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. 2016 May 15;79(10):850-857.
doi: 10.1016/j.biopsych.2015.07.015. Epub 2015 Jul 31.

Trajectory and Predictors of Depression and Anxiety Disorders in Mothers With the FMR1 Premutation

Jane E Roberts  1 , Bridgette L Tonnsen  2 , Lindsay M McCary  3 , Amy L Ford  4 , Robert N Golden  5 , Donald B Bailey Jr  6
Affiliations

Trajectory and Predictors of Depression and Anxiety Disorders in Mothers With the FMR1 Premutation

Jane E Roberts et al. Biol Psychiatry. .

Abstract

Background: Although the FMR1 premutation is associated with elevated prevalence of psychiatric disorders, the longitudinal course of symptoms has not been established. The present study followed a sample of women with the FMR1 premutation to characterize the incidence, stability, and predictors of mood and anxiety disorders across a 3-year period.

Methods: Participants included 83 women with the FMR1 premutation (mean age = 38.35) who completed the Structured Clinical Interview for DSM-IV Axis I Disorders at two time points, 3 years apart. Additional information was obtained regarding demographic, child, and biomedical (e.g., medication, menopause, CGG repeats) factors.

Results: We found increased prevalence of major depressive disorder (MDD) and anxiety disorders over time, with adverse outcomes predicted by complex interactions among biological, behavioral, and environmental risk factors. Lifetime MDD increased from 46% to 54% and lifetime anxiety disorders increased from 28% to 35%. Midrange CGG repeats, elevated child problem behaviors, and divorced marital status conveyed elevated risk for psychiatric diagnoses. Primary ovarian insufficiency was highly prevalent (41%) but did not account for elevated rates of psychiatric diagnoses. Medication use was highly reported (41%), particularly in women with MDD or anxiety, with selective serotonin reuptake inhibitors reported as the most commonly used medication across diagnostic groups.

Conclusions: The elevated prevalence of depression and anxiety in women with the FMR1 premutation is a clear and pressing concern given the frequent occurrence of the FMR1 premutation in the general community and the adverse outcomes-at both individual and systems levels-associated with psychiatric disorders in this population.

Keywords: Anxiety; Depression; FMR1 premutation; Fragile X; Longitudinal.

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Conflict of interest statement

Disclosures: The authors report no biomedical financial interests or potential conflicts of interest.

Figures

Figure 1
Figure 1
Longitudinal Patterns of MDD and Anxiety Disorders Never (not at Time 1 or Time 2; Remission (present at Time 1 and absent at Time 2); Emergence (absent at Time 1 and present at Time 2); Maintenance (present at Times 1 and 2).
See this image and copyright information in PMC

Comment in

References

    1. Roberts JE, Bailey DB, Mankowski J, Ford A, Sideris J, Weisenfeld LA, et al. Mood and anxiety disorders in females with the FMR1 premutation. Am J Med Genet B Neuropsychiatr Genet. 2009;150B:130–9. - PubMed
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    1. Hessl D, Tassone F, Loesch DZ, Berry-Kravis E, Leehey Ma, Gane LW, et al. Abnormal elevation of FMR1 mRNA is associated with psychological symptoms in individuals with the fragile X premutation. Am J Med Genet B Neuropsychiatr Genet. 2005;139B:115–21. - PubMed
    1. Bailey DB, Sideris J, Roberts J, Hatton D. Child and genetic variables associated with maternal adaptation to fragile X syndrome: a multidimensional analysis. Am J Med Genet A. 2008;146A:720–9. - PubMed

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