title: Lifetime prevalence of mood and anxiety disorders in fragile X premutation carriers.
abstract: 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.
authors.affiliation: Department of Psychiatry and Behavioral Sciences, University of California, Davis Medical Center, Sacramento, USA. bourgej@mcmaster.ca
authors.forename: James A
authors.initials: JA
authors.lastname: Bourgeois
authors.forename: Andreea L
authors.initials: AL
authors.lastname: Seritan
authors.forename: E Melina
authors.initials: EM
authors.lastname: Casillas
authors.forename: David
authors.initials: D
authors.lastname: Hessl
authors.forename: Andrea
authors.initials: A
authors.lastname: Schneider
authors.forename: Ying
authors.initials: Y
authors.lastname: Yang
authors.forename: Inderjeet
authors.initials: I
authors.lastname: Kaur
authors.forename: Jennifer B
authors.initials: JB
authors.lastname: Cogswell
authors.forename: Danh V
authors.initials: DV
authors.lastname: Nguyen
authors.forename: Randi J
authors.initials: RJ
authors.lastname: Hagerman
mesh_terms: 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
chemical_list: D051860:Fragile X Messenger Ribonucleoprotein 1; D012333:RNA, Messenger; C497683:FMR1 protein, human
references.citation: Am J Hum Genet. 2004 May;74(5):805-16
references.pmid: 15052536
references.citation: J Neuropsychiatry Clin Neurosci. 1996 Winter;8(1):20-5
references.pmid: 8845697
references.citation: Am J Med Genet B Neuropsychiatr Genet. 2009 Jan 5;150B(1):130-9
references.pmid: 18553360
references.citation: Psychiatry Res. 1998 Aug 17;80(2):113-27
references.pmid: 9754690
references.citation: Biochem Mol Med. 1995 Oct;56(1):63-9
references.pmid: 8593539
references.citation: J Clin Epidemiol. 2006 Dec;59(12):1274-84
references.pmid: 17098570
references.citation: J Med Genet. 2006 Oct;43(10):804-9
references.pmid: 16723388
references.citation: Br J Psychiatry Suppl. 1998;(34):24-8
references.pmid: 9829013
references.citation: J Neuropsychiatry Clin Neurosci. 2004 Winter;16(1):29-36
references.pmid: 14990756
references.citation: Am J Med Genet B Neuropsychiatr Genet. 2007 Jun 5;144B(4):566-9
references.pmid: 17427188
references.citation: Am J Hum Genet. 2003 Feb;72(2):454-64
references.pmid: 12529854
references.citation: Am J Hum Genet. 2000 Jan;66(1):6-15
references.pmid: 10631132
references.citation: Neurology. 2007 Aug 28;69(9):851-9
references.pmid: 17724287
references.citation: Am J Ment Retard. 2004 Mar;109(2):154-64
references.pmid: 15000674
references.citation: J Neurosurg. 2005 Aug;103(2):246-51
references.pmid: 16175853
references.citation: Int J Methods Psychiatr Res. 2006;15(4):167-80
references.pmid: 17266013
references.citation: Psychiatry Res. 1996 Sep 27;64(2):97-104
references.pmid: 8912951
references.citation: Psychol Med. 1997 Sep;27(5):1079-89
references.pmid: 9300513
references.citation: Soc Psychiatry Psychiatr Epidemiol. 1998 Dec;33(12):587-95
references.pmid: 9857791
references.citation: Am J Med Genet B Neuropsychiatr Genet. 2005 Nov 5;139B(1):115-21
references.pmid: 16184602
references.citation: J Med Genet. 2008 Aug;45(8):498-9
references.pmid: 18413371
references.citation: Brain Imaging Behav. 2008 Jan 18;2(2):105-116
references.pmid: 19430586
references.citation: Brain. 2002 Aug;125(Pt 8):1760-71
references.pmid: 12135967
references.citation: Am J Hum Genet. 2004 May;74(5):1051-6
references.pmid: 15065016
references.citation: Hum Reprod. 2005 Feb;20(2):402-12
references.pmid: 15608041
references.citation: Curr Neurol Neurosci Rep. 2005 Sep;5(5):405-10
