| 1. |
- Dinkler, Lisa, et al.
(författare)
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Maltreatment-associated neurodevelopmental disorders : a co-twin control analysis
- 2017
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Ingår i: Journal of Child Psychology and Psychiatry. - Stockholm : Karolinska Institutet, Dept of Medical Epidemiology and Biostatistics. - 0021-9630 .- 1469-7610.
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Childhood maltreatment (CM) is strongly associated with psychiatric disorders in childhood and adulthood. Previous findings suggest that the association between CM and psychiatric disorders is partly causal and partly due to familial confounding, but few studies have investigated the mechanisms behind the association between CM and neurodevelopmental disorders (NDDs). Our objective was to determine whether maltreated children have an elevated number of NDDs and whether CM is a risk factor for an increased NDD 'load' and increased NDD symptoms when controlling for familial effects. METHODS: We used a cross-sectional sample from a population-representative Swedish twin study, comprising 8,192 nine-year-old twins born in Sweden between 1997 and 2005. CM was defined as parent-reported exposure to emotional abuse/neglect, physical neglect, physical abuse, and/or sexual abuse. Four NDDs were measured with the Autism-Tics, AD/HD, and other comorbidities inventory. RESULTS: Maltreated children had a greater mean number of NDDs than nonmaltreated children. In a co-twin control design, CM-discordant monozygotic twins did not differ significantly for their number of NDDs, suggesting that CM is not associated with an increased load of NDDs when genetic and shared environmental factors are taken into account. However, CM was associated with a small increase in symptoms of attention-deficit/hyperactivity disorder and autism spectrum disorder in CM-discordant MZ twins, although most of the covariance of CM with NDD symptoms was explained by common genetic effects. CONCLUSIONS: Maltreated children are at higher risk of having multiple NDDs. Our findings are, however, not consistent with the notion that CM causes the increased NDD load in maltreated children. Maltreated children should receive a full neurodevelopmental assessment, and clinicians should be aware that children with multiple NDDs are at higher risk of maltreatment.
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| 2. |
- Lundström, Sebastian, et al.
(författare)
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Autism spectrum disorders and coexisting disorders in a nationwide Swedish twin study
- 2015
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Ingår i: Journal of Child Psychology and Psychiatry and Allied Disciplines. - Stockholm : Wiley. - 0021-9630 .- 1469-7610. ; 56:6, s. 702-710
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Tidskriftsartikel (refereegranskat)abstract
- Background: Evidence from twin and molecular genetic studies is accumulating that Autism Spectrum Disorder (ASD) shares substantial etiological factors with other disorders. This is mirrored in clinical practice where ASD without coexisting disorders is rare. The present study aims to examine the range of coexisting disorders in ASD in a genetically informative cohort. Methods: Parents of all Swedish 9-year-old twins born between 1992 and 2001 (n = 19,130) underwent a telephone interview designed to screen for child psychiatric disorders, including ASD. To ensure full coverage of child psychiatric disorders, data were also retrieved from population-based health registers. We investigated the coexistence of eight psychiatric disorders known to coexist with ASDs in probands and their co-twins. Results: Half of the individuals with ASDs (50.3%) had four or more coexisting disorders and only 4% did not have any concomitant disorder. The ‘healthy co-twin’ in ASD discordant monozygotic twin pairs was very often (79% of boys and 50% of girls) affected by at least one non-ASD disorder. The corresponding figures for ASD discordant dizygotic twin pairs were significantly lower (46% of males and 30% of females). Conclusions: Detailed phenotypic descriptions including symptoms of problems associated with a wide range of child psychiatric disorders may aid in unraveling the genetic architecture of ASD and should guide the development of intervention strategies addressing each problem type specifically.
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| 3. |
- Rydell, Mina, et al.
