Department of Psychiatry, Kaohsiung Veterans General Hospital, Kaohsiung.
Department of Psychiatry, Taipei Veterans General Hospital, Taipei.
Aust N Z J Psychiatry. 2023 Apr;57(4):583-593. doi: 10.1177/00048674221108897. Epub 2022 Jul 5.
Few studies have investigated the parental risk of major psychiatric disorders among patients with comorbid autism spectrum disorder and attention deficit hyperactivity disorder. This study examined the differences in such risk among patients with autism spectrum disorder-only, with attention deficit hyperactivity disorder-only and both conditions.
Between 2001 and 2011, we enrolled 132,624 patients with autism spectrum disorder or attention deficit hyperactivity disorder and 1:10 matched controls for age, sex and demographics from the National Health Insurance Database of Taiwan. Poisson regression models were used to examine the risk of five major psychiatric disorders in the patients' parents compared with those of the controls, including schizophrenia, bipolar disorder, major depressive disorder, alcohol use disorder, and substance use disorder. Patients were classified into the autism spectrum disorder-only, attention deficit hyperactivity disorder-only and dual-diagnosis groups.
The parents of attention deficit hyperactivity disorder-only and dual-diagnosis groups had a higher likelihood to be diagnosed with (odds ratios [95% confidence intervals]) schizophrenia (attention deficit hyperactivity disorder: 1.48 [1.39, 1.57]; dual: 1.79 [1.45, 1.20]), bipolar disorder (attention deficit hyperactivity disorder: 1.91 [1.82, 2.01]; dual: 1.81 [1.51, 2.17]), major depressive disorder (attention deficit hyperactivity disorder: 1.94 [1.89, 2.00]; dual: 1.99 [1.81, 2.20]), alcohol use disorder (attention deficit hyperactivity disorder: 1.39 [1.33, 1.45]; dual: 1.20 [1.01, 1.42]) and substance use disorder (attention deficit hyperactivity disorder: 1.66 [1.59, 1.73]; dual: 1.34 [1.13, 1.58]) than the controls. In contrast, the parents of autism spectrum disorder-only group had a higher likelihood to be diagnosed with schizophrenia (1.77 [1.46, 2.15]) and major depressive disorder (1.45 [1.32, 1.61]) and a lower likelihood to be diagnosed with alcohol use disorder (0.68 [0.55, 0.84]) than the controls.
The autism spectrum disorder-only group had a different parental incidence of major psychiatric disorders than the attention deficit hyperactivity disorder-only and dual-diagnosis groups. Our findings have implications for clinical practice and future genetic research.
鲜有研究调查伴自闭症谱系障碍和注意缺陷多动障碍患者的父母患主要精神疾病的风险。本研究旨在比较自闭症谱系障碍患者、注意缺陷多动障碍患者和同时患有这两种疾病的患者的父母患上述疾病的风险差异。
2001 年至 2011 年，我们从台湾全民健康保险数据库中纳入了 132624 例自闭症谱系障碍或注意缺陷多动障碍患者和 132624 例年龄、性别和人口统计学特征相匹配的对照。我们使用泊松回归模型比较了患者父母与对照组父母患五种主要精神疾病（精神分裂症、双相情感障碍、重度抑郁症、酒精使用障碍和物质使用障碍）的风险。患者被分为自闭症谱系障碍组、注意缺陷多动障碍组和双诊断组。
与对照组相比，注意缺陷多动障碍组和双诊断组的父母更有可能被诊断为精神分裂症（注意缺陷多动障碍：1.48[1.39，1.57]；双诊断：1.79[1.45，1.20]）、双相情感障碍（注意缺陷多动障碍：1.91[1.82，2.01]；双诊断：1.81[1.51，2.17]）、重度抑郁症（注意缺陷多动障碍：1.94[1.89，2.00]；双诊断：1.99[1.81，2.20]）、酒精使用障碍（注意缺陷多动障碍：1.39[1.33，1.45]；双诊断：1.20[1.01，1.42]）和物质使用障碍（注意缺陷多动障碍：1.66[1.59，1.73]；双诊断：1.34[1.13，1.58]）。相比之下，自闭症谱系障碍组的父母更有可能被诊断为精神分裂症（1.77[1.46，2.15]）和重度抑郁症（1.45[1.32，1.61]），而不太可能被诊断为酒精使用障碍（0.68[0.55，0.84]）。
与注意缺陷多动障碍组和双诊断组相比，自闭症谱系障碍组患者的父母患主要精神疾病的发生率存在差异。本研究结果对临床实践和未来的遗传研究具有重要意义。
