Subthreshold psychosis in 22q11.2 deletion syndrome: Multisite naturalistic study

Omri Weisman, Yael Guri, Raquel E. Gur, Donna M. McDonald-McGinn, Monica E. Calkins, Sunny X. Tang, Beverly Emanuel, Elaine H. Zackai, Stephan Eliez, Maude Schneider, Marie Schaer, Wendy R. Kates, Kevin M. Antshel, Wanda Fremont, Vandana Shashi, Stephen R. Hooper, Marco Armando, Stefano Vicari, Maria Pontillo, Leila KushanMaria Jalbrzikowski, Carrie E. Bearden, Joseph F. Cubells, Opal Y. Ousley, Elaine F. Walker, Tony J Simon, Joel Stoddard, Tara A Niendam, Marianne B.M. Van Den Bree, Doron Gothelf

Research output: Contribution to journalArticle

11 Citations (Scopus)

Abstract

Nearly one-third of individuals with 22q11.2 deletion syndrome (22q11.2DS) develop a psychotic disorder during life, most of them by early adulthood. Importantly, a fullblown psychotic episode is usually preceded by subthreshold symptoms. In the current study, 760 participants (aged 6-55 years) with a confirmed hemizygous 22q11.2 microdeletion have been recruited through 10 medical sites worldwide, as part of an international research consortium. Of them, 692 were nonpsychotic and with complete measurement data. Subthreshold psychotic symptoms were assessed using the Structured Interview for Prodromal Syndromes (SIPS). Nearly one-third of participants met criteria for positive subthreshold psychotic symptoms (32.8%), less than 1% qualified for acute positive subthreshold symptoms, and almost a quarter met criteria for negative/disorganized subthreshold symptoms (21.7%). Adolescents and young adults (13-25 years) showed the highest rates of subthreshold psychotic symptoms. Additionally, higher rates of anxiety disorders and attention deficit/hyperactivity disorder (ADHD) were found among the study participants with subthreshold psychotic symptoms compared to those without. Full-scale IQ, verbal IQ, and global functioning (GAF) scores were negatively associated with participants' subthreshold psychotic symptoms. This study represents the most comprehensive analysis reported to date on subthreshold psychosis in 22q11.2DS. Novel findings include age-related changes in subthreshold psychotic symptoms and evidence that cognitive deficits are associated with subthreshold psychosis in this population. Future studies should longitudinally follow these symptoms to detect whether and how early identification and treatment of these manifestations can improve long-term outcomes in those that eventually develop a psychotic disorder.

Original languageEnglish (US)
Pages (from-to)1079-1089
Number of pages11
JournalSchizophrenia Bulletin
Volume43
Issue number5
DOIs
StatePublished - Sep 1 2017

Fingerprint

DiGeorge Syndrome
Psychotic Disorders
Prodromal Symptoms
Neurobehavioral Manifestations
Attention Deficit Disorder with Hyperactivity
Anxiety Disorders
Young Adult
Interviews
Research
Population

Keywords

  • anxiety disorder
  • attention deficit
  • DiGeorge syndrome
  • global assessment of functioning (GAF)
  • hyperactivity disorder (ADHD)
  • IQ
  • structured interview for prodromal syndromes
  • subthreshold psychotic symptoms
  • velocardiofacial syndrome

ASJC Scopus subject areas

  • Psychiatry and Mental health

Cite this

Weisman, O., Guri, Y., Gur, R. E., McDonald-McGinn, D. M., Calkins, M. E., Tang, S. X., ... Gothelf, D. (2017). Subthreshold psychosis in 22q11.2 deletion syndrome: Multisite naturalistic study. Schizophrenia Bulletin, 43(5), 1079-1089. https://doi.org/10.1093/schbul/sbx005

