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Abstract

Objective:

Stimulant medications are effective for treating attention deficit hyperactivity disorder (ADHD), yet discontinuation and switch to nonstimulant ADHD medications are common. This study aimed to identify genetic, clinical, and sociodemographic factors influencing stimulant treatment initiation, discontinuation, and switch to nonstimulants in individuals with ADHD.

Methods:

The authors obtained genetic and national register data for 9,133 individuals with ADHD from the Danish iPSYCH2012 sample and defined stimulant treatment initiation, discontinuation, and switch from prescriptions. For each stimulant treatment outcome, they examined associations with polygenic risk scores (PRSs) for psychiatric disorders and clinical and sociodemographic factors using survival analyses, and conducted genome-wide association studies (GWASs) and estimated single-nucleotide polymorphism heritability (h2SNP).

Results:

Eighty-one percent of the sample initiated stimulant treatment. Within 2 years, 45% discontinued stimulants and 15% switched to nonstimulants. Bipolar disorder PRS (hazard ratio=1.05, 95% CI=1.02, 1.09) and schizophrenia PRS (hazard ratio=1.07, 95% CI=1.03, 1.11) were associated with discontinuation. Depression, bipolar disorder, and schizophrenia PRSs were marginally but not significantly associated with switch (hazard ratio range, 1.05–1.07). No associations were observed for ADHD and autism PRSs. Individuals diagnosed with ADHD at age 13 or older had higher rates of stimulant initiation, discontinuation, and switch (hazard ratio range, 1.27–2.01). Psychiatric comorbidities generally reduced rates of initiation (hazard ratio range, 0.84–0.88) and increased rates of discontinuation (hazard ratio range, 1.19–1.45) and switch (hazard ratio range, 1.40–2.08). h2SNP estimates were not significantly different from zero. No GWAS hits were identified for stimulant initiation or discontinuation. A locus on chromosome 16q23.3 reached genome-wide significance for switch.

Conclusions:

The study findings suggest that individuals with ADHD with higher polygenic liability for mood and/or psychotic disorders, delayed ADHD diagnosis, and psychiatric comorbidities have a higher risk for stimulant treatment discontinuation and switch to nonstimulants. Despite the study’s limited sample size, one putative GWAS hit for switch was identified, illustrating the potential of utilizing genomics linked to prescription databases to advance ADHD pharmacogenomics.

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Information & Authors

Information

Published In

Go to American Journal of Psychiatry
Go to American Journal of Psychiatry
American Journal of Psychiatry
Pages: 854 - 864
PubMed: 34154395

History

Received: 4 December 2020
Revision received: 16 March 2021
Revision received: 7 April 2021
Accepted: 19 April 2021
Published online: 22 June 2021
Published in print: September 01, 2021

Keywords

  1. Attention Deficit Hyperactivity Disorder (ADHD)
  2. Neurodevelopmental Disorders
  3. Treatment Discontinuation
  4. Pharmacogenetics
  5. Polygenic Risk Scores
  6. Electronic Health Records

