Skip to main content

Advertisement

SpringerLink
Log in

Developmental and mental health risks among siblings of patients with autism spectrum disorder: a nationwide study

  • Original Contribution
  • Published:
European Child & Adolescent Psychiatry Aims and scope Submit manuscript

Abstract

Studies have suggested that unaffected siblings of patients with autism spectrum disorder (ASD) have some other neurodevelopmental abnormalities. However, the risks of mental and developmental disorders have rarely been investigated among unaffected siblings. Using Taiwan’s National Health Insurance Research Database, 1304 unaffected siblings born between 1980 and 2010 with ASD probands and 13,040 age-/sex-/family structure-matched controls were included in our study and followed up from 1996 or birth to the end of 2011. Developmental delay, language delay, developmental coordination disorder, attention-deficit hyperactivity disorder (ADHD), anxiety disorders, disruptive behavior disorders, unipolar disorder, and bipolar disorder were identified during the follow-up period. Unaffected siblings were more likely to develop any developmental delay, developmental speech or language disorder, developmental coordination disorder, intelligence disability, ADHD, anxiety disorders, unipolar depression, and disruptive behavior disorders compared with the control group. Brothers of patients with ASD had a higher risk of neurodevelopmental abnormalities, ADHD, anxiety disorders, and disruptive behavior disorders; sisters were prone to having neurodevelopmental abnormalities, ADHD, anxiety disorders, unipolar depression, and disruptive behavior disorders. Unaffected siblings of patients with ASD were prone to developing any developmental or mental disorder later in life. Clinicians and public health officials should pay more attention to the developmental condition and mental health of unaffected siblings of patients with ASD.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Lai MC, Lombardo MV, Baron-Cohen S (2014) Autism. Lancet 383(9920):896–910

    Article  Google Scholar 

  2. Baio J, Wiggins L, Christensen DL, Maenner MJ, Daniels J, Warren Z et al (2018) Prevalence of autism spectrum disorder among children aged 8 years—autism and developmental disabilities monitoring network, 11 sites, United States, 2014. Morbid Mortal Week Report Surveill Summar (Washington, DC: 2002) 67(6):1–23

    Google Scholar 

  3. Loomes R, Hull L, Mandy WPL (2017) What is the male-to-female ratio in autism spectrum disorder? A systematic review and meta-analysis. J Am Acad Child Adolesc Psychiatry 56(6):466–474

    Article  Google Scholar 

  4. Dalton KM, Nacewicz BM, Alexander AL, Davidson RJ (2007) Gaze-fixation, brain activation, and amygdala volume in unaffected siblings of individuals with autism. Biol Psychiatry 61(4):512–520

    Article  Google Scholar 

  5. Gamliel I, Yirmiya N, Jaffe DH, Manor O, Sigman M (2009) Developmental trajectories in siblings of children with autism: cognition and language from 4 months to 7 years. J Autism Dev Disord 39(8):1131–1144

    Article  Google Scholar 

  6. Gamliel I, Yirmiya N, Sigman M (2007) The development of young siblings of children with autism from 4 to 54 months. J Autism Dev Disord 37(1):171–183

    Article  Google Scholar 

  7. Lauritsen MB, Pedersen CB, Mortensen PB (2005) Effects of familial risk factors and place of birth on the risk of autism: a nationwide register-based study. J Child Psychol Psychiatry Allied Discip 46(9):963–971

    Article  Google Scholar 

  8. Pisula E, Ziegart-Sadowska K (2015) Broader autism phenotype in siblings of children with ASD—a review. Int J Mol Sci 16(6):13217–13258

    Article  Google Scholar 

  9. Piven J, Palmer P, Jacobi D, Childress D, Arndt S (1997) Broader autism phenotype: evidence from a family history study of multiple-incidence autism families. Am J Psychiatry 154(2):185–190

    Article  CAS  Google Scholar 

  10. Tsai HJ, Cebula K, Fletcher-Watson S (2017) The role of the broader autism phenotype and environmental stressors in the adjustment of siblings of children with autism spectrum disorders in Taiwan and the United Kingdom. J Autism Dev Disord 47(8):2363–2377

    Article  Google Scholar 

  11. Yirmiya N, Gamliel I, Shaked M, Sigman M (2007) Cognitive and verbal abilities of 24- to 36-month-old siblings of children with autism. J Autism Dev Disord 37(2):218–229

