The role of pre-, peri-, and postnatal risk factors in bipolar disorder and adult ADHD

  • Franziska Tole
  • Juliane Kopf
  • Katrin Schröter
  • Viola Stella Palladino
  • Christian P. Jacob
  • Andreas Reif
  • Sarah Kittel-SchneiderEmail author
Psychiatry and Preclinical Psychiatric Studies - Original Article


Gene–environment–development interactions are suggested to play a crucial role in psychiatric disorders. However, it is not clear if there are specific risk gene interactions with particular pre-, peri-, and postnatal risk factors for distinct disorders, such as adult attention-deficit-/hyperactivity disorder (aADHD) and bipolar disorder (BD). In this pilot study, the first aim was to investigate retrospective self-reports of pre-, peri-, and postnatal complications and risk factors from 126 participants (aADHD, BD, and healthy controls) and their mothers. The second aim was to investigate possible interaction between the previously published common risk gene variants of ADHD in the ADGRL3 (=LPHN3) gene (rs2305339, rs1397548, rs734644, rs1397547, rs2271338, rs6551665, and rs2345039) and shared risk gene variants of aADHD and BD in the DGKH gene (DGKH rs994856/rs9525580/rs9525584 GAT haplotype) and pre-, peri-, and postnatal risk factors in comparison to a healthy control group. After correction for multiple comparison, the following pre-, peri-, and postnatal risk factors remained statistically significant (p  ≤ 0.0036) between healthy controls and ADHD and BD patients as one group: unplanned pregnancies, psychosocial stress of the mother during pregnancy, mode of delivery, shared decision-making regarding medical procedures during the delivery, perinatal bonding, number of crybabies, and quality of mother–child and father–child relationship. There were no significant environment–gene interactions. In our preliminary data, similar risk factors were found to be significantly associated with both disorders in comparison to healthy controls. However, larger and longitudinal studies and standardized and validated instruments to get a better understanding of the interaction of pre-, peri-, and postnatal complications and mental health in the offspring are needed.


Attendeficit-/hyperactivity disorder Bipolar disorder Prenatal risk factors Perinatal complications Postnatal risk factors Gene–environment–development interaction 



We thank Theresia Töpner for the technical support and the patients and controls for participating in this study.

Compliance with ethical standards

Conflict of interest

SKS and AR received travel grants and authors’ honoraria from Shire and Medice. The other authors declared no conflicts of interest.

Supplementary material

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© Springer-Verlag GmbH Austria, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Department of Psychiatry, Psychosomatic Medicine and Psychotherapy, University HospitalGoethe University, FrankfurtFrankfurt am MainGermany
  2. 2.Department of Psychiatry and PsychotherapyMedius Hospital KichheimKirchheimGermany

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