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- Li, Lin, 1989-
(författare)
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Somatic and occupational outcomes in adult ADHD : epidemiology studies based on real-world data
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Attention-deficit/hyperactivity disorder (ADHD) is one of the most common neurodevelopmental disorders, characterized by inattention or hyperactivity–impulsivity, or both. ADHD is a multifactorial disorder influenced by the complex interplay between genetic and environmental risk factors, but a detailed understanding of the causal status of these factors is lacking. ADHD is associated with many psychiatric disorders, but somatic comorbidity in ADHD has received less attention in the research literature. Pharmacological treatment is effective in reducing the core symptoms of ADHD, but the effects on occupational outcomes remain unclear. The overarching aim of this thesis is to extend previous knowledge on the early risk factors of ADHD, and to increase the awareness and the understanding on somatic and occupational outcomes of ADHD in adults.In Study I, we combined a systematic review and mate-analysis with a population based cohort of 971,501 individuals born between 1992 and 2004 in Sweden. The meta-analysis revealed a positive association between maternal pre-pregnancy overweight/obesity and risk of ADHD in offspring. However, these associations gradually attenuated toward the null when adjusted for measured confounders,unmeasured factors shared by cousins and unmeasured factors shared by siblings. In Study II, by using a Swedish population-based twin study with 17,999 individuals aged 20–47 years, we found both inattention and hyperactivity/impulsivity was associated with higher consumption of high-sugar food and unhealthy dietary habits, although these associations were generally weak. Further, the observed associations was explained by both genetic and non-shared environmental factors.In Study III, we explored the prospective associations between ADHD and a broad range of cardiovascular diseases in 5,389,519 adults from Sweden, and found that ADHD may be a novel and independent risk factor for cardiovascular diseases. In Study IV, based on the longitudinal cohort of 12,875 middle-aged adults with ADHD, we found the use of ADHD medications during the previous two years was associated with a 10% reduction in the risk of long-term unemployment in the following year.Taken together, findings from the thesis highlight the need of future studies with various study designs, to fully understand the aetiology and long-term health outcomes of ADHD across the lifespan.
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| 2. |
- Oskarsson, Sofi, 1989-
(författare)
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Biological risk factors for crime : Adverse perinatal events and psychophysiology
- 2022
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Doktorsavhandling (övrigt vetenskapligt/konstnärligt)abstract
- Biological risk factors for crime have been largely neglected within main-stream criminology. However, a large body of research has over the past few decades converged on the conclusion that it is important to consider biological risk factors for crime, as they may help to inform theory and etiology. We are gaining more knowledge about the biological underpinnings of crime in a rapidly evolving research field, but many questions remain to be answered.The overarching goal with the present dissertation was to expand the knowledge about biological risk factors, including adverse perinatal events and psychophysiology, for crime. Specifically, Study I aimed to examine the associations between adverse perinatal events and offspring crime in men and women respectively. Study II aimed to examine associations for resting heart rate and systolic blood pressure with reoffending in men. Study III aimed to examine associations for resting heart rate with crime in women. Lastly, Study IV aimed to synthesize existing evidence on the relationship between psychopathic personality and aversive startle potentiation. These aims were pursued through three studies utilizing Swedish population-based registers (Study I, Study II, and Study III), as well as one systematic review (Study IV).Taken together, the overall findings of the present dissertation suggest that biological risk factors are important for crime in various ways. Biological risk factors represent an important step forward to broaden our understanding of crime and may have the potential to inform theory and etiology as well as to ultimately improve prediction, prevention, and intervention strategies.
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| 3. |
- Fine, Kimberly L., et al.
(författare)
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Initiation of Opioid Prescription and Risk of Suicidal Behavior Among Youth and Young Adults
- 2022
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Ingår i: Pediatrics. - : American Academy of Pediatrics. - 0031-4005 .- 1098-4275. ; 149:3
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND AND OBJECTIVES: Opioids are involved in an increasing proportion of suicide deaths. This study examined the association between opioid analgesic prescription initiation and suicidal behavior among young people.METHODS: We analyzed Swedish population-register data on 1 895 984 individuals ages 9 to 29 years without prior recorded opioid prescriptions. We identified prescriptions dispensed from January 2007 onward and diagnosed self-injurious behavior and death by suicide through December 2013. We first compared initiators with demographically matched noninitiators. To account for confounding, we applied an active comparator design, which examined suicidal behavior among opioid initiators relative to prescription nonsteroidal antiinflammatory drug (NSAID) initiators while inverse-probability-of-treatment weighting with individual and familial covariates.RESULTS: Among the cohort, 201 433 individuals initiated opioid prescription. Relative to demographically matched noninitiators, initiators (N = 180 808) had more than doubled risk of incident suicidal behavior (hazard ratio = 2.64; 95% confidence interval [CI], 2.47-2.81). However, in the active comparator design, opioid initiators (N = 86 635) had only 19% relatively greater risk of suicidal behavior compared with NSAID initiators (N = 255 096; hazard ratio = 1.19; 95% CI,: 1.11-1.28), corresponding to a weighted 5-year cumulative incidence of 2.2% (95% CI, 2.1-2.4) for opioid and 1.9% (95% CI, 1.9-2.0) for NSAID initiators. Most sensitivity analyses produced comparable results.CONCLUSIONS: Opioid initiation may make only a small contribution to the elevated risk of suicidal behavior among young people receiving pharmacologic pain management. In weighing benefits and harms of opioid initiation, our results suggest that increased risk of suicidal behavior may not be a major concern.
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