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Latvala, A., Tideman, M., Sondenaa, E., Larsson, H., Butwicka, A., Fazel, S. & Lichtenstein, P. (2023). Association of intellectual disability with violent and sexual crime and victimization: A population-based cohort study. Psychological Medicine, 53(9), 3817-3825
Open this publication in new window or tab >>Association of intellectual disability with violent and sexual crime and victimization: A population-based cohort study
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2023 (English)In: Psychological Medicine, ISSN 0033-2917, E-ISSN 1469-8978, Vol. 53, no 9, p. 3817-3825Article in journal (Refereed) Published
Abstract [en]

Background Intellectual disability (ID) is associated with violent and sexual offending and victimization, but the importance of neuropsychiatric comorbidity and severity of disability remains unclear. Methods In a register-based cohort study of people born in Sweden 1980-1991 (n = 1 232 564), we investigated associations of mild and moderate/severe ID with any, violent and sexual crimes, and with assault victimization, stratified by comorbid autism and attention deficit hyperactivity disorder (ADHD). We defined ID by attendance at a special school or registered diagnosis and obtained data on criminal convictions and injuries or deaths due to assaults from nationwide registers until end of 2013. Results Compared to people without ID, autism or ADHD, men and women with mild or moderate/severe ID and comorbid ADHD had elevated risks of violent crimes [range of hazard ratios (HRs) 4.4-10.4] and assault victimization (HRs 2.0-7.7). Women with mild ID without comorbidities or with comorbid autism also had elevated risks of violent crimes and victimization (HRs 1.8-4.6) compared to women without ID, autism or ADHD. The relative risks of sexual offending and victimization were elevated in men and women with ID without comorbidities (HRs 2.6-12.7). The highest risks for sexual offending in men (HRs 9.4-11.0) and for sexual assault victimization in women (HRs 11.0-17.1) related to ID and comorbid ADHD. Conclusions The elevated risk of violent offending and assault victimization in people with ID is largely explained by comorbid ADHD, whereas ID is independently associated with sexual crimes and victimization, even though absolute risks are low. Copyright © The Author(s), 2022. Published by Cambridge University Press.

Place, publisher, year, edition, pages
Cambridge: Cambridge University Press, 2023
Keywords
ADHD, autism, Intellectual disability, sexual offending, victimization, violent offending
National Category
Psychiatry
Identifiers
urn:nbn:se:hh:diva-52088 (URN)10.1017/S0033291722000460 (DOI)000763764700001 ()35238292 (PubMedID)2-s2.0-85126274421 (Scopus ID)
Funder
Swedish Research Council, 2016-01989Forte, Swedish Research Council for Health, Working Life and Welfare, 2018-01789
Note

This research was supported by the Academy of Finland (grant 308698 to Dr Latvala), the Swedish Research Council for Health, Working Life and Welfare (grant 2018-01789 to Dr Tideman), the Swedish Research Council (grant 2016-01989 to Dr Lichtenstein), and MISA (grant 20100825 to Dr Tideman). Dr Fazel is funded by Wellcome Trust Senior Research Fellowship in Clinical Science (#202836/Z/16/Z).

Available from: 2023-11-21 Created: 2023-11-21 Last updated: 2023-11-21Bibliographically approved
Khemiri, L., Kuja-Halkola, R., Larsson, H., Butwicka, A., Tideman, M., D'Onofrio, B. M., . . . Lichtenstein, P. (2023). Parental substance use disorder and risk of intellectual disability in offspring in Sweden: a national register study. eClinicalMedicine, 63, Article ID 102170.
Open this publication in new window or tab >>Parental substance use disorder and risk of intellectual disability in offspring in Sweden: a national register study
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2023 (English)In: eClinicalMedicine, E-ISSN 2589-5370, Vol. 63, article id 102170Article in journal (Refereed) Published
Abstract [en]

