In youth, ADHD is more commonly diagnosed in males than females, but higher male-to-female ratios are found in clinical versus population-based samples, suggesting a sex bias in the process of ...receiving a clinical diagnosis of ADHD. This study investigated sex differences in the severity and presentation of ADHD symptoms, conduct problems, and learning problems in males and females with and without clinically diagnosed ADHD. We then investigated whether the predictive associations of these symptom domains on being diagnosed and treated for ADHD differed in males and females. Parents of 19,804 twins (50.64% male) from the Swedish population completed dimensional assessments of ADHD symptoms and co-occurring traits (conduct and learning problems) when children were aged 9 years. Children from this population sample were linked to Patient Register data on clinical ADHD diagnosis and medication prescriptions. At the population level, males had higher scores for all symptom domains (inattention, hyperactivity/impulsivity, conduct, and learning problems) compared to females, but similar severity was seen in clinically diagnosed males and females. Symptom severity for all domains increased the likelihood of receiving an ADHD diagnosis in both males and females. Prediction analyses revealed significant sex-by-symptom interactions on diagnostic and treatment status for hyperactivity/impulsivity and conduct problems. In females, these behaviours were stronger predictors of clinical diagnosis (hyperactivity/impulsivity: OR 1.08, 95% CI 1.01, 1.15; conduct: OR 1.43, 95% CI 1.09, 1.87), and prescription of pharmacological treatment (hyperactivity/impulsivity: OR 1.24, 95% CI 1.02, 1.50; conduct: OR 2.20, 95% CI 1.05, 4.63). Females with ADHD may be more easily missed in the ADHD diagnostic process and less likely to be prescribed medication unless they have prominent externalising problems.
IMPORTANCE: The frequency with which autism spectrum disorders (ASDs) are diagnosed has shown a marked increase in recent years. One suggestion is that this is partly because of secular changes in ...the environment, yet to our knowledge this hypothesis lacks evidence. OBJECTIVE: To assess whether the relative importance of genetic and environmental associations with ASD and autistic traits has changed over a 16-year and 26-year period. DESIGN, SETTING, AND PARTICIPANTS: A twin design was used to assess whether the heritability of ASD and autistic traits has changed over time. Data from 2 nationwide Swedish twin cohorts was used: the Swedish Twin Registry (STR; participants born between January 1982 and December 2008) and the Child and Adolescent Twin Study in Sweden (CATSS; participants born between January 1992 and December 2008). Autism spectrum disorder diagnoses were identified for twins in the STR, with follow-up to 2013. Questionnaires assigned screening diagnoses of ASD to CATSS participants and assessed autistic traits. Analyses were performed from September 1, 2018, to March 31, 2019. EXPOSURES: Each sample was divided into several birth cohorts covering 1982 to 1991 (for the STR only), 1992-1995, 1996-1999, 2000-2003, and 2004-2008. OUTCOMES: We assessed whether the genetric and environment variance underlying autistic traits changed across birth cohorts and examined whether the relative contribution of genetics and environment to liability for autism changed across birth cohorts. RESULTS: Data were available for 22 678 twin pairs (5922 female same-sex pairs 26.1%, 5563 male same-sex pairs 24.5%, and 11193 opposite-sex pairs 49.4%) in the STR and 15 280 pairs (4880 female same-sex pairs 31.9%, 5092 male same-sex pairs 33.3%, and 5308 opposite-sex pairs 34.7%) in CATSS. The heritability of ASD diagnoses in the STR ranged from 0.88 (95% CI, 0.74-0.96) to 0.97 (95% CI, 0.89-0.99). The heritability of screening diagnoses in CATSS varied from 0.75 (95% CI, 0.58-0.87) to 0.93 (95% CI, 0.84-0.98). Autistic traits showed a modest variance increase over time that was associated with increases in genetic and environmental variance, with the total variance increasing from 0.95 (95% CI, 0.92-0.98) to 1.17 (95% CI, 1.13-1.21) over time. CONCLUSIONS AND RELEVANCE: Weak evidence was found for changes in the genetic and environmental factors underlying ASD and autistic traits over time. Genetic factors played a consistently larger role than environmental factors. Environmental factors are thus unlikely to explain the increase in the prevalence of ASD.
