Psychiatric Diagnoses in Patients with Williams Syndrome and Their Families

J. Kennedy, D. Kaye, L. Sadler
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引用次数: 30

Abstract

Williams Syndrome (WS) is a genetic disorder associated with mental retardation (MR) and a distinct behavioral phenotype including a friendly and outgoing personality. This population, like others with MR, has been reported to have an increased rate of symptoms of mental illness; however, few studies have used DSM-IV criteria to quantify specific psychiatric diagnoses in WS and the prevalence of psychiatric illness in relatives of individuals with WS and the possible relationship between family and patient diagnoses is currently unknown. Methods: Twenty-one families participated; the patients’ average age was 16 years. DSM-IV diagnoses were applied by using the Anxiety Disorders Interview Schedule (ADIS, Parent and Child Versions) and the Family History Screen. Results: A diagnosis from the ADIS was applicable to 13 patients (62%), and in 16 patients (76%) a diagnosis was applicable in their first-degree family members. Ten patients (48%) had some form of anxiety, specific phobia being the most common. Three patients (14%) had major depressive disorder and 9 patients (43%) had attention-deficit/hyperactivity disorder (ADHD). The presence of anxiety or mood disorders in patients with WS and the presence of these disorders in their family members were unrelated. Conclusions: Patients with WS have a high prevalence of anxiety disorders and of ADHD. The presence of psychiatric disorders in WS did not appear to have a significant relationship to family history of psychiatric disorders, consistent with the hypothesis that the specific genetic alteration in WS causes, or contributes to causing, the anxiety disorders and the ADHD that are so common in the disorder. Populations with mental retardation (MR), especially those with known genetic alterations, offer a window into the effects of genes on determining cognition and behavior. Populations with MR are known to have increased rates of emotional distress and mental illness (1, 2). While estimates vary, the prevalence of
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威廉姆斯综合征患者及其家庭的精神病学诊断
威廉姆斯综合征(WS)是一种与智力迟钝(MR)相关的遗传疾病,具有独特的行为表型,包括友好和外向的个性。据报道,与其他MR患者一样,这一人群出现精神疾病症状的比例有所增加;然而,很少有研究使用DSM-IV标准来量化WS患者的具体精神病学诊断和WS患者亲属中精神疾病的患病率,目前尚不清楚家庭与患者诊断之间可能存在的关系。方法:21个家庭参与;患者的平均年龄为16岁。使用焦虑障碍访谈表(ADIS,家长和儿童版)和家族史筛查进行DSM-IV诊断。结果:ADIS的诊断适用于13例患者(62%),16例患者(76%)的诊断适用于其一级亲属。10名患者(48%)有某种形式的焦虑,特定恐惧症是最常见的。3例(14%)有重度抑郁症,9例(43%)有注意力缺陷/多动障碍(ADHD)。WS患者中焦虑或情绪障碍的存在与其家庭成员中这些障碍的存在无关。结论:WS患者有较高的焦虑症和ADHD患病率。WS中精神障碍的存在似乎与精神障碍家族史没有显著关系,这与WS中特定的遗传改变导致或促成了该疾病中常见的焦虑障碍和ADHD的假设一致。智力迟钝(MR)人群,特别是那些已知基因改变的人群,为研究基因在决定认知和行为方面的作用提供了一个窗口。已知患有MR的人群情绪困扰和精神疾病的发生率增加(1,2)
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