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Associations between ADHD and various eating disorders: A Swedish nationwide population study using multiple genetically informative approaches

Yao, Shuyang, Kuja-Halkola, Ralf, Martin, Joanna, Lu, Yi, Litchtenstein, Paul, Norring, Claes, Birgegård, Andreas, Yilmaz, Zeynep, Hübel, Christopher, Watson, Hunna, Baker, Jessica, Almqvist, Catrina, Thornton, Laura, Magnusson, Patrik, Bulik, Cynthia and Larsson, Henrik 2019. Associations between ADHD and various eating disorders: A Swedish nationwide population study using multiple genetically informative approaches. Biological Psychiatry 10.1016/j.biopsych.2019.04.036

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Background Although attention-deficit hyperactivity/impulsivity disorder (ADHD) and eating disorders (EDs) frequently co-occur, little is known about the shared etiology. In this study we comprehensively investigated the genetic association between ADHD and various EDs, including anorexia nervosa (AN) and other EDs (OED, including bulimia nervosa [BN]). Methods We applied different genetically informative designs to register-based information of a Swedish nationwide population (N=3,550,118). We first examined the familial co-aggregation of clinically diagnosed ADHD and EDs across multiple types of relatives. We then applied quantitative genetic modeling in full-sisters and maternal half-sisters to estimate the genetic correlations between ADHD and EDs. We further tested the associations between ADHD polygenic risk scores (PRS) and ED symptoms, and between AN PRS and ADHD symptoms, in a genotyped population-based sample (N=13,472). Results Increased risk of all types of EDs was found in individuals with ADHD (any ED: OR [95% CI]=3.97 [3.81-4.14], AN: 2.68 [2.15-2.86], OED: 4.66 [4.47-4.87], BN: 5.01 [4.63-5.41]) and their relatives compared to individuals without ADHD and their relatives. The magnitude of the associations reduced as the degree of relatedness decreased, suggesting shared familial liability between ADHD and EDs. Quantitative genetic models revealed stronger genetic correlation of ADHD with OED (0.37 [0.31-0.42]) than with AN (0.14 [0.05-0.22]). ADHD PRS correlated positively with ED symptom measures overall and sub-scales “drive for thinness” and “body dissatisfaction”, despite small effect sizes. Conclusions We observed stronger genetic association with ADHD for non-AN EDs than AN, highlighting specific genetic correlation beyond a general genetic factor across psychiatric disorders.

Item Type: Article
Date Type: Published Online
Status: In Press
Schools: Medicine
MRC Centre for Neuropsychiatric Genetics and Genomics (CNGG)
Publisher: Elsevier
ISSN: 0006-3223
Funders: Wellcome Trust
Date of First Compliant Deposit: 7 May 2019
Date of Acceptance: 23 April 2019
Last Modified: 11 Sep 2019 08:13

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