Subthreshold psychosis in 22q11.2 deletion syndrome : Multisite naturalistic study. / Weisman, Omri; Guri, Yael; Gur, Raquel E.; McDonald-McGinn, Donna M.; Calkins, Monica E.; Tang, Sunny X.; Emanuel, Beverly; Zackai, Elaine H.; Eliez, Stephan; Schneider, Maude; Schaer, Marie; Kates, Wendy R.; Antshel, Kevin M.; Fremont, Wanda; Shashi, Vandana; Hooper, Stephen R.; Armando, Marco; Vicari, Stefano; Pontillo, Maria; Kushan, Leila; Jalbrzikowski, Maria; Bearden, Carrie E.; Cubells, Joseph F.; Ousley, Opal Y.; Walker, Elaine F.; Simon, Tony J; Stoddard, Joel; Niendam, Tara A; Van Den Bree, Marianne B.M.; Gothelf, Doron.

In: Schizophrenia Bulletin, Vol. 43, No. 5, 01.09.2017, p. 1079-1089.

Research output: Contribution to journalArticle

Weisman, O, Guri, Y, Gur, RE, McDonald-McGinn, DM, Calkins, ME, Tang, SX, Emanuel, B, Zackai, EH, Eliez, S, Schneider, M, Schaer, M, Kates, WR, Antshel, KM, Fremont, W, Shashi, V, Hooper, SR, Armando, M, Vicari, S, Pontillo, M, Kushan, L, Jalbrzikowski, M, Bearden, CE, Cubells, JF, Ousley, OY, Walker, EF, Simon, TJ, Stoddard, J, Niendam, TA, Van Den Bree, MBM & Gothelf, D 2017, 'Subthreshold psychosis in 22q11.2 deletion syndrome: Multisite naturalistic study', Schizophrenia Bulletin, vol. 43, no. 5, pp. 1079-1089. https://doi.org/10.1093/schbul/sbx005
Weisman O, Guri Y, Gur RE, McDonald-McGinn DM, Calkins ME, Tang SX et al. Subthreshold psychosis in 22q11.2 deletion syndrome: Multisite naturalistic study. Schizophrenia Bulletin. 2017 Sep 1;43(5):1079-1089. https://doi.org/10.1093/schbul/sbx005
Weisman, Omri ; Guri, Yael ; Gur, Raquel E. ; McDonald-McGinn, Donna M. ; Calkins, Monica E. ; Tang, Sunny X. ; Emanuel, Beverly ; Zackai, Elaine H. ; Eliez, Stephan ; Schneider, Maude ; Schaer, Marie ; Kates, Wendy R. ; Antshel, Kevin M. ; Fremont, Wanda ; Shashi, Vandana ; Hooper, Stephen R. ; Armando, Marco ; Vicari, Stefano ; Pontillo, Maria ; Kushan, Leila ; Jalbrzikowski, Maria ; Bearden, Carrie E. ; Cubells, Joseph F. ; Ousley, Opal Y. ; Walker, Elaine F. ; Simon, Tony J ; Stoddard, Joel ; Niendam, Tara A ; Van Den Bree, Marianne B.M. ; Gothelf, Doron. / Subthreshold psychosis in 22q11.2 deletion syndrome : Multisite naturalistic study. In: Schizophrenia Bulletin. 2017 ; Vol. 43, No. 5. pp. 1079-1089.
@article{7f915302273d4f958b4673f7b8eca96c,
title = "Subthreshold psychosis in 22q11.2 deletion syndrome: Multisite naturalistic study",
