Parental Psychiatric Disorders Research Articles

Association between parental psychiatric disorders and risk of offspring autism spectrum disorder: a Swedish and Finnish population-based cohort study

Roughly more than one in six adults worldwide suffer from psychiatric conditions. Sporadic studies have associated parental psychiatric disorders with autism spectrum disorder in offspring. Comprehensively examining the association between parental psychiatric disorders and offspring autism spectrum disorder is needed to guide health policies, and to inform etiologic studies. We included all children born in Sweden and Finland 1997-2016. Diagnoses were clinically ascertained from National Registers through 2017. We calculated adjusted hazard ratios (aHRs) and 95% confidence intervals (CIs) for autism spectrum disorder in offspring of fathers and mothers with psychiatric disorders, in both parents jointly and across co-occurring conditions. Among 2,505,842 children, 33,612 were diagnosed with autism spectrum disorder, of which 20% had a parent with psychiatric disorders. The risk of autism spectrum disorder was increased across all psychiatric disorders in fathers (Sweden: aHR=2.02, 95% CI=1.92-2.12; Finland: aHR=1.63, 95% CI=1.50-1.77), mothers (Sweden: aHR=2.34, 95% CI=2.24-2.43; Finland aHR=2.12, 95% CI=1.92-2.28), or both parents (Sweden: aHR=3.76, 95% CI=3.48-4.07; Finland aHR=3.61, 95% CI=3.20-4.07), compared to neither parents. Co-occurrence of parental psychiatric disorders further increased risk (e.g., Sweden: for one, two or≥three different diagnostic categories compared to no diagnosis, in fathers aHR=1.81, 2.07, 2.52; in mothers aHR=2.05, 2.63, 3.57). Psychiatric disorders in both parents conveyed the highest risk of offspring autism spectrum disorder, followed by mothers and then fathers. The risk increased with number of co-occurring disorders. All parental psychiatric disorders were associated with increased the risk of autism spectrum disorder. To reliably assess the risk of autism spectrum disorder in children, a comprehensive history incorporating the full range of parental psychiatric disorders is needed beyond solely focusing on familial autism spectrum disorder. Swedish-Research-Council-2021-0214.

An Explanatory Model to Predict Pediatric Psychosis Spectrum Based on Parent Psychiatric Profile and Children and Adolescents Comorbid Disorders as a Mediator Construct.

Objective: Psychosis is one of the most vital disorders in children and youths. The definite pathophysiology of schizophrenia and other psychotic disorders in the growth period has remained ambiguous. Therefore, the purpose of the current study was to investigate the predictive value of parental psychiatric disorders and the mediator role of comorbid disorders of children and youths. Method : The sample, consisting of 29884 individuals aged between 6 to 18 years old from the Iranian population, were selected by multistage cluster sampling during September 22, 2016 to January 3, 2018. Parents were requested to complete a survey around their potential psychiatric disorders, based on their Millon's Clinical Multiaxial Inventory-III (MCMI-III). The Semi-Structured Interview (Kiddie-SADS-Present, Lifetime Form (K-SADS-PL)) was utilized to analyze psychiatric disorders concurring to the DSM. Results: The fit indices of the model show that the research model has a good fit and the psychiatric disorders of parents directly and indirectly through comorbid disorders are effective on the psychosis symptoms of children and adolescents (RMSEA=0.06, CFI=0.89, PGFI=0.75, PNFI=0.75).The incidence of Schizotypal Personality Disorder, Anxiety, Bipolar Spectrum Disorder, PTSD, Schizophrenia Spectrum and Delusional Disorder were statistically higher in parents of psychotic children and adolescents. However, Borderline Personality Disorder was more frequent among their mothers while Alcohol Dependency and Drug Dependency were significantly more prevalent among their fathers. Conclusion: The outcomes of our study showed that there were statistically significant differences between the mean scores of each scale assessed by Millon's inventory between parents of psychotic versus non-psychotic pediatric cases. In addition, psychiatric disorders were more common among children and youths with psychosis spectrum in comparison with the general population.

Child- and parent-related determinants for out-of-home care in a nationwide population with neurodevelopmental disorders: a register-based Finnish birth cohort 1997 study.

