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Trajectories of psychiatric diagnoses and medication usage in youth with 22q11.2 deletion syndrome: a 9-year longitudinal study

Published online by Cambridge University Press:  18 September 2018

Wendy R. Kates ,
Margaret A. Mariano ,
Kevin M. Antshel ,
Shanel Chandra ,
Hilary Gamble ,
Mark Giordano ,
Eric MacMaster ,
Mirabelle Mattar ,
Diane St. Fleur  and
Stephen V. Faraone
...Show all authors
Wendy R. Kates*
Affiliation:
Departments of Psychiatry and Behavioral Sciences, State University of New York at Upstate Medical University, Syracuse, New York, USA
Margaret A. Mariano
Affiliation:
Departments of Psychiatry and Behavioral Sciences, State University of New York at Upstate Medical University, Syracuse, New York, USA
Kevin M. Antshel
Affiliation:
Departments of Psychiatry and Behavioral Sciences, State University of New York at Upstate Medical University, Syracuse, New York, USA Department of Psychology, Syracuse University, Syracuse, New York, USA
Shanel Chandra
Affiliation:
Departments of Psychiatry and Behavioral Sciences, State University of New York at Upstate Medical University, Syracuse, New York, USA
Hilary Gamble
Affiliation:
Departments of Psychiatry and Behavioral Sciences, State University of New York at Upstate Medical University, Syracuse, New York, USA
Mark Giordano
Affiliation:
Departments of Psychiatry and Behavioral Sciences, State University of New York at Upstate Medical University, Syracuse, New York, USA
Eric MacMaster
Affiliation:
Departments of Psychiatry and Behavioral Sciences, State University of New York at Upstate Medical University, Syracuse, New York, USA
Mirabelle Mattar
Affiliation:
Departments of Psychiatry and Behavioral Sciences, State University of New York at Upstate Medical University, Syracuse, New York, USA
Diane St. Fleur
Affiliation:
Departments of Psychiatry and Behavioral Sciences, State University of New York at Upstate Medical University, Syracuse, New York, USA
Stephen V. Faraone
Affiliation:
Departments of Psychiatry and Behavioral Sciences, State University of New York at Upstate Medical University, Syracuse, New York, USA
Wanda P. Fremont
Affiliation:
Departments of Psychiatry and Behavioral Sciences, State University of New York at Upstate Medical University, Syracuse, New York, USA
*
Author for correspondence: Wendy R. Kates, E-mail: katesw@upstate.edu
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Abstract

Background

Chromosome 22q11.2 deletion syndrome (22q11DS) is associated with high rates of psychiatric disorders, including schizophrenia in up to 30% of individuals with the syndrome. Despite this, we know relatively little about trajectories and predictors of persistence of psychiatric disorders from middle childhood to early adulthood. Accordingly, we followed youth over four timepoints, every 3 years, to assess long-term trajectories of attention-deficit hyperactivity disorder (ADHD), anxiety, mood, and psychosis-spectrum disorders (PSDs), as well as medication usage.

Methods

Eighty-seven youth with 22q11DS and 65 controls between the ages of 9 and 15 years at the first timepoint (T1; mean age 11.88 ± 2.1) were followed for 9 years (mean age of 21.22 ± 2.01 years at T4). Baseline cognitive, clinical, and familial predictors of persistence were identified for each class of psychiatric disorders.

Results

Baseline age and parent-rated hyperactivity scores predicted ADHD persistence [area under curve (AUC) = 0.81]. The presence of family conflict predicted persistence of anxiety disorders (ADs) whereas parent ratings of child internalizing symptoms predicted persistence of both anxiety and mood disorders (MDs) (AUC = 0.84 and 0.83, respectively). Baseline prodromal symptoms predicted persistent and emergent PSDs (AUC = 0.83). Parent-reported use of anti-depressants/anxiolytics increased significantly from T1 to T4.

Conclusions

Psychiatric, behavioral, and cognitive functioning during late childhood and early adolescence successfully predicted children with 22q11DS who were at highest risk for persistent psychiatric illness in young adulthood. These findings emphasize the critical importance of early assessments and interventions in youth with 22q11DS.

Keywords

22q11.2 deletion syndromeDiGeorge syndromelongitudinal trajectoriesmedication usagepsychiatric diagnosticpersistencepsychosis-spectrum disorderschizophreniavelo-cardio-facial syndrome
Type
Original Articles
Information
Psychological Medicine , Volume 49 , Issue 11 , August 2019 , pp. 1914 - 1922
Copyright
Copyright © Cambridge University Press 2018 

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