    Article  Google Scholar 

  12. Ruzich E, Allison C, Smith P, Watson P, Auyeung B, Ring H et al (2016) Subgrouping siblings of people with autism: Identifying the broader autism phenotype. Autism Res 9(6):658–665

    Article  Google Scholar 

  13. Gronborg TK, Schendel DE, Parner ET (2013) Recurrence of autism spectrum disorders in full- and half-siblings and trends over time: a population-based cohort study. JAMA Pediatr 167(10):947–953

    Article  Google Scholar 

  14. Jokiranta-Olkoniemi E, Cheslack-Postava K, Sucksdorff D, Suominen A, Gyllenberg D, Chudal R et al (2016) Risk of psychiatric and neurodevelopmental disorders among siblings of probands with autism spectrum disorders. JAMA Psychiat 73(6):622–629

    Article  Google Scholar 

  15. Lovell B, Wetherell MA (2016) The psychophysiological impact of childhood autism spectrum disorder on siblings. Res Dev Disabilit 49–50:226–234

    Article  Google Scholar 

  16. Quintero N, McIntyre LL (2010) Sibling adjustment and maternal well-being: an examination of families with and without a child with an autism spectrum disorder. Focus Autism Other Dev Disabil 25(1):37–46

    Article  Google Scholar 

  17. Piven J, Gayle J, Chase GA, Fink B, Landa R, Wzorek MM et al (1990) A family history study of neuropsychiatric disorders in the adult siblings of autistic individuals. J Am Acad Child Adolesc Psychiatry 29(2):177–183

    Article  CAS  Google Scholar 

  18. Hodapp RM, Urbano RC (2007) Adult siblings of individuals with Down syndrome versus with autism: findings from a large-scale US survey. J Intell Disabil Res JIDR 51(Pt 12):1018–1029

    Article  CAS  Google Scholar 

  19. O’Neill LP, Murray LE (2016) Anxiety and depression symptomatology in adult siblings of individuals with different developmental disability diagnoses. Res Dev Disabil 51–52:116–125

    Article  Google Scholar 

  20. Kuo CF, Grainge MJ, Valdes AM, See LC, Luo SF, Yu KH et al (2015) Familial aggregation of systemic lupus erythematosus and coaggregation of autoimmune diseases in affected families. JAMA Intern Med 175(9):1518–1526

    Article  Google Scholar 

  21. Chen MH, Hsu JW, Huang KL, Bai YM, Ko NY, Su TP et al (2018) Sexually transmitted infection among adolescents and young adults with attention-deficit/hyperactivity disorder: a nationwide longitudinal study. J Am Acad Child Adolesc Psychiatry 57(1):48–53

    Article  Google Scholar 

  22. Chen MH, Lan WH, Hsu JW, Huang KL, Su TP, Li CT et al (2016) Risk of developing type 2 diabetes in adolescents and young adults with autism spectrum disorder: a nationwide longitudinal study. Diabetes Care 39(5):788–793

    Article  CAS  Google Scholar 

  23. Chen MH, Pan TL, Li CT, Lin WC, Chen YS, Lee YC et al (2015) Risk of stroke among patients with post-traumatic stress disorder: nationwide longitudinal study. Brit J Psychiatry J Mental Sci 206(4):302–307

    Article  Google Scholar 

  24. Cheng CM, Chang WH, Chen MH, Tsai CF, Su TP, Li CT et al (2018) Co-aggregation of major psychiatric disorders in individuals with first-degree relatives with schizophrenia: a nationwide population-based study. Mol Psychiatry 23(8):1756–1763

    Article  Google Scholar 

  25. Liu CY, Hung YT, Chuang YL, Chen YJ, Weng WS, Liu JS (2006) Incorporating development stratification of Taiwan townships into sampling design of large scale health interview survey. J Health Manage (Chin) 4:1–22

    CAS  Google Scholar 

  26. Miller M, Musser ED, Young GS, Olson B, Steiner RD, Nigg JT (2019) Sibling recurrence risk and cross-aggregation of attention-deficit/hyperactivity disorder and autism spectrum disorder. JAMA Pediatr 173(2):147–152

    Article  Google Scholar 

  27. Ghirardi L, Brikell I, Kuja-Halkola R, Freitag CM, Franke B, Asherson P et al (2018) The familial co-aggregation of ASD and ADHD: a register-based cohort study. Mol Psychiatry 23(2):257–262

    Article  CAS  Google Scholar 

  28. Musser ED, Hawkey E, Kachan-Liu SS, Lees P, Roullet JB, Goddard K et al (2014) Shared familial transmission of autism spectrum and attention-deficit/hyperactivity disorders. J Child Psychol Psychiatry Allied Discipl 55(7):819–827

