Indicators of anxiety and depression in women with the fragile X premutation: assessment of a clinical sample.
BACKGROUND
Current research suggests that depression and anxiety may be common problems in women with the fragile X (FMR1) premutation.


METHODS
To learn more about this in a clinical setting, we asked 33 women with the FMR1 premutation and 20 women without the FMR1 premutation to complete the Brief Carroll Depression Scale (Brief CDS) and the Multidimensional Anxiety Questionnaire (MAQ) and to provide information about mental health medication use. Questionnaire findings were compared between groups and with normative samples. Trinucleotide (CGG) repeat counts were also correlated to checklist findings.


RESULTS
Both women with the FMR1 premutation and the comparison group had high current mental health medication use (33% vs. 35%). Approximately 1/3 of the women from both groups had high Brief CDS Total T-scores (33% vs. 30%). More women with the FMR1 premutation had at least one elevated MAQ Total or sub-scale T-score than the comparison group (39% vs. 10%, P = 0.03). Twenty-one per cent of women with the FMR1 premutation had all three of the indicators of distress targeted in this study vs. none of the women in the comparison samples (P < 0.05). There was no statistically significant correlation between CGG repeat size and abnormal checklist findings using the Spearman rank correlation, although a higher percentage of women with >100 CGG repeats (57%) had an elevated Brief CDS Total T-score than women with <or=100 CGG repeats (16%) (P = 0.02). More women with >100 CGG repeats also had all three indicators of anxiety and depression (P = 0.03).


CONCLUSIONS
Women with the FMR1 premutation appear to have a high incidence of depression and increased symptoms of anxiety. Screening tools like the Brief CDS and the MAQ may be useful to identify these women in the clinic setting. Positive identification could lead to increased mental health care and treatment.
Lachiewicz
Ave
A
Duke University Medical Center, Pediatrics, Durham, North Carolina, USA. lachi002@mc.duke.edu
Dawson
D
D
Spiridigliozzi
G
G
Cuccaro
M
M
Lachiewicz
M
M
McConkie-Rosell
A
A
D000293:Adolescent; D000328:Adult; D000342:Affective Symptoms / Q000175:diagnosis / Q000453:epidemiology; D000928:Antidepressive Agents / Q000627:therapeutic use; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology*; D003866:Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology*; D004314:Down Syndrome / Q000453:epidemiology / Q000523:psychology; D005260:Female; D051860:Fragile X Messenger Ribonucleoprotein 1 / Q000235:genetics*; D005600:Fragile X Syndrome / Q000453:epidemiology / Q000235:genetics / Q000523:psychology; D006801:Humans; D015994:Incidence; D011581:Psychological Tests; D011795:Surveys and Questionnaires; D018911:Trinucleotide Repeats / Q000235:genetics*; D055815:Young Adult
D000928:Antidepressive Agents; D051860:Fragile X Messenger Ribonucleoprotein 1; C497683:FMR1 protein, human