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Mastey Ben-Yehuda H, Gross-Tsur V, Hirsch HJ, Genstil L, Derei D, Forer D, Benarroch F. Quality of Life for Adults with Prader-Willi Syndrome in Residential Group Homes. J Clin Med 2024; 13:3323. [PMID: 38893034 PMCID: PMC11173323 DOI: 10.3390/jcm13113323] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2024] [Revised: 05/24/2024] [Accepted: 05/28/2024] [Indexed: 06/21/2024] Open
Abstract
Background: Strict regimens of restricted caloric intake and daily physical exercise are life-saving in Prader-Willi syndrome (PWS) but are extremely challenging in home environments. PWS-specialized hostels (SH) succeed in preventing morbid obesity and in coping with behavioral disorders; however, effects of restricted living environments on quality of life (QOL) have not been described. Evidence on QOL is critical for clinicians involved in placement decisions. Methods: We examined the impact of living in SH versus at home or in non-specialized hostels (H and NSH) on QOL, behavior, and health parameters. All 58 adults (26 males) followed-up in the National Multidisciplinary Clinic for PWS were included: 33 resided in SH, 18 lived at home, and 7 lived in NSH. Questionnaires were administered to primary caregivers to measure QOL, and data were obtained from the medical records. Results: The H and NSH group were compared with those for adults in SH. Despite strict diet and exercise regimens, QOL was similar for both groups. Eight-year follow-up showed that food-seeking behavior decreased in SH but increased in H and NSH. BMI, cholesterol, and triglyceride levels were lower in SH. Conclusion: Our results suggest that living in SH is associated with benefits for physical health and behavior without negatively affecting QOL.
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Affiliation(s)
- Hadassa Mastey Ben-Yehuda
- Israel National Multidisciplinary Prader-Willi Syndrome Clinic, Department of Neuropediatrics, Shaare Zedek Medical Center, Jerusalem 9103102, Israel; (H.M.B.-Y.); (V.G.-T.); (H.J.H.); (L.G.); (D.D.); (D.F.)
| | - Varda Gross-Tsur
- Israel National Multidisciplinary Prader-Willi Syndrome Clinic, Department of Neuropediatrics, Shaare Zedek Medical Center, Jerusalem 9103102, Israel; (H.M.B.-Y.); (V.G.-T.); (H.J.H.); (L.G.); (D.D.); (D.F.)
- The Faculty of Medicine, The Hebrew University School of Medicine, Jerusalem 9112002, Israel
| | - Harry J. Hirsch
- Israel National Multidisciplinary Prader-Willi Syndrome Clinic, Department of Neuropediatrics, Shaare Zedek Medical Center, Jerusalem 9103102, Israel; (H.M.B.-Y.); (V.G.-T.); (H.J.H.); (L.G.); (D.D.); (D.F.)
| | - Larry Genstil
- Israel National Multidisciplinary Prader-Willi Syndrome Clinic, Department of Neuropediatrics, Shaare Zedek Medical Center, Jerusalem 9103102, Israel; (H.M.B.-Y.); (V.G.-T.); (H.J.H.); (L.G.); (D.D.); (D.F.)
| | - Dvorit Derei
- Israel National Multidisciplinary Prader-Willi Syndrome Clinic, Department of Neuropediatrics, Shaare Zedek Medical Center, Jerusalem 9103102, Israel; (H.M.B.-Y.); (V.G.-T.); (H.J.H.); (L.G.); (D.D.); (D.F.)
| | - Dorit Forer
- Israel National Multidisciplinary Prader-Willi Syndrome Clinic, Department of Neuropediatrics, Shaare Zedek Medical Center, Jerusalem 9103102, Israel; (H.M.B.-Y.); (V.G.-T.); (H.J.H.); (L.G.); (D.D.); (D.F.)
| | - Fortu Benarroch
- Israel National Multidisciplinary Prader-Willi Syndrome Clinic, Department of Neuropediatrics, Shaare Zedek Medical Center, Jerusalem 9103102, Israel; (H.M.B.-Y.); (V.G.-T.); (H.J.H.); (L.G.); (D.D.); (D.F.)