Neurodevelopmental disorders (NDDs) are among the most common health issues in childhood and adolescence. Psychiatric disorders are known to be overrepresented among children using child welfare services and placed in out-of-home care (OHC). Child- and parent-related determinants for OHC among a national population with NDDs were evaluated utilising longitudinal register data from the national Finnish Birth Cohort 1997 (n = 58,802) from birth to 18 years (1997-2015). The cohort members with NDDs (n = 5,143, 9% of total cohort) formed our study population. Based on their history of OHC, cohort members with NDD were categorised to OHC (n = 903) and non-OHC groups (n = 4,240). Of all cohort members with NDDs, 17.6% had a history of OHC. Within NDDs, a significant excess of ADHD diagnosis was observed in the OHC group compared to the non-OHC group (49% vs. 26%). The OHC group with NDDs was significantly characterised by having comorbid psychiatric diagnosis for conduct and oppositional disorders (adj. RR 2.21), substance use disorders (adj. RR 1.61) and depression and anxiety disorders (adj. RR 1.60). Of all parent-related determinants, the most prevailing in the OHC group compared to the non-OHC group, was social assistance received by parent (88% vs. 44.5%). The longer the period (in years) for received social assistance, the greater the likelihood for OHC (adj. RRs range from 2.41 for one year to 5.24 for over 4 years). Further, significantly associating determinants for OHC were parental psychiatric disorders (adj. RR 1.42) and parental death (adj. RR 1.23). Our findings from the population-based cohort of children and adolescents with NDDs highlight the importance of screening and assessment of family situation. Also, effective prevention and treating of comorbid psychiatric disorders, especially conduct and oppositional disorders is essential.

Offspring hospitalization for substance use and changes in parental mental health in Finland

Abstract Background Prior research indicates that parental psychiatric disorders increase their offspring's risk of substance use problems. Though the association is likely bidirectional, the effects of an adult child's substance use on parental mental health remain understudied. We examined parents’ psychotropic medication use trajectories by parental sex and educational attainment following a child's alcohol- or narcotics-attributable hospitalization. Methods We identified Finnish residents, born 1979-1988, with a first hospitalization for substance use during emerging adulthood (ages 18-29, n = 12,851). Their biological mothers (n = 12,283) and/or fathers (n = 10,765) were followed for the two years before and after the hospitalization. Psychotropic medication use was measured in three-month periods centered around the time of child's hospitalization, and the probability of psychotropic medication use at each time point was assessed using generalized estimating equations logit models. Results Among mothers, the predicted prevalence of psychotropic medication use increased during the year before, peaked during the 0-3 months after hospitalization, and remained at a similarly elevated level until the end of follow-up. The prevalence among fathers increased gradually and linearly across follow-up, with minimal changes evident either directly before or after the hospitalization. Parents’ educational attainment did not modify these trajectories. Conclusions Our results highlight the importance of considering linked lives when quantifying substance use-attributable harms and underscore the need for future research examining the intergenerational spillover effects of substance use in both directions, particularly in mother-child dyads. Key messages • Adult children’s substance use has a detrimental impact on maternal mental health, irrespective of the mother’s socioeconomic position. • The study highlights the importance of considering the intergenerational spillover effects when quantifying the burden of substance use-attributable harms.

Offspring hospitalization for substance use and changes in parental mental health: A Finnish register-based study.

Prior research indicates that parental psychiatric disorders increase their offspring's risk of substance use problems. Though the association is likely bidirectional, the effects of an adult child's substance use on parental mental health remain understudied. We examined parents' psychotropic medication use trajectories by parental sex and educational attainment before and after a child's alcohol- or narcotics-attributable hospitalization. We identified Finnish residents, born 1979-1988, with a first hospitalization for substance use during emerging adulthood (ages 18-29, n=12,851). Their biological mothers (n=12,283) and/or fathers (n=10,765) were followed for the two years before and after the hospitalization. Psychotropic medication use was measured in three-month periods centered around the time of child's hospitalization, and the probability of psychotropic medication use at each time point was assessed using generalized estimating equations logit models. Among mothers, the prevalence of psychotropic medication use increased during the year before, peaked during the 0-3 months after hospitalization, and remained at a similarly elevated level until the end of follow-up. The prevalence among fathers increased gradually and linearly across follow-up, with minimal changes evident either directly before or after the hospitalization. Parents' educational attainment did not modify these trajectories. Our results highlight the importance of considering linked lives when quantifying substance use-attributable harms and underscore the need for future research examining the intergenerational spillover effects of substance use in both directions, particularly in mother-child dyads.

Suicidal Ideation Among Medical and Nursing Students.

