Functional outcomes of adults with 22q11.2 deletion syndrome

Abstract

Purpose: The 22q11.2 deletion syndrome is a common multisystem genomic disorder with congenital and later-onset manifestations, including congenital heart disease, intellectual disability, and psychiatric illness, that may affect long-term functioning. There are limited data on adult functioning in 22q11.2 deletion syndrome.

Methods: We used the Vineland Adaptive Behavior Scales to assess functioning in 100 adults with 22q11.2 deletion syndrome (n = 46 male; mean age = 28.8 (standard deviation = 9.7) years) where intellect ranged from average to borderline (n = 57) to mild intellectual disability (n = 43).

Results: More than 75% of the subjects scored in the functional deficit range. Although personal, vocational, and financial demographics confirmed widespread functional impairment, daily living skills and employment were relative strengths. Intelligence quotient was a significant predictor (P < 0.001) of overall and domain-specific adaptive functioning skills. A diagnosis of schizophrenia was a significant predictor (P < 0.05) of overall adaptive functioning, daily living skills, and socialization scores. Notably, congenital heart disease, history of mood/anxiety disorders, sex, and age were not significant predictors of functioning.

Conclusion: Despite functional impairment in adulthood that is primarily mediated by cognitive and psychiatric phenotypes, relative strengths in activities of daily living and employment have important implications for services and long-term planning. These results may help to inform expectations about outcomes for patients with 22q11.2 deletion syndrome.

Figure 1. Full-scale IQ correlates with Vineland Adaptive Behavior Scales Adaptive Behavior Composite score (r = 0.60, n = 100) in adults with 22q11.2 deletion syndrome

Regression and predicted interval lines (95%) are shown. Subjects with an overall functioning score of less than 78 (dashed line) have functional deficits. Arrow denotes five subjects who have significantly higher functional scores than predicted by IQ. IQ, intelligence quotient.