Authors

Details

Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen and Aarhus, Denmark (Brikell, Wimberley, Albiñana, Pedersen, Vilhjálmsson, Agerbo, Demontis, Børglum, Schork, LaBianca, Werge, Mors, Hougaard, Mortensen, Dalsgaard); National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark (Brikell, Wimberley, Albiñana, Pedersen, Vilhjálmsson, Agerbo, Mortensen, Dalsgaard); Center for Integrated Register-Based Research (CIRRAU), Aarhus University, Aarhus, Denmark (Wimberley, Agerbo, Mortensen, Dalsgaard); Department of Biomedicine and Center for Integrative Sequencing, Aarhus University, Aarhus, Denmark (Demontis, Børglum); Center for Genomics and Personalized Medicine, Central Region Denmark and Aarhus University, Aarhus, Denmark (Demontis, Børglum); Neurogenomics Division, Translational Genomics Research Institute, Phoenix (Schork); Institute of Biological Psychiatry, Mental Health Services, Copenhagen University Hospital, Copenhagen (Schork, LaBianca, Werge); Department of Clinical Medicine and Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen (Werge); Psychosis Research Unit, Aarhus University Hospital, Psychiatry, Aarhus, Denmark (Mors); Department for Congenital Disorders, Statens Serum Institut, Copenhagen (Hougaard); Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Child and Adolescent Psychiatry, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff, U.K. (Thapar)
Theresa Wimberley, Ph.D.
Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen and Aarhus, Denmark (Brikell, Wimberley, Albiñana, Pedersen, Vilhjálmsson, Agerbo, Demontis, Børglum, Schork, LaBianca, Werge, Mors, Hougaard, Mortensen, Dalsgaard); National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark (Brikell, Wimberley, Albiñana, Pedersen, Vilhjálmsson, Agerbo, Mortensen, Dalsgaard); Center for Integrated Register-Based Research (CIRRAU), Aarhus University, Aarhus, Denmark (Wimberley, Agerbo, Mortensen, Dalsgaard); Department of Biomedicine and Center for Integrative Sequencing, Aarhus University, Aarhus, Denmark (Demontis, Børglum); Center for Genomics and Personalized Medicine, Central Region Denmark and Aarhus University, Aarhus, Denmark (Demontis, Børglum); Neurogenomics Division, Translational Genomics Research Institute, Phoenix (Schork); Institute of Biological Psychiatry, Mental Health Services, Copenhagen University Hospital, Copenhagen (Schork, LaBianca, Werge); Department of Clinical Medicine and Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen (Werge); Psychosis Research Unit, Aarhus University Hospital, Psychiatry, Aarhus, Denmark (Mors); Department for Congenital Disorders, Statens Serum Institut, Copenhagen (Hougaard); Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Child and Adolescent Psychiatry, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff, U.K. (Thapar)
Clara Albiñana, M.Sc.
Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen and Aarhus, Denmark (Brikell, Wimberley, Albiñana, Pedersen, Vilhjálmsson, Agerbo, Demontis, Børglum, Schork, LaBianca, Werge, Mors, Hougaard, Mortensen, Dalsgaard); National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark (Brikell, Wimberley, Albiñana, Pedersen, Vilhjálmsson, Agerbo, Mortensen, Dalsgaard); Center for Integrated Register-Based Research (CIRRAU), Aarhus University, Aarhus, Denmark (Wimberley, Agerbo, Mortensen, Dalsgaard); Department of Biomedicine and Center for Integrative Sequencing, Aarhus University, Aarhus, Denmark (Demontis, Børglum); Center for Genomics and Personalized Medicine, Central Region Denmark and Aarhus University, Aarhus, Denmark (Demontis, Børglum); Neurogenomics Division, Translational Genomics Research Institute, Phoenix (Schork); Institute of Biological Psychiatry, Mental Health Services, Copenhagen University Hospital, Copenhagen (Schork, LaBianca, Werge); Department of Clinical Medicine and Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen (Werge); Psychosis Research Unit, Aarhus University Hospital, Psychiatry, Aarhus, Denmark (Mors); Department for Congenital Disorders, Statens Serum Institut, Copenhagen (Hougaard); Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Child and Adolescent Psychiatry, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff, U.K. (Thapar)
Emil Michael Pedersen, M.Sc.
Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen and Aarhus, Denmark (Brikell, Wimberley, Albiñana, Pedersen, Vilhjálmsson, Agerbo, Demontis, Børglum, Schork, LaBianca, Werge, Mors, Hougaard, Mortensen, Dalsgaard); National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark (Brikell, Wimberley, Albiñana, Pedersen, Vilhjálmsson, Agerbo, Mortensen, Dalsgaard); Center for Integrated Register-Based Research (CIRRAU), Aarhus University, Aarhus, Denmark (Wimberley, Agerbo, Mortensen, Dalsgaard); Department of Biomedicine and Center for Integrative Sequencing, Aarhus University, Aarhus, Denmark (Demontis, Børglum); Center for Genomics and Personalized Medicine, Central Region Denmark and Aarhus University, Aarhus, Denmark (Demontis, Børglum); Neurogenomics Division, Translational Genomics Research Institute, Phoenix (Schork); Institute of Biological Psychiatry, Mental Health Services, Copenhagen University Hospital, Copenhagen (Schork, LaBianca, Werge); Department of Clinical Medicine and Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen (Werge); Psychosis Research Unit, Aarhus University Hospital, Psychiatry, Aarhus, Denmark (Mors); Department for Congenital Disorders, Statens Serum Institut, Copenhagen (Hougaard); Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Child and Adolescent Psychiatry, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff, U.K. (Thapar)
Bjarni Jóhann Vilhjálmsson, Ph.D.
Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen and Aarhus, Denmark (Brikell, Wimberley, Albiñana, Pedersen, Vilhjálmsson, Agerbo, Demontis, Børglum, Schork, LaBianca, Werge, Mors, Hougaard, Mortensen, Dalsgaard); National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark (Brikell, Wimberley, Albiñana, Pedersen, Vilhjálmsson, Agerbo, Mortensen, Dalsgaard); Center for Integrated Register-Based Research (CIRRAU), Aarhus University, Aarhus, Denmark (Wimberley, Agerbo, Mortensen, Dalsgaard); Department of Biomedicine and Center for Integrative Sequencing, Aarhus University, Aarhus, Denmark (Demontis, Børglum); Center for Genomics and Personalized Medicine, Central Region Denmark and Aarhus University, Aarhus, Denmark (Demontis, Børglum); Neurogenomics Division, Translational Genomics Research Institute, Phoenix (Schork); Institute of Biological Psychiatry, Mental Health Services, Copenhagen University Hospital, Copenhagen (Schork, LaBianca, Werge); Department of Clinical Medicine and Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen (Werge); Psychosis Research Unit, Aarhus University Hospital, Psychiatry, Aarhus, Denmark (Mors); Department for Congenital Disorders, Statens Serum Institut, Copenhagen (Hougaard); Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Child and Adolescent Psychiatry, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff, U.K. (Thapar)
Esben Agerbo, Ph.D.
Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen and Aarhus, Denmark (Brikell, Wimberley, Albiñana, Pedersen, Vilhjálmsson, Agerbo, Demontis, Børglum, Schork, LaBianca, Werge, Mors, Hougaard, Mortensen, Dalsgaard); National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark (Brikell, Wimberley, Albiñana, Pedersen, Vilhjálmsson, Agerbo, Mortensen, Dalsgaard); Center for Integrated Register-Based Research (CIRRAU), Aarhus University, Aarhus, Denmark (Wimberley, Agerbo, Mortensen, Dalsgaard); Department of Biomedicine and Center for Integrative Sequencing, Aarhus University, Aarhus, Denmark (Demontis, Børglum); Center for Genomics and Personalized Medicine, Central Region Denmark and Aarhus University, Aarhus, Denmark (Demontis, Børglum); Neurogenomics Division, Translational Genomics Research Institute, Phoenix (Schork); Institute of Biological Psychiatry, Mental Health Services, Copenhagen University Hospital, Copenhagen (Schork, LaBianca, Werge); Department of Clinical Medicine and Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen (Werge); Psychosis Research Unit, Aarhus University Hospital, Psychiatry, Aarhus, Denmark (Mors); Department for Congenital Disorders, Statens Serum Institut, Copenhagen (Hougaard); Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Child and Adolescent Psychiatry, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff, U.K. (Thapar)
Ditte Demontis, Ph.D.
Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen and Aarhus, Denmark (Brikell, Wimberley, Albiñana, Pedersen, Vilhjálmsson, Agerbo, Demontis, Børglum, Schork, LaBianca, Werge, Mors, Hougaard, Mortensen, Dalsgaard); National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark (Brikell, Wimberley, Albiñana, Pedersen, Vilhjálmsson, Agerbo, Mortensen, Dalsgaard); Center for Integrated Register-Based Research (CIRRAU), Aarhus University, Aarhus, Denmark (Wimberley, Agerbo, Mortensen, Dalsgaard); Department of Biomedicine and Center for Integrative Sequencing, Aarhus University, Aarhus, Denmark (Demontis, Børglum); Center for Genomics and Personalized Medicine, Central Region Denmark and Aarhus University, Aarhus, Denmark (Demontis, Børglum); Neurogenomics Division, Translational Genomics Research Institute, Phoenix (Schork); Institute of Biological Psychiatry, Mental Health Services, Copenhagen University Hospital, Copenhagen (Schork, LaBianca, Werge); Department of Clinical Medicine and Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen (Werge); Psychosis Research Unit, Aarhus University Hospital, Psychiatry, Aarhus, Denmark (Mors); Department for Congenital Disorders, Statens Serum Institut, Copenhagen (Hougaard); Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Child and Adolescent Psychiatry, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff, U.K. (Thapar)
