title: Brief report: association of sex chromosome anomalies with childhood-onset psychotic disorders.
abstract: OBJECTIVE
  An apparent excess of sex chromosome aneuploidies (XXY, XXX, and possibly XYY) has been reported in patients with adult-onset schizophrenia and with unspecified psychoses. This study describes the results of cytogenetic screening carried out for pediatric patients meeting DMS-III-R criteria for childhood-onset schizophrenia (COS) and a subgroup of patients with childhood-onset psychotic disorder not otherwise specified, provisionally labeled by the authors as multidimensionally impaired (MDI).
  
  
  METHODS
  From August 1990 to July 1997, karyotypes were determined for 66 neuroleptic-nonresponsive pediatric patients (28 MDI, 38 COS), referred to the National Institute of Mental Health for an inpatient treatment trial of clozapine.
  
  
  RESULTS
  Four (6.1%) of 66 patients (3 MDI, 1 COS) were found to have sex chromosome anomalies (mosaic 47,XXY; 47,XXY; 47,XYY; mosaic 45,XO, respectively), which is higher than the expected rate of 1 per 426 children or 2.34 per 1,000 in the general population (4/66 versus 1/426, chi 2 = 19.2, df = 1, p = .00001). All cases had been previously undiagnosed.
  
  
  CONCLUSIONS
  These findings lend support to a hypothesis that a loss of balance of gene products on the sex chromosomes may predispose affected individuals to susceptibility to additional genetic and environmental insults that result in childhood-onset psychotic disorders. Karyotyping of children with psychotic disorders should be routine.
authors.affiliation: Child Psychiatry Branch, NIMH, Bethesda, MD 20892, USA.
authors.forename: S
authors.initials: S
authors.lastname: Kumra
authors.forename: E
authors.initials: E
authors.lastname: Wiggs
authors.forename: D
authors.initials: D
authors.lastname: Krasnewich
authors.forename: J
authors.initials: J
authors.lastname: Meck
authors.forename: A C
authors.initials: AC
authors.lastname: Smith
authors.forename: J
authors.initials: J
authors.lastname: Bedwell
authors.forename: T
authors.initials: T
authors.lastname: Fernandez
authors.forename: L K
authors.initials: LK
authors.lastname: Jacobsen
authors.forename: M
authors.initials: M
authors.lastname: Lenane
authors.forename: J L
authors.initials: JL
authors.lastname: Rapoport
mesh_terms: D000293:Adolescent; D000782:Aneuploidy; D002648:Child; D005260:Female; D006801:Humans; D008297:Male; D009030:Mosaicism; D019965:Neurocognitive Disorders / Q000175:diagnosis / Q000235:genetics / Q000523:psychology; D011569:Psychiatric Status Rating Scales; D012307:Risk Factors; D012561:Schizophrenia, Childhood / Q000175:diagnosis / Q000235:genetics* / Q000523:psychology; D012729:Sex Chromosome Aberrations / Q000235:genetics* / Q000523:psychology; D014960:X Chromosome; D014997:XYY Karyotype / Q000235:genetics / Q000523:psychology; D014998:Y Chromosome