- The Faculty of Medicine, The Hebrew University School of Medicine, Jerusalem 9112002, Israel
- Herman Dana Division of Child and Adolescent Psychiatry, Hadassah-Hebrew University Medical Center, Jerusalem 9112001, Israel
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Van Roessel IMAA, Van Den Brink M, Dekker J, Ruitenburg-van Essen BG, Tissing WJE, van Santen HM. Feasibility, safety, and efficacy of dietary or lifestyle interventions for hypothalamic obesity: A systematic review. Clin Nutr 2024; 43:1798-1811. [PMID: 38955055 DOI: 10.1016/j.clnu.2024.05.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2023] [Revised: 04/11/2024] [Accepted: 05/16/2024] [Indexed: 07/04/2024]
Abstract
BACKGROUND & AIMS A dysfunctional hypothalamus may result in decreased feelings of satiety (hyperphagia), decreased energy expenditure, and increased fat storage as a consequence of hyperinsulinemia. Hypothalamic dysfunction may thus lead to morbid obesity and can be encountered in childhood as a consequence of congenital, genetic, or acquired disorders. There is currently no effective treatment for hypothalamic obesity (HO). However, comparable to alimentary obesity, dietary and lifestyle interventions may be considered the cornerstones of obesity treatment. We questioned the effect of dietary or lifestyle interventions for HO and systematically searched the literature for evidence on feasibility, safety, or efficacy of dietary or lifestyle interventions for childhood hypothalamic overweight or obesity. METHODS A systematic search was conducted in MEDLINE (including Cochrane Library), EMBASE, and CINAHL (May 2023). Studies assessing feasibility, safety, or efficacy of any dietary or lifestyle intervention in children with hypothalamic overweight or obesity, were included. Animal studies, studies on non-diet interventions, and studies with no full text available were excluded. Because the number of studies to be included was low, the search was repeated for adults with hypothalamic overweight or obesity. Risk of bias was assessed with an adapted Cochrane Risk of Bias Tool. Level of evidence was assessed using the GRADE system. Descriptive data were described, as pooled-data analysis was not possible due to heterogeneity of included studies. RESULTS In total, twelve studies were included, with a total number of 118 patients (age 1-19 years) of whom one with craniopharyngioma, one with ROHHAD-NET syndrome, 50 with monogenic obesity, and 66 with Prader-Willi syndrome (PWS). Four studies reported a dietary intervention as feasible. However, parents did experience difficulties with children still stealing food, and especially lowering carbohydrates was considered to be challenging. Seven studies reported on efficacy of a dietary intervention: a well-balanced restrictive caloric diet (30% fat, 45% carbohydrates, and 25% protein) and various hypocaloric diets (8-10 kcal/cm/day) were considered effective in terms of weight stabilization or decrease. No negative effect on linear growth was reported. Four studies reported on specific lifestyle interventions, of which three also included a dietary intervention. Combined dietary and lifestyle intervention resulted in decreased BMI, although BMI returned to baseline values on long-term. One additional study was identified in adults after brain trauma and showed a significant reduction in BMI in one out of eight patients after a combined dietary and lifestyle intervention. CONCLUSIONS Hypocaloric diet or restrictive macronutrient diet with lower percentage of carbohydrates seems feasible and effective for childhood HO, although most of the studies had a high risk of bias, small cohorts without control groups, and were conducted in children with PWS only, compromising the generalizability. Lifestyle interventions only resulted in BMI decrease in short-term, indicating that additional guidance is needed to sustain its effect in the long-term. Literature on feasibility and efficacy of a dietary or lifestyle intervention for hypothalamic overweight or obesity is scarce, especially in children with acquired HO (following treatment for a suprasellar tumor). There is need for prospective (controlled) studies to determine which dietary and lifestyle intervention are most helpful for this specific patient group.
