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Familial association of attention-deficit hyperactivity disorder with autoimmune diseases in the population of Sweden

Li, Xinjuna; Sjöstedt, Ceciliaa; Sundquist, Jana,b; Zöller, Bengta; Sundquist, Kristinaa,b

doi: 10.1097/YPG.0000000000000212

Aims In the era of genome-wide association studies, familial risks are used to estimate disease heritability and success in gene identification. We wanted to estimate associations of 42 autoimmune diseases with attention-deficit hyperactivity disorder (ADHD) between individuals and family members.

Participants and methods The availability of a Multigeneration Register in Sweden provides reliable access to family data that covers the last century. An open cohort design of the diseases in individual and family members was obtained through linkage to the Hospital Discharge Register. Standardized incidence ratios were calculated as relative risks for ADHD in family members of affected patients compared with those without affected family members.

Results Among a total of 86 493 patients, 18 153 had a family history of autoimmune diseases. ADHD was associated with 14 autoimmune diseases in the first-degree relatives, including ankylosing spondylitis (standardized incidence ratio:1.13), celiac disease (1.16), Crohn’s disease (1.07), diabetes mellitus type 1 (1.19), discoid lupus erythematosus (1.26), glomerular nephritis chronic (1.13), Hashimoto/hypothyroidism (1.11), lupoid hepatitis (1.44), multiple sclerosis (1.11), psoriasis (1.18), Reiter’s disease (1.38), rheumatoid arthritis (1.07), Sjögren’s syndrome (1.21), and ulcerative colitis (1.05).

Conclusion Familial associations with several autoimmune diseases suggest genetic sharing and challenge to gene identification.

aCenter for Primary Health Care Research, Lund University, Malmö, Sweden

bDepartment of Family Medicine and Community Health, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York City, New York, USA

Correspondence to Xinjun Li, MD, PhD, Center for Primary Health Care Research, Lund University, Jan Waldenströms gata 35, Skåne University Hospital, 205 02 Malmö, Sweden Tel: +46 40 391 381; fax: +46 40 391 370; e-mail:

Received March 9, 2018

Received in revised form October 4, 2018

Accepted October 17, 2018

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