Suicidal ideation is a major predictor of suicide attempts. The present study was conducted to compare the prevalence of suicidal ideation and its risk factors among medical and nursing students in Nepal. An online survey was carried out among a cohort of medical and nursing students of Lumbini Medical College using questions derived from General Health Questionnaire-28 and Patient Health Questionnaire-9. 153 medical and 148 nursing students participated in the study. Lifetime suicidal ideation was present in 20.6%(n=62) medical and 13.95%(n=42) nursing students. Suicidal ideation in the last one year was present in 48 medical and 36 nursing students. There were higher odds of suicidal ideation in medical students who had parental neglect, psychiatric disorder, physical and sexual abuse, substance abuse, and academic performance dissatisfaction (p<0.05), whereas the odds were higher in nursing students with psychiatric disorder, parental demands, alcohol consumption, and academic performance dissatisfaction but was not statistically significant. Thematic analysis of the responses for open-ended question for reasons for previous suicide plans or attempts among four medical and eight nursing students revealed relationship issues, history of adverse childhood experiences, academics-related circumstances, and other individual problems as suicide antecedents. Periodic motivational speeches and counselling sessions during all the semesters of professional schooling would help decrease suicidal ideation. Mental health awareness programs for medical and nursing students should be aimed at reducing mental illness-associated stigma and promoting timely professional help-seeking behavior.

Attention deficit hyperactivity and oppositional defiant disorder symptoms in adolescence and risk of substance use disorders-A general population-based birth cohort study.

Externalizing symptoms are associated with risk of future substance use disorder (SUD). Few longitudinal studies exist using general population-based samples which assess the spectrum of attention deficit hyperactivity disorder (ADHD) and oppositional defiant disorder (ODD) symptoms. We aimed to study the associations between adolescent ADHD symptoms and subsequent SUD and additionally examine whether the risk of SUD is influenced by comorbid oppositional defiant disorder (ODD) symptoms. The Northern Finland Birth Cohort 1986 was linked to nationwide health care register data for incident SUD diagnoses until age 33 years (n = 6278, 49.5% male). ADHD/ODD-case status at age 16 years was defined using parent-rated ADHD indicated by Strengths and Weaknesses of ADHD symptoms and Normal Behaviors (SWAN) questionnaire with 95% percentile cut-off. To assess the impact of ODD comorbidity on SUD risk, participants were categorized into four groups based on their ADHD/ODD case status. Cox-regression analysis with hazard ratios (HRs) and 95% confidence intervals (CIs) were used to study associations between adolescent ADHD/ODD case statuses and subsequent SUD. In all, 552 participants (8.8%) presented with ADHD case status at the age of 16 years, and 154/6278 (2.5%) were diagnosed with SUD during the follow-up. ADHD case status was associated with SUD during the follow-up (HR = 3.84, 95% CI 2.69-5.50). After adjustments for sex, family structure, and parental psychiatric disorder and early substance use the association with ADHD case status and SUD remained statistically significant (HR = 2.60, 95% CI 1.70-3.98). The risk of SUD remained elevated in individuals with ADHD case status irrespective of ODD symptoms. ADHD in adolescence was associated with incident SUD in those with and without symptoms of ODD. The association of ADHD and SUD persisted even after adjustment for a wide range of potential confounds. This emphasizes the need to identify preventative strategies for adolescents with ADHD so as to improve health outcomes.

Maternal cortisol in 3rd trimester is associated with traits of neurodevelopmental disorder in offspring. Odense Child Cohort.

BackgroundPrenatal cortisol exposure is essential for neurodevelopment. Maternal cortisol levels could be associated with offspring autism spectrum disorder (ASD) and attention deficit hyperactivity disorder (ADHD). AimTo investigate associations between maternal 3rd trimester cortisol and offspring traits of ASD and ADHD. Material and methodsMother-child pairs were included from the prospective study Odense Child Cohort. Morning serum cortisol and 24-hour urine cortisol/cortisone were collected at gestational week 27–30. Offspring ASD and ADHD traits were assessed at age three and five years using the Child Behavior Checklist. Maternal cortisol measurements and offspring ASD and ADHD traits assessment were available in (n = 1131; 52% boys) mother-child pairs at age three and (n = 717; 54% boys) at five years of age. Maternal 24-hour urine measurement was available in a subset, at offspring three years of age (n = 300) and at five years of age (n = 217). Associations between maternal cortisol (continuous and tertiles) and offspring ASD or ADHD traits were examined in regression models adjusted for offspring sex, maternal age, pre-pregnancy BMI, parity, maternal education level, parental psychiatric disorders, and maternal smoking and stratified for offspring sex. ResultsMaternal mean age ( ± SD) was 30 years ( ± 4.4) and median BMI (25%; 75% percentiles) 23.5 kg/m2 (21.3; 26.6). Higher maternal serum cortisol levels were associated with higher prevalence of offspring ASD traits at three years of age in the total study cohort and in boys after stratifying for offspring sex. In the total population, tertiles of serum cortisol showed a significant dose-response relationship to ASD traits in unadjusted and adjusted models (p-values for linear trend, p < 0.01 and p = 0.02, respectively). In offspring at five years, associations between maternal cortisol and offspring ASD traits were non-significant (all p-values > 0.2). Maternal cortisol was not associated with offspring ADHD traits (all p-values > 0.07) in offspring at three and five years. Maternal 24-hour urine cortisol, cortisone, or cortisol/cortisone ratio were not associated with offspring ASD or ADHD traits. ConclusionHigher maternal serum cortisol in 3rd trimester was associated with offspring ASD traits at three years of age in the whole study cohort and in boys, but not in girls. This association was non-significant at five years of age.