references.pmid: 16131424
references.citation: Am J Med Genet B Neuropsychiatr Genet. 2008 Sep 5;147B(6):859-72
references.pmid: 18165971
references.citation: J Clin Psychiatry. 2006 Mar;67(3):363-74
references.pmid: 16649821
references.citation: Am J Med Genet. 1994 Jul 15;51(4):378-85
references.pmid: 7943003
references.citation: Neuron. 2008 Oct 23;60(2):201-14
references.pmid: 18957214
references.citation: Nat Clin Pract Neurol. 2007 Feb;3(2):107-12
references.pmid: 17279084
references.citation: Lancet Neurol. 2007 Jan;6(1):45-55
references.pmid: 17166801
references.citation: Arch Gen Psychiatry. 1978 Nov;35(11):1304-11
references.pmid: 708194
references.citation: JAMA. 2004 Jan 28;291(4):460-9
references.pmid: 14747503
references.citation: J Affect Disord. 2006 Dec;96(3):259-69
references.pmid: 16997383
references.citation: J Clin Psychiatry. 2006 Jan;67(1):87-94
references.pmid: 16426093
references.citation: Psychol Med. 1988 Feb;18(1):141-53
references.pmid: 3363034
references.citation: Arch Gen Psychiatry. 1992 Aug;49(8):624-9
references.pmid: 1637252
references.citation: J Dev Behav Pediatr. 2008 Aug;29(4):293-302
references.pmid: 18698192
references.citation: J Neuropsychiatry Clin Neurosci. 2006 Spring;18(2):171-7
references.pmid: 16720793
references.citation: J Dev Behav Pediatr. 2006 Apr;27(2 Suppl):S137-44
references.pmid: 16685180
references.citation: Arch Gen Psychiatry. 2005 Jun;62(6):593-602
references.pmid: 15939837
references.citation: J Clin Psychiatry. 2005 Nov;66(11):1351-61
references.pmid: 16420070
references.citation: Gen Hosp Psychiatry. 2007 Jul-Aug;29(4):349-56
references.pmid: 17591512
references.citation: Arch Gen Psychiatry. 1992 Aug;49(8):630-6
references.pmid: 1637253
references.citation: Arch Gen Psychiatry. 1994 Jan;51(1):8-19
references.pmid: 8279933
references.citation: J Dev Behav Pediatr. 2006 Feb;27(1):63-74
references.pmid: 16511373
references.citation: Brain. 2006 Jan;129(Pt 1):243-55
references.pmid: 16332642
references.citation: Am J Hum Genet. 2001 Aug;69(2):351-60
references.pmid: 11443541
references.citation: Am J Hum Genet. 1995 Nov;57(5):1006-18
references.pmid: 7485149
references.citation: Psychol Med. 2005 Dec;35(12):1747-59
references.pmid: 16202187
references.citation: Neurology. 2006 Oct 24;67(8):1426-31
references.pmid: 17060569
references.citation: Int J Methods Psychiatr Res. 2004;13(2):122-39
references.pmid: 15297907
references.citation: Am J Hum Genet. 1993 May;52(5):884-94
references.pmid: 8488838
references.citation: Arch Gen Psychiatry. 1996 Feb;53(2):159-68
references.pmid: 8629891
references.citation: Hum Mol Genet. 2002 Feb 15;11(4):371-8
references.pmid: 11854169
references.citation: Arch Gen Psychiatry. 2006 Apr;63(4):415-24
references.pmid: 16585471
references.citation: Am J Hum Genet. 2003 Apr;72(4):869-78
references.pmid: 12638084
references.citation: Brain. 2007 Feb;130(Pt 2):404-16
references.pmid: 17166860
references.citation: Mov Disord. 2007 Jan 15;22(2):203-6
references.pmid: 17133502
references.citation: Am J Med Genet B Neuropsychiatr Genet. 2008 Oct 5;147B(7):1138-44
references.pmid: 18384046
references.citation: Mov Disord. 2003 Apr;18(4):414-8
references.pmid: 12671948
references.citation: Brain Cogn. 2009 Apr;69(3):551-8
references.pmid: 19114290
references.citation: JAMA. 2003 Jun 18;289(23):3095-105
references.pmid: 12813115
references.citation: Curr Opin Genet Dev. 2002 Jun;12(3):278-83
references.pmid: 12076670
references.citation: Cogn Behav Neurol. 2003 Dec;16(4):225-33
references.pmid: 14665822