Risk Factors and the Evolution of Psychosis in 22q11.2 Deletion Syndrome: A Longitudinal 2-Site Study
Risk Factors and the Evolution of Psychosis in 22q11.2 Deletion Syndrome: A Longitudinal 2-Site Study
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DOI：
10.1016/j.jaac.2013.08.008
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发表时间：
2013-11-01
影响因子：
13.3
通讯作者：
Eliez, Stephan
中科院分区：
文献类型：
--
作者：
Gothelf, Doron;Schneider, Maude;Eliez, Stephan
目的：22q11.2缺失综合征（22q11.2DS）与精神分裂症、其他神经精神障碍和认知缺陷的高发病率相关。这项2中心研究的目的是纵向评估22q11.2DS中精神疾病从儿童到成年的轨迹，并确定其出现的风险因素。方法：共125名患有22q11.2DS的儿童和成人在基线和随访（间隔4年）的2个时间点进行了评估，使用标准化的精神和认知测量。结果：情绪障碍的发生率在儿童期呈下降趋势，在青春期后期呈上升趋势。精神病性障碍的存在以及随访时阳性症状严重程度的统计学显着预测因素是相同的，包括基线焦虑症、基线全面智商较低以及时间点之间言语智商评分的更大下降。9/10的新出现的精神障碍患者在基线时有焦虑症。在82.6%的病例中，精神障碍的发病年龄在14至22岁之间。结论：重要的是要评估22q11.2DS的儿童和青少年中是否存在焦虑障碍，因为它们是出现精神病性障碍的主要风险因素，通常发生在青春期后期的高危人群中。
Objective: 22q11.2 Deletion syndrome (22q11.2DS) is associated with high rates of schizophrenia, other neuropsychiatric disorders, and cognitive deficits. The objectives of this 2-center study were to longitudinally assess the trajectories of psychiatric disorders in 22q11.2DS from childhood to adulthood, and to identify risk factors for their emergence. Method: A total of 125 children and adults with 22q11.2DS were evaluated at 2 time points, baseline and follow-up (4 years apart), using standardized psychiatric and cognitive measures. Results: The rate of mood disorders tended to decrease during childhood and increase during late adolescence. Statistically significant predictors for the presence of a psychotic disorder as well as the severity of positive symptoms at follow-up were identical, and consisted of an anxiety disorder at baseline, lower baseline Full Scale IQ, and a greater decrease in verbal IQ scores between time points. Nine of 10 individuals with an emerging psychotic disorder had an anxiety disorder at baseline. The age of onset for a psychotic disorder was between 14 and 22 years in 82.6% of cases. Conclusions: It is important to evaluate the presence of anxiety disorders in children and adolescents with 22q11.2DS, as they are major risk factors for the emergence of psychotic disorders, which usually occur during late adolescence in this at-risk population.