{
  "abstract": "Background: Attention-deficit/hyperactivity disorder (ADHD) and borderline personality disorder (BPD) frequently co-occur, but the contributions of shared genetic susceptibility and directional associations remain unclear. Methods: We analyzed European-ancestry GWAS summary statistics for ADHD (38,691 cases; 186,843 controls) and BPD (12,339 cases; 1,041,717 controls). Linkage disequilibrium score regression, conjunctional false discovery rate (conjFDR), bidirectional Mendelian randomization (MR), MR-LAP, CAUSE, colocalization, and SuSiE fine-mapping assessed genetic overlap and directional associations. Results: ADHD and BPD showed substantial genetic correlation (r_g = 0.733). ConjFDR identified 48 shared loci, of which 36 (75%) showed consistent effect directions across independent phenotype-specific comparisons. Functional annotation highlighted axon guidance, oxidative phosphorylation, and a developing midbrain cell-type signature. ADHD-to-BPD MR supported a positive association (22 instruments; IVW-beta = 0.487, SE = 0.082, p = 3.27 x 10^-9), persisting after outlier removal, MR-LAP correction, and exclusion of two instruments indexing colocalized loci. Reverse MR was also positive (five instruments; IVW-beta = 0.303, SE = 0.112, p = 6.83 x 10^-3), but showed heterogeneity and sensitivity to individual variants. CAUSE favored directional over sharing-only models for ADHD-to-BPD (Delta ELPD = 6.98; p = 7.3 x 10^-8) and BPD-to-ADHD (Delta ELPD = 5.92; p = 6.2 x 10^-5). Colocalization and SuSiE supported shared signals at loci indexed by rs17576773 and rs9969232 for ADHD-to-BPD and rs4727799 in the reverse direction. Conclusions: ADHD and BPD share extensive genetic susceptibility. Although CAUSE favored directional models in both directions, evidence across MR approaches was more consistent for ADHD-to-BPD. Shared genetic mechanisms and residual pleiotropy limit causal interpretation.",
  "abstract_shown": true,
  "affiliations": [
    "Azienda Sanitaria Provinciale di Vibo Valentia, Ospedale Jazzolino"
  ],
  "article_type": "PUBLISHAHEADOFPRINT",
  "arxiv": null,
  "author_total": 3,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "G. Gorgone"
    },
    {
      "name": "C. Galati"
    },
    {
      "name": "S. Ciappina"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/2feadhc2p9rrm.bib",
  "cited_by": 0,
  "doi": "10.64898/2026.11.06.26367465",
  "fulltext_url": "https://www.medrxiv.org/content/10.64898/2026.11.06.26367465v1.full",
  "id": "2feadhc2p9rrm",
  "issns": [],
  "landing_url": "https://www.medrxiv.org/content/10.64898/2026.11.06.26367465v1",
  "language": null,
  "licence": "CC-BY-NC-ND",
  "licence_label": "CC BY-NC-ND",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "medrxiv",
      "psychiatry and clinical psychology"
    ]
  ],
  "openalex": null,
  "pdf_url": "https://www.medrxiv.org/content/10.64898/2026.11.06.26367465v1.full.pdf",
  "pmcid": null,
  "pmid": null,
  "published": "2026-11-06",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/2feadhc2p9rrm.ris",
  "sources": [
    {
      "first_seen": "2026-11-10T00:22:06Z",
      "native_id": "10.64898/2026.11.06.26367465",
      "source": "medrxiv",
      "url": "https://www.medrxiv.org/content/10.64898/2026.11.06.26367465v2"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "medrxiv:psychiatry and clinical psychology",
      "subfield": "psychiatry"
    }
  ],
  "title": "SHARED GENETIC ARCHITECTURE AND DIRECTIONAL ASSOCIATIONS BETWEEN ATTENTION-DEFICIT/HYPERACTIVITY AND BORDERLINE PERSONALITY DISORDERS: AN INTEGRATIVE GENOMIC ANALYSIS",
  "title_text": "SHARED GENETIC ARCHITECTURE AND DIRECTIONAL ASSOCIATIONS BETWEEN ATTENTION-DEFICIT/HYPERACTIVITY AND BORDERLINE PERSONALITY DISORDERS: AN INTEGRATIVE GENOMIC ANALYSIS",
  "type": "preprint",
  "updated_at": "2026-11-10T00:23:26Z",
  "url": "https://research.draconitic.com/paper/2feadhc2p9rrm",
  "venue": "medRxiv",
  "versions": []
}