title: Multilevel analysis of ADHD, anxiety and depression symptoms aggregation in families.
abstract: A strong genetic role in the etiology of attention-deficit hyperactivity disorder (ADHD) has been demonstrated by several studies using different methodologies. Shortcomings of genetic studies often include the lack of golden standard practices for diagnosis for ADHD, the use of categorical instead of a dimensional approach, and the disregard for assortative mating phenomenon in parents. The current study aimed to overcome these shortcomings and analyze data through a novel statistical approach, using multilevel analyses with Bayesian procedures and a specific mathematical model, which takes into account data with an elevated number of zero responses (expected in samples with few or no ADHD symptoms). Correlations of parental clinical variables (ADHD, anxiety and depression) to offspring psychopathology may vary according to gender and type of symptoms. We aimed to investigate how those variables interact within each other. One hundred families, comprising a proband child or adolescent with ADHD or a typically developing child or adolescent were included and all family members (both biological parents, the proband child or adolescent and their sibling) were examined through semi-structured interviews using DSM-IV criteria. Results indicated that: (a) maternal clinical variables (ADHD, anxiety and depression) were more correlated with offspring variables than paternal ones; (b) maternal inattention (but not hyperactivity) was correlated with both inattention and hyperactivity in the offspring; (c) maternal anxiety was correlated with offspring inattention; on the other hand, maternal inattention was correlated with anxiety in the offspring. Although a family study design limits the possibility of revealing causality and cannot disentangle genetic and environmental factors, our findings suggest that ADHD, anxiety and depression are variables that correlate in families and should be addressed together. Maternal variables significantly correlated with offspring variables, but the paternal variables did not.
authors.affiliation: Institute of Psychiatry (IPUB), Federal University of Rio de Janeiro (UFRJ), Rua Voluntários da Pátria 445, Room 903, Rio De Janeiro, RJ, 22270-005, Brazil, danielsegen@gmail.com.
authors.forename: Daniel
authors.initials: D
authors.lastname: Segenreich
authors.forename: Marina Silva
authors.initials: MS
authors.lastname: Paez
authors.forename: Maria Angélica
authors.initials: MA
authors.lastname: Regalla
authors.forename: Dídia
authors.initials: D
authors.lastname: Fortes
authors.forename: Stephen V
authors.initials: SV
authors.lastname: Faraone
authors.forename: Joseph
authors.initials: J
authors.lastname: Sergeant
authors.forename: Paulo
authors.initials: P
authors.lastname: Mattos
mesh_terms: D000293:Adolescent; D000328:Adult; D001007:Anxiety / Q000453:epidemiology* / Q000235:genetics*; D001289:Attention Deficit Disorder with Hyperactivity / Q000453:epidemiology* / Q000235:genetics*; D001499:Bayes Theorem; D001938:Brazil / Q000453:epidemiology; D002648:Child; D015986:Confounding Factors, Epidemiologic; D003863:Depression / Q000453:epidemiology* / Q000235:genetics*; D005260:Female; D006801:Humans; D008297:Male; D015233:Models, Statistical; D055361:Multilevel Analysis; D010290:Parents; D012737:Sex Factors; D035781:Siblings