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Affiliation(s)
- I M A A Van Roessel
- Princess Máxima Center, Heidelberglaan 25, 3584 CS Utrecht, the Netherlands; Department of Pediatric Endocrinology, Wilhelmina Children's Hospital, University Medical Center, Lundlaan 6, 3584 EA Utrecht, the Netherlands.
| | - M Van Den Brink
- Princess Máxima Center, Heidelberglaan 25, 3584 CS Utrecht, the Netherlands; Laboratory of Behavioral Gastronomy, Centre for Healthy Eating and Food Innovation, Nassaustraat 36, 5911 BV, Venlo, the Netherlands
| | - J Dekker
- Department of Dietetics, Princess Máxima Center, Heidelberglaan 25, 3584 CS Utrecht, the Netherlands
| | - B G Ruitenburg-van Essen
- Department of Dietetics, Princess Máxima Center, Heidelberglaan 25, 3584 CS Utrecht, the Netherlands
| | - W J E Tissing
- Princess Máxima Center, Heidelberglaan 25, 3584 CS Utrecht, the Netherlands; Department of Pediatric Oncology and Hematology, University of Groningen, University Medical Center Groningen, Hanzeplein 1, 9713 GZ Groningen, the Netherlands
| | - H M van Santen
- Princess Máxima Center, Heidelberglaan 25, 3584 CS Utrecht, the Netherlands; Department of Pediatric Endocrinology, Wilhelmina Children's Hospital, University Medical Center, Lundlaan 6, 3584 EA Utrecht, the Netherlands
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3
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Analysis of Effect of Six Sigma Method Combined with CI Strategy on Improving of Nursing Quality in Outpatient Infusion Rooms. BIOMED RESEARCH INTERNATIONAL 2022; 2022:8975435. [PMID: 36254138 PMCID: PMC9569210 DOI: 10.1155/2022/8975435] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Revised: 09/21/2022] [Accepted: 09/27/2022] [Indexed: 11/18/2022]
Abstract
Objective. The infusion room is the last part of an outpatient visit, with high patient density, large staff mobility, and a wide variety of conditions. In addition, most patients are accompanied by their families during infusion, and nursing staff in infusion rooms have to face more trivial and miscellaneous tasks than nursing staff in other treatment departments, which are more complex. The purpose of this research is to explore the impact of the Six Sigma method and CI strategy on the quality of nursing management in infusion rooms, so as to provide reference for clinical research. Methods. A total of 2142 patients treated in our outpatient infusion rooms from June 2019 to June 2020 was included into this retrospective analysis. Of these, 1105 patients admitted before 2020 received routine care management services and were considered as the control group. Another 1037 patients were admitted after 2020 and received the Six Sigma method combined with CI strategic care management and were considered as the research group. The incidence of adverse events during treatment was counted in both groups, and patients’ compliance behavior and psychology were investigated. After treatment, patients’ evaluation of the quality of nursing and their satisfaction with the nursing were investigated. Results. The incidence of adverse events during infusion in the research group was dramatically lower than that in the control group, while the compliance behavior scores were higher (
). In addition, SAS and SDS in the research group were lower than those in the control group, while the quality of nursing were higher (
). It was also clear that the research group had 93.39% satisfaction with nursing, which was also higher than the control group (
). Conclusion. Implementation of infusion room nursing management according to the Six Sigma method with CI strategic plan can avoid adverse events and improve infusion nursing satisfaction. It also helps reduce the incidence of dispute events.
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Baker EK, Merton CF, Tan WH, Dudding-Byth T, Godler DE, Sadhwani A. Methylation analysis and developmental profile of two individuals with Angelman syndrome due to mosaic imprinting defects. Eur J Med Genet 2022; 65:104456. [PMID: 35218942 PMCID: PMC9800002 DOI: 10.1016/j.ejmg.2022.104456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Revised: 01/14/2022] [Accepted: 02/14/2022] [Indexed: 12/31/2022]
Abstract
Angelman syndrome (AS) is a severe neurodevelopmental disorder caused by loss of expression of the maternally-inherited UBE3A on chromosome 15q11.2. In AS due to a chromosomal deletion that encompasses UBE3A, paternal uniparental disomy of chromosome 15, or imprinting defects (ImpD), the SNRPN locus is unmethylated, while in neurotypical individuals, it is ∼50% methylated. We present the developmental profile of two adults with mild AS assessed using standardized behavioral and neurodevelopmental measures. Both had intellectual disability with unusually advanced verbal communication skills compared to other individuals with AS. Methylation of the SNRPN locus was examined using Methylation Specific Quantitative Melt Analysis (MS-QMA) in different tissues at one time point for participant A (22 years) and two time points for participant B (T1: 22 years, T2: 25 years), and these levels were compared to a typical AS cohort. While participant A showed methylation levels comparable to the typical AS cohort, participant B showed methylation mosaicism in all tissues at both time points and changes in methylation levels from T1 to T2. AS should be considered in individuals with intellectual disability and verbal speech who may not have the typical symptoms of AS.
