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Premorbid adjustment and schizophrenia in individuals with 22q11.2 deletion syndrome.
[22q11.2 deletion syndrome]
The
literature
on
idiopathic
schizophrenia
has
consistently
reported
that
poor
premorbid
functioning
precedes
onset
of
psychosis
.
Individuals
with
22
q
11
.
2
deletion
syndrome
(
22
q
11
.
2
DS
)
are
at
heightened
risk
of
developing
schizophrenia
.
The
present
study
examined
the
relationship
between
adult-onset
schizophrenia
and
social
and
academic
functioning
across
childhood
and
early
adolescent
development
in
22
q
11
.
2
DS
.
Premorbid
adjustment
in
social
and
academic
domains
during
childhood
(
ages
5
-
11
years
)
and
early
adolescence
(
ages
12
-
15
years
)
of
103
adults
with
22
q
11
.
2
DS
was
assessed
using
the
Premorbid
Adjustment
Scale
(
PAS
)
.
Linear
mixed
-models
were
used
to
compare
PAS
scores
between
the
43
subjects
who
later
developed
schizophrenia
and
the
60
subjects
who
did
not
.
Social
functioning
and
academic
functioning
deteriorated
from
childhood
to
early
adolescence
among
those
who
later
developed
schizophrenia
compared
to
stable
functioning
,
on
average
,
in
those
who
did
not
later
develop
a
psychotic
disorder
.
Those
who
developed
schizophrenia
had
significantly
higher
PAS
scores
(
indicating
poorer
functioning
)
in
social
(
β
=
0
.
118
,
95
%
CI
:
0
.
046
-
0
.
189
)
and
academic
(
β
=
0
.
072
,
95
%
CI
:
0
.
015
-
0
.
129
)
domains
between
childhood
and
early
adolescence
,
independent
of
the
presence
of
intellectual
disability
.
The
two
groups
had
similar
PAS
scores
during
childhood
.
Consistent
with
the
literature
on
idiopathic
schizophrenia
,
deterioration
in
social
and
academic
functioning
between
childhood
and
early
adolescence
preceded
onset
of
schizophrenia
in
this
cohort
of
22
q
11
.
2
DS
patients
,
regardless
of
functioning
at
baseline
.
These
findings
suggest
that
monitoring
for
changes
in
functioning
,
in
addition
to
emergence
of
typical
symptoms
,
may
help
to
prevent
delays
in
diagnosis
and
treatment
of
major
psychotic
illness
in
22
q
11
.
2
DS
.
Diseases
Validation
Diseases presenting
"schizophrenia"
symptom
22q11.2 deletion syndrome
achondroplasia
alexander disease
cadasil
child syndrome
congenital toxoplasmosis
kabuki syndrome
kallmann syndrome
krabbe disease
neuralgic amyotrophy
oligodontia
oral submucous fibrosis
zellweger syndrome
This symptom has already been validated