Emory University School of Medicine, Emory Autism Center, Department of Psychiatry and Behavioral Sciences, 1551 Shoup Court, 30322 Atlanta, Georgia, United States.
Eur Psychiatry. 2013 Sep;28(7):417-22. doi: 10.1016/j.eurpsy.2013.06.002. Epub 2013 Aug 2.
22q11.2 deletion syndrome (22q11DS) associates with schizophrenia spectrum disorders (SSDs), autism spectrum disorders (ASDs), and other psychiatric disorders, but co-occurrence of diagnoses are not well described.
We evaluated the co-occurrence of SSDs, ASDs and other axis I psychiatric diagnoses in 31 adolescents and adults with 22q11DS, assessing ASDs using either stringent Collaborative Program for Excellence in Autism (ASD-CPEA) criteria, or less stringent DSM-IV criteria alone (ASD-DSM-IV).
Ten (32%) individuals met criteria for an SSD, five (16%) for ASD-CPEA, and five others (16%) for ASD-DSM-IV. Of those with ASD-CPEA, one (20%) met SSD criteria. Of those with ASD-DSM-IV, four (80%) met SSD criteria. Depressive disorders (8 individuals; 26%) and anxiety disorders (7; 23%) sometimes co-occurred with SSDs and ASDs. SSDs, ASDs, and anxiety occurred predominantly among males and depression predominantly among females.
Individuals with 22q11DS can manifest SSDs in the presence or absence of ASDs and other axis I diagnoses. The results suggest that standard clinical care should include childhood screening for ASDs, and later periodic screening for all axis I diagnoses.
22q11.2 缺失综合征(22q11DS)与精神分裂谱系障碍(SSDs)、自闭症谱系障碍(ASDs)和其他精神障碍相关,但诊断的同时发生情况并未得到很好的描述。
我们评估了 31 名患有 22q11DS 的青少年和成年人中 SSDs、ASDs 和其他 I 轴精神诊断的同时发生情况,使用严格的卓越自闭症合作计划(ASD-CPEA)标准或单独使用较宽松的 DSM-IV 标准(ASD-DSM-IV)评估 ASD。
10 名(32%)个体符合 SSD 标准,5 名(16%)符合 ASD-CPEA 标准,另外 5 名(16%)符合 ASD-DSM-IV 标准。在符合 ASD-CPEA 的个体中,有 1 名(20%)符合 SSD 标准。在符合 ASD-DSM-IV 的个体中,有 4 名(80%)符合 SSD 标准。抑郁障碍(8 名;26%)和焦虑障碍(7 名;23%)有时与 SSDs 和 ASDs 同时发生。SSD、ASDs 和焦虑主要发生在男性中,而抑郁主要发生在女性中。
患有 22q11DS 的个体可能在存在或不存在 ASDs 和其他 I 轴诊断的情况下表现出 SSD。结果表明,标准临床护理应包括儿童时期的 ASD 筛查,以及以后所有 I 轴诊断的定期筛查。