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 - Johnson -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 -