Childhood neurodivergent traits, inflammation and chronic disabling fatigue in adolescence: a longitudinal case–control study
Objectives To test whether inflammatory processes link the expression of childhood neurodivergent traits to chronic disabling fatigue in adolescence.Design Longitudinal case–control study.Setting We analysed data from The Avon Longitudinal Study of Parents and Children (ALSPAC).Participants 8115 and...
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BMJ Publishing Group
2024-07-01
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| Series: | BMJ Open |
| Online Access: | https://bmjopen.bmj.com/content/14/7/e084203.full |
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| author | Neil A Harrison Hugo D Critchley Jessica Eccles Kevin A Davies Lisa Quadt Rod Bond Jenny Csecs |
| author_facet | Neil A Harrison Hugo D Critchley Jessica Eccles Kevin A Davies Lisa Quadt Rod Bond Jenny Csecs |
| author_sort | Neil A Harrison |
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| description | Objectives To test whether inflammatory processes link the expression of childhood neurodivergent traits to chronic disabling fatigue in adolescence.Design Longitudinal case–control study.Setting We analysed data from The Avon Longitudinal Study of Parents and Children (ALSPAC).Participants 8115 and 8036 children of the ALSPAC cohort at ages 7 and 9 years, respectively, 4563 of whom also completed self-report measures at age 18 years.Primary and secondary outcome measures We assessed if children scoring above screening threshold for autism/attention deficit hyperactivity disorder (ADHD) at ages 7 and 9 years had increased risk of chronic disabling fatigue at age 18 years, computing ORs and CIs for effects using binary logistic regression. Mediation analyses were conducted to test if an inflammatory marker (interleukin 6 (IL-6)) at age 9 years linked neurodivergent traits to chronic disabling fatigue at age 18 years.Results Children with neurodivergent traits at ages 7 and 9 years were two times as likely to experience chronic disabling fatigue at age 18 years (likely ADHD OR=2.18 (95% CI=1.33 to 3.56); p=0.002; likely autism OR=1.78 (95% CI=1.17 to 2.72); p=0.004). Levels of IL-6 at age 9 were associated with chronic disabling fatigue at age 18 (OR=1.54 (95% CI=1.13 to 2.11); p=0.006). Inflammation at age 9 years mediated effects of neurodivergent traits on chronic disabling fatigue (indirect effect via IL-6: ADHD b=1.08 (95% CI=1.01 to 1.15); autism b=1.06; (95% CI=1.03 to 1.10)). All effects remained significant when controlling for the presence of depressive symptoms.Conclusions Our results indicate higher risk of chronic disabling fatigue for children with neurodivergent traits, likely linked to higher levels of inflammation. The implementation of transdiagnostic screening criteria to inform support strategies to counteract risk early in life is recommended. |
| format | Article |
| id | doaj-art-81eed684f0e046c38c3f566e7f25537a |
| institution | Kabale University |
| issn | 2044-6055 |
| language | English |
| publishDate | 2024-07-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open |
| spelling | doaj-art-81eed684f0e046c38c3f566e7f25537a2025-02-07T08:30:09ZengBMJ Publishing GroupBMJ Open2044-60552024-07-0114710.1136/bmjopen-2024-084203Childhood neurodivergent traits, inflammation and chronic disabling fatigue in adolescence: a longitudinal case–control studyNeil A Harrison0Hugo D Critchley1Jessica Eccles2Kevin A Davies3Lisa Quadt4Rod Bond5Jenny Csecs64 Cardiff University Brain Research Imaging Centre, Cardiff University, Cardiff, UKDepartment of Clinical Neuroscience, Brighton and Sussex Medical School, Brighton, UK1 Department of Clinical Neuroscience, Brighton and Sussex Medical School, Brighton, UKDepartment of Clinical and Experimental Medicine, Brighton and Sussex Medical School, Brighton, UKDepartment of Clinical Neuroscience, Brighton and Sussex Medical School, Brighton, UK3 School of Psychology, University of Sussex, Brighton, UK2 Berkshire Healthcare NHS Foundation Trust, Bracknell, Bracknell Forest, UKObjectives To test whether inflammatory processes link the expression of childhood neurodivergent traits to chronic disabling fatigue in adolescence.Design Longitudinal case–control study.Setting We analysed data from The Avon Longitudinal Study of Parents and Children (ALSPAC).Participants 8115 and 8036 children of the ALSPAC cohort at ages 7 and 9 years, respectively, 4563 of whom also completed self-report measures at age 18 years.Primary and secondary outcome measures We assessed if children scoring above screening threshold for autism/attention deficit hyperactivity disorder (ADHD) at ages 7 and 9 years had increased risk of chronic disabling fatigue at age 18 years, computing ORs and CIs for effects using binary logistic regression. Mediation analyses were conducted to test if an inflammatory marker (interleukin 6 (IL-6)) at age 9 years linked neurodivergent traits to chronic disabling fatigue at age 18 years.Results Children with neurodivergent traits at ages 7 and 9 years were two times as likely to experience chronic disabling fatigue at age 18 years (likely ADHD OR=2.18 (95% CI=1.33 to 3.56); p=0.002; likely autism OR=1.78 (95% CI=1.17 to 2.72); p=0.004). Levels of IL-6 at age 9 were associated with chronic disabling fatigue at age 18 (OR=1.54 (95% CI=1.13 to 2.11); p=0.006). Inflammation at age 9 years mediated effects of neurodivergent traits on chronic disabling fatigue (indirect effect via IL-6: ADHD b=1.08 (95% CI=1.01 to 1.15); autism b=1.06; (95% CI=1.03 to 1.10)). All effects remained significant when controlling for the presence of depressive symptoms.Conclusions Our results indicate higher risk of chronic disabling fatigue for children with neurodivergent traits, likely linked to higher levels of inflammation. The implementation of transdiagnostic screening criteria to inform support strategies to counteract risk early in life is recommended.https://bmjopen.bmj.com/content/14/7/e084203.full |
| spellingShingle | Neil A Harrison Hugo D Critchley Jessica Eccles Kevin A Davies Lisa Quadt Rod Bond Jenny Csecs Childhood neurodivergent traits, inflammation and chronic disabling fatigue in adolescence: a longitudinal case–control study BMJ Open |
| title | Childhood neurodivergent traits, inflammation and chronic disabling fatigue in adolescence: a longitudinal case–control study |
| title_full | Childhood neurodivergent traits, inflammation and chronic disabling fatigue in adolescence: a longitudinal case–control study |
| title_fullStr | Childhood neurodivergent traits, inflammation and chronic disabling fatigue in adolescence: a longitudinal case–control study |
| title_full_unstemmed | Childhood neurodivergent traits, inflammation and chronic disabling fatigue in adolescence: a longitudinal case–control study |
| title_short | Childhood neurodivergent traits, inflammation and chronic disabling fatigue in adolescence: a longitudinal case–control study |
| title_sort | childhood neurodivergent traits inflammation and chronic disabling fatigue in adolescence a longitudinal case control study |
| url | https://bmjopen.bmj.com/content/14/7/e084203.full |
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