Anders D. Børglum, Ph.D.
Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen and Aarhus, Denmark (Brikell, Wimberley, Albiñana, Pedersen, Vilhjálmsson, Agerbo, Demontis, Børglum, Schork, LaBianca, Werge, Mors, Hougaard, Mortensen, Dalsgaard); National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark (Brikell, Wimberley, Albiñana, Pedersen, Vilhjálmsson, Agerbo, Mortensen, Dalsgaard); Center for Integrated Register-Based Research (CIRRAU), Aarhus University, Aarhus, Denmark (Wimberley, Agerbo, Mortensen, Dalsgaard); Department of Biomedicine and Center for Integrative Sequencing, Aarhus University, Aarhus, Denmark (Demontis, Børglum); Center for Genomics and Personalized Medicine, Central Region Denmark and Aarhus University, Aarhus, Denmark (Demontis, Børglum); Neurogenomics Division, Translational Genomics Research Institute, Phoenix (Schork); Institute of Biological Psychiatry, Mental Health Services, Copenhagen University Hospital, Copenhagen (Schork, LaBianca, Werge); Department of Clinical Medicine and Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen (Werge); Psychosis Research Unit, Aarhus University Hospital, Psychiatry, Aarhus, Denmark (Mors); Department for Congenital Disorders, Statens Serum Institut, Copenhagen (Hougaard); Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Child and Adolescent Psychiatry, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff, U.K. (Thapar)
Andrew J. Schork, Ph.D.
Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen and Aarhus, Denmark (Brikell, Wimberley, Albiñana, Pedersen, Vilhjálmsson, Agerbo, Demontis, Børglum, Schork, LaBianca, Werge, Mors, Hougaard, Mortensen, Dalsgaard); National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark (Brikell, Wimberley, Albiñana, Pedersen, Vilhjálmsson, Agerbo, Mortensen, Dalsgaard); Center for Integrated Register-Based Research (CIRRAU), Aarhus University, Aarhus, Denmark (Wimberley, Agerbo, Mortensen, Dalsgaard); Department of Biomedicine and Center for Integrative Sequencing, Aarhus University, Aarhus, Denmark (Demontis, Børglum); Center for Genomics and Personalized Medicine, Central Region Denmark and Aarhus University, Aarhus, Denmark (Demontis, Børglum); Neurogenomics Division, Translational Genomics Research Institute, Phoenix (Schork); Institute of Biological Psychiatry, Mental Health Services, Copenhagen University Hospital, Copenhagen (Schork, LaBianca, Werge); Department of Clinical Medicine and Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen (Werge); Psychosis Research Unit, Aarhus University Hospital, Psychiatry, Aarhus, Denmark (Mors); Department for Congenital Disorders, Statens Serum Institut, Copenhagen (Hougaard); Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Child and Adolescent Psychiatry, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff, U.K. (Thapar)
Sonja LaBianca, Ph.D.
Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen and Aarhus, Denmark (Brikell, Wimberley, Albiñana, Pedersen, Vilhjálmsson, Agerbo, Demontis, Børglum, Schork, LaBianca, Werge, Mors, Hougaard, Mortensen, Dalsgaard); National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark (Brikell, Wimberley, Albiñana, Pedersen, Vilhjálmsson, Agerbo, Mortensen, Dalsgaard); Center for Integrated Register-Based Research (CIRRAU), Aarhus University, Aarhus, Denmark (Wimberley, Agerbo, Mortensen, Dalsgaard); Department of Biomedicine and Center for Integrative Sequencing, Aarhus University, Aarhus, Denmark (Demontis, Børglum); Center for Genomics and Personalized Medicine, Central Region Denmark and Aarhus University, Aarhus, Denmark (Demontis, Børglum); Neurogenomics Division, Translational Genomics Research Institute, Phoenix (Schork); Institute of Biological Psychiatry, Mental Health Services, Copenhagen University Hospital, Copenhagen (Schork, LaBianca, Werge); Department of Clinical Medicine and Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen (Werge); Psychosis Research Unit, Aarhus University Hospital, Psychiatry, Aarhus, Denmark (Mors); Department for Congenital Disorders, Statens Serum Institut, Copenhagen (Hougaard); Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Child and Adolescent Psychiatry, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff, U.K. (Thapar)
