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Identifying Novel Types of Irritability Using a Developmental Genetic Approach.
- Source :
- American Journal of Psychiatry; Aug2019, Vol. 176 Issue 8, p635-642, 8p
- Publication Year :
- 2019
-
Abstract
- <bold>Objective: </bold>Irritability, which is strongly associated with impairment and negative outcomes, is a common reason for referral to mental health services but is a nosological and treatment challenge. A major issue is how irritability should be conceptualized. The authors used a developmental approach to test the hypothesis that there are several forms of irritability, including a "neurodevelopmental/ADHD-like" type, with onset in childhood, and a "depression/mood" type, with onset in adolescence.<bold>Methods: </bold>Data were analyzed from the Avon Longitudinal Study of Parents and Children, a prospective U.K. population-based cohort. Irritability trajectory classes were estimated for 7,924 individuals with data at multiple time points across childhood and adolescence (four possible time points from approximately ages 7 to 15). Psychiatric diagnoses were assessed at approximately ages 7 and 15. Psychiatric genetic risk was indexed by polygenic risk scores (PRSs) for attention deficit hyperactivity disorder (ADHD) and depression, derived using large genome-wide association study results.<bold>Results: </bold>Five irritability trajectory classes were identified: low (81.2%), decreasing (5.6%), increasing (5.5%), late-childhood limited (5.2%), and high-persistent (2.4%). The early-onset high-persistent trajectory was associated with male preponderance, childhood ADHD (odds ratio=108.64, 95% CI=57.45-204.41), and ADHD PRS (odds ratio=1.31, 95% CI=1.09-1.58). The adolescent-onset increasing trajectory was associated with female preponderance, adolescent depression (odds ratio=5.14, 95% CI=2.47-10.73), and depression PRS (odds ratio=1.20, 95% CI=1.05-1.38). Both the early-onset high-persistent and adolescent-onset increasing trajectory classes were associated with adolescent depression diagnosis and ADHD PRS.<bold>Conclusions: </bold>The developmental context of irritability may be important in its conceptualization: early-onset persistent irritability may be more neurodevelopmental/ADHD-like and later-onset irritability more depression/mood-like. These findings have implications for treatment as well as nosology. [ABSTRACT FROM AUTHOR]
Details
- Language :
- English
- ISSN :
- 0002953X
- Volume :
- 176
- Issue :
- 8
- Database :
- Complementary Index
- Journal :
- American Journal of Psychiatry
- Publication Type :
- Academic Journal
- Accession number :
- 137828053
- Full Text :
- https://doi.org/10.1176/appi.ajp.2019.18101134