(författare)
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Has the attention deficit hyperactivity disorder phenotype become more common in children between 2004 and 2014? : Trends over 10 years from a Swedish general population sample
- 2018
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Ingår i: Journal of Child Psychology and Psychiatry. - Stockholm : Blackwell Publishing. - 0021-9630 .- 1469-7610. ; 59:8, s. 863-871
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Studies have reported increases in clinically diagnosed and treated attention deficit hyperactivity disorder (ADHD) during the last decade, but it is unclear if this reflects an increase in the underlying ADHD phenotype. We aimed to clarify if there has been an increase in the prevalence of ADHD-like traits in the general population from 2004 to 2014.METHOD: Data were collected from 9-year-old twins (19,271), participating in the population-based Child and Adolescent Twin Study in Sweden between 2004 and 2014. We assessed lifetime ADHD symptoms using the Autism-Tics, ADHD and other Comorbidities inventory. Research proxies for diagnostic-level ADHD and subthreshold ADHD were derived from this scale. We modeled the lifetime prevalence of diagnostic-level and subthreshold ADHD with logistic regression, and assessed mean ADHD scores each year with linear regression. Lifetime prevalence of clinically diagnosed ADHD was retrieved from the National Patient Register and modeled with logistic regression.RESULTS: The prevalence of diagnostic-level ADHD based on parent ratings did not differ significantly over time from 2004 to 2014 (OR 1.37; 95% CI: 0.77-2.45; p-value .233). Both subthreshold ADHD and mean ADHD scores increased significantly over time (both p-values <.001). Clinically diagnosed ADHD increased more than fivefold from 2004 to 2014 (OR 5.27, 95% CI: 1.85-14.96).CONCLUSIONS: We found no evidence of an increase in ADHD-like traits at the extreme end of the distribution from 2004 to 2014, but small increases in normal and subthreshold variations of ADHD-like traits were observed. This suggests that the increased rates of clinically diagnosed ADHD might reflect changes in diagnostic and treatment practices of ADHD, administrative changes in reporting diagnoses, greater awareness of ADHD, better access to healthcare, or current overdiagnosis, rather than an increase in the ADHD phenotype.
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| 4. |
- Lundström, Sebastian, et al.
(författare)
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Trajectories leading to autism spectrum disorders are affected by paternal age: findings from two nationally representative twin studies.
- 2010
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Ingår i: Journal of Child Psychology and Psychiatry, and Allied Disciplines. - : Wiley. - 0021-9630 .- 1469-7610. ; 51:7, s. 850-856
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Tidskriftsartikel (refereegranskat)abstract
- Background: Despite extensive efforts, the causes of autism remain unknown. Advancing paternal age has been associated with various neurodevelopmental disorders. We aim to investigate three unresolved questions: (a) What is the association between paternal age and autism spectrum disorders (ASD)?; (b) Does paternal age moderate the genetic and environmental etiological factors for ASD? (c) Does paternal age affect normal variation in autistic-like traits? Methods: Two nationally representative twin studies from Sweden (n = 11, 122, assessed at age 9 or 12) and the UK (n = 13, 524, assessed at age 9) were used. Categorical and continuous measures of ASD, autistic-like traits and autistic similarity were calculated and compared over paternal age categories. Results: Both cohorts showed a strong association between paternal age and the risk for ASD. A U-shaped risk association could be discerned since the offspring of both the youngest and oldest fathers showed an elevation in the risk for ASD. Autistic similarity increased with advancing paternal age in both monozygotic and dizygotic twins. Both cohorts showed significantly higher autistic-like traits in the offspring of the youngest and oldest fathers. Conclusions: Phenomena associated with paternal age are clearly involved in the trajectories leading to autistic-like traits and ASD. Mechanisms influencing the trajectories might differ between older and younger fathers. Molecular genetic studies are now needed in order to further understand the association between paternal age and ASD, as well as normal variation in social, language, and repetitive behaviors in the general population.
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| 5. |
- Billstedt, Eva, 1961, et al.
(författare)
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Autism in adults: symptom patterns and early childhood predictors. Use of the DISCO in a community sample followed from childhood.
- 2007
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Ingår i: Journal of Child Psychology and Psychiatry, and Allied Disciplines. - : Wiley. - 0021-9630 .- 1469-7610. ; 48:11, s. 1102-1110
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Few studies have looked at the very long-term outcome of individuals with autism who were diagnosed in childhood. METHODS: A longitudinal, prospective, community-based follow-up study of adults who had received the diagnosis of autism (classic and atypical) in childhood (n = 105) was conducted. A structured interview (the Diagnostic Interview for Social and COmmunication disorders--the DISCO) was used in order to evaluate symptoms and symptom patterns 13-22 years after original diagnosis. Childhood measures, including IQ-level at time of childhood diagnosis and communicative speech registered before age 5 years, were studied in relation to the presence of autism symptoms at follow-up. RESULTS: The classical and atypical autism groups were fairly homogeneously impaired in terms of symptoms in the social interaction category whereas other common childhood autism symptoms, including maladaptive and stereotyped behaviours, were more variable in the study group at follow-up. Odd responses to sensory stimuli were still extremely common. Speech before 5 years of age, IQ, gender, diagnosed medical disorder and onset of epilepsy before 5 years were variables that correlated to outcome on the DISCO algorithm for autistic spectrum disorders (Wing & Gould, 1979) concerning style and quality of social interaction, communication style and pattern of self-chosen activities. CONCLUSIONS: Social interaction problems were still present in the vast majority of adults with autism/atypical autism, but behavioural impairments were much more variable in adulthood. Almost all cases were reported to show persistent perceptual problems. Certain childhood measures were found to prospectively predict adult social interaction style, communication type, and pattern of self-chosen activities, which still met diagnostic criteria for autism/atypical autism in adulthood.