The Advanced Land Observing Satellite (ALOS) is Japan's new-generation Earth Observation satellite, launched in January 2006 by the Japan Aerospace Exploration Agency. ALOS carries two optical ...instruments (Panchromatic Remote-sensing Instrument for Stereo Mapping and Advanced Visible and Near-Infrared Radiometer type 2) and, to maintain Japan's commitment to spaceborne L-band Synthetic Aperture Radar (SAR), the Phased Array L-band SAR (PALSAR). The successor to the SAR onboard the Japanese Earth Resources Satellite (1992-1998), the PALSAR instrument provides enhanced sensor characteristics, including full polarimetry, variable off-nadir viewing, and ScanSAR operations, as well as significantly improved radiometric and geometric performance. As important as the technical improvements and the reason PALSAR here is referred to as a pathfinder mission for global environmental monitoring is the systematic data-acquisition strategy which has been implemented for ALOS. With a priority second only to emergency observations, the PALSAR observation strategy has been designed to provide consistent, wall-to-wall observations at fine resolution of all land areas on the Earth on a repetitive basis, in a manner which has earlier been conceived only for coarse- and medium-resolution instruments.
With the launch of the Advanced Land Observing Satellite (ALOS) in 2006, the Japanese Space Agency (JAXA) took the initiative to implement the first global-scale systematic acquisition strategy for ...satellite sensors at fine and medium (2.5–20m) spatial resolution. Comprising all three sensors on ALOS (PALSAR, PRISM, AVNIR-2), the plan was designed to serve all ALOS user categories and aimed at producing spatially and temporally consistent baseline coverages over the planet on a repetitive basis, to accommodate systematic global-scale, fine-resolution, monitoring of the environment. Unlike the common background missions defined for most fine-resolution Earth Observation satellites, the observation strategy was implemented as a top-level foreground mission with a priority second only to that of special observation requests and emergency observations and sensor calibration.
While the ALOS mission regrettably ended in April 2011, the global acquisition strategy nevertheless produced a comprehensive and homogeneous global archive in which consistent time-series of data are available for any arbitrary land area on Earth (excluding Antarctica >77.5° South latitude, which could not be reached by the sensors). Clouds and haze inevitably constituted limitations for the optical sensors, while for the PALSAR instrument, two cloud-free and near-gap free (~95%) global coverages were achieved annually during the 4.5years in operations. Previously, such uniform data archives existed only for coarse-resolution sensors such as AVHRR, MERIS and MODIS. The ALOS BOS supported a variety applications from local to global scales, ranging from structural deformation, monitoring of wetlands regional inundation patterns and mapping of forest extent and changes over nations and continents at spatial resolutions as fine as 10m.
The Advanced Land Observing Satellite 2 (ALOS-2) was launched on May 24, 2014. Equipped with an enhanced L-band SAR sensor (PALSAR-2), ALOS-2 resumes the global wall-to-wall acquisitions to assure continuity and consistency with JAXA’s global mission objectives and unique L-band SAR archive created by ALOS PALSAR.
•First global acquisition strategy implemented for a mid-resolution SAR mission•Continental wall-to-wall observation planning prevents fragmented data archives•75-80% average acquisition success rate achieved for the ALOS mission•Follow-on mission (ALOS-2) will also feature systematic acquisition strategy•Global strategic planning now accepted approach for many near-future missions
Attention-deficit/hyperactivity disorder (ADHD) is an increasingly commonly diagnosed neurodevelopmental condition. One possibility is that this reflects a genuine increase in the prevalence of ADHD ...due to secular environmental changes, yet this hypothesis remains untested. We therefore investigated whether the genetic and environmental variance underlying ADHD, and traits of ADHD, has changed over time.
We identified twins born from 1982 to 2008 from the Swedish Twin Registry (STR). We linked the STR with the Swedish National Patient Register and Prescribed Drug Register to identify diagnoses of ADHD and prescriptions of ADHD medication for these twins. We also utilized data collected from participants in the Child and Adolescent Twin Study in Sweden (CATSS), born from 1992 to 2008. Their parents completed a structured ADHD screening tool, which was used to measure traits of ADHD and assign broad screening diagnoses of ADHD. We used the classical twin design to test whether the degree to which variation in these measures was influenced by genetic and environmental variation changed over time.
We included 22,678 twin pairs from the STR and 15,036 pairs from CATSS. The heritability of ADHD in the STR ranged from 66% to 86% over time, although these fluctuations were not statistically significant. We observed a modest increase in variance in ADHD traits, from 0.98 to 1.09. This was driven by small increases in the underlying genetic and environmental variance, with heritability estimated as 64%-65%. No statistically significant changes in variance in screening diagnoses were observed.
