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Longitudinal study of premorbid adjustment in 22q11.2 deletion (velocardiofacial) syndrome and association with psychosis

Published online by Cambridge University Press:  11 February 2016

Petya D. Radoeva ,
Wanda Fremont ,
Kevin M. Antshel  and
Wendy R. Kates
Petya D. Radoeva
Affiliation:
State University of New York at Upstate Medical University
Wanda Fremont
Affiliation:
State University of New York at Upstate Medical University
Kevin M. Antshel
Affiliation:
Syracuse University
Wendy R. Kates*
Affiliation:
State University of New York at Upstate Medical University
*
Address correspondence and reprint requests to: Wendy R. Kates, 750 East Adams Street, Syracuse, NY 13210; E-mail: katesw@upstate.edu.
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Abstract

Velocardiofacial syndrome, also known as 22q11.2 deletion syndrome (22q11DS), is associated with an increased risk of major psychiatric disorders, including schizophrenia. The emergence of psychotic symptoms in individuals with schizophrenia in the general population is often preceded by a premorbid period of poor or worsening social and/or academic functioning. Our current study evaluated premorbid adjustment (via the Cannon–Spoor Premorbid Adjustment Scale [PAS]) and psychotic symptoms (via the Structured Interview for Prodromal Symptoms and the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children—Present and Lifetime Version) in youth with 22q11DS (N = 96), unaffected siblings (N = 40), and community controls (N = 50). The PAS scores indicated greater maladjustment during all developmental periods in individuals with 22q11DS compared to the controls. Many participants with 22q11DS had chronically poor (n = 33) or deteriorating (n = 6) PAS scores. In 22q11DS, chronically poor PAS trajectories and poor childhood and early adolescence academic domain and total PAS scores significantly increased the risk of prodromal symptoms or overt psychosis. Taking into account the catechol-O-methyltransferase (COMT) genotype, the best predictor of (prodromal) psychosis was the early adolescence academic domain score, which yielded higher sensitivity and specificity in the subgroup of youth with 22q11DS and the high-activity (valine) allele. PAS scores may help identify individuals at higher risk for psychosis.

Type
Regular Articles
Information
Development and Psychopathology , Volume 29 , Special Issue 1: Developmental and Social–Ecological Perspectives on Children, Political Violence, and Armed Conflict , February 2017 , pp. 93 - 106
Copyright
Copyright © Cambridge University Press 2016 

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