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| 6. |
- Gillberg, Christopher, 1950, et al.
(författare)
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Autism Under Age 3 Years: A Clinical Study of 28 Cases Referred for Autistic Symptoms in Infancy
- 1990
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Ingår i: Journal of Child Psychology and Psychiatry and Allied Disciplines. - : Wiley. - 0021-9630 .- 1469-7610. ; 31:6, s. 921-934
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Tidskriftsartikel (refereegranskat)abstract
- Twenty-eight children referred with a preliminary diagnosis of autistic disorder under age 3 yrs were extensively examined from the neuropsychiatric point of view and followed up for several months to several years. A diagnosis of autistic disorder was confirmed in 75% of the cases. A variety of associated medical conditions was identified. It was concluded that autism can be diagnosed in a substantial proportion of cases before age 3 yrs and that the neurobiological background is similar to that seen in older autistic children.
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| 7. |
- Hysing, Mari, et al.
(författare)
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Chronic physical illness and mental health in children. Results from a large-scale population study.
- 2007
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Ingår i: Journal of Child Psychology and Psychiatry, and Allied Disciplines. - : Wiley. - 0021-9630 .- 1469-7610. ; 48:8, s. 785-792
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The aim of the present study was to evaluate the sensitivity and specificity of the Strengths and Difficulties Questionnaire (SDQ) in detecting emotional and behavioural problems among children with chronic illness (CI). METHODS: Parents and teachers of a population of primary school children in Norway (n = 9430) completed a questionnaire including the SDQ, and a question about chronic illness. A total of 74% (n = 7007) of the parents participated. A sub-sample (n = 1040) was given a psychiatric diagnostic evaluation according to the Development and Well-Being Assessment (DAWBA). RESULTS: According to parent reports, 537 (8%) children had a CI. The SDQ revealed an increased risk of emotional and behavioural problems in children with CI as compared with non-CI peers, both among boys (OR = 2.10 CI 95% 1.56-2.83) and girls (OR = 2.11 CI 95% 1.49-2.99). Children with CI also showed an increased risk of psychiatric disorder as assessed by the DAWBA (OR = 1.70 CI 95% 1.04-2.85). Both the sensitivity and specificity of the SDQ in predicting a psychiatric diagnosis were high, even when only information from parents was included. CONCLUSION: Children with CI in the general population are at increased risk of behavioural and emotional problems and psychiatric disorders. Given its high sensitivity and specificity the SDQ might work well as a screening instrument for behaviour/emotional problems and psychiatric disorder in children with CI.
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| 8. |
- Posserud, Maj-Britt, et al.
(författare)
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Autistic features in a total population of 7-9-year-old children assessed by the ASSQ (Autism Spectrum Screening Questionnaire).
- 2006
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Ingår i: Journal of child psychology and psychiatry, and allied disciplines. - : Wiley. - 0021-9630 .- 1469-7610. ; 47:2, s. 167-75
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: The prevalence of autism is reported to be on the rise worldwide. Change of diagnostic criteria and a broadening of the concept of autism have been mentioned as contributing factors. Further studies of general populations are needed. The present study assessed the distribution of autistic features in a total population of children 7-9 years of age, and explored the impact of age, gender, informant, and participation bias on symptom report. METHODS: Teacher and parent forms of the Autism Spectrum Screening Questionnaire (ASSQ) were used in the "Bergen Child Study", a total population study of 9430 children aged 7-9 years. Completed teacher forms were returned for 97% and parent forms for 71% of the children. High-scorers were defined according to the ASSQ validation study by Ehlers, Gillberg, and Wing (1999). RESULTS: The distribution of ASSQ scores was found to be almost continuous. Of the children with both a teacher and a parent form, 2.1% were defined as high-scorers. Children without parent informed consent (i.e., anonymous children) obtained significantly higher teacher scores than those who had questionnaires completed by both parent and teacher. Adjusting prevalence for the anonymous children, the prevalence of high-scorers was 2.7% of the total population. Age did not affect symptom scores. Boys scored higher and parents reported more symptoms, particularly in girls. Agreement between informants was low to moderate. CONCLUSIONS: Autism symptoms are not uncommon in the general population of children. Our findings are consistent with the concept of autism as a spectrum. Non-responders had a higher load of autism symptoms than identified children, indicating that reports on the prevalence of autism in a responder group underestimate true prevalence. Large differences across informants suggested the need to gather information both from families and from schools when screening for autism spectrum disorders.