The relative contribution of genetic and environmental factors to ADHD has remained stable over time, despite its increasing prevalence. Thus, changes in the underlying etiology of ADHD over time are unlikely to explain the increase in ADHD diagnoses.
Psychiatric disorders are common among autistic children and adults. Little is known about sex differences in psychiatric disorders and hospitalization in early adulthood.
To examine sex differences ...in psychiatric diagnoses and hospitalizations in autistic compared with nonautistic young adults.
This population-based cohort study assessed all individuals born in Sweden between 1985 and 1997. A total of 1 335 753 individuals, including 20 841 autistic individuals (7129 34.2% female individuals), were followed up from age 16 through 24 years between 2001 and 2013. Analysis took place between June 2021 and August 2022.
Autism was defined as having received at least 1 clinical diagnosis of autism based on the International Classification of Diseases.
The cumulative incidence of 11 psychiatric diagnoses up until age 25 years was estimated, and birth year-standardized risk difference was used to compare autistic female and male individuals directly. Sex-specific birth year-adjusted hazard ratios (HRs) with 95% CIs were calculated using Cox regression. Analyses were repeated for inpatient diagnoses to assess psychiatric hospitalization.
Of 1 335 753 individuals included in this study, 650 314 (48.7%) were assigned female at birth. Autism was clinically diagnosed in 20 841 individuals (1.6%; 7129 34.2% female) with a mean (SD) age of 16.1 (5.1) years (17.0 4.8 years in female individuals and 15.7 5.2 years in male individuals) for the first recorded autism diagnosis. For most disorders, autistic female individuals were at higher risk for psychiatric diagnoses and hospitalizations. By age 25 years, 77 of 100 autistic female individuals and 62 of 100 autistic male individuals received at least 1 psychiatric diagnosis. Statistically significant standardized risk differences were observed between autistic female and male individuals for any psychiatric disorder (-0.18; 95% CI, -0.26 to -0.10) and specifically for anxiety, depressive, and sleep disorders. Risk differences were larger among autistic than nonautistic individuals. Compared with nonautistic same-sex individuals, autistic female individuals (HR range 95% CI, 3.17 2.50-4.04.-20.78 18.48-23.37) and male individuals (HR range 95% CI, 2.98 2.75-3.23-18.52 17.07-20.08) were both at increased risk for all psychiatric diagnoses. Any psychiatric hospitalization was statistically significantly more common in autistic female individuals (32 of 100) compared with autistic male individuals (19 of 100). However, both autistic female and male individuals had a higher relative risk for psychiatric hospitalization compared with nonautistic female and male individuals for all disorders (female individuals: HR range 95% CI, 5.55 4.63-6.66-26.30 21.50-32.16; male individuals: HR range 95% CI, 3.79 3.22-4.45-29.36 24.04-35.87).
These findings highlight the need for profound mental health services among autistic young adults. Autistic female individuals, who experience more psychiatric difficulties at different levels of care, require increased clinical surveillance and support.
How obesity and elevated androgen levels in women with polycystic ovary syndrome (PCOS) affect their offspring is unclear. In a Swedish nationwide register-based cohort and a clinical case-control ...study from Chile, we found that daughters of mothers with PCOS were more likely to be diagnosed with PCOS. Furthermore, female mice (F
) with PCOS-like traits induced by late-gestation injection of dihydrotestosterone, with and without obesity, produced female F
-F
offspring with PCOS-like reproductive and metabolic phenotypes. Sequencing of single metaphase II oocytes from F
-F
offspring revealed common and unique altered gene expression across all generations. Notably, four genes were also differentially expressed in serum samples from daughters in the case-control study and unrelated women with PCOS. Our findings provide evidence of transgenerational effects in female offspring of mothers with PCOS and identify possible candidate genes for the prediction of a PCOS phenotype in future generations.
