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

Familiar E Environ onment a and Psychiatric Sym ymptoms in Young Ch Children w with 22q 22q11 D 11 Deletion on Syn yndrome Yaffa Serur Psychiatric Division of Children and Adolescents Sheba Medical Center

22q11DS psychopathology What is known? What we did? ~70% have at least one psychiatric disorder: Children with 22q11DS Schizophrenia spectrum disorders - Children with Idiopathic Autism ADHD - Anxiety - 3-8 years old Mood disorders - Psychiatric symptoms and diagnosis ASD ● - Autism diagnosis- direct observation ● Rates of Autism Disorder: 7% to 50% (ADOS) Schneider 2014

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 outcomes 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 other 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 of major psychiatric disorders during childhood, adolescence and young adulthood In 22q11DS? Apter , G. 2017

STUDY AIMS: Children’s Psychopathology Familial Relationship Parental Parental Stress Psychopathology

Pa Parental stress in 22q11DS compared with iA iASD

Pa Parental Psychiatric Symptoms

Expressed Emotion

RESULTS Higher psychiatric 22q11DS Higher Parental symptomatology in Stress children (CBCL) iASD High Expressed Higher psychiatric symptomatology in Emotion children (CBCL)

1-High rate of psychiatric diagnoses 2-Lower rate of ASD diagnosis CO CONCLUSIONS 3-Unfavorable familial environment (parental stress and Young expressed emotion), similar to families of children with iASD Children with 4-Some higher parental psychopathology in iASD compared to 22q11DS 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