Sex differences in anxiety and depression in children with attention deficit hyperactivity disorder: Investigating genetic liability and comorbidity

Joanna Martin*, Sharifah Shameem Agha, Olga Eyre, Lucy Riglin, Kate Langley, Leon Hubbard, Evie Stergiakouli, Michael O'Donovan, Anita Thapar, Ole A. Andreassen, Aurina Arnatkeviciute, Tobias Banaschewski, Mark Bellgrove, Anders Borglum, Jan Buitelaar, Christie Burton, Alice Charach, Elizabeth Corfield, Bru Cormand, Jennifer CrosbieDitte Demontis, Steve V. Faraone, Barbara Franke, Ian Gizer, Eugenio H. Grevet, Jan Haavik, Hakon Hakonarson, Catharina Hartman, Alexandra Havdahl, Ziarih Hawi, Johannes Hebebrand, Anke Hinney, Ridha Joober, Richard Karlsson Linnér, Marieke Klein, Jonna Kuntsi, Henrik Larsson, Klaus P. Lesch, Patrick W.L. Leung, Calwing Liao, Sandra Loo, Sarah Medland, Alexandra Philipsen, Josep A. Ramos-Quiroga, Ted Reichborn-Kjennerud, Andreas Reif, Marta Ribases, Giovanni Salum, Russell Schachar, Sarojini M. Sengupta, Psychiatric Genomics Consortium ADHD Working Group

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

It is unknown why attention deficit hyperactivity disorder (ADHD) is more common in males, whereas anxiety and depression show a female population excess. We tested the hypothesis that anxiety and depression risk alleles manifest as ADHD in males. We also tested whether anxiety and depression in children with ADHD show a different etiology to typical anxiety and depression and whether this differs by sex. The primary clinical ADHD sample consisted of 885 (14% female) children. Psychiatric symptoms were assessed using standardized interviews. Polygenic risk scores (PRS) were derived using large genetic studies. Replication samples included independent clinical ADHD samples (N = 3,794; 25.7% female) and broadly defined population ADHD samples (N = 995; 33.4% female). We did not identify sex differences in anxiety or depression PRS in children with ADHD. In the primary sample, anxiety PRS were associated with social and generalized anxiety in males, with evidence of a sex-by-PRS interaction for social anxiety. These results did not replicate in the broadly defined ADHD sample. Depression PRS were not associated with comorbid depression symptoms. The results suggest that anxiety and depression genetic risks are not more likely to lead to ADHD in males. Also, the evidence for shared etiology between anxiety symptoms in those with ADHD and typical anxiety was weak and needs replication.
Original languageEnglish
Pages (from-to)412-422
Number of pages11
JournalAmerican Journal of Medical Genetics Part B-neuropsychiatric Genetics
Volume186
Issue number7
DOIs
Publication statusPublished - 1 Oct 2021

Keywords

  • ADHD
  • ALSPAC
  • anxiety disorders
  • depression
  • polygenic risk scores
  • sex differences

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