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22q11.2缺失综合征中精神分裂症高发病率的进一步证据。

Further evidence for high rates of schizophrenia in 22q11.2 deletion syndrome.

作者信息

Monks Stephen, Niarchou Maria, Davies Aimée R, Walters James T R, Williams Nigel, Owen Michael J, van den Bree Marianne B M, Murphy Kieran C

机构信息

Department of Psychiatry, Royal College of Surgeons in Ireland, Education and Research Centre, Beaumont Hospital, Dublin, Ireland.

Institute of Psychological Medicine and Clinical Neurosciences, MRC Centre for Neuropsychiatric Genetics and Genomics, Cardiff University, Cardiff, UK.

出版信息

Schizophr Res. 2014 Mar;153(1-3):231-6. doi: 10.1016/j.schres.2014.01.020. Epub 2014 Feb 15.

Abstract

22q11.2 deletion syndrome (22q11.2DS) is associated with high rates of psychotic disorder, particularly schizophrenia. The deletion is considered to be a biological model for understanding this debilitating psychiatric disorder. It is unclear whether the psychotic manifestations in 22q11.2DS are similar to those in schizophrenia patients without the deletion. Catechol-O-methyltransferase (COMT), a positional candidate gene for schizophrenia, resides within the 22q11.2 region. It remains unknown whether hemizygosity for this gene is associated with risk of psychotic disorder. This study includes 83 adults with 22q11.2DS, 90 non-deleted individuals with schizophrenia, and 316 normal controls. Psychopathology was assessed using the Schedules for Clinical Assessment in Neuropsychiatry, the Schedules for the Assessment of Positive and Negative Symptoms and the Global Assessment Scale. Schizotypy was assessed with the Kings Schizotypy Questionnaire and Oxford Liverpool Inventory of Feelings and Emotions. IQ estimates were also obtained. Adults with 22q11.2DS were genotyped for a number of COMT polymorphisms as well as the Ashkenazi risk haplotype. This study confirms high rates of psychotic disorder (29%) in individuals with 22q11.2DS of which the majority had schizophrenia (22%). There does not appear to be a differential expression of schizophrenic symptom clusters in 22q11.2DS in relation to sporadic schizophrenia, though schizophrenia in 22q11.2DS seems to be less severe in terms of global assessment scores. Psychosis proneness seems to be of genetic origin in 22q11.2DS as individuals with 22q11.2DS without schizophrenia had higher schizotypy scores than normal controls. Finally, COMT was not associated with schizophrenia status or schizotypy.

摘要

22q11.2缺失综合征(22q11.2DS)与精神障碍尤其是精神分裂症的高发病率相关。该缺失被认为是理解这种使人衰弱的精神障碍的生物学模型。目前尚不清楚22q11.2DS中的精神病性表现是否与无该缺失的精神分裂症患者相似。儿茶酚-O-甲基转移酶(COMT)是精神分裂症的一个定位候选基因,位于22q11.2区域内。该基因的半合子状态是否与精神障碍风险相关尚不清楚。本研究纳入了83名患有22q11.2DS的成年人、90名未发生缺失的精神分裂症患者以及316名正常对照。使用神经精神病学临床评估量表、阳性和阴性症状评估量表以及总体评估量表对精神病理学进行评估。使用金斯分裂型人格问卷和牛津利物浦情感与情绪量表对分裂型人格进行评估。还获得了智商估计值。对患有22q11.2DS的成年人进行了多种COMT多态性以及阿什肯纳兹风险单倍型的基因分型。本研究证实,22q11.2DS个体中精神障碍的发病率很高(29%),其中大多数患有精神分裂症(22%)。与散发性精神分裂症相比,22q11.2DS中精神分裂症症状群似乎没有差异表达,不过从总体评估得分来看,22q11.2DS中的精神分裂症似乎不太严重。在22q11.2DS中,精神病易感性似乎源于遗传,因为没有精神分裂症的22q11.2DS个体的分裂型人格得分高于正常对照。最后,COMT与精神分裂症状态或分裂型人格无关。

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