abstract = "Nearly one-third of individuals with 22q11.2 deletion syndrome (22q11.2DS) develop a psychotic disorder during life, most of them by early adulthood. Importantly, a fullblown psychotic episode is usually preceded by subthreshold symptoms. In the current study, 760 participants (aged 6-55 years) with a confirmed hemizygous 22q11.2 microdeletion have been recruited through 10 medical sites worldwide, as part of an international research consortium. Of them, 692 were nonpsychotic and with complete measurement data. Subthreshold psychotic symptoms were assessed using the Structured Interview for Prodromal Syndromes (SIPS). Nearly one-third of participants met criteria for positive subthreshold psychotic symptoms (32.8{\%}), less than 1{\%} qualified for acute positive subthreshold symptoms, and almost a quarter met criteria for negative/disorganized subthreshold symptoms (21.7{\%}). Adolescents and young adults (13-25 years) showed the highest rates of subthreshold psychotic symptoms. Additionally, higher rates of anxiety disorders and attention deficit/hyperactivity disorder (ADHD) were found among the study participants with subthreshold psychotic symptoms compared to those without. Full-scale IQ, verbal IQ, and global functioning (GAF) scores were negatively associated with participants' subthreshold psychotic symptoms. This study represents the most comprehensive analysis reported to date on subthreshold psychosis in 22q11.2DS. Novel findings include age-related changes in subthreshold psychotic symptoms and evidence that cognitive deficits are associated with subthreshold psychosis in this population. Future studies should longitudinally follow these symptoms to detect whether and how early identification and treatment of these manifestations can improve long-term outcomes in those that eventually develop a psychotic disorder.",
keywords = "anxiety disorder, attention deficit, DiGeorge syndrome, global assessment of functioning (GAF), hyperactivity disorder (ADHD), IQ, structured interview for prodromal syndromes, subthreshold psychotic symptoms, velocardiofacial syndrome",
author = "Omri Weisman and Yael Guri and Gur, {Raquel E.} and McDonald-McGinn, {Donna M.} and Calkins, {Monica E.} and Tang, {Sunny X.} and Beverly Emanuel and Zackai, {Elaine H.} and Stephan Eliez and Maude Schneider and Marie Schaer and Kates, {Wendy R.} and Antshel, {Kevin M.} and Wanda Fremont and Vandana Shashi and Hooper, {Stephen R.} and Marco Armando and Stefano Vicari and Maria Pontillo and Leila Kushan and Maria Jalbrzikowski and Bearden, {Carrie E.} and Cubells, {Joseph F.} and Ousley, {Opal Y.} and Walker, {Elaine F.} and Simon, {Tony J} and Joel Stoddard and Niendam, {Tara A} and {Van Den Bree}, {Marianne B.M.} and Doron Gothelf",
year = "2017",
month = "9",
day = "1",
doi = "10.1093/schbul/sbx005",
language = "English (US)",
volume = "43",
pages = "1079--1089",
journal = "Schizophrenia Bulletin",
issn = "0586-7614",
publisher = "Oxford University Press",
number = "5",

