PMID- 26528648
OWN - NLM
STAT- MEDLINE
DCOM- 20160314
LR  - 20171014
IS  - 1555-2101 (Electronic)
IS  - 0160-6689 (Linking)
VI  - 76
IP  - 10
DP  - 2015 Oct
TI  - Impact of psychiatric comorbidity and cognitive deficit on function in 22q11.2 
      deletion syndrome.
PG  - e1262-70
LID - 10.4088/JCP.14m09197 [doi]
AB  - OBJECTIVE: Presence of psychiatric comorbidity is associated with poor 
      functioning and is an important consideration in treatment. Many individuals with 
      22q11.2 deletion syndrome (22q11DS) develop comorbid psychiatric disorders, yet 
      its pattern and impact on functioning have not been formally investigated. In 
      this cross-sectional study, we examined the relationship between comorbid 
      psychopathology and neurocognitive deficits and their association with global 
      functioning. We hypothesized that higher psychiatric burden and 
      psychosis-spectrum features would be associated with reduced functioning and 
      increased neurocognitive deficits. METHOD: The cohort included 171 individuals 
      with 22q11DS and mean (SD) age of 17.4 (8.1) years, recruited from a tertiary 
      children's hospital and nationally through social media between September 2010 
      and December 2013. Psychiatric diagnoses and functioning were assessed using 
      semistructured interviews and the Global Assessment of Functioning (GAF) scale, 
      respectively. On the basis of psychopathology and number of comorbid diagnoses, 
      participants were assigned to unaffected (n = 32), nonpsychosis spectrum (n = 
      24), nonpsychosis spectrum-plus (n = 15), psychosis spectrum (n = 29), and 
      psychosis spectrum-plus (n = 71) groups. Executive function, episodic memory, 
      complex cognition, social cognition, and praxis speed were assessed using a 
      computerized neurocognitive battery (CNB). Cognitive profile and GAF scores were 
      compared among the groups, and the association of GAF with cognitive performance 
      and psychopathology was examined. RESULTS: We observed high rates of comorbid 
      psychiatric disorders. Approximately 50% of the participants had >/= 2 diagnoses. 
      Psychosis spectrum disorders were most frequently comorbid with other disorders. 
      GAF score was progressively worse with increased psychiatric burden. Mean (SD) 
      GAF score for the unaffected group (81.1 [8.9]) was significantly different from 
      those of nonpsychosis spectrum (68.6 [12.1]), nonpsychosis spectrum-plus (63.4 
      [8.8]), psychosis spectrum (58.7 [13.1]), or psychosis spectrum-plus (55.5 
      [13.3]) (P < .05) groups. All groups performed poorly and were comparable to each 
      other on the CNB (P = .273). Notably, verbal memory (P = .003), spatial 
      processing (P = .001), and parent education level (P < .001) were significantly 
      associated with GAF. CONCLUSIONS: Individuals with 22q11DS have high rates of 
      comorbid psychiatric disorders and diffuse cognitive deficits regardless of 
      psychiatric burden. Those with psychotic spectrum disorders and comorbid 
      psychiatric disorders are at an increased risk for poor overall functioning.
CI  - (c) Copyright 2015 Physicians Postgraduate Press, Inc.
FAU - Yi, James J
AU  - Yi JJ
AD  - Department of Psychiatry, Perelman School of Medicine, University of 
      Pennsylvania, 3400 Spruce St, 10th Floor Gates Pavilion, Philadelphia, PA 19104 
      yij@email.chop.edu.
FAU - Calkins, Monica E
AU  - Calkins ME
FAU - Tang, Sunny X
AU  - Tang SX
FAU - Kohler, Christian G
AU  - Kohler CG
FAU - McDonald-McGinn, Donna M
AU  - McDonald-McGinn DM
FAU - Zackai, Elaine H
AU  - Zackai EH
FAU - Savitt, Adam P
AU  - Savitt AP
FAU - Bilker, Warren B
AU  - Bilker WB
FAU - Whinna, Daneen A
AU  - Whinna DA
FAU - Souders, Margaret C
AU  - Souders MC
FAU - Emanuel, Beverly S
AU  - Emanuel BS
FAU - Gur, Ruben C
AU  - Gur RC
FAU - Gur, Raquel E
AU  - Gur RE
LA  - eng
GR  - T32 MH019112/MH/NIMH NIH HHS/United States
GR  - MH087626/MH/NIMH NIH HHS/United States
GR  - K08 MH079364/MH/NIMH NIH HHS/United States
GR  - MH101719/MH/NIMH NIH HHS/United States
GR  - MH087636/MH/NIMH NIH HHS/United States
PT  - Journal Article
PT  - Research Support, N.I.H., Extramural
PT  - Research Support, Non-U.S. Gov't
PL  - United States
TA  - J Clin Psychiatry
JT  - The Journal of clinical psychiatry
JID - 7801243
SB  - IM
MH  - Adolescent
MH  - Adult
MH  - Child
MH  - Cognition Disorders/*epidemiology/genetics
MH  - Comorbidity
MH  - Cross-Sectional Studies
MH  - DiGeorge Syndrome/*epidemiology/psychology
MH  - Female
MH  - Humans
MH  - Interview, Psychological
MH  - Male
MH  - Mental Disorders/*epidemiology/genetics
MH  - Middle Aged
MH  - Neuropsychological Tests
MH  - Psychiatric Status Rating Scales
MH  - Psychopathology
MH  - Psychotic Disorders/epidemiology/genetics
MH  - Young Adult
EDAT- 2015/11/04 06:00
MHDA- 2016/03/15 06:00
CRDT- 2015/11/04 06:00
PHST- 2014/04/14 00:00 [received]
PHST- 2014/10/22 00:00 [accepted]
PHST- 2015/11/04 06:00 [entrez]
PHST- 2015/11/04 06:00 [pubmed]
PHST- 2016/03/15 06:00 [medline]
AID - 10.4088/JCP.14m09197 [doi]
PST - ppublish
SO  - J Clin Psychiatry. 2015 Oct;76(10):e1262-70. doi: 10.4088/JCP.14m09197.