Department of Medical Epidemiology and Biostatistics,Karolinska Institutet,Stockholm,Sweden.
Department of Child and Adolescent Psychiatry, Psychosomatics and Psychotherapy,University Hospital Frankfurt, Goethe University,Frankfurt am Main,Germany.
Psychol Med. 2019 Jul;49(10):1713-1721. doi: 10.1017/S003329171800243X. Epub 2018 Sep 7.
BACKGROUND: Traits of attention-deficit/hyperactivity disorder (ADHD) and autism spectrum disorder (ASD) are strongly associated in children and adolescents, largely due to genetic factors. Less is known about the phenotypic and aetiological overlap between ADHD and ASD traits in adults. METHODS: We studied 6866 individuals aged 20-28 years from the Swedish Study of Young Adult Twins. Inattention (IA) and hyperactivity/impulsivity (HI) were assessed using the WHO Adult ADHD Self-Report Scale-V1.1. Repetitive and restricted behaviours (RRB) and social interaction and communication (SIC) were assessed using the Autism-Tics, ADHD, and other Comorbidities inventory. We used structural equation modelling to decompose covariance between these ADHD and ASD trait dimensions into genetic and shared/non-shared environmental components. RESULTS: At the phenotypic level, IA was similarly correlated with RRB (r = 0.33; 95% Confidence Interval (CI) 0.31-0.36) and with SIC (r = 0.32; 95% CI 0.29-0.34), whereas HI was more strongly associated with RRB (r = 0.38; 95% CI 0.35-0.40) than with SIC (r = 0.24; 95% CI 0.21-0.26). Genetic and non-shared environmental effects accounted for similar proportions of the phenotypic correlations, whereas shared environmental effects were of minimal importance. The highest genetic correlation was between HI and RRB (r = 0.56; 95% 0.46-0.65), and the lowest was between HI and SIC (r = 0.33; 95% CI 0.23-0.43). CONCLUSIONS: We found evidence for dimension-specific phenotypic and aetiological overlap between ADHD and ASD traits in adults. Future studies investigating mechanisms underlying comorbidity between ADHD and ASD may benefit from exploring several symptom-dimensions, rather than considering only broad diagnostic categories.
背景:在儿童和青少年中,注意力缺陷/多动障碍 (ADHD) 和自闭症谱系障碍 (ASD) 的特征密切相关,这主要归因于遗传因素。然而,成年人中 ADHD 和 ASD 特征在表型和病因学上的重叠情况则知之甚少。
方法:我们研究了来自瑞典青年双胞胎研究的 6866 名 20-28 岁的个体。使用世界卫生组织成人 ADHD 自评量表 V1.1 评估注意力不集中 (IA) 和多动/冲动 (HI)。使用自闭症-抽搐、ADHD 和其他共病清单评估重复和受限行为 (RRB) 和社交互动和交流 (SIC)。我们使用结构方程模型将这些 ADHD 和 ASD 特征维度之间的协方差分解为遗传和共享/非共享环境成分。
结果:在表型水平上,IA 与 RRB(r = 0.33;95%置信区间 (CI) 0.31-0.36)和 SIC(r = 0.32;95% CI 0.29-0.34)具有相似的相关性,而 HI 与 RRB(r = 0.38;95% CI 0.35-0.40)的相关性强于与 SIC(r = 0.24;95% CI 0.21-0.26)的相关性。遗传和非共享环境效应在表型相关性中占相似的比例,而共享环境效应则微不足道。HI 与 RRB 之间的遗传相关性最高 (r = 0.56;95% CI 0.46-0.65),HI 与 SIC 之间的遗传相关性最低 (r = 0.33;95% CI 0.23-0.43)。
结论:我们发现成年人中 ADHD 和 ASD 特征在表型和病因学上存在特定维度的重叠。未来研究 ADHD 和 ASD 共病的机制可能受益于探索多个症状维度,而不仅仅是考虑广泛的诊断类别。
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