Subthreshold psychotic symptoms in 22q11.2 deletion syndrome.

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TitleSubthreshold psychotic symptoms in 22q11.2 deletion syndrome.
Publication TypeJournal Article
Year of Publication2014
AuthorsTang, SX, Yi, JJ, Moore, TM, Calkins, ME, Kohler, CG, Whinna, DA, Souders, MC, Zackai, EH, McDonald-McGinn, DM, Emanuel, BS, Bilker, WB, Gur, RC, Gur, RE
JournalJ Am Acad Child Adolesc Psychiatry
Volume53
Issue9
Pagination991-1000.e2
Date Published2014 Sep
ISSN1527-5418
Keywords22q11 Deletion Syndrome, Adolescent, Adult, Female, Humans, Male, Prodromal Symptoms, Psychiatric Status Rating Scales, Psychotic Disorders, Young Adult
Abstract

OBJECTIVE: Chromosome 22q11.2 deletion syndrome (22q11DS) confers 25% risk for psychosis and is an invaluable window for understanding the neurobiological substrate of psychosis risk. The Structured Interview for Prodromal Syndromes (SIPS) is well validated in nondeleted populations for detecting clinical risk but has only recently been applied to 22q11DS. We assessed the largest 22q11DS cohort to date and report on SIPS implementation and symptoms elicited.METHOD: The SIPS, including its 19 subscales, was administered to 157 individuals with 22q11DS aged 8 to 25 years. Youth and caregiver interviews were conducted and rated separately, then compared for agreement. Implementation of the SIPS in 22q11DS was challenging because of the prevalence of developmental delay and comorbid conditions. However, by explaining questions and eliciting examples, we were able to help youths and caregivers understand and respond appropriately. Consensus ratings were formulated and analyzed with itemwise and factor analysis.RESULTS: Subthreshold symptoms were common, with 85% of individuals endorsing 1 or more. The most commonly rated items were ideational richness (47%) and trouble with focus and attention (44%). Factor analysis revealed a 3-factor solution with positive, negative, and disorganized components. Youth-caregiver comparisons suggested that youths report greater symptoms of perceptual abnormalities, suspiciousness, trouble with emotional expression, and bizarre thinking. Caregivers reported more impaired tolerance to normal stress, poor hygiene, and inattention.CONCLUSION: The SIPS was adapted for 22q11DS through comprehensive and semi-structured administration methods, yielding a high prevalence of subthreshold psychotic symptoms. The significance and predictive validity of these symptoms require future longitudinal analysis.

DOI10.1016/j.jaac.2014.05.009
Alternate JournalJ Am Acad Child Adolesc Psychiatry
PubMed ID25151422
PubMed Central IDPMC4159384
Grant ListT32 MH019112 / MH / NIMH NIH HHS / United States
U01 MH087626 / MH / NIMH NIH HHS / United States
K08 MH079364 / MH / NIMH NIH HHS / United States
MH087626 / MH / NIMH NIH HHS / United States
MH087636 / MH / NIMH NIH HHS / United States
U01 MH087636 / MH / NIMH NIH HHS / United States
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