It is unknown why attention deficit hyperactivity disorder (ADHD) is more common in males, whereas anxiety and depression show a female population excess. We tested the hypothesis that anxiety and depression risk alleles manifest as ADHD in males. We also tested whether anxiety and depression in children with ADHD show a different etiology to typical anxiety and depression and whether this differs by sex. The primary clinical ADHD sample consisted of 885 (14% female) children. Psychiatric symptoms were assessed using standardized interviews. Polygenic risk scores (PRS) were derived using large genetic studies. Replication samples included independent clinical ADHD samples (N = 3,794; 25.7% female) and broadly defined population ADHD samples (N = 995; 33.4% female). We did not identify sex differences in anxiety or depression PRS in children with ADHD. In the primary sample, anxiety PRS were associated with social and generalized anxiety in males, with evidence of a sex-by-PRS interaction for social anxiety. These results did not replicate in the broadly defined ADHD sample. Depression PRS were not associated with comorbid depression symptoms. The results suggest that anxiety and depression genetic risks are not more likely to lead to ADHD in males. Also, the evidence for shared etiology between anxiety symptoms in those with ADHD and typical anxiety was weak and needs replication.

中文翻译：

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注意缺陷多动障碍儿童焦虑和抑郁的性别差异：调查遗传责任和合并症

尚不清楚为什么注意力缺陷多动障碍 (ADHD) 在男性中更常见，而焦虑和抑郁显示女性人口过多。我们检验了焦虑和抑郁风险等位基因在男性中表现为多动症的假设。我们还测试了 ADHD 儿童的焦虑和抑郁是否与典型的焦虑和抑郁有不同的病因，以及这是否因性别而异。主要临床 ADHD 样本由 885 名（14% 为女性）儿童组成。使用标准化访谈评估精神症状。多基因风险评分 (PRS) 是使用大型遗传研究得出的。复制样本包括独立的临床 ADHD 样本（N  = 3,794；25.7% 为女性）和广义人群 ADHD 样本（N = 995; 33.4% 女性）。我们没有发现 ADHD 儿童在焦虑或抑郁 PRS 方面的性别差异。在主要样本中，焦虑 PRS 与男性的社交和广泛性焦虑相关，有证据表明社交焦虑与 PRS 的性别相互作用有关。这些结果并未在广义定义的 ADHD 样本中复制。抑郁症 PRS 与共病抑郁症症状无关。结果表明，焦虑和抑郁的遗传风险并不更容易导致男性患多动症。此外，ADHD 患者的焦虑症状与典型焦虑症之间的共同病因学证据薄弱，需要复制。