Background: Intellectual disability (ID) is a disorder with unknown aetiology in many cases. Maternal alcohol use is a known risk factor for ID, but less is known about the importance of maternal and paternal substance use disorder (SUD) and risk of ID in offspring. Methods: Data from multiple nationwide registers were used to create a cohort of children born from January 01, 1978 to December 31, 2002. All participants were born in Sweden, had available parental identification information and did not emigrate or die before age 12 (n = 1,940,820). Logistic regression modelling was performed with exposure defined as having a parent who received any SUD diagnosis, including alcohol use disorder (AUD) and drug use disorder (DUD). The outcome was registration of diagnosis of any form of ID. First, we analysed the risk of ID if parental SUD was registered prior to childbirth with stepwise adjustment of multiple covariates. Second, the effect of timing of SUD diagnosis in relation to childbirth was analysed. Findings: Of 37,410 offspring with parental SUD registered prior to birth, 3.0% (n = 1110) had any form of ID compared to 1.2% (n = 23,168) of those 1,903,410 individuals without parental SUD prior birth. Parental SUD prior birth was associated with an increased risk of any form of ID (Odds Ratio [OR]: 2.3 [2.2–2.5]), with ORs similar for maternal (OR: 2.3 [2.1–2.5]) and paternal SUD (OR: 2.3 [2.1–2.5]). These ORs were reduced but remained statistically significant after adjusting for parental education, migration, psychiatric comorbidity, and co-parent SUD (OR parental SUD: 1.6 [1.5–1.8]; OR maternal SUD: 1.4 [1.2–1.5]; OR paternal SUD: 1.6 [1.5–1.7]). Parental SUD was associated with increased risk of ID in offspring irrespective of timing of diagnosis, but if mothers or fathers were diagnosed with AUD during pregnancy (OR maternal AUD: 5.0 [3.1–8.2]; OR paternal AUD: 2.8 [2.2–3.6]), the risk was significantly greater than if the AUD diagnosis was first registered after childbirth (OR maternal AUD: 1.9 [1.8–2.0]; OR paternal AUD: 1.6 [1.6–1.7]). Interpretation: Both paternal and maternal SUD were associated with an increased risk of ID in offspring, with greatest risk observed when AUD was diagnosed during pregnancy. Possible mechanisms may involve shared genetic and environmental factors, including toxic effects from alcohol intake. These findings have clinical implications in suggesting that parental SUD in either parent represents a possibly modifiable risk factor to consider when developing prevention, diagnostics and treatment programs for children with ID. Funding: Stockholm County Council, the Research Council of the Swedish Alcohol Retailing Monopoly, Fredrik and Ingrid Thurings stiftelse, Academy of Finland, the Swedish Research Council and the Swedish Research Council for Health, Working Life and Welfare, Nordforsk by the Nordic Council of Ministers and the Polish Medical Research Agency. © 2023 The Authors

Place, publisher, year, edition, pages
London: Elsevier, 2023
Keywords
Intellectual disability, Mental retardation, Parental alcohol use disorder, Parental drug use disorder, Parental substance use disorder
National Category
Psychiatry
Identifiers
urn:nbn:se:hh:diva-51618 (URN)10.1016/j.eclinm.2023.102170 (DOI)001072668100001 ()37680949 (PubMedID)2-s2.0-85169052113 (Scopus ID)
Funder
Region StockholmFredrik och Ingrid Thurings StiftelseAcademy of FinlandSwedish Research CouncilForte, Swedish Research Council for Health, Working Life and WelfareNordic Council of Ministers
Note

Funding text:

Research Council of the Swedish Alcohol Retailing Monopoly

Polish Medical Research Agency

Available from: 2023-11-13 Created: 2023-11-13 Last updated: 2023-11-13Bibliographically approved
Taubner, H., Tideman, M. & Carin, S. (2023). People with intellectual disability and employment sustainability: A qualitative interview study. JARID: Journal of applied research in intellectual disabilities, 36(1), 78-86
Open this publication in new window or tab >>People with intellectual disability and employment sustainability: A qualitative interview study
2023 (English)In: JARID: Journal of applied research in intellectual disabilities, ISSN 1360-2322, E-ISSN 1468-3148, Vol. 36, no 1, p. 78-86Article in journal (Refereed) Published
Abstract [en]

Background: Swedish employment rates are disproportionately low among people with intellectual disability and research on employment sustainability in this group is scarce. This study investigated employment sustainability among people with intellectual disability, with a focus on identifying facilitators. Method: Fifteen persons with intellectual disability who were gainfully employed and had been so for at least 1 year during the last 3 years, and 10 representatives from their employers, were interviewed. Results: Five facilitators were identified: (1) having tried various types of work, (2) liking to be at work, (3) balance concerning expectations and adaptations, (4) mutual engagement and flexibility, and (5) wage subsidies. Conclusion: Employment sustainability needs to be understood at individual as well as environmental and societal levels. In addition, both duration and progress should be considered regarding employment sustainability in this population. © 2022 The Authors. Journal of Applied Research in Intellectual Disabilities published by John Wiley & Sons Ltd.