Comment on: “Associations between parental psychiatric disorders and autism spectrum disorder in the offspring”

Autism ResearchEarly View LETTER TO THE EDITOR Comment on: “Associations between parental psychiatric disorders and autism spectrum disorder in the offspring” Kuan-Jung Chen, Kuan-Jung Chen Division of Pediatric Genetics and Metabolism, Changhua Christian Children's Hospital, Changhua, Taiwan Institute of Medicine, Chung Shan Medical University, Taichung, TaiwanSearch for more papers by this authorChin-Ming Liu, Chin-Ming Liu Department of Psychiatry, Cheng Ching Hospital, Taichung, TaiwanSearch for more papers by this authorJames Cheng-Chung Wei, Corresponding Author James Cheng-Chung Wei jccwei@gmail.com Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan Department of Allergy, Immunology & Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan Correspondence James Cheng-Chung Wei, Department of Allergy, Immunology & Rheumatology, Chung Shan Medical University Hospital, No. 110, Sec. 1, Jianguo N. Rd., South District, Taichung City 40201, Taiwan. Email: jccwei@gmail.comSearch for more papers by this author Kuan-Jung Chen, Kuan-Jung Chen Division of Pediatric Genetics and Metabolism, Changhua Christian Children's Hospital, Changhua, Taiwan Institute of Medicine, Chung Shan Medical University, Taichung, TaiwanSearch for more papers by this authorChin-Ming Liu, Chin-Ming Liu Department of Psychiatry, Cheng Ching Hospital, Taichung, TaiwanSearch for more papers by this authorJames Cheng-Chung Wei, Corresponding Author James Cheng-Chung Wei jccwei@gmail.com Institute of Medicine, Chung Shan Medical University, Taichung, Taiwan Department of Allergy, Immunology & Rheumatology, Chung Shan Medical University Hospital, Taichung, Taiwan Graduate Institute of Integrated Medicine, China Medical University, Taichung, Taiwan Correspondence James Cheng-Chung Wei, Department of Allergy, Immunology & Rheumatology, Chung Shan Medical University Hospital, No. 110, Sec. 1, Jianguo N. Rd., South District, Taichung City 40201, Taiwan. Email: jccwei@gmail.comSearch for more papers by this author First published: 09 March 2023 https://doi.org/10.1002/aur.2909Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Early ViewOnline Version of Record before inclusion in an issue RelatedInformation

Early treatment response as predictor of long-term outcome in a clinical cohort of children with ADHD

This study investigates early onset of treatment response as predictor of symptomatic and functional outcome 3 years after initiation of methylphenidate (MPH) administration in a naturalistic, clinical cohort of children and adolescents with ADHD. Children were followed across an initial 12-week MPH treatment trial and after 3 years, with ratings of symptoms and impairment. Associations between a clinically significant MPH treatment response in week 3 (defined as ≥ 20% reduction in clinician-rated symptoms) and in week 12 (defined as ≥ 40% reduction), and 3-year outcome were tested in multivariate linear regression models, adjusting for sex, age, comorbidity, IQ, maternal education, parental psychiatric disorder, and baseline symptoms and function. We did not have information on treatment adherence or the nature of treatments beyond 12 weeks. 148 children, mean age 12.4 years (range 10–16 years), 77% males, participated in the follow-up. We found a significant decrease in symptom score from baseline [M = 41.9 (SD = 13.2)] to 3-year follow-up [M = 27.5 (SD = 12.7), p < 0.001, and in impairment score from baseline (M = 41.6 (SD = 19.4)] to 3-year follow-up [M = 35.6 (SD = 20.2), p = 0.005]. Treatment responses in week 3 and week 12 were significant predictors of the long-term outcome of symptoms, but not of impairment at 3-year follow-up, when adjusting for other well-known predictors. Early treatment response predicts long-term outcome over and above other well-known predictors. Clinicians should follow-up patients carefully, during the first months of treatment, and detect non-responders, since there might be a window of opportunity to alter the outcome, by changing the treatment strategy.Clinical trial registration: ClinicalTrials.gov, registration number NCT04366609, April 28, 2020 retrospectively registered.