    Article  Google Scholar 

  29. Septier M, Peyre H, Amsellem F, Beggiato A, Maruani A, Poumeyreau M et al (2019) Increased risk of ADHD in families with ASD. Eur Child Adolesc Psychiatry 28(2):281–288

    Article  Google Scholar 

  30. Stergiakouli E, Davey Smith G, Martin J, Skuse DH, Viechtbauer W, Ring SM et al (2017) Shared genetic influences between dimensional ASD and ADHD symptoms during child and adolescent development. Mol Autism 8:18

    Article  Google Scholar 

  31. Nasr Esfahani F, Hakim Shooshtari M, Shirmohammadi Sosfadi R, Saeed F, Jalai F, Farsham A et al (2018) Internalizing and externalizing problems, empathy quotient, and systemizing quotient in 4 to 11 years-old siblings of children with autistic spectrum disorder compared to control group. Iran J Psychiatry 13(3):191–199

    PubMed  PubMed Central  Google Scholar 

  32. Orsmond GI, Seltzer MM (2009) Adolescent siblings of individuals with an autism spectrum disorder: testing a diathesis-stress model of sibling well-being. J Autism Dev Disord 39(7):1053–1065

    Article  Google Scholar 

  33. Schalbroeck R, Termorshuizen F, Visser E, van Amelsvoort T, Selten JP (2019) Risk of non-affective psychotic disorder or bipolar disorder in autism spectrum disorder: a longitudinal register-based study in the Netherlands. Psychol Med 49(15):2543–2550

    Article  CAS  Google Scholar 

  34. Skokauskas N, Frodl T (2015) Overlap between autism spectrum disorder and bipolar affective disorder. Psychopathology 48(4):209–216

    Article  Google Scholar 

Download references

Acknowledgement

We thank Mr I-Fan Hu for his friendship and support.

Funding

The study was supported by grant from Taipei Veterans General Hospital (V105A-049, V106B-020, V107B-010, V107C-181) and Ministry of Science and Technology, Taiwan (107–2314-B-075–063-MY3, 108–2314-B-075 -037). The funding source had no role in any process of our study.

Author information

Author notes

  1. Hung-Chen Lin and Chih-Ming Cheng contributed equally to this work.

Authors and Affiliations

  1. Department of Psychiatry, Taipei Veterans General Hospital, No. 201, Shih-Pai Road, Sec. 2, 11217, Taipei, Taiwan

    Hung-Chen Lin, Chih-Ming Cheng, Kai-Lin Huang, Ju-Wei Hsu, Ya-Mei Bai, Shih-Jen Tsai & Mu-Hong Chen

  2. Division of Psychiatry, School of Medicine, National Yang Ming Chiao Tung University, Taipei, Taiwan

    Hung-Chen Lin, Chih-Ming Cheng, Kai-Lin Huang, Ju-Wei Hsu, Ya-Mei Bai, Shih-Jen Tsai & Mu-Hong Chen

  3. Department of Family Medicine, Taipei Veterans General Hospital, Taipei, Taiwan

    Tzeng-Ji Chen

  4. Institute of Hospital and Health Care Administration, National Yang Ming Chiao Tung University, Taipei, Taiwan

    Tzeng-Ji Chen

  5. Department of Psychiatry, General Cheng Hsin Hospital, Taipei, Taiwan

    Hung-Chen Lin, Chih-Ming Cheng, Kai-Lin Huang, Ju-Wei Hsu, Ya-Mei Bai, Shih-Jen Tsai, Tzeng-Ji Chen & Mu-Hong Chen

Authors
  1. Hung-Chen Lin
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Chih-Ming Cheng
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Kai-Lin Huang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Ju-Wei Hsu
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Ya-Mei Bai
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Shih-Jen Tsai
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Tzeng-Ji Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Mu-Hong Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding authors

Correspondence to Ju-Wei Hsu or Mu-Hong Chen.

Ethics declarations

Conflict of interest

All the authors declare no conflict of interest. All the authors have no financial relationships relevant to this article to disclose.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Lin, HC., Cheng, CM., Huang, KL. et al. Developmental and mental health risks among siblings of patients with autism spectrum disorder: a nationwide study. Eur Child Adolesc Psychiatry 31, 1361–1366 (2022). https://doi.org/10.1007/s00787-021-01784-9

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00787-021-01784-9

Keywords

Search

Navigation