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22q11.2 缺失综合征成人的功能预后。

Functional outcomes of adults with 22q11.2 deletion syndrome.

机构信息

Clinical Genetics Research Program, Centre for Addiction and Mental Health, Toronto, Ontario, Canada.

出版信息

Genet Med. 2012 Oct;14(10):836-43. doi: 10.1038/gim.2012.66. Epub 2012 Jun 28.

Abstract

PURPOSE

The 22q11.2 deletion syndrome is a common multisystem genomic disorder with congenital and later-onset manifestations, including congenital heart disease, intellectual disability, and psychiatric illness, that may affect long-term functioning. There are limited data on adult functioning in 22q11.2 deletion syndrome.

METHODS

We used the Vineland Adaptive Behavior Scales to assess functioning in 100 adults with 22q11.2 deletion syndrome (n = 46 male; mean age = 28.8 (standard deviation = 9.7) years) where intellect ranged from average to borderline (n = 57) to mild intellectual disability (n = 43).

RESULTS

More than 75% of the subjects scored in the functional deficit range. Although personal, vocational, and financial demographics confirmed widespread functional impairment, daily living skills and employment were relative strengths. Intelligence quotient was a significant predictor (P < 0.001) of overall and domain-specific adaptive functioning skills. A diagnosis of schizophrenia was a significant predictor (P < 0.05) of overall adaptive functioning, daily living skills, and socialization scores. Notably, congenital heart disease, history of mood/anxiety disorders, sex, and age were not significant predictors of functioning.

CONCLUSION

Despite functional impairment in adulthood that is primarily mediated by cognitive and psychiatric phenotypes, relative strengths in activities of daily living and employment have important implications for services and long-term planning. These results may help to inform expectations about outcomes for patients with 22q11.2 deletion syndrome.

摘要

目的

22q11.2 缺失综合征是一种常见的多系统基因组疾病,具有先天性和后天性表现,包括先天性心脏病、智力障碍和精神疾病,可能影响长期功能。关于 22q11.2 缺失综合征患者的成人功能,数据有限。

方法

我们使用 Vineland 适应行为量表评估了 100 名 22q11.2 缺失综合征患者的功能(n = 46 名男性;平均年龄 = 28.8(标准差 = 9.7)岁),智力范围从平均到边缘(n = 57)到轻度智力障碍(n = 43)。

结果

超过 75%的受试者得分处于功能缺陷范围。尽管个人、职业和财务人口统计学证实了广泛的功能障碍,但日常生活技能和就业是相对优势。智商是整体和特定领域适应功能技能的显著预测因素(P < 0.001)。精神分裂症的诊断是整体适应功能、日常生活技能和社交评分的显著预测因素(P < 0.05)。值得注意的是,先天性心脏病、心境/焦虑障碍史、性别和年龄不是功能的显著预测因素。

结论

尽管成年人存在功能障碍,主要由认知和精神表型介导,但日常生活活动和就业方面的相对优势对服务和长期规划具有重要意义。这些结果可能有助于为 22q11.2 缺失综合征患者的结果提供信息。

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