A Link between Parental Psychopathology and Preschool Depression: Take Care of Parents to Take Care of Children.

The first aim of this outcome research was to analyze the impact of parental support treatment in a sample of depressed preschool children divided into two groups of comparison (under-reactive and over-reactive) through evolution in the Clinical Global Impression (CGI). The second aim was to analyze the correlation between the presence of parental psychopathology and the severity of children's disorders. Our clinical sample consisted of 32 preschool-age children with a final diagnosis of MDD. The children's assessment included a psychiatric assessment to establish a diagnosis of MDD, confirmed by means of a semi-structured interview, which was administered again one month after the end of parental treatment. All the parents began a six-month parent training treatment conducted by experienced child psychiatrists, whereas children were not treated. During this period, the Clinical Global Impression Scale (CGI) was filled out monthly in order to observe the evolution of the children's disorders. Post-hoc tests showed a significant difference from before the treatment to after the treatment only in the over-reactive group (p = 0.00). Regarding parental psychiatric disorders, in the over-reactive group, only 3 children had no parents with psychopathology. In the under-reactive group, no child lacked a parent with psychopathology. Parent training treatment seems to be a valid intervention to improve preschool depression, especially in over-reactive groups, and to prevent dysfunctional parental styles connected to parental psychopathology.

Risk of parental psychiatric disorders among adolescents with major depressive disorder according to response to antidepressant treatment: does the type of antidepressant matter?

The genetic load for major depressive disorder (MDD) may be higher in people who develop MDD earlier in life. This study aimed to investigate whether the parents of adolescents with MDD were more likely to have MDD, bipolar disorder (BD), schizophrenic disorder (SZ), alcohol use disorder, or substance use disorder than the parents of adolescents without MDD. We also examined whether the response to antidepressant treatment predicted the likelihood of parental psychiatric disorders. In all, 1,758 adolescents aged 12-19 years with antidepressant-resistant depression, 7,032 (1:4) age-/sex-matched adolescents with antidepressant-responsive depression and 7,032 (1:4) age-/sex-matched controls were included. Parental psychiatric disorders of individuals enrolled were assessed. The parents of the adolescents with MDD were more likely to be diagnosed with MDD, BD, SZ, alcohol use disorder, or substance use disorder than the parents of the control group. The parents of adolescents who were antidepressant resistant and the mothers of adolescents who were either treatment resistant or treatment responsive were more likely to be diagnosed with a psychiatric disorder. Our study demonstrated that parents of adolescents with MDD may be more likely to be diagnosed with MDD, BD, SZ, alcohol use disorder, or substance use disorder than parents of adolescents without MDD, suggesting the within-disorder transmission and cross-disorder transmission of these psychiatric disorders. Furthermore, the parent's sex and the response to antidepressant treatment may affect the within-disorder transmission of MDD.

Estimated prevalence study of attention-deficit/hyperactivity disorder among eastern province children in the Kingdom of Saudi Arabia.

Studying mental disorders in children is significantly important due to the huge suffering of educational and psychosocial impairments in adult life. Attention-deficit/hyperactivity disorder (ADHD) is considered the most common mental disorder in children, especially in early school-aged children. It manifests in about 8%-12% of children in the world. In Saudi Arabia, it affects 4%-12% of children. The study aimed to count the number of undiagnosed ADHD cases and the associated risk factors in Eastern Province in Kingdom of Saudi Arabia (KSA). A cross-sectional study was performed among girls' and boys' children aged 6-10 years old in Eastern Province in KSA with a random selection of parents. Sample size is equal to 1658. The assessment was done by an online questionnaire filled it by parents using Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition diagnostic criteria and Connor's scale of ADHD excluding any developmental or mental disorder at the beginning of the questionnaire. After excluding the participants who were diagnosed with behavioral and growth developmental disorder, the remaining 1430 have been screened for ADHD based on Connor's scale. 185 of a child out of 1430 were suggested to have ADHD, of which 10 out of them show the signs of ADHD, 76 of them have moderately severe ADHD, and 99 out of them have atypical or severe ADHD based on Connor's scale of ADHD. The study shows that there is a significant relationship between the positive screening of ADHD and gender males (71.35%), females (28.64%), family history (20.5%), nervous system diseases (4.32%), brain damage from trauma (9.72%), smoking habit of the mother (8.64%), smoking during pregnancy (3.78%), mother exposure to second-hand smoking (42.16%), child exposure to a toxic substance like lead during the early life (1.62%), and the preterm labor (15.13%). However, the study shows there is no significant relationship between the positive screening of ADHD with age, drinking alcohol, and central nervous system infection. The prevalence of undiagnosed ADHD is slightly high. Also, it has many causes of ADHD including gender, smoking, parental psychiatric disorders, and obstetric and pregnancy problems.