Place, publisher, year, edition, pages
Chichester: Wiley-Blackwell Publishing Inc., 2023
Keywords
employment, intellectual disability, qualitative interviews, sustainability
National Category
Social Work Work Sciences
Identifiers
urn:nbn:se:hh:diva-48141 (URN)10.1111/jar.13036 (DOI)000855788300001 ()36129123 (PubMedID)2-s2.0-85138434820 (Scopus ID)
Funder
Swedish Social Insurance Agency, 008432-2019
Available from: 2022-09-23 Created: 2022-09-23 Last updated: 2023-01-12Bibliographically approved
Tideman, M., Kristén, L. & Szönyi, K. (2023). The preparation for entry into adulthood - supported decision-making in upper secondary school for students with intellectual disability. European Journal of Special Needs Education, 38(2), 155-167
Open this publication in new window or tab >>The preparation for entry into adulthood - supported decision-making in upper secondary school for students with intellectual disability
2023 (English)In: European Journal of Special Needs Education, ISSN 0885-6257, E-ISSN 1469-591X, Vol. 38, no 2, p. 155-167Article in journal (Refereed) Published
Abstract [en]

The upper secondary school for individuals with intellectual disability should prepare for an adult life as an active citizen with great self-determination and participation in democratic decision-making processes. The extent to which and in what way the schools work to prepare the students and develop their skills are likely of great importance for the students’ adult life. The purpose of the study was to increase the knowledge of how students with intellectual disability in Sweden are prepared for adulthood, with special focus on self-determination. Case studies on three schools were carried out through observations of decision-making processes and interviews with students and staff. The main findings consist of three different approaches to self-determination for students with intellectual disability: ‘Targeted and Conscious’, ‘Forward with Uncertainty’ and ‘Braking and Protecting’. Increased knowledge about, and analyses of, the processes that take place when young people with reduced decision-making capacity, due to intellectual disability, make decisions with the support of others are important. Implications underline the need to strengthen the awareness, knowledge and support of school staff when it comes to strengthening students’ decision-making capacity. The students with intellectual disability need to be equipped for a society where they as adults will be surrounded by choices and expectations of making decisions. © 2022 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

Place, publisher, year, edition, pages
Abingdon: Routledge, 2023
Keywords
Active citizen, intellectual disability, self-determination, supported decision-making, upper secondary school
National Category
Didactics
Identifiers
urn:nbn:se:hh:diva-46498 (URN)10.1080/08856257.2022.2045814 (DOI)000761501800001 ()2-s2.0-85125938119 (Scopus ID)
Note

Funding: Stiftelsen Sävstaholm under Grant number ST 2015-040

Available from: 2022-03-21 Created: 2022-03-21 Last updated: 2023-04-19Bibliographically approved
Ahlström, G., Wallén, E. F., Tideman, M. & Holmgren, M. (2022). Ageing people with intellectual disabilities and the association between frailty factors and social care: A Swedish national register study. Journal of Intellectual Disabilities, 26(4), 900-918
Open this publication in new window or tab >>Ageing people with intellectual disabilities and the association between frailty factors and social care: A Swedish national register study
2022 (English)In: Journal of Intellectual Disabilities, ISSN 1744-6295, E-ISSN 1744-6309, Vol. 26, no 4, p. 900-918Article in journal (Refereed) Published
Abstract [en]

The aim of this study was to describe the social care provided for different age groups of people with intellectual disability, 55 years or above, and to investigate the association between such care and frailty factors for those with diagnosed level of intellectual disabilities. Descriptive and logistic regression analyses were used. Commonest forms of social care among the 7936 people were Residential care, Daily activities and Contact person. Home help and Security alarm increased with age. The frailty factors significantly associated with increased social care were age, polypharmacy and severe levels of intellectual disabilities. Persons most likely to be in residential care were in the age group 65–79 with polypharmacy and severe disability. The results indicate a need for further research of how frailty factors are considered in social care and longstanding medication, especially then severe intellectual disability hinders communication. A national strategic plan for preventive interventions should be developed to ensure the best possible healthy ageing. © The Author(s) 2021.

