Familiar E Environ onment a and Psychiatric Sym ymptoms in Young - - PowerPoint PPT Presentation

Familiar E Environ

• nment a

and Psychiatric Sym ymptoms in Young Ch Children w with 22q 22q11 D 11 Deletion

• n

Syn yndrome

Yaffa Serur Psychiatric Division of Children and Adolescents Sheba Medical Center

22q11DS psychopathology

What is known? ~70% have at least one psychiatric disorder:

• Schizophrenia spectrum disorders
• ADHD
• Anxiety
• Mood disorders
• ASD

Rates of Autism Disorder: 7% to 50%

Schneider 2014

What we did? Children with 22q11DS Children with Idiopathic Autism 3-8 years old

• Psychiatric symptoms and diagnosis
• Autism diagnosis- direct observation

(ADOS)

Serur, Y, Gothelf, D. European Psychiatry, 2019

ASD in 22q11DS

16% of children with 22q11DS diagnosed with ASD

• ASD symptoms in 22q11DS are

less severe than children with iASD

• High repetitive restricted

behaviors

Serur, Y, Gothelf, D. European Psychiatry, 2019

What about the Environment?

Familial Environment

Quality of interactions and relationships between individuals in the family, and the ways in which individuals within the family unit perceive those

• Direct context for child's development
• Impact on cognitive and psychosocial
• utcomes in children

Lach 2013, Farah 2006, 2010

Expressed emotion

• Caregiver's attitude towards a person with a

psychiatric disorder as reflected by comments about the patient made to an interviewer

• High criticism
• Over-involvement
• One of the predictors of relapse in medical

and psychiatric disorders

Amaresha, A. C., & Venkatasubramanian, G.,2012.

Parental Stress

Parents of children with developmental disorders: increased risk of psychological stress compared to

• ther parents.

Children’s high levels of internalizing and externalizing problems contribute to the elevated level of stress

Woodman,2015

Parental Psychiatric Symptomatology

Offspring of parents with mental illness are at high risk

• f major psychiatric disorders during childhood,

adolescence and young adulthood

In 22q11DS?

Apter , G. 2017

STUDY AIMS:

Children’s Psychopathology Parental Psychopathology Familial Relationship Parental Stress

Pa Parental stress in 22q11DS compared with iA iASD

Pa Parental Psychiatric Symptoms

Expressed Emotion

RESULTS

Higher Parental Stress High Expressed Emotion

Higher psychiatric symptomatology in children (CBCL)

22q11DS iASD

Higher psychiatric symptomatology in children (CBCL)

CO CONCLUSIONS Young Children with 22q11DS

1-High rate of psychiatric diagnoses 2-Lower rate of ASD diagnosis 3-Unfavorable familial environment (parental stress and expressed emotion), similar to families of children with iASD 4-Some higher parental psychopathology in iASD compared to 22q11DS 5-Parental stress, specifically in 22q11DS, predictor of children’s psychiatric symptomatology 6-High expressed emotion, specifically in iASD, predictor of children’s psychiatric symptomatology