A population-based study of unintentional injury and premature death among non-imprisoned and imprisoned youth offenders

BackgroundYouth offenders have a high risk of being injured or dying prematurely. However, few studies have considered the role of imprisonment and potential childhood risk factors for these high rates. AimTo examine the risk of unintentional injury and premature death in non-imprisoned and imprisoned youth offenders, and to examine the role of parental criminal convictions and psychiatric disorders and own childhood psychiatric disorders. MethodsAll individuals (N = 1,839,711) born in Sweden between 1978 and 1996 were identified using Swedish population-based registers. The exposure was criminal conviction between ages 15–20 years of age. ResultsImprisoned youth offenders had the highest risk for unintentional injury (HR = 2.29 [2.19–2.40]) and premature death (HR = 10.76 [9.52–12.16]), followed by nonimprisoned youth offenders, compared to non-convicted youth. All childhood risk factors increased the risk for these outcomes among non-imprisoned youth offenders. Among imprisoned youth offenders, parental criminal convictions and parental psychiatric disorders increased the risk for unintentional injury, and parental psychiatric disorders and own childhood psychiatric disorders increased the risk for premature death. ConclusionsOur study shows there are robust modifiable childhood risk factors for injury and mortality among youth offenders. However, the importance of them to assess risk may differ between non-imprisoned and imprisoned youth offenders.

The influence of sex on major psychiatric comorbidities and parental psychiatric disorders in 22,698 children and adolescents with ICD-9-CM-based autism spectrum disorder.

It remains unclear how major psychiatric comorbidities and parental psychiatric disorders differ in males and females with autism spectrum disorder (ASD). Between 2001 and 2011, 17,627 children and 5071 adolescents with ASD (ICD-9-CM code: 299) were identified from Taiwan's National Health Insurance Research Database and assessed for major psychiatric comorbidities and parental psychiatric disorders. Compared with females with ASD, males with ASD were more likely to be diagnosed as having attention deficit hyperactivity disorder (relative risk [RR], 95% confidence interval [CI] 1.63, 1.51-1.75) and disruptive behavior disorder (1.38, 1.17-1.62) and less likely to be diagnosed as having schizophrenia (0.45, 0.36-0.56), bipolar disorder (0.58, 0.45-0.74), or intellectual disability (0.53, 0.49-0.58). Furthermore, compared with women, having a parental history of schizophrenia (RR, 95% CI 0.66, 0.49-0.89) or intellectual disability (0.34, 0.19-0.61) was less associated with ASD among men. However, the difference in ASD diagnosis between ICD-9-CM and ICD-10/11-CM systems may reflect the different, but surely overlapping, entity of ASD, which may limit the generalization of our results. Additional studies should be performed.

Associations between parental psychiatric disorders and autism spectrum disorder in the offspring.

Whether parental psychiatric disorders are associated with autism spectrum disorder (ASD) in offspring has remained inconclusive. We examined the associations of parental psychiatric disorders with ASD in offspring. This population-based case-control study used Taiwan's National Health Insurance Research Database to identify a cohort of children born from 2004 to 2017 and their parents. A total of 24,279 children with ASD (diagnostic ICD-9-CM code: 299.x or ICD-10 code F84.x) and 97,715 matched controls were included. Parental psychiatric disorders, including depressive disorders, bipolar spectrum disorders, anxiety disorders, obsessive-compulsive disorder, schizophrenia, substance use disorders, autism spectrum disorder, attention-deficit hyperactivity disorder (ADHD), and adjustment disorders were identified. Conditional logistic regressions with covariate adjustment were performed. The results suggest that parental diagnosis with any of the psychiatric disorders is associated with ASD in offspring (adjusted odds ratio [AOR]=1.45, 95%CI: 1.40-1.51 for mothers; and AOR=1.12, 95%CI: 1.08-1.17 for fathers). ASD in offspring was associated with schizophrenia, depressive disorders, obsessive-compulsive disorder, adjustment disorders, ADHD and ASD in both parents. The relationship between parental psychiatric disorders and the timing of the child's birth and ASD diagnosis varied across the different psychiatric disorders. The present study provides supportive evidence that parental psychiatric disorders are associated with autistic children. Furthermore, because the associations between parental psychiatric disorders and the timing of child's birth and ASD diagnosis varied across psychiatric disorders, the observed relationships may be affected by both genetic and environmental factors. Future studies are needed to disentangle the potential influence of genetic and environmental factors on the observed associations.