Place, publisher, year, edition, pages
Thousand Oaks, CA: Sage Publications, 2022
Keywords
frailty, intellectual disability, older people, social care, multimorbidity
National Category
Sociology
Identifiers
urn:nbn:se:hh:diva-45884 (URN)10.1177/17446295211037170 (DOI)000715947700001 ()34727746 (PubMedID)2-s2.0-85118553594 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2014-4753
Note

Funding: Faculty of Medicine, Lund University

Available from: 2021-11-16 Created: 2021-11-16 Last updated: 2023-03-13Bibliographically approved
Taubner, H., Tideman, M. & Staland Nyman, C. (2022). Employment Sustainability for People with Intellectual Disability: A Systematic Review. Journal of occupational rehabilitation, 32(3), 353-364
Open this publication in new window or tab >>Employment Sustainability for People with Intellectual Disability: A Systematic Review
2022 (English)In: Journal of occupational rehabilitation, ISSN 1053-0487, E-ISSN 1573-3688, Vol. 32, no 3, p. 353-364Article, review/survey (Refereed) Published
Abstract [en]

Purpose: Previous reviews about employment for people with intellectual disability (ID) have left questions about employment sustainability unanswered. Therefore, the aim of this systematic review was to identify and analyse research regarding employment sustainability for people with ID. The research questions were: What research about employment sustainability for people with ID has been published internationally between 2010 and 2020? In the identified studies, how is employment sustainability defined and measured and what are the main findings regarding employment sustainability?

Methods: A systematic review was conducted using eight databases from various disciplines including medical, health, and social sciences. After a selection process, 10 articles remained, and a framework matrix was created to analyse them. An employment sustainability definition was used as an analytical tool.

Results: Ten articles were identified as being about employment sustainability for people with ID. Five of them used qualitative designs and five used quantitative designs. Only four out of ten contained a definition of employment sustainability, and there was an inconsistency in measurement methods. The reported findings in the studied articles were categorised into three types: proportions of long-term employed individuals within the studied population, facilitators and barriers to long-term employment.

Conclusions: There is only a limited amount of research about employment sustainability for people with ID. Nevertheless, a few facilitators and barriers could be identified. There is no consensus about how to define or measure employment sustainability, making comparisons difficult. © The Author(s) 2021

Place, publisher, year, edition, pages
New York: Springer, 2022
Keywords
Intellectual disability, Employment, Sustainability, Systematic review
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:hh:diva-46158 (URN)10.1007/s10926-021-10020-9 (DOI)000734696600001 ()34958449 (PubMedID)2-s2.0-85121667639 (Scopus ID)
Funder
Swedish Social Insurance Agency, 008432-2019Halmstad University
Note

Funding: Open access funding provided by Halmstad University.

Available from: 2021-12-27 Created: 2021-12-27 Last updated: 2024-01-22Bibliographically approved
Lichtenstein, P., Tideman, M., Sullivan, P. F., Serlachius, E., Larsson, H., Kuja-Halkola, R. & Butwicka, A. (2022). Familial risk and heritability of intellectual disability: a population-based cohort study in Sweden. Journal of Child Psychology and Psychiatry, 63(9), 1092-1102
Open this publication in new window or tab >>Familial risk and heritability of intellectual disability: a population-based cohort study in Sweden
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2022 (English)In: Journal of Child Psychology and Psychiatry, ISSN 0021-9630, E-ISSN 1469-7610, Vol. 63, no 9, p. 1092-1102Article in journal (Refereed) Published
Abstract [en]

