Ultra high-risk status and transition to psychosis in 22q11.2 Deletion Syndrome

Poster B42, Friday, October 21, 11:30 am - 1:00 pm, Le Baron

Maude Schneider1,2, Marco Armando1,3, Maria Pontillo3, Stefano Vicari3, Martin Debbane1,4,5, Frauke Schultze-Lutter6, Stephan Eliez1,7; 1Office Medico-Pedagogique research unit, Faculty of Medicine, University of Geneva, Switzerland, 2Center for Contextual Psychiatry, Department of Neurosciences, KU Leuven, Belgium, 3Child and Adolescence Neuropsychiatry Unit, Department of Neuroscience, Children Hospital Bambino Gesù, Italy, 4Developmental Clinical Psychology Unit, Faculty of Psychology, University of Geneva, Switzerland, 5Research Department of Clinical, Educational and Health Psychology, University College London, UK, 6University Hospital of Child and Adolescent Psychiatry and Psychotherapy, University of Bern, Switzerland, 7Department of Genetic Medicine and Development, School of Medicine, University of Geneva, Switzerland

Objective: The 22q11.2 deletion syndrome (22q11DS) is characterized by high rates of psychotic symptoms and schizophrenia, making this condition a promising human model for studying risk factors for psychosis. Therefore, we explored ultra-high risk (UHR) criteria and their predictive value in 22q11DS. We also examined the additional contribution of socio-demographic, clinical and cognitive variables to predict transition to psychosis within an interval of 32.5 months (SD = 17.6) after initial assessment. Method: 89 participants with 22q11DS (age: 8-30 years; M = 16.08; SD = 4.72) were assessed using the Structured Interview for Psychosis-Risk Syndromes (SIPS). Information on axis-I diagnoses, internalizing and externalizing symptoms, level of functioning, and IQ were also collected at baseline and follow-up. Results: At baseline, 22 (24.7%) patients met UHR criteria. Compared to those without a UHR condition, UHR participants had a significantly lower functioning, more frequent anxiety disorders, and more severe internalizing and externalizing symptoms. Transition rate to psychosis was 27.3% in UHR and, 4.5% in non-UHR patients. Cox regression analyses revealed that UHR status significantly predicted conversion to psychosis. Baseline level of functioning was the only other additional predictor. Conclusions: This is the first study investigating the predictive value of UHR criteria in 22q11DS. It indicates that the clinical path leading to psychosis is comparable to that observed in other clinical high-risk samples. Nevertheless, the relatively high transition rate in non-UHR patients suggests an impact of other risk factors in the pathogenesis of psychosis in patients with 22q11DS.

Topic Area: Neurodevelopmental

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