Psychiatric illness in a cohort of adults with Prader-Willi syndrome
Psychiatric illness in a cohort of adults with Prader-Willi syndrome
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DOI：
10.1016/j.ridd.2011.02.027
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发表时间：
2011-09-01
影响因子：
3.1
通讯作者：
Curfs, Leopold M. G.
中科院分区：
文献类型：
--
作者：
Sinnema, Margje;Boer, Harm;Curfs, Leopold M. G.
以前的研究表明PWS和共病精神疾病之间存在关联。关于精神病理学流行率的数据仍然很少。本文描述了一个大规模的，系统的研究调查精神疾病的患病率在荷兰成年PWS队列。对102人进行了精神病筛查。第一作者根据访谈、病史、药物使用和行为问卷对63名精神病理学筛查阳性的个体撰写了病例插图。这些案例插图由两名专门研究智力残疾（ID）的精神病学家进行评定。精神病理学分为四个诊断类别：双相情感障碍伴精神病性症状、精神病性疾病、抑郁症伴精神病性症状和抑郁症不伴精神病性症状。53名15 q11 -13缺失的患者中有9名（17%）和44名母亲单亲二体（mUPD）患者中有28名（64%）被诊断患有当前或既往精神疾病。在大多数因缺失而患有PWS的人中，伴有精神病症状的抑郁症是精神问题的原因（56%）。在mUPD的情况下，几乎所有有精神病理学史的人都患有精神病症状（85%），有或没有情感成分。精神科检查应该是PWS成人患者的一般管理的一部分，特别是当由mUPD引起时。应更多地关注前驱症状的存在，这表明正在发展的精神病发作。需要进行纵向研究，以更深入地了解PWS成人精神疾病的自然史。(C)2011爱思唯尔有限公司保留所有权利。
Previous studies have suggested an association between PWS and comorbid psychiatric illness. Data on prevalence rates of psychopathology is still scarce. This paper describes a large-scale, systematic study investigating the prevalence of psychiatric illness in a Dutch adult PWS cohort. One hundred and two individuals were screened for psychiatric illness. Case vignettes were written by the first author on 63 individuals with a positive screening on psychopathology according to the interviews, medical history, medication use and behavioural questionnaires. These case vignettes were rated by two psychiatrists specializing in intellectual disability (ID). Psychopathology was divided into four diagnostic categories: bipolar disorder with psychotic symptoms, psychotic illness, depressive illness with psychotic symptoms and depressive illness without psychotic symptoms. Nine out of 53 persons (17%) with a 15q11-13 deletion and 28 out of 44 (64%) persons with maternal uniparental disomy (mUPD) were diagnosed with a current or previous psychiatric illness. Depressive illness with psychotic symptoms was the cause of psychiatric problems in the majority of persons with PWS due to deletion (56%). In the case of mUPD, almost all individuals with histories of psychopathology suffered from psychotic symptoms (85%) with or without affective component. Psychiatric examination should be part of general management of adults with PWS, especially when caused by mUPD. More attention should be paid to the presence of precursor symptoms, indicating a developing psychiatric episode. Longitudinal studies are needed to gain more insight into the natural history of psychiatric illness in adults with PWS. (C) 2011 Elsevier Ltd. All rights reserved.