Background: Intellectual disability (ID) aggregates in families, but factors affecting individual risk and heritability estimates remain unknown. Methods: A population-based family cohort study of 4,165,785 individuals born 1973–2013 in Sweden, including 37,787 ID individuals and their relatives. The relative risks (RR) of ID with 95% confidence intervals (95% CI) were obtained from stratified Cox proportional-hazards models. Relatives of ID individuals were compared to relatives of unaffected individuals. Structural equation modeling was used to estimate heritability. Results: Relatives of ID individuals were at increased risk of ID compared to individuals with unaffected relatives. The RR of ID among relatives increased proportionally to the degree of genetic relatedness with ID probands; 256.70(95% CI 161.30–408.53) for monozygotic twins, 16.47(13.32–20.38) for parents, 14.88(12.19–18.16) for children, 7.04(4.67–10.61) for dizygotic twins, 8.38(7.97–8.83) for full siblings, 4.56(4.02–5.16) for maternal, 2.90(2.49–3.37) for paternal half-siblings, 3.03(2.61–3.50) for nephews/nieces, 2.84(2.45–3.29) for uncles/aunts, and 2.04(1.91–2.20) for cousins. Lower RRs were observed for siblings of probands with chromosomal abnormalities (RR 5.53, 4.74–6.46) and more severe ID (mild RR 9.15, 8.55–9.78, moderate RR 8.13, 7.28–9.08, severe RR 6.80, 5.74–8.07, and profound RR 5.88, 4.52–7.65). Male sex of relative and maternal line of relationship with proband was related to higher risk (RR 1.33, 1.25–1.41 for brothers vs. sisters and RR 1.49, 1.34–1.68 for maternal vs. paternal half-siblings). ID was substantially heritable with 0.95(95% CI 0.93–0.98) of the variance in liability attributed to genetic influences. Conclusions: The risk estimates will benefit researchers, clinicians, families in understanding the risk of ID in the family and the whole population. The higher risk of ID related to male sex and maternal linage will be of value for planning and interpreting etiological studies in ID. © 2021 The Authors. Journal of Child Psychology and Psychiatry published by John Wiley & Sons Ltd on behalf of Association for Child and Adolescent Mental Health

Place, publisher, year, edition, pages
Hoboken, New Jersey: Wiley-Blackwell Publishing Inc., 2022
Keywords
family factors, genetics, Intellectual disability, siblings, twins
National Category
Psychiatry
Identifiers
urn:nbn:se:hh:diva-46470 (URN)10.1111/jcpp.13560 (DOI)000731289500001 ()2-s2.0-85121417293 (Scopus ID)
Funder
Forte, Swedish Research Council for Health, Working Life and Welfare, 2018-01789Forte, Swedish Research Council for Health, Working Life and Welfare, 2012-1678Region Stockholm, 20180718Swedish Foundation for Strategic ResearchSwedish Research Council, 340-2013-5867EU, Horizon 2020, 610307
Note

Funding agency:

Swedish Research Council, European Commission Grant number: 2016-01989, 2017-00788, D088650, 2017-00641

Swedish Research Council through the Swedish Initiative for Research on Microdata in the Social and Medical Sciences (SIMSAM) Grant number: 340-2013-5867

Horizon 2020 Program of the European Union (COSYN, RIA grant) Grant number: 610307

United States Department of Health & Human Services, National Institutes of Health (NIH) - USA, NIH National Institute of Mental Health (NIMH) Grant number:: U01 MH109528, R01 MH077139

Shire

Available from: 2022-03-17 Created: 2022-03-17 Last updated: 2023-08-28Bibliographically approved
Jormfeldt, M. & Tideman, M. (2021). Ageing with Intellectual Disability In Sweden: Participation and Self Determination (1ed.). In: Michelle Putnam; Christine Bigby (Ed.), Handbook on Ageing with Disability: (pp. 262-272). New York: Routledge
Open this publication in new window or tab >>Ageing with Intellectual Disability In Sweden: Participation and Self Determination
2021 (English)In: Handbook on Ageing with Disability / [ed] Michelle Putnam; Christine Bigby, New York: Routledge, 2021, 1, p. 262-272Chapter in book (Refereed)
Place, publisher, year, edition, pages
New York: Routledge, 2021 Edition: 1
Series
Routhledge Handbooks
Keywords
Intellectual Disability, ageing, selfdetemination participation
National Category
Social Work
Identifiers
urn:nbn:se:hh:diva-45885 (URN)2-s2.0-85106859627 (Scopus ID)978-1-138-61149-8 (ISBN)978-0-429-46535-2 (ISBN)
Available from: 2021-11-16 Created: 2021-11-16 Last updated: 2021-12-10Bibliographically approved
Hirvikoski, T., Boman, M., Tideman, M., Lichtenstein, P. & Butwicka, A. (2021). Association of Intellectual Disability with All-Cause and Cause-Specific Mortality in Sweden. JAMA Network Open, 4(6), Article ID e2113014.
Open this publication in new window or tab >>Association of Intellectual Disability with All-Cause and Cause-Specific Mortality in Sweden
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2021 (English)In: JAMA Network Open, E-ISSN 2574-3805, Vol. 4, no 6, article id e2113014Article in journal (Refereed) Published
Abstract [en]

