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Psychiatric comorbidities in women with cardiometabolic conditions with and without ADHD : a population-based study

Psychiatric comorbidities in women with cardiometabolic conditions with and without ADHD : a population-based study


Title: Psychiatric comorbidities in women with cardiometabolic conditions with and without ADHD : a population-based study
Author: Smári, Unnur Jakobsdóttir
Valdimarsdóttir, Unnur Anna
Aspelund, Thor   orcid.org/0000-0002-7998-5433
Hauksdóttir, Arna   orcid.org/0000-0002-4253-1059
Þórðardóttir, Edda Björk
Hartman, Catharina A
Andell, Pontus
Larsson, Henrik
Zoéga, Helga
Date: 2023-11-20
Language: English
Scope: 1391846
University/Institute: Landspitali - The National University Hospital of Iceland
Department: Interdisciplinary Graduate Studies
Faculty of Medicine
Series: BMC Medicine; 21(1)
ISSN: 1741-7015
DOI: 10.1186/s12916-023-03160-7
Subject: Sálfræði; Anxiety disorders; Attention-deficit/hyperactivity disorder; Cardiometabolic risk factors; Cardiovascular diseases; Females; Hypertension; Mood disorders; Obesity; Self-harm; Type 2 diabetes; Medicine (all)
URI: https://hdl.handle.net/20.500.11815/4568

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Citation:

Smári , U J , Valdimarsdóttir , U A , Aspelund , T , Hauksdóttir , A , Þórðardóttir , E B , Hartman , C A , Andell , P , Larsson , H & Zoéga , H 2023 , ' Psychiatric comorbidities in women with cardiometabolic conditions with and without ADHD : a population-based study ' , BMC Medicine , vol. 21 , no. 1 , 450 , pp. 450 . https://doi.org/10.1186/s12916-023-03160-7

Abstract:

BACKGROUND: Leveraging a large nationwide study of Icelandic women, we aimed to narrow the evidence gap around female attention-deficit/hyperactivity disorder (ADHD) and cardiometabolic comorbidities by determining the prevalence of obesity, hypertension, type 2 diabetes, and cardiovascular diseases among women with ADHD and examine the association between cardiometabolic conditions and co-occurring ADHD with anxiety and mood disorders, alcoholism/substance use disorder (SUD), self-harm, and suicide attempts. METHODS: We conducted a cross-sectional analysis of the nationwide, all-female, population-based SAGA Cohort Study (n = 26,668). To ascertain diagnoses and symptoms, we used self-reported history of ADHD diagnoses, selected cardiometabolic conditions and psychiatric disorders, and measured current depressive, anxiety, and PTSD symptoms through appropriate questionnaires (PHQ-9, GAD-7, and PCL-5). We calculated age-adjusted prevalences of cardiometabolic conditions by women's ADHD status and estimated adjusted prevalence ratios (PR) and 95% confidence intervals (CI), using modified Poisson regression models. Similarly, we assessed the association of cardiometabolic conditions and co-occurring ADHD with current psychiatric symptoms and psychiatric disorders, using adjusted PRs and 95% CIs. RESULTS: We identified 2299 (8.6%) women with a history of ADHD diagnosis. The age-adjusted prevalence of having at least one cardiometabolic condition was higher among women with ADHD (49.5%) than those without (41.7%), (PR = 1.19, 95% CI 1.14-1.25), with higher prevalence of all measured cardiometabolic conditions (myocardial infarctions (PR = 2.53, 95% CI 1.83--3.49), type 2 diabetes (PR = 2.08, 95% CI 1.66-2.61), hypertension (PR = 1.23, 95% CI 1.12-1.34), and obesity (PR = 1.18, 95% CI 1.11-1.25)). Women with cardiometabolic conditions and co-occurring ADHD had, compared with those without ADHD, substantially increased prevalence of (a) all measured mood and anxiety disorders, e.g., depression (PR = 2.38, 95% CI 2.19-2.58), bipolar disorder (PR = 4.81, 95% CI 3.65-6.35), posttraumatic stress disorder (PR = 2.78, 95% CI 2.52-3.07), social phobia (PR = 2.96, 95% CI 2.64-3.32); (b) moderate/severe depressive, anxiety, and PTSD symptoms with PR = 1.76 (95% CI 1.67-1.85), PR = 1.97 (95% CI 1.82-2.12), and PR = 2.01 (95% CI 1.88-2.15), respectively; (c) alcoholism/SUD, PR = 4.79 (95% CI 3.90-5.89); and (d) self-harm, PR = 1.47 (95% CI 1.29-1.67) and suicide attempts, PR = 2.37 (95% CI 2.05-2.73). CONCLUSIONS: ADHD is overrepresented among women with cardiometabolic conditions and contributes substantially to other psychiatric comorbidities among women with cardiometabolic conditions.

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Publisher Copyright: © 2023, The Author(s).

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