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Deletion syndrome may predict schizophrenia risk

Patients with 22q11.2 deletion syndrome have an increased risk for developing schizophrenia, according to researchers.

They found that the cognitive decline appeared to begin as early as age 11 years, according to data.

“This is further support that 22q11DS provides a unique opportunity to prospectively examine the pathophysiology of cognitive decline preceding the onset of psychosis,” the researchers wrote. “Our results also suggest that cognitive decline could potentially become a useful marker in the clinical management of youths with 22q11DS.”

Jacob A. S. Vorstman, MD, PhD, of the department of psychiatry in the Brain Center Rudolf Magnus, University Medical Center Utrecht, the Netherlands, and colleagues, examined psychiatric assessments and longitudinal IQ measurements for 411 patients from 22 international clinical research sites.

Of those with the 22q11deletion syndrome (DS), 55 (13.4%) were diagnosed with a psychotic disorder, according to data. The mean age of the most recent psychiatric assessment was 16.1 years, they wrote.

Patients who developed a psychotic disorder demonstrated a lower full-scale IQ at first cognitive assessment, compared with those who did not develop a psychiatric disorder (65.5 vs. 74), according to data.

Children with the deletion syndrome tended to show a mild, 7.04-point decline in IQ, which increased with age, according to researchers. This was most evident in the domain of verbal IQ, with a decline of 9.02 points. Significant declines were recognized among those who developed a psychotic illness (P < .001), the researchers wrote.

The average age of onset for first psychosis was 18.1 years, with the youngest onset at 12.7 years, they added.

When the researchers considered the negative deviation from the average cognitive trajectory seen in patients with the deletion syndrome, they found a significantly increased risk for psychotic disorders (OR = 2.49; 95% CI, 1.24-5).

“Our observations have potential ramifications for clinical management of patients with 22q11DS and for understanding the pathophysiology of schizophrenia, especially the importance of early cognitive decline preceding the first psychotic episode,” the researchers wrote. – by Samantha Costa

Disclosure: Vorstman reports no relevant financial disclosures. Please see the full study for a list of all other authors’ relevant financial disclosures.