© 2021 American Medical Association. All rights reserved.Importance: Knowledge of the health challenges and mortality in people with intellectual disability (ID) should guide health policies and practices in contemporary society. Objective: To examine premature mortality in individuals with ID. Design, Setting, and Participants: This population-based longitudinal cohort study obtained data from several national health care, education, and population registers in Sweden. Two registers were used to identify individuals with ID: the National Patient Register and the Halmstad University Register on Pupils With Intellectual Disability. Two cohorts were created: cohort 1 comprised young adults (born between 1980 and 1991) with mild ID, and cohort 2 comprised individuals (born between 1932 and 2013) with mild ID or moderate to profound ID; each cohort had matched reference cohorts. Data analyses were conducted between June 1, 2020, and March 31, 2021. Exposures: Mild or moderate to profound ID. Main Outcomes and Measures: The primary outcome was overall (all-cause) mortality, and the secondary outcomes were cause-specific mortality and potentially avoidable mortality. Results: Cohort 1 included 13 541 young adults with mild ID (mean [SD] age at death, 24.53 [3.66] years; 7826 men [57.8%]), and its matched reference cohort consisted of 135410 individuals. Cohort 2 included 24059 individuals with mild ID (mean [SD] age at death, 52.01 [16.88] years; 13649 male individuals [56.7%]) and 26602 individuals with moderate to profound ID (mean [SD] age at death, 42.16 [21.68] years; 15338 male individuals [57.7%]); its matched reference cohorts consisted of 240590 individuals with mild ID and 266020 with moderate to profound ID. Young adults with mild ID had increased overall mortality risk compared with the matched reference cohort (odds ratio [OR], 2.86; 95% CI, 2.33-3.50), specifically excess mortality in neoplasms (OR, 3.58; 95% CI, 2.02-6.35), diseases of the nervous system (OR, 40.00; 95% CI, 18.43-86.80) and circulatory system (OR, 9.24; 95% CI, 4.76-17.95). Among deaths that were amenable to health care (OR, 7.75; 95% CI, 4.85-12.39), 55% were attributed to epilepsy. In cohort 2, increased risk of overall mortality was observed among both individuals with mild ID (OR, 6.21; 95% CI, 5.79-6.66) and moderate to profound ID (OR, 13.15; 95% CI, 12.52-13.81) compared with the matched reference cohorts. Those with moderate to profound ID had a higher risk in several cause-of-death categories compared with those with mild ID or the matched reference cohort. Adjustment for epilepsy and congenital malformations attenuated the associations. The relative risk of premature death was higher in women (OR, 6.23; 95% CI, 4.42-8.79) than in men (OR, 1.99; 95% CI, 1.53-2.60), but the absolute risk of mortality was similar (0.9% for women vs 0.9% for men). Conclusions and Relevance: This study found excess premature mortality and high risk of deaths with causes that were potentially amenable to health care intervention among people with ID. This finding suggests that this patient population faces persistent health challenges and inequality in health care encounters..

Place, publisher, year, edition, pages
American Medical Association, 2021
National Category
Geriatrics
Identifiers
urn:nbn:se:hh:diva-45337 (URN)10.1001/jamanetworkopen.2021.13014 (DOI)000667449200004 ()34156453 (PubMedID)2-s2.0-85108535404 (Scopus ID)
Available from: 2021-07-23 Created: 2021-07-23 Last updated: 2021-10-20Bibliographically approved
Liu, S., Kuja-Halkola, R., Larsson, H., Lichtenstein, P., Ludvigsson, J. F., Svensson, A.-M., . . . Butwicka, A. (2021). Neurodevelopmental Disorders, Glycemic Control, and Diabetic Complications in Type 1 Diabetes: a Nationwide Cohort Study. Journal of Clinical Endocrinology and Metabolism, 106(11), e4459-e4470
Open this publication in new window or tab >>Neurodevelopmental Disorders, Glycemic Control, and Diabetic Complications in Type 1 Diabetes: a Nationwide Cohort Study
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2021 (English)In: Journal of Clinical Endocrinology and Metabolism, ISSN 0021-972X, E-ISSN 1945-7197, Vol. 106, no 11, p. e4459-e4470Article in journal (Refereed) Published
Abstract [en]

Context: Neurodevelopmental disorders are more prevalent in childhood-onset type 1 diabetes than in the general population, and the symptoms may limit the individual’s ability for diabetes management.

