The Psychosis Spectrum in 22q11.2 Deletion Syndrome Is Comparable to That of Nondeleted Youths.
BACKGROUND
Chromosome 22q11.2 deletion syndrome (22q11DS) is a promising model for studying psychosis risk. Direct comparisons of psychosis features between 22q11DS and nondeleted (ND) individuals are limited by inconsistency and small samples. In the largest study to date, we compare 22q11DS to ND in comorbidities, functioning, cognition, and psychosis features across the full range of overall severity.


METHODS
ND youths (n = 150) ages 9 to 24 years were matched to 22q11DS individuals (n = 150) on age and sex, stratifying for presence of psychosis spectrum disorder. Individuals were evaluated for psychosis using the Structured Interview for Prodromal Syndromes, and for attention-deficit/hyperactivity, substance-related, and mood disorders. Differential item functioning analysis addressed whether 22q11DS differs from ND in the probability of clinically significant ratings while holding constant the overall level of psychosis.


RESULTS
Onset of psychosis proneness was similar among 22q11DS (mean: 11.0 years) and ND (mean: 12.1 years) individuals. Accounting for higher overall psychosis symptoms, 22q11DS participants were still more likely to manifest impaired stress tolerance, avolition, and ideational richness; ND individuals were more likely to exhibit unusual thoughts, persecutory ideas, and bizarre thinking. Cognition was impaired in 22q11DS, but it did not correlate with symptoms except ideational richness. Comorbid anxiety disorders were more likely in psychosis spectrum 22q11DS; substance-related disorders were more likely in ND. Global assessment of function was similar in 22q11DS and ND individuals, except among those with low total Structured Interview for Prodromal Syndromes scores.


CONCLUSIONS
Individuals with 22q11DS share overarching similarities with ND individuals in psychosis symptoms and age of onset for psychosis proneness; this continues to support the 22q11DS model as a valuable window into mechanisms contributing to psychosis.
['Tang|Sunny X|SX|', 'Moore|Tyler M|TM|', 'Calkins|Monica E|ME|', 'Yi|James J|JJ|', 'Savitt|Adam|A|', 'Kohler|Christian G|CG|', 'Souders|Margaret C|MC|', 'Zackai|Elaine H|EH|', 'McDonald-McGinn|Donna M|DM|', 'Emanuel|Beverly S|BS|', 'Gur|Ruben C|RC|', 'Gur|Raquel E|RE|']
D000293:Adolescent D001289:Attention Deficit Disorder with Hyperactivity D016022:Case-Control Studies D002648:Child D003071:Cognition D015897:Comorbidity D004062:DiGeorge Syndrome D005260:Female D006801:Humans D008297:Male D019964:Mood Disorders D010414:Pennsylvania D011618:Psychotic Disorders D019966:Substance-Related Disorders D013997:Time Factors D055815:Young Adult
Psychosis 22q11.2 Deletion syndrome Prodromal Clinical high risk DiGeorge syndrome Schizophrenia