Adolescents at ultra-high risk for psychosis with and without 22q11 deletion syndrome: A comparison of prodromal psychotic symptoms and general functioning

Armando, Marco; Girardi, Paolo; Vicari, Stefano; Menghini, Deny; Digilio, María Cristina; Pontillo, Maria; Saba, Riccardo; Mazzone, Luigi; Lin, Ashleigh; Klier, Claudia M.; Schäfer, Miriam R.; Amminger, G. Paul

doi:10.1016/j.schres.2012.04.020

Cited by 47 publications

(39 citation statements)

References 62 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[42][43][44] The collective prevalence rates of those with positive subthreshold symptoms (32.8%) and those with negative/ disorganized subthreshold symptoms (21.7%) sum up to 54.5%, which is similar to the 54% who met criteria for "psychosis-proneness" in the research conducted by Tang et al 5 Similarly, the rates of negative/disorganized subthreshold symptoms found in our cohort parallel those reported in several previous studies with 22q11.2DS individuals, suggesting that negative symptoms are common in this population. 11,22 Negative symptoms are considered important predictors of the likelihood to convert to psychosis in high-risk populations without 22q11.2DS. 11,45 For example, moderate and severe subthreshold negative symptoms were highly abundant in individuals at high risk for psychosis in the North American Prodrome Longitudinal Study (NAPLS), and the severity and persistence of these symptoms were positively associated with transition rates into a psychotic state at 6-and 12-months post-baseline visits.…”

Section: Discussionmentioning

confidence: 99%

“…Among these are longitudinal decline in verbal IQ (VIQ), 17,18 lower baseline IQ, 3,8,19 the presence of comorbid anxiety disorders, 7,8,20 and lower global functioning. 21,22 However, the comorbidity of these conditions with subthreshold psychotic symptoms has not been sufficiently explored. Moreover, assessment of this phenomenon in 22q11.2DS individuals of various ages is vital for elucidating the rate and nature of subthreshold psychotic symptoms across development in this population.…”

mentioning

confidence: 99%

See 1 more Smart Citation

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

Weisman

Guri

Gur

et al. 2017

Schizophrenia Bulletin

Self Cite

View full text Add to dashboard Cite

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 fullblown 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.

show abstract

Section: Discussionmentioning

confidence: 99%

mentioning

confidence: 99%

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

Weisman

Guri

Gur

et al. 2017

Schizophrenia Bulletin

Self Cite

View full text Add to dashboard Cite

show abstract

“…Thus, negative symptoms appear to be one of the clinical characteristic of 22q11DS since they are present in roughly a third of patients in the absence of positive symptoms (Schneider et al, 2014b). Additionally, negative symptoms are more severe in patients with 22q11DS at risk for developing psychosis compared to at-risk subjects without the microdeletion (Armando et al, 2012;Tang et al, 2015).…”

Section: Introductionmentioning

confidence: 99%

Morphological brain changes associated with negative symptoms in patients with 22q11.2 Deletion Syndrome

Mihailov

Padula

Scariati

et al. 2017

Schizophrenia Research

View full text Add to dashboard Cite

Approximately 30% of individuals with 22q11.2 Deletion Syndrome (22q11DS) develop schizophrenia during adolescence/early adulthood, making this syndrome a model for the disorder. Furthermore, negative symptoms exist in up to 80% of patients diagnosed with 22q11DS. The present study aims to uncover morphological brain alterations associated with negative symptoms in a cohort of patients with 22q11DS who are at-risk for developing schizophrenia. A total of 71 patients with 22q11DS aged 12 to 35 (54% females) with no past or present diagnosis of a schizophrenia were included in the study. Psychotic symptom scores were used to divide patients into subgroups by means of a cluster analysis. Three major subgroups were evident: patients with low negative and positive symptoms; patients with high negative symptoms and low positive symptoms; and patients with high negative and positive symptoms. Cortical volume, thickness and gyrification were compared between subgroups using FreeSurfer software. Results showed that patients with high negative symptoms, compared to those with low negative symptoms, have decreased gyrification in the medial occipito-temporal (MOT) and lateral temporo-parietal (LTP) cortices of the left hemisphere, and in the medial temporal (MT)/posterior cingulate (PCC) cortices of the right hemisphere. These findings suggest that high negative symptoms are associated with gyrification reductions predominantly in medial occipital and temporal regions, which are areas implicated in social cognition and early visual processing. Furthermore, as cortical folding develops in utero and during the first years of life, reduced gyrification may represent an early biomarker predicting the development of negative symptoms.

show abstract

“…Research supports a relationship between early onset psychosis and poor prognosis (Lay et al, 2000; Remschmidt, 2002) suggesting that treatment of deficits early on may be helpful (Mcglashan and Johannessen, 1996). Thus, examining adolescents with 22q11DS could offer a unique opportunity to investigate specific and early interventions related to potential psychotic onset (Armando et al, 2012). …”

Section: Introductionmentioning

confidence: 99%

Cognitive remediation for adolescents with 22q11 deletion syndrome (22q11DS): A preliminary study examining effectiveness, feasibility, and fidelity of a hybrid strategy, remote and computer-based intervention

Mariano¹,

Tang²,

Kurtz³

et al. 2015

Schizophrenia Research

View full text Add to dashboard Cite

Background 22q11DS is a multiple anomaly syndrome involving intellectual and behavioral deficits, and increased risk for schizophrenia. As cognitive remediation (CR) has recently been found to improve cognition in younger patients with schizophrenia, we investigated the efficacy, feasibility, and fidelity of a remote, hybrid strategy, computerized CR program in youth with 22q11DS. Methods A longitudinal design was implemented in which 21 participants served as their own controls. Following an eight month baseline period in which no interventions were provided, cognitive coaches met with participants remotely for CR via video conferencing three times a week over a targeted 8 month timeframe and facilitated their progress through the intervention, offering task-specific strategies. A subset of strategies were examined for fidelity. Outcomes were evaluated using a neurocognitive test battery at baseline, pre-treatment and post-treatment. Results All participants adhered to the intervention. The mean length of the treatment phase was 7.96 months. A moderately high correlation (intraclass correlation coefficient, 0.73) was found for amount and type of strategies offered by coaches. Participants exhibited significant improvements (ES = .36–.55, p ≤ .009) in working memory, shifting attention and cognitive flexibility. All significant models were driven by improvements in pre to post-treatment scores. Conclusions Based on our preliminary investigation, a remote, hybrid strategy, computerized CR program can be implemented with 22q11DS youth despite geographic location, health, and cognitive deficits. It appears effective in enhancing cognitive skills during the developmental period of adolescence, making this type of CR delivery useful for youth with 22q11DS transitioning into post-school environments.

show abstract

Adolescents at ultra-high risk for psychosis with and without 22q11 deletion syndrome: A comparison of prodromal psychotic symptoms and general functioning

Cited by 47 publications

References 62 publications

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

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

Morphological brain changes associated with negative symptoms in patients with 22q11.2 Deletion Syndrome

Cognitive remediation for adolescents with 22q11 deletion syndrome (22q11DS): A preliminary study examining effectiveness, feasibility, and fidelity of a hybrid strategy, remote and computer-based intervention

Contact Info

Product

Resources

About