Objective: This study investigated whether comorbid neurodevelopmental disorders are associated with long-term glycemic control and risk of diabetic complications.

Methods: This population-based cohort study used longitudinally collected data from Swedish registers. We identified 11 326 individuals born during 1973-2013, diagnosed with type 1 diabetes during 1990-2013 (median onset age: 9.6 years). Among them, 764 had a comorbid neurodevelopmental disorder, including attention-deficit/hyperactivity disorder (ADHD), autism spectrum disorder, and intellectual disability. We used multinomial logistic regression to calculate odds ratios (ORs) of having poor glycemic control (assessed by glycated hemoglobin [HbA1c]) and Cox regression to estimate hazard ratios (HRs) of nephropathy and retinopathy.

Results: The median follow-up was 7.5 years (interquartile range [IQR] 3.9, 11.2). Having any neurodevelopmental disorder (ORadjusted 1.51 [95% CI 1.13, 2.03]), or ADHD (ORadjusted 2.31 [95% CI 1.54, 3.45]) was associated with poor glycemic control (mean HbA1c > 8.5%). Increased risk of diabetic complications was observed in patients with comorbid neurodevelopmental disorders (HRadjusted 1.72 [95% CI 1.21, 2.44] for nephropathy, HRadjusted 1.18 [95% CI 1.00, 1.40] for retinopathy) and patients with ADHD (HRadjusted 1.90 [95% CI 1.20, 3.00] for nephropathy, HRadjusted 1.33 [95% CI 1.07, 1.66] for retinopathy). Patients with intellectual disability have a particularly higher risk of nephropathy (HRadjusted 2.64 [95% CI 1.30, 5.37]).

Conclusion: Comorbid neurodevelopmental disorders, primarily ADHD and intellectual disability, were associated with poor glycemic control and a higher risk of diabetic complications in childhood-onset type 1 diabetes. © The Author(s) 2021.

Place, publisher, year, edition, pages
Cary, NC: Oxford University Press, 2021
Keywords
Biochemistry, medical, Clinical Biochemistry, Endocrinology, Biochemistry, Endocrinology, Diabetes and Metabolism
National Category
Psychiatry Endocrinology and Diabetes
Identifiers
urn:nbn:se:hh:diva-45915 (URN)10.1210/clinem/dgab467 (DOI)000715561700035 ()34171098 (PubMedID)2-s2.0-85119503813 (Scopus ID)
Funder
Swedish Research Council, 2017-00788Stockholm County Council
Note

Funding: The Swedish Research Council (No 2017-00788), Stockholm Region Council (No 20180718) and Karolinska Institutet, Strategic Research Program in Neuroscience (StratNeuro).

Available from: 2021-11-21 Created: 2021-11-21 Last updated: 2021-12-01Bibliographically approved
Projects
Between care paternalism and empowerment? On self-organization: The case of activities for young adults with intellectual disabilities. [2012-00576_Forte]; Halmstad UniversityThe entering into adulthood – occupational patterns and individual prerequisites for young adults with intellectual disability in Sweden [2018-01789_Forte]; Halmstad UniversityUnga vuxna med intellektuell funktionsnedsättning på arbetsmarknaden - framgångsfaktorer för förvärvsarbete och därmed minskat beroende av socialförsäkringen [008432-2019]; Halmstad University; Publications
Taubner, H., Tideman, M. & Staland Nyman, C. (2022). Employment Sustainability for People with Intellectual Disability: A Systematic Review. Journal of occupational rehabilitation, 32(3), 353-364
Utvärdering av V.I.P – Viktig Intressant Person; Marie Cederschiöld UniversityA global survey exploring the impact of Covid 19 on individuals with intellectual disability and their caregivers - the Swedish sub-study [2020-02694_Formas]; Marie Cederschiöld UniversityPersoner med intellektuell funktionsnedsättning och deras erfarenheter och upplevelser av covid-19; Marie Cederschiöld UniversityForskningsprogrammet Människovärde och delaktighet (MOD); Marie Cederschiöld UniversityKommunala riktlinjer för LSS-insatser; Marie Cederschiöld UniversityImplementering av active support; Marie Cederschiöld UniversityLeder individuella stöd till ökad delaktighet?; Marie Cederschiöld UniversityErfarenheter av att få stöd och vara företrädd av en god man; Marie Cederschiöld University
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0002-7519-6488

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