22q11.2 deletion syndrome (22q.11.2DS) might be one of the strongest genetic risk factors for psychosis, but robust estimates of prevalence and incidence of psychotic disorders in this condition are not available. To address this gap, we performed a multistep systematic PRISMA/MOOSE-compliant literature search of articles reporting prevalence (primary outcome) or incidence (secondary outcome) of psychotic disorders in 22q11.2DS samples (protocol: https://osf.io/w6hpg) using random-effects meta-analysis, subgroup analyses and meta-regressions. The meta-analytical prevalence of psychotic disorders was 11.50% (95%CI:9.40-14.00%), largely schizophrenia (9.70%, 95%CI:6.50-14.20). Prevalence was significantly higher in samples with a mean age over 18 years, with both psychiatric and non-psychiatric comorbidities and recruited from healthcare services (compared to the community). Mean age was also significantly positively associated with prevalence in meta-regressions (p<0.01). The meta-analytical incidence of psychotic disorders was 10.60% (95%CI:6.60%-16.70%) at a mean follow-up time of 59.27±40.55 months; meta-regressions were not significant. To our knowledge, this is the first comprehensive systematic review and meta-analysis of the prevalence and incidence of psychotic disorders in 22q11.2DS individuals. It demonstrates that around one in ten individuals with 22q11.2DS displays comorbid psychotic disorders, and around one in ten will develop psychosis in the following five years, indicating that preventive approaches should be implemented systematically in 22q11.2DS.
La sindrome da delezione 22q11.2 (22q.11.2DS) potrebbe essere uno dei più forti fattori di rischio genetico per la psicosi, ma non sono disponibili stime solide della prevalenza e dell'incidenza dei disturbi psicotici in questa condizione. Per colmare questa lacuna, abbiamo effettuato una ricerca sistematica multistep della letteratura conforme a PRISMA/MOOSE di articoli che riportavano la prevalenza (esito primario) o l'incidenza (esito secondario) di disturbi psicotici in campioni 22q11.2DS (protocollo: https://osf.io/w6hpg) utilizzando meta-analisi a effetti casuali, analisi di sottogruppo e meta-regressioni. La prevalenza meta-analitica dei disturbi psicotici è stata dell'11,50% (95%CI:9,40-14,00%), in gran parte schizofrenia (9,70%, 95%CI:6,50-14,20). La prevalenza è risultata significativamente più elevata nei campioni di età media superiore ai 18 anni, con comorbidità sia psichiatriche che non psichiatriche e reclutati nei servizi sanitari (rispetto alla comunità). Anche l'età media era significativamente associata alla prevalenza nelle meta-regressioni (p<0,01). L'incidenza meta-analitica dei disturbi psicotici è stata del 10,60% (95%CI:6,60%-16,70%) a un follow-up medio di 59,27±40,55 mesi; le meta-regressioni non sono risultate significative. A nostra conoscenza, questa è la prima revisione sistematica completa e meta-analisi della prevalenza e dell'incidenza dei disturbi psicotici negli individui con 22q11.2DS. Dimostra che circa un individuo su dieci con 22q11.2DS presenta disturbi psicotici in comorbilità e circa uno su dieci svilupperà una psicosi nei cinque anni successivi, indicando che gli approcci preventivi dovrebbero essere implementati sistematicamente nel 22q11.2DS.
PREVALENCE AND INCIDENCE OF PSYCHOTIC DISORDERS IN 22Q11.2 DELETION SYNDROME: A META-ANALYSIS
BERSANO, ILARIA
2021/2022
Abstract
22q11.2 deletion syndrome (22q.11.2DS) might be one of the strongest genetic risk factors for psychosis, but robust estimates of prevalence and incidence of psychotic disorders in this condition are not available. To address this gap, we performed a multistep systematic PRISMA/MOOSE-compliant literature search of articles reporting prevalence (primary outcome) or incidence (secondary outcome) of psychotic disorders in 22q11.2DS samples (protocol: https://osf.io/w6hpg) using random-effects meta-analysis, subgroup analyses and meta-regressions. The meta-analytical prevalence of psychotic disorders was 11.50% (95%CI:9.40-14.00%), largely schizophrenia (9.70%, 95%CI:6.50-14.20). Prevalence was significantly higher in samples with a mean age over 18 years, with both psychiatric and non-psychiatric comorbidities and recruited from healthcare services (compared to the community). Mean age was also significantly positively associated with prevalence in meta-regressions (p<0.01). The meta-analytical incidence of psychotic disorders was 10.60% (95%CI:6.60%-16.70%) at a mean follow-up time of 59.27±40.55 months; meta-regressions were not significant. To our knowledge, this is the first comprehensive systematic review and meta-analysis of the prevalence and incidence of psychotic disorders in 22q11.2DS individuals. It demonstrates that around one in ten individuals with 22q11.2DS displays comorbid psychotic disorders, and around one in ten will develop psychosis in the following five years, indicating that preventive approaches should be implemented systematically in 22q11.2DS.È consentito all'utente scaricare e condividere i documenti disponibili a testo pieno in UNITESI UNIPV nel rispetto della licenza Creative Commons del tipo CC BY NC ND.
Per maggiori informazioni e per verifiche sull'eventuale disponibilità del file scrivere a: unitesi@unipv.it.
https://hdl.handle.net/20.500.14239/14133