}

TY - JOUR

T1 - Subthreshold psychosis in 22q11.2 deletion syndrome

T2 - Multisite naturalistic study

AU - Weisman, Omri

AU - Guri, Yael

AU - Gur, Raquel E.

AU - McDonald-McGinn, Donna M.

AU - Calkins, Monica E.

AU - Tang, Sunny X.

AU - Emanuel, Beverly

AU - Zackai, Elaine H.

AU - Eliez, Stephan

AU - Schneider, Maude

AU - Schaer, Marie

AU - Kates, Wendy R.

AU - Antshel, Kevin M.

AU - Fremont, Wanda

AU - Shashi, Vandana

AU - Hooper, Stephen R.

AU - Armando, Marco

AU - Vicari, Stefano

AU - Pontillo, Maria

AU - Kushan, Leila

AU - Jalbrzikowski, Maria

AU - Bearden, Carrie E.

AU - Cubells, Joseph F.

AU - Ousley, Opal Y.

AU - Walker, Elaine F.

AU - Simon, Tony J

AU - Stoddard, Joel

AU - Niendam, Tara A

AU - Van Den Bree, Marianne B.M.

AU - Gothelf, Doron

PY - 2017/9/1

Y1 - 2017/9/1

N2 - Nearly one-third of individuals with 22q11.2 deletion syndrome (22q11.2DS) develop a psychotic disorder during life, most of them by early adulthood. Importantly, a fullblown psychotic episode is usually preceded by subthreshold symptoms. In the current study, 760 participants (aged 6-55 years) with a confirmed hemizygous 22q11.2 microdeletion have been recruited through 10 medical sites worldwide, as part of an international research consortium. Of them, 692 were nonpsychotic and with complete measurement data. Subthreshold psychotic symptoms were assessed using the Structured Interview for Prodromal Syndromes (SIPS). Nearly one-third of participants met criteria for positive subthreshold psychotic symptoms (32.8%), less than 1% qualified for acute positive subthreshold symptoms, and almost a quarter met criteria for negative/disorganized subthreshold symptoms (21.7%). Adolescents and young adults (13-25 years) showed the highest rates of subthreshold psychotic symptoms. Additionally, higher rates of anxiety disorders and attention deficit/hyperactivity disorder (ADHD) were found among the study participants with subthreshold psychotic symptoms compared to those without. Full-scale IQ, verbal IQ, and global functioning (GAF) scores were negatively associated with participants' subthreshold psychotic symptoms. This study represents the most comprehensive analysis reported to date on subthreshold psychosis in 22q11.2DS. Novel findings include age-related changes in subthreshold psychotic symptoms and evidence that cognitive deficits are associated with subthreshold psychosis in this population. Future studies should longitudinally follow these symptoms to detect whether and how early identification and treatment of these manifestations can improve long-term outcomes in those that eventually develop a psychotic disorder.

AB - Nearly one-third of individuals with 22q11.2 deletion syndrome (22q11.2DS) develop a psychotic disorder during life, most of them by early adulthood. Importantly, a fullblown psychotic episode is usually preceded by subthreshold symptoms. In the current study, 760 participants (aged 6-55 years) with a confirmed hemizygous 22q11.2 microdeletion have been recruited through 10 medical sites worldwide, as part of an international research consortium. Of them, 692 were nonpsychotic and with complete measurement data. Subthreshold psychotic symptoms were assessed using the Structured Interview for Prodromal Syndromes (SIPS). Nearly one-third of participants met criteria for positive subthreshold psychotic symptoms (32.8%), less than 1% qualified for acute positive subthreshold symptoms, and almost a quarter met criteria for negative/disorganized subthreshold symptoms (21.7%). Adolescents and young adults (13-25 years) showed the highest rates of subthreshold psychotic symptoms. Additionally, higher rates of anxiety disorders and attention deficit/hyperactivity disorder (ADHD) were found among the study participants with subthreshold psychotic symptoms compared to those without. Full-scale IQ, verbal IQ, and global functioning (GAF) scores were negatively associated with participants' subthreshold psychotic symptoms. This study represents the most comprehensive analysis reported to date on subthreshold psychosis in 22q11.2DS. Novel findings include age-related changes in subthreshold psychotic symptoms and evidence that cognitive deficits are associated with subthreshold psychosis in this population. Future studies should longitudinally follow these symptoms to detect whether and how early identification and treatment of these manifestations can improve long-term outcomes in those that eventually develop a psychotic disorder.

KW - anxiety disorder

KW - attention deficit

KW - DiGeorge syndrome

KW - global assessment of functioning (GAF)

KW - hyperactivity disorder (ADHD)

KW - IQ

KW - structured interview for prodromal syndromes

KW - subthreshold psychotic symptoms

KW - velocardiofacial syndrome

UR - http://www.scopus.com/inward/record.url?scp=85032035071&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=85032035071&partnerID=8YFLogxK

U2 - 10.1093/schbul/sbx005

DO - 10.1093/schbul/sbx005

M3 - Article

C2 - 28204757

AN - SCOPUS:85032035071

VL - 43

SP - 1079

EP - 1089

JO - Schizophrenia Bulletin

JF - Schizophrenia Bulletin

SN - 0586-7614

IS - 5

ER -