Jacob A S Vorstman1, Monique E J Morcus2, Sasja N Duijff2, Petra W J Klaassen2, Josien A Heineman-de Boer2, Frits A Beemer2, Hanna Swaab2, René S Kahn2, Herman van Engeland2. 1. Drs. Vorstman, Swaab, and van Engeland and Ms. Morcus are with the Department of Child and Adolescent Psychiatry; Dr. Heineman-de Boer, Ms. Duijff, and Ms. Klaassen are with the Department of Pediatric Psychology; Dr. Beemer is with the Department of Medical Genetics; Dr. Kahn is with the Department of Psychiatry, University Medical Centre, Utrecht, The Netherlands. Drs. Vorstman, Swaab, Kahn, and van Engeland and Ms. Morcus are also with the Rudolf Magnus Institute of Neurosciences, Utrecht, The Netherlands. Electronic address: J.A.S.Vorstman@umcutrecht.nl. 2. Drs. Vorstman, Swaab, and van Engeland and Ms. Morcus are with the Department of Child and Adolescent Psychiatry; Dr. Heineman-de Boer, Ms. Duijff, and Ms. Klaassen are with the Department of Pediatric Psychology; Dr. Beemer is with the Department of Medical Genetics; Dr. Kahn is with the Department of Psychiatry, University Medical Centre, Utrecht, The Netherlands. Drs. Vorstman, Swaab, Kahn, and van Engeland and Ms. Morcus are also with the Rudolf Magnus Institute of Neurosciences, Utrecht, The Netherlands.
Abstract
OBJECTIVE: To examine psychopathology and influence of intelligence level on psychiatric symptoms in children with the 22q11.2 deletion syndrome (22q11DS). METHOD: Sixty patients, ages 9 through 18 years, were evaluated. Assessments followed standard protocols, including structured and semistructured interviews of parents, videotaped psychiatric interview, and intelligence assessment of the child. Intelligence level, psychiatric symptoms, and classification provided the main outcome. RESULTS: High rates of autism spectrum disorders (30 of 60, 50.0%) and psychotic symptoms (16 of 60, 26.7%) were found in this sample. In 7 of 60 (11.7%), the psychotic symptoms interfered with behavior and caused considerable distress. In these cases, the diagnosis of a psychotic disorder was applied. The average age of the children with psychotic symptoms at time of assessment was 14.2 years. Although it is likely that the high rate of psychopathology in this sample is to some extent associated with the lower level of cognitive function, a major effect of the degree of cognitive impairment on psychiatric morbidity was not found. CONCLUSION: Autism spectrum disorders and subthreshold autistic symptomatology are common in children with 22q11DS. Furthermore, a high rate of psychosis and psychotic symptoms is found in this childhood sample, suggesting an early onset of psychosis in 22q11DS patients. Autistic and psychotic disorders should be considered to be main elements of the behavioral phenotype of 22q11DS children.
OBJECTIVE: To examine psychopathology and influence of intelligence level on psychiatric symptoms in children with the 22q11.2 deletion syndrome (22q11DS). METHOD: Sixty patients, ages 9 through 18 years, were evaluated. Assessments followed standard protocols, including structured and semistructured interviews of parents, videotaped psychiatric interview, and intelligence assessment of the child. Intelligence level, psychiatric symptoms, and classification provided the main outcome. RESULTS: High rates of autism spectrum disorders (30 of 60, 50.0%) and psychotic symptoms (16 of 60, 26.7%) were found in this sample. In 7 of 60 (11.7%), the psychotic symptoms interfered with behavior and caused considerable distress. In these cases, the diagnosis of a psychotic disorder was applied. The average age of the children with psychotic symptoms at time of assessment was 14.2 years. Although it is likely that the high rate of psychopathology in this sample is to some extent associated with the lower level of cognitive function, a major effect of the degree of cognitive impairment on psychiatric morbidity was not found. CONCLUSION:Autism spectrum disorders and subthreshold autistic symptomatology are common in children with 22q11DS. Furthermore, a high rate of psychosis and psychotic symptoms is found in this childhood sample, suggesting an early onset of psychosis in 22q11DS patients. Autistic and psychotic disorders should be considered to be main elements of the behavioral phenotype of 22q11DS children.
Authors: Sunny X Tang; James J Yi; Tyler M Moore; Monica E Calkins; Christian G Kohler; Daneen A Whinna; Margaret C Souders; Elaine H Zackai; Donna M McDonald-McGinn; Beverly S Emanuel; Warren B Bilker; Ruben C Gur; Raquel E Gur Journal: J Am Acad Child Adolesc Psychiatry Date: 2014-06-19 Impact factor: 8.829
Authors: Lauren Bishop-Fitzpatrick; Arezoo Movaghar; Jan S Greenberg; David Page; Leann S DaWalt; Murray H Brilliant; Marsha R Mailick Journal: Autism Res Date: 2018-05-07 Impact factor: 5.216