Identifying patterns of anxiety and depression in children with chromosome 22q11.2 deletion syndrome: Comorbidity predicts behavioral difficulties and impaired functional communications.

[22q11.2 deletion syndrome]

Chromosome 22 q 11 .2 deletion syndrome (22 q 11 .2 DS ) is a complex genetic disorder with a variable clinical presentation that can include cardiac , neural , immunological , and psychological issues . Previous studies have measured elevated anxiety and depression in children with 22 q 11 .2 DS . Comorbity of anxiety and depression is well established in the pediatric literature but the nature of comorbidity patterns has not been empirically established in children with 22 q 11 .2 DS . Comorbidity of anxiety and depression has important implications for treatment and prognosis , and may be a marker of risk in this population of children at high -risk for developing schizophrenia .Participants were 131 boys and girls ages 8 -14 with (n =76 ) and without (n =55 ) 22 q 11 .2 DS and their mothers . Children and mothers independently completed self- and parent-report measures of anxiety and depression . Mothers also completed measures of behavioral functioning including the Behavioral Assessment for Children , 2nd ed . (BASC-2 ). Cluster analyses were conducted to test if theoretically based groupings of anxiety and depression could be identified . We hypothesized four psychological profiles based on child- and mother-reports : low /no anxiety and low /no depression , higher depression and low /no anxiety , higher anxiety and no /low depression , and a comorbid profile of higher anxiety and higher depression . BASC-2 subscale scores were then compared across subgroups of children to determine if a comorbid profile would predict greater behavioral difficulties .In the full sample of children both with and without 22 q 11 .2 DS , cluster analyses of self and maternal reported anxiety and depression revealed the expected subgroups : (1 ) a group of children with higher anxiety /lower depression (anxious ); (2 ) a group with primary depression (lower anxiety /higher depression (depressed )); (3 ) a comorbid group with higher anxiety /higher depression (comorbid ); and , (4 ) a lowest anxiety /lowest depression group (NP ). Mothers ' reports produced highly similar groupings . Furthermore , the 22 q 11 .2 DS youth were more likely to be in anxiety , depressed or comorbid clusters than the typically developing (TD ) youth . Children with 22 q 11 .2 DS comorbid for anxiety and depression exhibited the worst functional outcomes (e .g ., poor poorer functional communication , and reduced daily life activities ).Anxiety , comorbid with depression may be of particular concern in children with 22 q 11 .2 DS who arguably carry a greater burden on their stress coping resources than children without a complex genetic disorder . Furthermore , the manifestation of negative mood , anxiety and difficult behavior is likely to reverberate between the child and her or his environment . This can lead to negative interactions with family , peers , and teachers , which in turn further taxes coping resources . Comorbidity of anxiety and depression within a vulnerable population highlights the need for the development of tailored interventions .

Diseases
Validation

Diseases presenting "depression" symptom

22q11.2 deletion syndrome

achondroplasia

adrenal incidentaloma

adrenomyeloneuropathy

alexander disease

aromatase deficiency

cadasil

child syndrome

classical phenylketonuria

congenital adrenal hyperplasia

congenital toxoplasmosis

cushing syndrome

cutaneous mastocytosis

dracunculiasis

fabry disease

familial hypocalciuric hypercalcemia

gm1 gangliosidosis

hereditary cerebral hemorrhage with amyloidosis

krabbe disease

locked-in syndrome

malignant atrophic papulosis

oligodontia

oral submucous fibrosis

phenylketonuria

sneddon syndrome

triple a syndrome

trochlear dysplasia

von hippel-lindau disease

This symptom has already been validated