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Somatic comorbidities of ADHD: epidemiological and genetic data

Presented by
Dr Isabell Brikell , Karolinska Institutet, Sweden
ECNP 2021
Individuals with higher ADHD polygenic liability have a slightly increased risk for several physical health issues in mid-to-late life. The evidence for cardio-metabolic associations was the most consistent. The results for migraine illustrated that pathways can differ between and within disease domains  [1].

Emerging evidence suggests an increased risk of several somatic health conditions in individuals with ADHD, but the extent of the risk and the underlining aetiology of somatic comorbidity are not well known. Weak-to-moderate genetic associations have been found between ADHD and obesity, type-2 diabetes, asthma, certain autoimmune disorders, and migraine. Dr Isabell Brikell (Karolinska Institutet, Sweden) presented the results of 2 recent studies on the physical health of ADHD patients in mid-to-late life, using 2 Swedish national registers with family data.

One of the studies used Swedish register data to map phenotypic and aetiological associations between ADHD and physical conditions in adulthood [2]. Analyses in 10,645 twins demonstrated that adults with ADHD are at an increased risk for 34 of 35 investigated somatic conditions. The strongest associations were with neurological, respiratory, metabolic, and musculoskeletal conditions. Most conditions showed familial associations with ADHD, which seemed to be largely driven by genetic factors, except for neurological and age-related disorders. Migraine was the only neurological condition associated with ADHD, almost entirely due to shared genetics.

The second, ongoing study looks at the contribution of ADHD polygenic risk to somatic health problems. The results so far highlight that patients with a higher ADHD polygenic liability have an increased risk –albeit small– for several physical health issues in mid-to-late life, especially cardio-metabolic issues (see Figure). This association seems to be mediated by modifiable factors such as alcohol abuse, smoking, BMI, and education. A limited association was found between the nervous system and age-related disorders, except for migraine.

Figure: ADHD polygenic risk score associations [1]









  1. Brikell I. Somatic comorbidites of ADHD: epidemiological and genetic evidence. S0.04.03, ECNP 2021 Congress, 2–5 October.
  2. Du Rietz E, et al. Lancet Psychiatry. 2021;8(9):774–83.

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