Psychiatric disorders in 22q11.2 deletion syndrome are prevalent but undertreated. Issue 6 (April 2014)

• Record Type: Journal Article
• Authors: Tang, S. X.; Yi, J. J.; Calkins, M. E.; Whinna, D. A.; Kohler, C. G.; Souders, M. C.; McDonald-McGinn, D. M.; Zackai, E. H.; Emanuel, B. S.; Gur, R. C.; Gur, R. E.
• Is Part Of: Psychological medicine. Volume 44:Issue 6(2014)
• Page Start: 1267
• Page End: 1277
• Publication Date: 2014-04
• Subjects: Psychiatry -- Periodicals; Medicine and psychology -- Periodicals; Clinical psychology -- Periodicals; 616.89
• DOI: 10.1017/S0033291713001669
• Languages: English
• ISSNs: 0033-2917

Abstract

<abstract abstract-type="normal"> <title> <x content-type="archive" xml:space="preserve">Abstract</x> </title> <sec id="sec_a1"> <title>Background</title> <p>Chromosome 22q11.2 deletion syndrome (22q11DS) is a common genetic disorder with high rates of psychosis and other psychopathologies, but few studies discuss treatment. Our aim was to characterize the prevalence and treatment of major psychiatric illnesses in a well-characterized sample of individuals with 22q11DS.</p> </sec> <sec id="sec_a2" sec-type="methods"> <title>Method</title> <p>This was a cross-sectional study of 112 individuals aged 8 to 45 years with a confirmed diagnosis of 22q11DS. Each participant was administered a modified Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS) and the Structured Interview for Prodromal Syndromes (SIPS). Phenotypes assessed were threshold and subthreshold psychosis, depression, mania, generalized and separation anxiety, obsessions/compulsions, inattention/hyperactivity and substance use. Histories of mental health care and current psychotropic treatment were obtained.</p> </sec> <sec id="sec_a3" sec-type="results"> <title>Results</title> <p>Psychopathology was common, with 79% of individuals meeting diagnostic criteria for a disorder at the time of assessment. Diagnoses of psychosis were made in 11% of cases, attenuated positive symptom syndrome (APS) in 21%, and 47% experienced significant subthreshold symptoms. Peak occurrence of psychosis risk was during adolescence (62% of those aged 12–17 years). Criteria for a mood disorder were met by 14%, for anxiety disorder 34% and for attention deficit hyperactivity disorder (ADHD) 31%. Mental health care had been received by 63% of individuals in their lifetime, but only 40% continued therapy and 39% used psychotropics. Antipsychotics were used by 42% of participants with psychosis and none of the participants with APS. Half of those at risk for psychosis were receiving no mental health care.</p> </sec> <sec id="sec_a4" sec-type="conclusion"> <title>Conclusions</title> <p>Psychopathology is common in 22q11DS but is not adequately treated or clinically followed. Particular attention should be paid to subthreshold psychotic symptoms, especially in adolescents.</p> </sec> </abstract>