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Attention deficit hyperactivity disorder symptoms as antecedents of later psychotic outcomes in 22q11.2 deletion syndrome

Niarchou, Maria ORCID:, Chawner, Samuel, Fiksinski, Ania, Vorstman, Jacob A.S., Maeder, Johanna, Schneider, Maude, Eliez, Stephan, Armando, Marco, Pontillo, Maria, Vicari, Stefano, McDonald-McGinn, Donna M., Emanuel, Beverly, Zackai, Elaine, Bearden, Carrie E., Shashi, Vandana, Hooper, Stephen R., Owen, Michael J. ORCID:, Gur, Raquel A., Wray, Naomi R., van den Bree, Marianne ORCID: and Thapar, Anita ORCID: 2019. Attention deficit hyperactivity disorder symptoms as antecedents of later psychotic outcomes in 22q11.2 deletion syndrome. Schizophrenia Research 204 , pp. 320-325. 10.1016/j.schres.2018.07.044

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Individuals with 22q11.2 Deletion Syndrome (22q11.2DS) are at substantially heightened risk for psychosis. Thus, prevention and early intervention strategies that target the antecedents of psychosis in this high-risk group are a clinical priority. Attention Deficit Hyperactivity Disorder (ADHD) is one the most prevalent psychiatric disorders in children with 22q11.2DS, particularly the inattentive subtype. The aim of this study was to test the hypothesis that ADHD inattention symptoms predict later psychotic symptoms and/or psychotic disorder in those with 22q11.2DS. 250 children and adolesents with 22q11.2DS without psychotic symptoms at baseline took part in a longitudinal study. Assessments were performed using well-validated structured diagnostic instruments at two time points (T1 (mean age=11.2, SD=3.1) and T2 (mean age=14.3, SD=3.6)). Inattention symptoms at T1 were associated with development of psychotic symptoms at T2 (OR:1.2, p=0.01) but weak associations were found with development of psychotic disorder (OR:1.2, p=0.15). ADHD diagnosis at T1 was strongly associated with development of psychotic symptoms at T2 (OR:4.5, p<0.001) and psychotic disorder (OR:5.9, p=0.02). Our findings that inattention symptoms and the diagnosis of ADHD are associated with subsequent psychotic outcomes in 22q11.2DS have important clinical implications. Future studies examining the effects of stimulant and other ADHD treatments on individuals with 22q11.2DS are warranted.

Item Type: Article
Date Type: Publication
Status: Published
Schools: Medicine
MRC Centre for Neuropsychiatric Genetics and Genomics (CNGG)
Publisher: Elsevier
ISSN: 0920-9964
Date of First Compliant Deposit: 31 July 2018
Date of Acceptance: 31 July 2018
Last Modified: 19 May 2023 19:22

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