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Hypospadias and increased risk for neurodevelopmental disorders
Author(s) -
Butwicka Agnieszka,
Lichtenstein Paul,
Landén Mikael,
Nordenvall Anna S.,
Nordenström Anna,
Nordenskjöld Agneta,
Frisén Louise
Publication year - 2015
Publication title -
journal of child psychology and psychiatry
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.652
H-Index - 211
eISSN - 1469-7610
pISSN - 0021-9630
DOI - 10.1111/jcpp.12290
Subject(s) - hypospadias , cohort , anxiety , psychiatry , attention deficit hyperactivity disorder , autism , psychology , pediatrics , medicine , autism spectrum disorder , mood , surgery
Background Hypospadias (aberrant opening of the urethra on the underside of the penis) occurs in 1 per 300 newborn boys. It has been previously unknown whether this common malformation is associated with increased psychiatric morbidity later in life. Studies of individuals with hypospadias also provide an opportunity to examine whether difference in androgen signaling is related to neurodevelopmental disorders. To elucidate the mechanisms behind a possible association, we also studied psychiatric outcomes among brothers of the hypospadias patients. Methods Registry study within a national cohort of all 9,262 males with hypospadias and their 4,936 healthy brothers born in Sweden between 1973 and 2009. Patients with hypospadias and their brothers were matched with controls by year of birth and county. The following outcomes were evaluated (1) any psychiatric (2) psychotic, (3) mood, (4) anxiety, (5) eating, and (6) personality disorders, (7) substance misuse, (8) attention‐deficit hyperactivity disorder (ADHD), (9) autism spectrum disorders (ASD), (10) intellectual disability, and (11) other behavioral/emotional disorders with onset in childhood. Results Patients with hypospadias were more likely to be diagnosed with intellectual disability (OR 3.2; 95% CI 2.8–3.8), ASD (1.4; 1.2–1.7), ADHD (1.5; 1.3–1.9), and behavioral/emotional disorders (1.4; 1.2–1.6) compared with the controls. Brothers of patients with hypospadias had an increased risk of ASD (1.6; 1.3–2.1) and other behavioral/emotional disorders with onset in childhood (1.2; 0.9–1.5) in comparison to siblings of healthy individuals. A slightly higher, although not statistically significant, risk was found for intellectual disability (1.3; 1.0–1.9). No relation between other psychiatric diagnosis and hypospadias was found. Conclusions This is the first study to identify an increased risk for neurodevelopmental disorders in patients with hypospadias, as well as an increased risk for ASD in their brothers, suggesting a common familial (genetic and/or environmental) liability.