Lifetime prevalence of mood and anxiety disorders in fragile X premutation carriers.
OBJECTIVE
The authors studied the lifetime prevalence of DSM-IV-TR psychiatric disorders in a population of adults with the fragile X premutation.


METHODS
The Structured Clinical Interview for DSM-IV was conducted, from 2007-2008, in 85 individuals with the fragile X premutation, 47 with the fragile X-associated tremor/ataxia syndrome (FXTAS; 33 male, 14 female; mean age = 66 years) and 38 without FXTAS (16 male, 22 female; mean age = 52 years). Lifetime prevalence for mood and anxiety disorders among carriers with and without FXTAS was compared to available age-specific population estimates from the National Comorbidity Survey Replication (NCS-R).


RESULTS
Among participants with FXTAS, 30 (65%) met lifetime DSM-IV-TR criteria for a mood disorder; 24 (52%) met lifetime DSM-IV-TR criteria for an anxiety disorder. Among the non-FXTAS participants, there were 15 instances of lifetime mood disorder (42%) and 18 of lifetime anxiety disorder (47%). When compared to age-specific NCS-R data, the lifetime prevalences of any mood disorder (P < .0001), major depressive disorder (P < .0001), any anxiety disorder (P < .0001), panic disorder (P = .006), specific phobia (P = .0003), and posttraumatic stress disorder (P = .004) were significantly higher in participants with FXTAS. The lifetime rates of social phobia in individuals with the premutation without FXTAS were significantly higher than NCS-R data (P = .001).


CONCLUSIONS
This sample of carriers of the fragile X premutation had a notably high lifetime risk of mood and anxiety disorders. Mood and anxiety disorders may be part of the clinical phenotype of the fragile X premutation conditions, especially in carriers with FXTAS. Clinicians encountering these patients are advised to consider FXTAS as a neuropsychiatric syndrome as well as a neurologic disorder.
Bourgeois
James A
JA
Department of Psychiatry and Behavioral Sciences, University of California, Davis Medical Center, Sacramento, USA. bourgej@mcmaster.ca
Seritan
Andreea L
AL
Casillas
E Melina
EM
Hessl
David
D
Schneider
Andrea
A
Yang
Ying
Y
Kaur
Inderjeet
I
Cogswell
Jennifer B
JB
Nguyen
Danh V
DV
Hagerman
Randi J
RJ
D000368:Aged; D001008:Anxiety Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000235:genetics*; D015897:Comorbidity; D003430:Cross-Sectional Studies; D004252:DNA Mutational Analysis; D003865:Major Depressive Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000235:genetics; D039721:Diagnostic and Statistical Manual of Mental Disorders; D005260:Female; D051860:Fragile X Messenger Ribonucleoprotein 1 / Q000235:genetics*; D005600:Fragile X Syndrome / Q000175:diagnosis / Q000453:epidemiology* / Q000235:genetics*; D006580:Genetic Carrier Screening; D020022:Genetic Predisposition to Disease / Q000235:genetics*; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000175:diagnosis / Q000453:epidemiology* / Q000235:genetics*; D016584:Panic Disorder / Q000175:diagnosis / Q000453:epidemiology / Q000235:genetics; D010641:Phenotype; D010698:Phobic Disorders / Q000175:diagnosis / Q000453:epidemiology / Q000235:genetics; D012333:RNA, Messenger / Q000235:genetics*; D013313:Stress Disorders, Post-Traumatic / Q000175:diagnosis / Q000453:epidemiology / Q000235:genetics
D051860:Fragile X Messenger Ribonucleoprotein 1; D012333:RNA, Messenger; C497683:FMR1 protein, human
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