How might stress contribute to increased risk for schizophrenia in children with chromosome 22q11.2 deletion syndrome?

Abstract

The most common human microdeletion occurs at chromosome 22q11.2. The associated syndrome (22q11.2DS) has a complex and variable phenotype with a high risk of schizophrenia. While the role of stress in the etiopathology of schizophrenia has been under investigation for over 30 years (Walker et al. 2008), the stress–diathesis model has yet to be investigated in children with 22q11.2DS. Children with 22q11.2DS face serious medical, behavioral, and socioemotional challenges from infancy into adulthood. Chronic stress elevates glucocorticoids, decreases immunocompetence, negatively impacts brain development and function, and is associated with psychiatric illness in adulthood. Drawing knowledge from the extant and well-developed anxiety and stress literature will provide invaluable insight into the complex etiopathology of schizophrenia in people with 22q11.2DS while suggesting possible early interventions. Childhood anxiety is treatable and stress coping skills can be developed thereby improving quality of life in the short-term and potentially mitigating the risk of developing psychosis.

Depression and anxiety disorders in children and adolescents with velo-cardio-facial syndrome (VCFS)

“…Moreover, as already reported, anxious and depressive symptoms are associated with psychotic symptoms [17,37] and with an increased risk for the emergence of psychotic disorders in adulthood [16]. Regular screening and prompt treatment of anxiety or depression are therefore likely to decrease the rate of psychotic symptoms and subsequent development of schizophrenia.…”

Cognitive and behavioral trajectories in 22q11DS from childhood into adolescence: A prospective 6-year follow-up study

“…For instance, one could argue that a growing discrepancy between cognitive abilities and the expectations of school and home environment lead to increase in stress. Subsequently, enduring chronic stress may induce in those vulnerable the emergence of psychosis (Beaton & Simon, 2011). It could be hypothesized that, behavioral changes may precede the onset of psychosis and could therefore be a first indicator of schizophrenia.…”

22q11.2 Deletion Syndrome: Symptoms, Diagnosis, Treatment

“…Распространенность синдрома дефицита внимания и гиперактивности у пациентов с 22q11DS составляет от 30 до 46% [55,56], расстройства аутистического спектра -от 14 до 50% [56,57], генерализованного тревожного расстройства -от 11 до 29% [54,57], спе-ци фической фобии -от 23 до 61% [55], депрессии -от 6 до 20% [54], шизофрении -около 25% [58,59].…”