The relationships between use of alcohol, tobacco and coffee in adolescence and mood disorders in adulthood.

Alcohol, tobacco and coffee are commonly used substances and use in adolescence has previously been linked to mood disorders. However, few large prospective studies have investigated adolescent use in relation to mental health outcomes in adulthood. The main aim of this study was to examine the prospective associations between alcohol use, cigarette smoking and coffee consumption at age 16 and subsequent mood disorders up to 33 years of age. Data from The Northern Finland Birth Cohort 1986 Study were used and a total of 7660 participants (49.9% male) were included. Associations between alcohol use, cigarette smoking and coffee consumption at age 16 and later diagnoses of major depression and bipolar disorder were examined using multinomial logistic regression analyses. Mean number of cigarettes/day (OR,1.23 [95% CI 1.01-1.50]) and mean volume of alcohol consumption (OR,1.22 [95% CI 1.01-1.47]), but not frequency of excessive drinking, in adolescence were associated with increased risk for subsequent bipolar disorder after adjustment for sex, parental psychiatric disorders, family structure, illicit substance use, and emotional and behavioral problems at age 16. An association between cigarette smoking and major depression attenuated to statistically non-significant when adjusted for emotional and behavioral problems. No associations were observed between adolescent coffee consumption and subsequent mood disorders. This is the first study to report an association of adolescent cigarette smoking and subsequent bipolar disorder diagnosis providing grounds for further research and pointing to a place for preventive measures among adolescents.

Risk of parental major psychiatric disorders in patients with comorbid autism spectrum disorder and attention deficit hyperactivity disorder: A population-based family-link study.

Few studies have investigated the parental risk of major psychiatric disorders among patients with comorbid autism spectrum disorder and attention deficit hyperactivity disorder. This study examined the differences in such risk among patients with autism spectrum disorder-only, with attention deficit hyperactivity disorder-only and both conditions. Between 2001 and 2011, we enrolled 132,624 patients with autism spectrum disorder or attention deficit hyperactivity disorder and 1:10 matched controls for age, sex and demographics from the National Health Insurance Database of Taiwan. Poisson regression models were used to examine the risk of five major psychiatric disorders in the patients' parents compared with those of the controls, including schizophrenia, bipolar disorder, major depressive disorder, alcohol use disorder, and substance use disorder. Patients were classified into the autism spectrum disorder-only, attention deficit hyperactivity disorder-only and dual-diagnosis groups. The parents of attention deficit hyperactivity disorder-only and dual-diagnosis groups had a higher likelihood to be diagnosed with (odds ratios [95% confidence intervals]) schizophrenia (attention deficit hyperactivity disorder: 1.48 [1.39, 1.57]; dual: 1.79 [1.45, 1.20]), bipolar disorder (attention deficit hyperactivity disorder: 1.91 [1.82, 2.01]; dual: 1.81 [1.51, 2.17]), major depressive disorder (attention deficit hyperactivity disorder: 1.94 [1.89, 2.00]; dual: 1.99 [1.81, 2.20]), alcohol use disorder (attention deficit hyperactivity disorder: 1.39 [1.33, 1.45]; dual: 1.20 [1.01, 1.42]) and substance use disorder (attention deficit hyperactivity disorder: 1.66 [1.59, 1.73]; dual: 1.34 [1.13, 1.58]) than the controls. In contrast, the parents of autism spectrum disorder-only group had a higher likelihood to be diagnosed with schizophrenia (1.77 [1.46, 2.15]) and major depressive disorder (1.45 [1.32, 1.61]) and a lower likelihood to be diagnosed with alcohol use disorder (0.68 [0.55, 0.84]) than the controls. The autism spectrum disorder-only group had a different parental incidence of major psychiatric disorders than the attention deficit hyperactivity disorder-only and dual-diagnosis groups. Our findings have implications for clinical practice and future genetic research.

