MRC Centre for Neuropsychiatric Genetics and Genomics,Division of Psychological Medicine and Clinical Neurosciences,Cardiff University School of Medicine,Cardiff,UK.
School of Healthcare Sciences,Cardiff University,Cardiff,UK.
Br J Psychiatry. 2018 Jan;212(1):27-33. doi: 10.1192/bjp.2017.6.
22q11.2 deletion syndrome (22q11.2DS) is associated with high rates of neurodevelopmental disorder, however, the links between developmental coordination disorder (DCD), intellectual function and psychiatric disorder remain unexplored. Aims To establish the prevalence of indicative DCD in children with 22q11.2DS and examine associations with IQ, neurocognition and psychopathology.
Neurocognitive assessments and psychiatric interviews of 70 children with 22q11.2DS (mean age 11.2, s.d. = 2.2) and 32 control siblings (mean age 11.5, s.d. = 2.1) were carried out in their homes. Nine children with 22q11.2DS and indicative DCD were subsequently assessed in an occupational therapy clinic.
Indicative DCD was found in 57 (81.4%) children with 22q11.2DS compared with 2 (6.3%) control siblings (odds ratio (OR) = 36.7, P < 0.001). Eight of nine (89%) children with indicative DCD met DSM-5 criteria for DCD. Poorer coordination was associated with increased numbers of anxiety, (P < 0.001), attention-deficit hyperactivity disorder (ADHD) (P < 0.001) and autism-spectrum disorder (ASD) symptoms (P < 0.001) in children with 22q11.2DS. Furthermore, 100% of children with 22q11.2DS and ADHD had indicative DCD (20 of 20), as did 90% of children with anxiety disorder (17 of 19) and 96% of children who screened positive for ASD (22 of 23). The Developmental Coordination Disorder Questionnaire score was related to sustained attention (P = 0.006), even after history of epileptic fits (P = 0.006) and heart problems (P = 0.009) was taken into account.
Clinicians should be aware of the high risk of coordination difficulties in children with 22q11.2DS and its association with risk of mental disorder and specific neurocognitive deficits. Declaration of interest None.
22q11.2 缺失综合征（22q11.2DS）与神经发育障碍的发生率较高有关，但发育协调障碍（DCD）、智力功能和精神障碍之间的联系仍未得到探索。目的：确定 22q11.2DS 儿童中指示性 DCD 的患病率，并检查其与智商、神经认知和精神病理学之间的关联。
在儿童家中对 70 名 22q11.2DS 儿童（平均年龄 11.2，标准差=2.2）和 32 名对照组兄弟姐妹（平均年龄 11.5，标准差=2.1）进行神经认知评估和精神病学访谈。随后，对 9 名患有 22q11.2DS 和指示性 DCD 的儿童在职业治疗诊所进行评估。
与 2 名（6.3%）对照组兄弟姐妹相比，22q11.2DS 中有 57 名（81.4%）儿童存在指示性 DCD（优势比（OR）=36.7，P < 0.001）。9 名指示性 DCD 儿童中有 8 名（89%）符合 DSM-5 中 DCD 的标准。协调能力较差与 22q11.2DS 儿童焦虑症（P < 0.001）、注意缺陷多动障碍（ADHD）（P < 0.001）和自闭症谱系障碍（ASD）症状（P < 0.001）的数量增加有关。此外，22q11.2DS 中患有 ADHD 的儿童 100%（20 名中有 20 名）、焦虑症儿童 90%（19 名中有 17 名）和 ASD 筛查阳性儿童 96%（23 名中有 22 名）存在指示性 DCD。发育协调障碍问卷评分与持续注意力有关（P=0.006），即使考虑到癫痫发作史（P=0.006）和心脏问题（P=0.009）也是如此。
临床医生应注意到 22q11.2DS 儿童协调困难的风险较高，以及其与精神障碍和特定神经认知缺陷的风险之间的关联。利益声明无。
