Environmental and Genetic Influences in ADHD

Dear Colleagues,

Attention Deficit Hyperactivity Disorder (ADHD) is a neurobiological disorder which can be diagnosed in children or adults, and is becoming a significant public health concern. There are many discussions about increasing numbers of children being medicated for ADHD globally, and higher rates of medication usage in the USA than in Europe. The Centres for Disease Control and Prevention (CDC) reports that 9% of children in the USA have been reported by their parents as having received a diagnosis of ADHD, although the American Psychiatric Association would expect a lower prevalence rate of 5%. The long-term impact of ADHD is now becoming clearer, with large-scale epidemiological studies having identified a two-fold increase in mortality, an increased risk of criminality, increased risk of suicidality as well as an increased risk of road traffic accidents. Many of these risks may be reduced through the use of medication.

ADHD is associated with strong genetic influences, but is also associated with diverse environmental factors including socio-economic factors, early childhood adversity, obstetric difficulties, exposure to nicotine in utero, environmental toxins and the quality of the family and home environment. ADHD traits are continuous variable traits in society, and a metanalysis of twin studies estimates that the heritability of ADHD may be 76%. Numerous genes associated with ADHD have been identified, but as yet the genetic architecture has not been clarified. While it is clear that ADHD traits in society are highly heritable and may be influenced by a number of genes, it should be noted that the prevalence of the disorder of ADHD is considerably higher in situations where young people have been exposed to severe childhood adversity, such as those in foster care, or in areas with high rates of social deprivation. This leads us to question if environmental factors are more important than was previously estimated in the aetiology of the disorder of ADHD, and if environmental factors act as a trigger which “switches on” ADHD, leading to those who have a genetic predisposition to ADHD traits developing the disorder of ADHD. 

This Special Issue on ADHD seeks to further clarify the interplay of genetic and environmental factors in the development of the disorder.

Prof. Aisling Mulligan
Guest Editor

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• ADHD
• Environment
• Genetics
• Epigenetics
• Childhood adversity
• Social deprivation