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Familial coaggregation of major psychiatric disorders in first-degree relatives of individuals with autism spectrum disorder: a nationwide population-based study

Published online by Cambridge University Press:  11 September 2020

Hohui E. Wang Open the ORCID record for Hohui E. Wang [Opens in a new window] ,
Chih-Ming Cheng ,
Ya-Mei Bai ,
Ju-Wei Hsu ,
Kai-Lin Huang ,
Tung-Ping Su ,
Shih-Jen Tsai ,
Cheng-Ta Li ,
Tzeng-Ji Chen  and
Bennett L. Leventhal
...Show all authors
Hohui E. Wang
Affiliation:
Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, USA
Chih-Ming Cheng
Affiliation:
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
Ya-Mei Bai
Affiliation:
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
Ju-Wei Hsu
Affiliation:
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
Kai-Lin Huang
Affiliation:
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
Tung-Ping Su
Affiliation:
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan Department of Psychiatry, General Cheng Hsin Hospital, Taipei, Taiwan
Shih-Jen Tsai
Affiliation:
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
Cheng-Ta Li
Affiliation:
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
Tzeng-Ji Chen
Affiliation:
Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan Institute of Hospital and Health Care Administration, National Yang-Ming University, Taipei, Taiwan
Bennett L. Leventhal*
Affiliation:
Division of Child and Adolescent Psychiatry, Department of Psychiatry and Behavioral Sciences, University of California San Francisco, San Francisco, CA, USA
Mu-Hong Chen*
Affiliation:
Department of Psychiatry, Taipei Veterans General Hospital, Taipei, Taiwan Division of Psychiatry, School of Medicine, National Yang-Ming University, Taipei, Taiwan
*
Authors for correspondence: Mu-Hong Chen, E-mail: kremer7119@gmail.com; Bennett L. Leventhal, E-mail: Bennett.Leventhal@ucsf.edu
Authors for correspondence: Mu-Hong Chen, E-mail: kremer7119@gmail.com; Bennett L. Leventhal, E-mail: Bennett.Leventhal@ucsf.edu
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Abstract

Background

Family coaggregation of attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder (ASD), bipolar disorder (BD), major depressive disorder (MDD) and schizophrenia have been presented in previous studies. The shared genetic and environmental factors among psychiatric disorders remain elusive.

Methods

This nationwide population-based study examined familial coaggregation of major psychiatric disorders in first-degree relatives (FDRs) of individuals with ASD. Taiwan's National Health Insurance Research Database was used to identify 26 667 individuals with ASD and 67 998 FDRs of individuals with ASD. The cohort was matched in 1:4 ratio to 271 992 controls. The relative risks (RRs) and 95% confidence intervals (CI) of ADHD, ASD, BD, MDD and schizophrenia were assessed among FDRs of individuals with ASD and ASD with intellectual disability (ASD-ID).

Results

FDRs of individuals with ASD have higher RRs of major psychiatric disorders compared with controls: ASD 17.46 (CI 15.50–19.67), ADHD 3.94 (CI 3.72–4.17), schizophrenia 3.05 (CI 2.74–3.40), BD 2.22 (CI 1.98–2.48) and MDD 1.88 (CI 1.76–2.00). Higher RRs of schizophrenia (4.47, CI 3.95–5.06) and ASD (18.54, CI 16.18–21.23) were observed in FDRs of individuals with both ASD-ID, compared with ASD only.

Conclusions

The risk for major psychiatric disorders was consistently elevated across all types of FDRs of individuals with ASD. FDRs of individuals with ASD-ID are at further higher risk for ASD and schizophrenia. Our results provide leads for future investigation of shared etiologic pathways of ASD, ID and major psychiatric disorders and highlight the importance of mental health care delivered to at-risk families for early diagnoses and interventions.

Keywords

Autism spectrum disorderattention-deficit/hyperactivity disorder (ADHD)bipolar disorderfamilial coaggregationfirst-degree relatives (FDRs)intellectual disabilitymajor depressive disorderschizophrenia
Type
Original Article
Information
Psychological Medicine , Volume 52 , Issue 8 , June 2022 , pp. 1437 - 1447
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Copyright
Copyright © The Author(s), 2020. Published by Cambridge University Press

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