O-271 The impacts of intracytoplasmic sperm injection on the neurodevelopmental disorders in offspring with male or female infertility parents: a national population cohort study in Taiwan

Abstract Study question This study aims to evaluate whether ICSI intervention in male or female infertility will increase the risks of neurodevelopmental disorders in offspring or not. Summary answer ICSI increases the risks of autism spectrum disorder and delayed developments in offspring with female infertility but has no impact on male infertility. What is known already Damaged sperm has been proved to change epigenetics and increase the genome instability in early embryogenesis. It might also affect the offspring’s health, such as neurodevelopmental disorders. ICSI is the most common procedure in assisted reproductive technology. It is used not only in male infertility but also in female infertility. Several studies have advocated the potential risks of epigenetic alternation in embryos and neurodevelopmental disorders in the offspring. However, there is no conclusion to determine the risk of ICSI in the offspring’s health. Neurodevelopmental disorders are associated with epigenetic alterations such as ASD, ADHD, DD. Study design, size, duration Patients were collected between January 2008 and December 2016 in the national report of the ART database and the national population database in Taiwan. The inclusion criteria were singleton, infertility parents with fresh embryos transfer, and embryos without invasion procedure except for ICSI. The exclusion criteria were donated eggs or sperms. The follow-up time started from birth to December 2018. Participants/materials, setting, methods In total, 1,580,267 singletons were conducted in this study. They were divided into three groups: female infertility, male infertility, and spontaneous conception. Inverse probability of treatment weighting was used to lower the bias among the study groups. The covariate factors include maternal age, obstetrics risk factors, pregnancy complications, and parental psychiatric disorders. The offspring outcome includes ADHD, ASD, and DD. The result was analyzed with multivariate regression. The value of P &amp;lt; 0.05 is significant. Main results and the role of chance Offspring with male infertility showed to increase risk of ADHD (attention deficit and hyperactivity disorder) compared to spontaneous conception (Hazard ratio 1.76, 95% CI 1.03-3.02, p = 0.0389). There was no increased risks of ADHD, ASD (autism spectrum disorder), and DD (delayed developments) in offspring with female infertility compared to spontaneous conception. We further analyzed the impact of ICSI on offspring’s neurodevelopmental disorders. In singletons with male infertility, the risk of ADHD increased in offspring without ICSI intervention compared to spontaneous conception and male infertility with ICSI intervention (Hazard ratio 3.88, 95% CI 1.56-9.62, p = 0.0252) In newborns with female infertility, the risk of ASD and DD increased in offspring with ICSI intervention compared to spontaneous conception and female infertility without ICSI intervention. (ASD: hazard ratio 2.50, 95% CI 1.33-4.70, p = 0.0157; DD: hazard ratio 1.59, 95% CI 1.13-2.24, p = 0.0142) We also found the risks of neurodevelopmental disorders were higher in boys than girls. Preterm infants had increased risks of neurodevelopmental disorders than full-term infants. Limitations, reasons for caution This study had several limitations, such as the severity of sperm, the quality of embryos, and various laboratory conditions. However, we have tried to lower the potential cofactors such as maternal age, pregnancy complications, risk factors during pregnancy and labor, and psychiatric disorders in parents. Wider implications of the findings ICSI is widely used in female infertility to achieve pregnancy. However, our preliminary data shows that ICSI in female infertility increases the risk of neurodevelopmental disorders in offspring. This finding implies that we should pay attention on when using ICSI in female infertility couples. Trial registration number KMUHIRB-E(II)-20200217

Trajectories of adolescent psychotic-like experiences and early cannabis exposure: Results from a Finnish Birth Cohort Study

BackgroundLongitudinal studies examining the effect of cannabis exposure (CE) on the prognosis of adolescents with psychotic-like experiences (PLEs) are scarce. We examined trajectories of mental health in adolescents with PLEs and cannabis exposure. MethodsThe Northern Finland Birth Cohort 1986 (n = 6552) with linkage to nationwide register data was used. Information on lifetime cannabis exposure was collected when participants were aged 15/16. Register-based outcome data on diagnoses made in clinical practice were obtained until age 33. Logistic regression was used to study the association of PLE/CE patterns and subsequent psychiatric disorders. The group with neither PLEs nor CE was utilized as the reference group. Parental psychiatric disorders, family structure, sex, frequent alcohol intoxications, daily smoking and illicit substance use other than cannabis were adjusted for. ResultsIn all, 6552 subjects (49.2 % males) were included in analysis. PLEs with cannabis exposure were associated with any psychiatric disorder (OR = 2.59; 95 % CI 1.82–3.68), psychotic disorders (OR = 3.86; 95 % CI 1.83–8.11), mood disorders (OR 4.07; 95 % CI 2.74–6.04), depressive disorders (OR = 4.35; 95 % CI 2.93–6.48), anxiety disorders (OR = 2.06; 95 % CI 1.34–3.17) and substance use disorders (OR = 2.26; 95 % CI 1.13–4.50) compared to reference group. Effect sizes were greater for group with both PLEs and cannabis use than for group with PLEs only. ConclusionsEarly-onset cannabis use is an adverse prognostic marker for adolescents with PLEs after extensive confounder control including other substance use.