ASD and ADHD symptoms in 18-year-olds - A population-based study of twins born 1993 to 2001

The diagnostic prevalences of Autism Spectrum Disorder (ASD) and Attention-Deficit/Hyperactivity Disorder (ADHD) have increased dramatically over the past two decades in the western world, particularly among teenagers and young adults. Here, we aimed to investigate whether there had been a corresponding increase in parent reported symptoms of ASD and ADHD in a population-based sample of 18-year-old twins born between 1993-2001.

Data were collected in the Child and Adolescent Twin Study in Sweden (CATSS), in which parents report on symptoms of ASD and ADHD in connection with their children´s 18^th birthday. Trends across 9 consecutive birth years in reported symptoms were analyzed as population mean scores and with percentile-based cut-offs using linear and logistic regression methods.

For ASD, there was no increase in the symptom phenotype across the examined birth years, neither at the population mean level nor at or above the 95^th percentile of the ASD symptom score. For ADHD, there was a small - but statistically significant - increase over time of the population mean ADHD symptom score in girls (regression coefficient: 0.046 (95 % Confidence interval 0.025 - 0.066). p < 0.001), but not in boys. The prevalence at or above the 90^th percentile of the ADHD symptom score was stable in boys but increased statistically significantly in girls (Odds Ratio: 1.053 (95 % Confidence interval 1.016-1.094). p = 0.005).

The rise in clinical diagnoses of ASD and ADHD in the adolescent/young adult population does not seem to be parallelled by a similar increase in ASD and ADHD symptoms.