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Psychosis a Risk in Children With Deletion Syndrome

Patients should be monitored early for signs of psychosis and internalizing behavior

THURSDAY, April 19 (HealthDay News) -- Adolescents with the 22q11.2 deletion syndrome are at higher risk of developing psychotic disorders than children with other developmental disabilities, but early monitoring for subthreshold signs of psychosis and internalizing behavior can help identify at-risk patients, according to a study in the April issue of the American Journal of Psychiatry.

Since deletion of 22q11.2 is the most common known genetic risk factor for schizophrenia, Doron Gothelf, M.D., from the Schneider Children's Medical Center in Petah Tiqwa, Israel, and colleagues compared the development of psychotic symptoms in 28 adolescents with the deletion and 23 matched controls with idiopathic developmental disability.

After a mean of 4.8 years in the deletion group and 6 years in the control group, the researchers found that significantly more adolescents in the deletion group had developed a psychotic disorder (32.1 percent vs. 4.3 percent). In the deletion group, 61 percent of the variance in the severity of psychosis at follow-up was predicted by baseline subthreshold psychotic symptoms, which interacted with the catechol O-methyltransferase genotype and baseline symptoms of anxiety or depression.

"Our results indicate that children with 22q11.2 deletion syndrome exhibit more severe psychiatric symptoms than children with idiopathic developmental disability as they pass through adolescence," Gothelf and colleagues concluded. "Early intervention in the subgroup of children with subthreshold signs of psychosis and internalizing symptoms (especially anxiety symptoms) may reduce the risk of developing psychotic disorders during adolescence."

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