Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2011 Mar;3(1):57-67.
doi: 10.1007/s11689-010-9067-y. Epub 2010 Dec 3.

Clinical assessment of DSM-IV anxiety disorders in fragile X syndrome: prevalence and characterization

Lisa Cordeiro, Elizabeth Ballinger, Randi Hagerman, David Hessl

Clinical assessment of DSM-IV anxiety disorders in fragile X syndrome: prevalence and characterization

Lisa Cordeiro et al. J Neurodev Disord. 2011 Mar.

Abstract

Fragile X syndrome (FXS) is the most common form of inherited intellectual disability (ID). Anxiety and social withdrawal are considered core features of the FXS phenotype, yet there is limited diagnostic evidence of the prevalence of formal anxiety disorders in FXS. This study assessed the prevalence of anxiety disorders in a sample of 58 males and 39 females with FXS (ages 5.0-33.3 years). Participants' parents completed the Anxiety Disorders Interview Schedule (ADIS-IV), a clinical interview based on DSM-IV criteria, and the Anxiety Depression and Mood Scale (ADAMS), a psychiatric disorders screening instrument normed in ID. We conducted cognitive (IQ) and autism (AUT) assessments and surveyed medication use. Despite a high rate of psychopharmacological treatment, 86.2% of males and 76.9% of females met criteria for an anxiety disorder, with social phobia and specific phobia the most commonly diagnosed. Proband status, gender, and IQ were not significantly related to any anxiety disorders, however significantly higher rates of a few anxiety disorders were found in older age and AUT groups. Significant correlations between ADIS diagnoses and ADAMS scores provided cross-validation of instruments, indicating that the ADIS is suitable for use in FXS. A greater percentage of our sample met criteria for most anxiety disorders than has been reported in other ID groups or the general population. The rate of anxiety compared to general ID suggests that the FMR1 full mutation confers an especially high risk for these disorders, regardless of factors commonly associated with FXS clinical involvement. A thorough clinical assessment and treatment of anxiety should be included in the FXS standard of care.

Keywords: Anxiety; Fragile X syndrome; Intellectual disability; Social phobia; Specific phobia.

PubMed Disclaimer

Figures

Fig. 1
Fig. 1
DSM-IV anxiety disorders: males with fragile X syndrome. Features (open portion of bars) shows the percentage of participants who demonstrated clinically significant symptoms but did not meet formal diagnostic criteria
Fig. 2
Fig. 2
DSM-IV anxiety disorders: females with fragile X syndrome. Features (open portion of bars) shows the percentage of participants who demonstrated clinically significant symptoms but did not meet formal diagnostic criteria
See this image and copyright information in PMC

References

    1. Bailey DB, Jr, Raspa M, Olmsted M, Holiday DB. Co-occurring conditions associated with FMR1 gene variations: findings from a national parent survey. Am J Med Genet A. 2008;146A(16):2060–9. doi: 10.1002/ajmg.a.32439. - DOI - PubMed
    1. Bassell GJ, Warren ST. Fragile X syndrome: loss of local mRNA regulation alters synaptic development and function. Neuron. 2008;60(2):201–14. doi: 10.1016/j.neuron.2008.10.004. - DOI - PMC - PubMed
    1. Berry-Kravis E, Potanos K. Psychopharmacology in fragile X syndrome–present and future. Ment Retard Dev Disabil Res Rev. 2004;10(1):42–8. doi: 10.1002/mrdd.20007. - DOI - PubMed
    1. Berry-Kravis E, Hessl D, Coffey S, Hervey C, Schneider A, Yuhas J, et al. A pilot open label, single dose trial of fenobam in adults with fragile X syndrome. J Med Genet. 2009;46(4):266–71. doi: 10.1136/jmg.2008.063701. - DOI - PMC - PubMed
    1. Bodden DH, Bogels SM, Nauta MH, De Haan E, Ringrose J, Appelboom C, et al. Child versus family cognitive-behavioral therapy in clinically anxious youth: an efficacy and partial effectiveness study. J Am Acad Child Adolesc Psychiatry. 2008;47(12):1384–94. doi: 10.1097/CHI.0b013e318189148e. - DOI - PubMed