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Affiliation(s)
- Emma K. Baker
- Diagnosis and Development, Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, Parkville, 3052, Australia,Faculty of Medicine, Dentistry and Health Sciences, Department of Paediatrics, University of Melbourne, Parkville, 3052, Australia,School of Psychology and Public Health, La Trobe University, Melbourne, 3083, Australia
| | - Catherine F. Merton
- Division of Genetics and Genomics, Boston Children’s Hospital, Boston, MA, USA
| | - Wen-Hann Tan
- Division of Genetics and Genomics, Boston Children’s Hospital, Boston, MA, USA
| | | | - David E. Godler
- Diagnosis and Development, Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, Parkville, 3052, Australia,Faculty of Medicine, Dentistry and Health Sciences, Department of Paediatrics, University of Melbourne, Parkville, 3052, Australia,Corresponding author. Murdoch Children’s Research Institute, Royal Children’s Hospital, Melbourne, Parkville, 3052, Australia. (D.E. Godler)
| | - Anjali Sadhwani
- Department of Psychiatry, Boston Children’s Hospital, Boston, MA, USA,Corresponding author. Department of Psychiatry, Boston Children’s Hospital, Boston, MA, 02115, USA. (A. Sadhwani)
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Campbell N, Van Zant S, Lammers J. Multifactorial influences on successful health outcomes for an adolescent with Prader-Willi syndrome: a qualitative case study. Physiother Theory Pract 2022; 39:1215-1223. [PMID: 35100943 DOI: 10.1080/09593985.2022.2036277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE Prader-Willi syndrome (PWS) is the most common syndromic cause of childhood obesity. This qualitative case study aimed to identify and describe lifestyle themes of an adolescent with PWS that resulted in maintenance of a healthy body mass index (BMI). CASE DESCRIPTION The 16-year-old female demonstrated failure to thrive upon birth and underwent 9 months supplemented tube feeding, achieving 50th percentile weight for height. Throughout childhood she received treatment of physical, occupational, and speech therapies, and has maintained a healthy BMI ranging from 25-50th percentile weight for height. METHODS AND RESULTS Two video interviews were completed separately. Qualitative analysis of the transcribed data identified two overarching themes for maintaining a healthy BMI in this adolescent: 1) adolescent and parent individual characteristics; and 2) family dynamics and lifestyle. Adolescent and parental characteristics included: high level of cognitive function for diagnosis, mild hyperphagia, desire for a regimented schedule, parental type A personalities, intentionality in parental decisions/actions. Family lifestyle characteristics included strong parental involvement and well-defined expectations for their daughter, purposeful integration of physical activity into lifestyle, and presence of a strong family support system. CONCLUSION The convergence of multiple optimal influences provided an ideal health outcome in the adolescent.