Attention-deficit/hyperactivity disorder (ADHD) has been associated with an increased risk of tobacco smoking, and more difficulties with smoking cessation compared to non-ADHD individuals. Women ...with ADHD may therefore show elevated rates of smoking during pregnancy. To examine the association between ADHD and smoking habits among pregnant women in Sweden and Norway. Women pregnant for the first time were identified in Sweden (n = 622,037), and Norway (n = 293,383), of which 1.2% (n = 7,444), and 1.7% (n = 4,951) were defined as having ADHD, respectively. Data on smoking habits were collected early and late in pregnancy. In Sweden, ADHD was associated with an increased risk of smoking early in pregnancy, adjusted risk ratio (adjRR) 2.69 (95% confidence interval, 2.58-2.81), and late in pregnancy, adjRR 2.95 (2.80-3.10). Similar findings were observed in the Norwegian data, early in pregnancy, adjRR 2.31 (2.21-2.40), and late in pregnancy, adjRR 2.56 (2.42-2.70). Women with ADHD were more likely to continue smoking during pregnancy, compared to women without ADHD, both in Sweden adjRR 1.13 (1.10-1.17), and in Norway, adjRR 1.16 (1.12-1.20). Having a sibling diagnosed with ADHD was associated with an increased risk of smoking early and late in pregnancy, in both Sweden and Norway. Women with ADHD are considerably more likely to smoke early and late in (their first) pregnancy and are less likely to stop smoking between the two time points. Smoking, early and late in pregnancy, co-aggregates in families with ADHD. Smoking prevention and intervention programs should be targeted towards women with ADHD, specifically during their childbearing years, to ensure better mother and child outcomes.
Celotno besedilo
Dostopno za:
DOBA, IZUM, KILJ, NUK, PILJ, PNG, SAZU, SIK, UILJ, UKNU, UL, UM, UPUK
If and how obesity and elevated androgens in women with polycystic ovary syndrome (PCOS) affect their offspring's psychiatric health is unclear. Using data from Swedish population health registers, ...we showed that daughters of mothers with PCOS have a 78% increased risk of being diagnosed with anxiety disorders. We next generated a PCOS-like mouse (F
) model induced by androgen exposure during late gestation, with or without diet-induced maternal obesity, and showed that the first generation (F
) female offspring develop anxiety-like behavior, which is transgenerationally transmitted through the female germline into the third generation of female offspring (F
) in the androgenized lineage. In contrast, following the male germline, F
male offspring (mF
) displayed anxiety-like behavior in the androgenized and the obese lineages. Using a targeted approach to search for molecular targets within the amygdala, we identified five differentially expressed genes involved in anxiety-like behavior in F
females in the androgenized lineage and eight genes in the obese lineage. In mF
male offspring, three genes were dysregulated in the obese lineage but none in the androgenized lineage. Finally, we performed in vitro fertilization (IVF) using a PCOS mouse model of continuous androgen exposure. We showed that the IVF generated F
and F
offspring in the female germline did not develop anxiety-like behavior, while the F
male offspring (mF
) in the male germline did. Our findings provide evidence that elevated maternal androgens in PCOS and maternal obesity may underlie the risk of a transgenerational transmission of anxiety disorders in children of women with PCOS.
Cumulative exposure to psychosocial adversity at an early age has been shown to be a risk factor for attention-deficit hyperactivity disorder (ADHD) and autism that often co-occur. However, it is not ...clear if this association reflects a causal effect or familial confounding. We aimed to assess whether cumulative psychosocial adversity in the family increases the risk for ADHD and autism in offspring while accounting for unmeasured familial confounding. We used a population-based cohort of 1,877,901 individuals born in Sweden between 1990 and 2009. Participants were followed from the age of 3 until 2013, with a median follow up time of 13.8 years. We created a cumulative index based on 7 psychosocial adversity factors. We used Cox regression to estimate the hazard ratios (HRs) relating neurodevelopmental conditions to cumulative psychosocial adversity. To address familial confounding, the analyses were repeated in groups of relatives of different kinship: siblings and half-siblings and cousins. A dose-response relationship was observed between cumulative exposure to psychosocial adversity and ADHD at a general population level (covariate adjusted HRs (aHRs) with 95% confidence intervals ranged from 1.55 one adversity; 1.53-1.58 to 2.65 ≥ 4 adversities; 1.98-3.54). No clear dose-response relation was seen for autism (aHRs ranged from 1.04 .59-1.84 to 1.37 1.30-1.45). HRs of ADHD and autism decreased with increasing level of kinship in the analysis of relatives. Cumulative exposure to psychosocial adversity was associated with both ADHD and autism in the general population, these associations were partly explained by unmeasured familial confounding between relatives. This highlights the need for using family-based designs in studies of psychosocial adversity and ADHD and autism.
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