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| 9. |
- Arvidsson, Olof, et al.
(författare)
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Secular changes in the symptom level of clinically diagnosed autism.
- 2018
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Ingår i: Journal of child psychology and psychiatry, and allied disciplines. - : Wiley. - 1469-7610 .- 0021-9630. ; 59:7, s. 744-751
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Tidskriftsartikel (refereegranskat)abstract
- The prevalence of autism has been reported to have increased worldwide. A decrease over time in the number of autism symptoms required for a clinical autism diagnosis would partly help explain this increase. This study aimed to determine whether the symptom level of clinically diagnosed autism cases below age 13 had changed over time.Parents of Swedish 9-year old twins (n=28,118) participated in a telephone survey, in which symptoms and dysfunction/suffering related to neurodevelopmental disorders [including autism, but also attention-deficit/hyperactivity disorder (ADHD), Developmental Coordination Disorder (DCD), and Learning Disabilities (LD)] in their children were assessed over a 10-year period. Survey data was merged with the National Patient Register containing clinically registered autism diagnoses (n=271).In individuals who had been clinically diagnosed with autism before the age of 13, the symptom score for autism decreased on average 30% over more than a decade in birth cohorts 1992-2002. There was an average decrease of 50% in the autism symptom score from 2004 to 2014 in individuals who were diagnosed with autism at ages 7-12, but there was no decrease in those diagnosed at ages 0-6.Over time, considerably fewer autism symptoms seemed to be required for a clinical diagnosis of autism, at least for those diagnosed after the preschool years. The findings add support for the notion that the observed increase in autism diagnoses is, at least partly, the by-product of changes in clinical practice, and flag up the need for working in agreement with best practice guidelines.
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| 10. |
- Castellheim, Albert, et al.
(författare)
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The role of general anesthesia on traits of neurodevelopmental disorders in a Swedish cohort of twins.
- 2018
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Ingår i: Journal of child psychology and psychiatry, and allied disciplines. - : Wiley. - 1469-7610 .- 0021-9630. ; 59:9, s. 966-972
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Tidskriftsartikel (refereegranskat)abstract
- The role of general anesthetics as a risk factor for possible neurodevelopmental disorders (NDDs) in humans is unresolved. The investigation of the role of anesthetics in the development of postgeneral anesthesia (anesthesia onward) NDDs has proven to be complicated, partly because of the inherent confounding in clinical cohort studies, and partly by the fact that anesthetics are only one part in the complex process of anesthesia-surgery.Utilizing the Swedish databases Child and Adolescent Twins Study in Sweden (CATSS) and National Patient Register (NPR), we investigated twins discordant for anesthesia, born between 1997 and 2004 for traits of NDDs. We identified 68 twin pairs discordant for anesthesia and explored traits of Attention-Deficit/Hyperactivity Disorder (ADHD), Learning Disability (LD), and Autism Spectrum Disorder (ASD) in them while simultaneously taking congenital abnormalities and systemic disorders (CSDs) into account. We analyzed the possible effect of anesthesia on neurodevelopmental problems, and we analyzed the within-pair differences using conditional linear regression.Twins with a recorded episode of anesthesia had higher traits of NDDs than twins without; similarly twins with CSDs had higher mean scores on all traits than twins without CSDs. The within-pair analyses suggested that exposure to anesthesia was associated with higher scores of ADHD (regression coefficient 1.02 and 95% confidence intervals: 0.27-1.78) in monozygotic (MZ) twins discordant for anesthesia. This effect remained when adjusting for congenital abnormalities.Our finding that traits of ADHD were slightly associated with anesthesia in a genetically sensitive design is in need of replication and warrants further investigation. Future studies should aim to elucidate mechanisms behind this possible association (e.g. anesthetics doses, age at exposure, exposure duration).
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