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Affiliation(s)
- Nicole Campbell
- Physical Therapy Program, University of Findlay, Findlay, OH, USA
| | - Scott Van Zant
- Doctor of Physical Therapy Program, Hanover College, Hanover, IN, USA
| | - Joyce Lammers
- Physical Therapy Program, University of Findlay, Findlay, OH, USA
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6
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Amaro AS, Rubin DA, Teixeira MCTV, Ferreira AJ, Rodrigues GM, Carreiro LRR. Health Problems in Individuals With PWS Are Associated With Lower Quality of Life for Their Parents: A Snapshot in the Brazilian Population. Front Pediatr 2022; 10:746311. [PMID: 35242723 PMCID: PMC8885721 DOI: 10.3389/fped.2022.746311] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/23/2021] [Accepted: 01/03/2022] [Indexed: 11/13/2022] Open
Abstract
Prader-Willi syndrome (PWS) is a complex genetic disorder requiring interdisciplinary team monitoring and intensive care by parents. So far there is little information on people with PWS in Brazil. Our aim was to describe health problems and treatments used by people with PWS in Brazil and their relationship to their parents' quality of life. Parents answered questionnaires about their child's medical and exercise history, behavior problems, sociodemographic characteristics, and their own quality of life. Results: The responses of the participants showed similar health problems as in other countries. Anxiety and tantrums were the behavioral problems most commonly cited by parents. Parents of people with PWS had lower scores in respect of quality of life than the Brazilian population. Behavioral problems in individuals with PWS were negatively associated with their parents' quality of life. Behavioral and medical conditions in the children were associated with reduced quality of life in the parents. We conclude that heath care should not only be directed toward those with PWS, but also their parents.
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Affiliation(s)
- Alexandre Slowetzky Amaro
- Development Disorders Graduate Program, Center for Health and Biological Science, Universidade Presbiteriana Mackenzie, São Paulo, Brazil
| | - Daniela Andrea Rubin
- Department of Kinesiology, California State University, Fullerton, CA, United States
| | | | - Arcenio José Ferreira
- Development Disorders Graduate Program, Center for Health and Biological Science, Universidade Presbiteriana Mackenzie, São Paulo, Brazil
| | - Graciele Massoli Rodrigues
- Physical Education Program, Universidade São Judas Tadeu, São Paulo, Brazil.,Physical Education Program, Escola Superior de Educação Física de Jundiaí, Jundiaí, Brazil
| | - Luiz Renato Rodrigues Carreiro
- Development Disorders Graduate Program, Center for Health and Biological Science, Universidade Presbiteriana Mackenzie, São Paulo, Brazil
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Mortillo M, Mulle JG. A cross-comparison of cognitive ability across 8 genomic disorders. Curr Opin Genet Dev 2021; 68:106-116. [PMID: 34082144 DOI: 10.1016/j.gde.2021.04.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/28/2021] [Revised: 03/01/2021] [Accepted: 04/08/2021] [Indexed: 12/23/2022]
Abstract
Genomic disorders result from rearrangement of the human genome. Most genomic disorders are caused by copy number variants (CNV), deletions or duplications of several hundred kilobases. Many CNV loci are associated with autism, schizophrenia, and most commonly, intellectual disability (ID). However, there is little comparison of cognitive ability measures across these CNV disorders. This study aims to understand whether existing data can be leveraged for a cross-comparison of cognitive ability among multiple CNV. We found there is a lack of harmonization among assessment instruments and little standardization for reporting summary data across studies. Despite these limitations, we identified a differential impact of CNV loci on cognitive ability. Our data suggest that future cross-comparisons of CNV disorders will reveal meaningful differences across the phenotypic spectrum, especially if standardized phenotypic assessment is achieved.
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Affiliation(s)
- Michael Mortillo
- Department of Human Genetics, Emory University, Atlanta, GA, United States
| | - Jennifer G Mulle
- Department of Human Genetics, Emory University, Atlanta, GA, United States.
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8
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Guinovart M, Coronas R, Caixàs A. Psychopathological disorders in Prader-Willi syndrome. ACTA ACUST UNITED AC 2019; 66:579-587. [PMID: 31006652 DOI: 10.1016/j.endinu.2019.03.004] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2018] [Revised: 02/27/2019] [Accepted: 03/02/2019] [Indexed: 01/07/2023]
Abstract
Prader-Willi syndrome is a genetic disorder caused by chromosomal changes in segment 15q11-q13 including cognitive, mental, and behavioral symptoms, as well as a specific physical phenotype. Both the most common psychopathological changes (intellectual disability, obsessions, impulsivity, autism spectrum disorders, self-injuries) and the main psychiatric comorbidities (affective disorders, psychosis, obsessive-compulsive disorder, autism spectrum disorder) are characterized by a great heterogeneity, which warrants the need for better identification of their frequency and clinical signs. In addition to its effects on body compositionand hypotony, growth hormone has been shown to be useful for regulating patient behavior, and psychoactive drugs are also an option. Other alternatives have shown promising results in experimental trials. Adequate understanding of the psychopathology associated to Prader-Willi syndrome would allow for improving clinical approach, symptom identification, detection of comorbidities, and administration of more effective treatments, leading to better clinical outcomes.
