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Publication - Dr Dheeraj Rai

    Family History of Mental and Neurologic Disorders and Risk of Autism

    Citation

    Xie, S, Karlsson, H, Dalman, C, Widman, L, Rai, D, Gardner, R, Magnusson, C, Schendel, D, Newschaffer, CJ & Lee, B, 2019, ‘Family History of Mental and Neurologic Disorders and Risk of Autism’. JAMA Network Open, vol 2.

    Abstract

    Importance 
    Familial aggregation of mental and neurological disorders is
    often observed in autism spectrum disorders (ASD), but reports have
    generally focused on single disorders and are limited to first-degree
    relatives.

    Objectives 
    To examine family history of mental and neurological disorders
    among first- to fourth-degree relatives and risk of ASD with and
    without intellectual disability (ID) in index persons.

    Design, Setting, and Participants 
    In this population-based cohort study, 567 436 index persons
    were identified from the Stockholm Youth Cohort, an ongoing longitudinal
    register-linkage cohort study of the total population aged 0 to 17
    years residing in Stockholm County, Sweden. Index persons were
    nonadopted singleton births born between 1984 and 2009 who were at least
    2 years of age at the end of follow-up on December 31, 2011, had
    resided in Stockholm County for at least 2 years since birth, and could
    be linked to both biological parents. Data analysis was conducted from
    May 2017 to December 2018.

    Exposure 
    Mental and neurological diagnoses of relatives of the index persons.

    Main Outcomes and Measures 
    Diagnosis of ASD, with or without co-occurring ID, in the index persons.

    Results 
    The cohort included 567 436 index persons (291 191 [51.3%]
    male; mean [SD] age at the end of follow-up, 14.3 [7.5] years). The
    prevalence of ASD with and without ID was 0.4% and 1.5%, respectively.
    Positive family history of mental and neurological disorders was
    associated with higher odds of ASD in index persons; 6895 (63.1%) of
    index persons with ASD had a parent with history of mental and/or
    neurological disorders, compared with 252 454 (45.4%) of index persons
    without ASD. Family history of multiple disorders was associated with
    higher odds of ASD in index persons, including history of ASD (odds
    ratio among first-degree relatives for ASD with and without ID: 14.2,
    9.0), intellectual disability (7.6, 2.3),
    attention-deficit/hyperactivity disorder (3.3, 4.7), obsessive
    compulsive disorder (1.9, 2.1), schizophrenia and other nonaffective
    psychotic disorders (2.1, 1.8), depression (1.4, 2.0), bipolar disorder
    (1.4, 2.2), personality disorder (2.1, 2.6), cerebral palsy (2.2, 1.5),
    and epilepsy (2.0, 1.3). The more closely related the affected family
    member was, the higher the odds was of ASD for the index person. ASD
    without intellectual disability was associated with more disorders
    compared to ASD with intellectual disability. ASD with intellectual
    disability exhibited a weaker familial association with other mental
    disorder diagnoses but a stronger familial association with some
    neurological diagnoses as compared to ASD without intellectual
    disability.

    Conclusions and Relevance 
    This study suggests that family history of mental and
    neurological disorders is associated with increased risk of ASD. The
    familial component of ASD etiology may differ by presence or absence of
    co-occurring ID.

    Full details in the University publications repository