Thomas Werge, Ph.D.
Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen and Aarhus, Denmark (Brikell, Wimberley, Albiñana, Pedersen, Vilhjálmsson, Agerbo, Demontis, Børglum, Schork, LaBianca, Werge, Mors, Hougaard, Mortensen, Dalsgaard); National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark (Brikell, Wimberley, Albiñana, Pedersen, Vilhjálmsson, Agerbo, Mortensen, Dalsgaard); Center for Integrated Register-Based Research (CIRRAU), Aarhus University, Aarhus, Denmark (Wimberley, Agerbo, Mortensen, Dalsgaard); Department of Biomedicine and Center for Integrative Sequencing, Aarhus University, Aarhus, Denmark (Demontis, Børglum); Center for Genomics and Personalized Medicine, Central Region Denmark and Aarhus University, Aarhus, Denmark (Demontis, Børglum); Neurogenomics Division, Translational Genomics Research Institute, Phoenix (Schork); Institute of Biological Psychiatry, Mental Health Services, Copenhagen University Hospital, Copenhagen (Schork, LaBianca, Werge); Department of Clinical Medicine and Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen (Werge); Psychosis Research Unit, Aarhus University Hospital, Psychiatry, Aarhus, Denmark (Mors); Department for Congenital Disorders, Statens Serum Institut, Copenhagen (Hougaard); Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Child and Adolescent Psychiatry, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff, U.K. (Thapar)
Ole Mors, Ph.D., M.D.
Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen and Aarhus, Denmark (Brikell, Wimberley, Albiñana, Pedersen, Vilhjálmsson, Agerbo, Demontis, Børglum, Schork, LaBianca, Werge, Mors, Hougaard, Mortensen, Dalsgaard); National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark (Brikell, Wimberley, Albiñana, Pedersen, Vilhjálmsson, Agerbo, Mortensen, Dalsgaard); Center for Integrated Register-Based Research (CIRRAU), Aarhus University, Aarhus, Denmark (Wimberley, Agerbo, Mortensen, Dalsgaard); Department of Biomedicine and Center for Integrative Sequencing, Aarhus University, Aarhus, Denmark (Demontis, Børglum); Center for Genomics and Personalized Medicine, Central Region Denmark and Aarhus University, Aarhus, Denmark (Demontis, Børglum); Neurogenomics Division, Translational Genomics Research Institute, Phoenix (Schork); Institute of Biological Psychiatry, Mental Health Services, Copenhagen University Hospital, Copenhagen (Schork, LaBianca, Werge); Department of Clinical Medicine and Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen (Werge); Psychosis Research Unit, Aarhus University Hospital, Psychiatry, Aarhus, Denmark (Mors); Department for Congenital Disorders, Statens Serum Institut, Copenhagen (Hougaard); Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Child and Adolescent Psychiatry, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff, U.K. (Thapar)
David M. Hougaard, Ph.D.
Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen and Aarhus, Denmark (Brikell, Wimberley, Albiñana, Pedersen, Vilhjálmsson, Agerbo, Demontis, Børglum, Schork, LaBianca, Werge, Mors, Hougaard, Mortensen, Dalsgaard); National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark (Brikell, Wimberley, Albiñana, Pedersen, Vilhjálmsson, Agerbo, Mortensen, Dalsgaard); Center for Integrated Register-Based Research (CIRRAU), Aarhus University, Aarhus, Denmark (Wimberley, Agerbo, Mortensen, Dalsgaard); Department of Biomedicine and Center for Integrative Sequencing, Aarhus University, Aarhus, Denmark (Demontis, Børglum); Center for Genomics and Personalized Medicine, Central Region Denmark and Aarhus University, Aarhus, Denmark (Demontis, Børglum); Neurogenomics Division, Translational Genomics Research Institute, Phoenix (Schork); Institute of Biological Psychiatry, Mental Health Services, Copenhagen University Hospital, Copenhagen (Schork, LaBianca, Werge); Department of Clinical Medicine and Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen (Werge); Psychosis Research Unit, Aarhus University Hospital, Psychiatry, Aarhus, Denmark (Mors); Department for Congenital Disorders, Statens Serum Institut, Copenhagen (Hougaard); Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Child and Adolescent Psychiatry, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff, U.K. (Thapar)
Anita Thapar, Ph.D.
Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen and Aarhus, Denmark (Brikell, Wimberley, Albiñana, Pedersen, Vilhjálmsson, Agerbo, Demontis, Børglum, Schork, LaBianca, Werge, Mors, Hougaard, Mortensen, Dalsgaard); National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark (Brikell, Wimberley, Albiñana, Pedersen, Vilhjálmsson, Agerbo, Mortensen, Dalsgaard); Center for Integrated Register-Based Research (CIRRAU), Aarhus University, Aarhus, Denmark (Wimberley, Agerbo, Mortensen, Dalsgaard); Department of Biomedicine and Center for Integrative Sequencing, Aarhus University, Aarhus, Denmark (Demontis, Børglum); Center for Genomics and Personalized Medicine, Central Region Denmark and Aarhus University, Aarhus, Denmark (Demontis, Børglum); Neurogenomics Division, Translational Genomics Research Institute, Phoenix (Schork); Institute of Biological Psychiatry, Mental Health Services, Copenhagen University Hospital, Copenhagen (Schork, LaBianca, Werge); Department of Clinical Medicine and Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen (Werge); Psychosis Research Unit, Aarhus University Hospital, Psychiatry, Aarhus, Denmark (Mors); Department for Congenital Disorders, Statens Serum Institut, Copenhagen (Hougaard); Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Child and Adolescent Psychiatry, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff, U.K. (Thapar)
Preben Bo Mortensen, Ph.D.
Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen and Aarhus, Denmark (Brikell, Wimberley, Albiñana, Pedersen, Vilhjálmsson, Agerbo, Demontis, Børglum, Schork, LaBianca, Werge, Mors, Hougaard, Mortensen, Dalsgaard); National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark (Brikell, Wimberley, Albiñana, Pedersen, Vilhjálmsson, Agerbo, Mortensen, Dalsgaard); Center for Integrated Register-Based Research (CIRRAU), Aarhus University, Aarhus, Denmark (Wimberley, Agerbo, Mortensen, Dalsgaard); Department of Biomedicine and Center for Integrative Sequencing, Aarhus University, Aarhus, Denmark (Demontis, Børglum); Center for Genomics and Personalized Medicine, Central Region Denmark and Aarhus University, Aarhus, Denmark (Demontis, Børglum); Neurogenomics Division, Translational Genomics Research Institute, Phoenix (Schork); Institute of Biological Psychiatry, Mental Health Services, Copenhagen University Hospital, Copenhagen (Schork, LaBianca, Werge); Department of Clinical Medicine and Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen (Werge); Psychosis Research Unit, Aarhus University Hospital, Psychiatry, Aarhus, Denmark (Mors); Department for Congenital Disorders, Statens Serum Institut, Copenhagen (Hougaard); Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Child and Adolescent Psychiatry, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff, U.K. (Thapar)
Søren Dalsgaard, Ph.D.
Lundbeck Foundation Initiative for Integrative Psychiatric Research (iPSYCH), Copenhagen and Aarhus, Denmark (Brikell, Wimberley, Albiñana, Pedersen, Vilhjálmsson, Agerbo, Demontis, Børglum, Schork, LaBianca, Werge, Mors, Hougaard, Mortensen, Dalsgaard); National Center for Register-Based Research, Department of Economics and Business Economics, Aarhus University, Aarhus, Denmark (Brikell, Wimberley, Albiñana, Pedersen, Vilhjálmsson, Agerbo, Mortensen, Dalsgaard); Center for Integrated Register-Based Research (CIRRAU), Aarhus University, Aarhus, Denmark (Wimberley, Agerbo, Mortensen, Dalsgaard); Department of Biomedicine and Center for Integrative Sequencing, Aarhus University, Aarhus, Denmark (Demontis, Børglum); Center for Genomics and Personalized Medicine, Central Region Denmark and Aarhus University, Aarhus, Denmark (Demontis, Børglum); Neurogenomics Division, Translational Genomics Research Institute, Phoenix (Schork); Institute of Biological Psychiatry, Mental Health Services, Copenhagen University Hospital, Copenhagen (Schork, LaBianca, Werge); Department of Clinical Medicine and Center for GeoGenetics, GLOBE Institute, University of Copenhagen, Copenhagen (Werge); Psychosis Research Unit, Aarhus University Hospital, Psychiatry, Aarhus, Denmark (Mors); Department for Congenital Disorders, Statens Serum Institut, Copenhagen (Hougaard); Division of Psychological Medicine and Clinical Neurosciences, Cardiff University School of Medicine, Child and Adolescent Psychiatry, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff, U.K. (Thapar)

Notes

Send correspondence to Dr. Brikell ([email protected]).

Competing Interests

Dr. Demontis has received speaking fees from Takeda. The other authors report no financial relationships with commercial interests.

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