Clinical assessment of DSM-IV anxiety disorders in fragile X syndrome: Prevalence and characterization

Lisa Cordeiro, Elizabeth Ballinger, Randi Hagerman, David Hessl

Research output: Contribution to journalArticlepeer-review

206 Scopus citations


Fragile X syndrome (FXS) is the most common form of inherited intellectual disability (ID). Anxiety and social withdrawal are considered core features of the FXS phenotype, yet there is limited diagnostic evidence of the prevalence of formal anxiety disorders in FXS. This study assessed the prevalence of anxiety disorders in a sample of 58 males and 39 females with FXS (ages 5.0-33. 3years). Participants' parents completed the Anxiety Disorders Interview Schedule (ADIS-IV), a clinical interview based on DSM-IV criteria, and the Anxiety Depression and Mood Scale (ADAMS), a psychiatric disorders screening instrument normed in ID. We conducted cognitive (IQ) and autism (AUT) assessments and surveyed medication use. Despite a high rate of psychopharmacological treatment, 86.2% of males and 76.9% of females met criteria for an anxiety disorder, with social phobia and specific phobia the most commonly diagnosed. Proband status, gender, and IQ were not significantly related to any anxiety disorders, however significantly higher rates of a few anxiety disorders were found in older age and AUT groups. Significant correlations between ADIS diagnoses and ADAMS scores provided cross-validation of instruments, indicating that the ADIS is suitable for use in FXS. A greater percentage of our sample met criteria for most anxiety disorders than has been reported in other ID groups or the general population. The rate of anxiety compared to general ID suggests that the FMR1 full mutation confers an especially high risk for these disorders, regardless of factors commonly associated with FXS clinical involvement. A thorough clinical assessment and treatment of anxiety should be included in the FXS standard of care.

Original languageEnglish (US)
Pages (from-to)57-67
Number of pages11
JournalJournal of Neurodevelopmental Disorders
Issue number1
StatePublished - Mar 2011


  • Anxiety
  • Fragile X syndrome
  • Intellectual disability
  • Social phobia
  • Specific phobia

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Pathology and Forensic Medicine
  • Clinical Neurology
  • Cognitive Neuroscience


Dive into the research topics of 'Clinical assessment of DSM-IV anxiety disorders in fragile X syndrome: Prevalence and characterization'. Together they form a unique fingerprint.

Cite this