Back to Search
Start Over
[In Process Citation]
- Source :
- Vorstman, JAS; Breetvelt, EJ; Duijff, SN; Eliez, S; Schneider, M; Jalbrzikowski, M; et al.(2015). Cognitive decline preceding the onset of psychosis in patients with 22q11.2 deletion syndrome. JAMA Psychiatry, 72(4), 377-385. doi: 10.1001/jamapsychiatry.2014.2671. UC Davis: Retrieved from: http://www.escholarship.org/uc/item/9rb845gn, JAMA psychiatry, vol 72, iss 4, JAMA Psychiatry, 72(4), 377. American Medical Association, JAMA Psychiatry, 72(4), 377-385. American Medical Association, JAMA Psychiatry, Vol. 72, No 4 (2015) pp. 377-85
- Publication Year :
- 2015
-
Abstract
- © 2015 American Medical Association. All rights reserved. Importance: Patients with 22q11.2 deletion syndrome (22q11DS) have an elevated (25%) risk of developing schizophrenia. Recent reports have suggested that a subgroup of children with 22q11DS display a substantial decline in cognitive abilities starting at a young age.Objective: To determine whether early cognitive decline is associated with risk of psychotic disorder in 22q11DS.Design, Setting, And Participants: Prospective longitudinal cohort study. As part of an international research consortium initiative, we used the largest data set of intelligence (IQ) measurements in patients with 22q11DS reported to date to investigate longitudinal IQ trajectories and the risk of subsequent psychotic illness. A total of 829 patients with a confirmed hemizygous 22q11.2 deletion, recruited through 12 international clinical research sites, were included. Both psychiatric assessments and longitudinal IQ measurements were available for a subset of 411 patients (388 with≥1 assessment at age 8-24 years).Main Outcomes And Measures: Diagnosis of a psychotic disorder, initial IQ, longitudinal IQ trajectory, and timing of the last psychiatric assessment with respect to the last IQ test.Results: Among 411 patients with 22q11DS, 55 (13.4%) were diagnosed as having a psychotic disorder. The mean (SD) age at the most recent psychiatric assessment was 16.1 (6.2) years. The mean (SD) full-scale IQ at first cognitive assessment was lower in patients who developed a psychotic disorder (65.5 [12.0]) compared with those without a psychotic disorder (74.0 [14.0]). On average, children with 22q11DS showed a mild decline in IQ (full-scale IQ, 7.04 points) with increasing age, particularly in the domain of verbal IQ (9.02 points). In those who developed psychotic illness, this decline was significantly steeper (P < .001). Those with a negative deviation from the average cognitive trajectory observed in 22q11DS were at significantly increased risk for the development of a psychotic disorder (odds ratio = 2.49; 95%CI, 1.24-5.00; P = .01). The divergence of verbal IQ trajectories between those who subsequently developed a psychotic disorder and those who did not was distinguishable from age 11 years onward.Conclusions And Relevance: In 22q11DS, early cognitive decline is a robust indicator of the risk of developing a psychotic illness. These findings mirror those observed in idiopathic schizophrenia. The results provide further support for investigations of 22q11DS as a genetic model for elucidating neurobiological mechanisms underlying the development of psychosis.
- Subjects :
- Male
Chromosomes, Human, Pair 22
Neuropsychological Tests
Pair 22 / genetics
ddc:616.89
0302 clinical medicine
Risk Factors
Psychology
Prospective Studies
Cognitive decline
Child
Prospective cohort study
Pediatric
Intelligence Tests
Intelligence quotient
Psychiatric assessment
Age Factors
Serious Mental Illness
3. Good health
Psychiatry and Mental health
Mental Health
Schizophrenia
Cognitive Sciences
Female
Human
Clinical psychology
Psychosis
Adolescent
International Consortium on Brain and Behavior in 22q11.2 Deletion Syndrome
Chromosomes
Article
Young Adult
03 medical and health sciences
Settore MED/39 - NEUROPSICHIATRIA INFANTILE
Arts and Humanities (miscellaneous)
Clinical Research
Genetic model
medicine
DiGeorge Syndrome
Dementia
Humans
Other Medical and Health Sciences
Prevention
medicine.disease
Brain Disorders
030227 psychiatry
Chromosomes, Human, Pair 22 / genetics
Psychotic Disorders
Pair 22
Cognition Disorders
030217 neurology & neurosurgery
Subjects
Details
- Language :
- Dutch; Flemish
- ISSN :
- 03037339 and 2168622X
- Volume :
- 57
- Issue :
- 8
- Database :
- OpenAIRE
- Journal :
- Tijdschrift voor psychiatrie
- Accession number :
- edsair.doi.dedup.....5c77b7662f5eed5e9e66b0587fe8686a