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Multicenter Study
. 2017 Sep 1;43(5):1079-1089.
doi: 10.1093/schbul/sbx005.

Subthreshold Psychosis in 22q11.2 Deletion Syndrome: Multisite Naturalistic Study

Omri Weisman  1   2 , Yael Guri  1 , Raquel E Gur  3   4 , Donna M McDonald-McGinn  5   6 , Monica E Calkins  3 , Sunny X Tang  3 , Beverly Emanuel  5   6 , Elaine H Zackai  5   6 , Stephan Eliez  7 , Maude Schneider  7 , Marie Schaer  7 , Wendy R Kates  8 , Kevin M Antshel  9 , Wanda Fremont  8 , Vandana Shashi  10 , Stephen R Hooper  11 , Marco Armando  7   12 , Stefano Vicari  12 , Maria Pontillo  12 , Leila Kushan  13 , Maria Jalbrzikowski  14 , Carrie E Bearden  13 , Joseph F Cubells  15   16 , Opal Y Ousley  15   16 , Elaine F Walker  17 , Tony J Simon  18 , Joel Stoddard  18 , Tara A Niendam  18 , Marianne B M van den Bree  19 , Doron Gothelf  1   2 ; International Consortium on Brain and Behavior in 22q11.2 Deletion Syndrome
Affiliations
Multicenter Study

Subthreshold Psychosis in 22q11.2 Deletion Syndrome: Multisite Naturalistic Study

Omri Weisman et al. Schizophr Bull. .

Abstract

Nearly one-third of individuals with 22q11.2 deletion syndrome (22q11.2DS) develop a psychotic disorder during life, most of them by early adulthood. Importantly, a full-blown psychotic episode is usually preceded by subthreshold symptoms. In the current study, 760 participants (aged 6-55 years) with a confirmed hemizygous 22q11.2 microdeletion have been recruited through 10 medical sites worldwide, as part of an international research consortium. Of them, 692 were nonpsychotic and with complete measurement data. Subthreshold psychotic symptoms were assessed using the Structured Interview for Prodromal Syndromes (SIPS). Nearly one-third of participants met criteria for positive subthreshold psychotic symptoms (32.8%), less than 1% qualified for acute positive subthreshold symptoms, and almost a quarter met criteria for negative/disorganized subthreshold symptoms (21.7%). Adolescents and young adults (13-25 years) showed the highest rates of subthreshold psychotic symptoms. Additionally, higher rates of anxiety disorders and attention deficit/hyperactivity disorder (ADHD) were found among the study participants with subthreshold psychotic symptoms compared to those without. Full-scale IQ, verbal IQ, and global functioning (GAF) scores were negatively associated with participants' subthreshold psychotic symptoms. This study represents the most comprehensive analysis reported to date on subthreshold psychosis in 22q11.2DS. Novel findings include age-related changes in subthreshold psychotic symptoms and evidence that cognitive deficits are associated with subthreshold psychosis in this population. Future studies should longitudinally follow these symptoms to detect whether and how early identification and treatment of these manifestations can improve long-term outcomes in those that eventually develop a psychotic disorder.

Keywords: DiGeorge syndrome; IQ; anxiety disorder; attention deficit/hyperactivity disorder (ADHD); global assessment of functioning (GAF); structured interview for prodromal syndromes; subthreshold psychotic symptoms; velocardiofacial syndrome.

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Figures

Fig. 1.
Fig. 1.
Comparison of the mean scores of individual SIPS items between the four 22q11.2 deletion syndrome age groups; mean + SEM; **P < .01; ***P < .001.
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