity have been reported between autistic spectrum disorders (ASD) and attention deficit hyperactivity disorder (ADHD). This study takes an individual differences approach to determine the degree of phenotypic and aetiological overlap between autistic traits and ADHD behaviours in the general population.
The Twins Early Development Study is a community sample born in England and Wales. Families with twins born in 1994-6 were invited to join; 6,771 families participated in the study when the twins were 8 years old. Parents completed the Childhood Asperger Syndrome Test and the Conners' DSM-IV subscales. Teacher data were also collected on a sub-sample. High scores on the Conners' subscales were used to identify possible ADHD cases. Potential ASD cases were interviewed using the Development and Well-Being Assessment. Multivariate structural equation model-fitting was employed, as well as DeFries Fulker extremes analysis and liability threshold model-fitting.
Significant correlations were found between autistic and ADHD traits in the general population (.54 for parent data, .51 for teacher data). In the bivariate models, all genetic correlations were >.50, indicating a moderate degree of overlap in genetic influences on autistic and ADHD traits, both throughout the general population and at the quantitative extreme. This phenotypic and genetic overlap still held when sex, IQ and conduct problems were controlled for, for both parent and teacher data. There was also substantial overlap in suspected cases (41% of children who met criteria for an ASD had suspected ADHD; 22% with suspected ADHD met criteria for an ASD).
These results suggest there are some common genetic influences operating across autistic traits and ADHD behaviours throughout normal variation and at the extreme. This is relevant for molecular genetic research, as well as for psychiatrists and psychologists, who may have assumed these two sets of behaviours are independent.
据报道,自闭症谱系障碍(ASD)与注意力缺陷多动障碍(ADHD)之间存在高度的临床共病现象。本研究采用个体差异方法来确定普通人群中自闭症特质与ADHD行为之间的表型和病因重叠程度。
双胞胎早期发展研究是一项针对在英格兰和威尔士出生的社区样本开展的研究。邀请了1994年至1996年出生的双胞胎家庭参与;当双胞胎8岁时,有6771个家庭参与了该研究。父母完成了儿童阿斯伯格综合征测试和康纳斯DSM-IV分量表。还对一个子样本收集了教师数据。康纳斯分量表上的高分被用于识别可能的ADHD病例。使用发育与幸福评估对潜在的ASD病例进行访谈。采用了多变量结构方程模型拟合,以及德弗里斯-富尔克极端分析和责任阈值模型拟合。
在普通人群中,自闭症和ADHD特质之间存在显著相关性(父母数据为0.54,教师数据为0.51)。在双变量模型中,所有遗传相关性均>.50,表明在整个普通人群以及数量极端情况下,对自闭症和ADHD特质的遗传影响存在中度重叠。对于父母和教师数据,在控制了性别、智商和行为问题后,这种表型和遗传重叠仍然存在。疑似病例中也存在大量重叠(符合ASD标准的儿童中有41%疑似患有ADHD;疑似患有ADHD的儿童中有22%符合ASD标准)。
这些结果表明,在整个正常变异和极端情况下,自闭症特质和ADHD行为存在一些共同的遗传影响。这对于分子遗传学研究以及精神科医生和心理学家而言具有重要意义,因为他们可能曾认为这两组行为是相互独立的。