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Affiliation(s)
- Martí Guinovart
- Servicio de Salud Mental, Hospital Universitari Parc Taulí, Universidad Autónoma de Barcelona, Sabadell (Barcelona), España
| | - Ramón Coronas
- Servicio de Salud Mental, Hospital Universitari Parc Taulí, Universidad Autónoma de Barcelona, Sabadell (Barcelona), España; Centro de Investigación Biomédica en Red de Salud Mental (CIBERSAM), Madrid, España
| | - Assumpta Caixàs
- Servicio de Endocrinología y Nutrición, Hospital Universitari Parc Taulí, Universidad Autónoma de Barcelona, Sabadell (Barcelona), España.
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Bizaoui V, Gage J, Brar R, Rauen KA, Weiss LA. RASopathies are associated with a distinct personality profile. Am J Med Genet B Neuropsychiatr Genet 2018; 177:434-446. [PMID: 29659143 PMCID: PMC6039190 DOI: 10.1002/ajmg.b.32632] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 02/02/2018] [Accepted: 03/01/2018] [Indexed: 11/08/2022]
Abstract
Personality is a complex, yet partially heritable, trait. Although some Mendelian diseases like Williams-Beuren syndrome are associated with a particular personality profile, studies have failed to assign the personality features to a single gene or pathway. As a family of monogenic disorders caused by mutations in the Ras/MAPK pathway known to influence social behavior, RASopathies are likely to provide insight into the genetic basis of personality. Eighty subjects diagnosed with cardiofaciocutaneous syndrome, Costello syndrome, neurofibromatosis type 1, and Noonan syndrome were assessed using a parent-report BFQ-C (Big Five Questionnaire for Children) evaluating agreeableness, extraversion, conscientiousness, intellect/openness, and neuroticism, along with 55 unaffected sibling controls. A short questionnaire was added to assess sense of humor. RASopathy subjects and sibling controls were compared for individual components of personality, multidimensional personality profiles, and individual questions using Student tests, analysis of variance, and principal component analysis. RASopathy subjects were given lower scores on average compared to sibling controls in agreeableness, extraversion, conscientiousness, openness, and sense of humor, and similar scores in neuroticism. When comparing the multidimensional personality profile between groups, RASopathies showed a distinct profile from unaffected siblings, but no difference in this global profile was found within RASopathies, revealing a common profile for the Ras/MAPK-related disorders. In addition, several syndrome-specific strengths or weaknesses were observed in individual domains. We describe for the first time an association between a single pathway and a specific personality profile, providing a better understanding of the genetics underlying personality, and new tools for tailoring educational and behavioral approaches for individuals with RASopathies.
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Affiliation(s)
- Varoona Bizaoui
- Department of Psychiatry and Weill Institute for Neurosciences, University of California San Francisco, San Francisco, California, USA,Institute for Human Genetics, University of California San Francisco, San Francisco, California, USA,Laboratoire de Génétique moléculaire et Histocompatibilité, CHRU de Brest, Brest, France,Inserm UMR1078, Etablissement français du sang – Bretagne, Brest, France, Association Gaëtan Saleun
| | - Jessica Gage
- Department of Psychiatry and Weill Institute for Neurosciences, University of California San Francisco, San Francisco, California, USA,Institute for Human Genetics, University of California San Francisco, San Francisco, California, USA,Department of Biological Sciences, California State University, Stanislaus, Turlock, California, USA
| | - Rita Brar
- Department of Psychiatry and Weill Institute for Neurosciences, University of California San Francisco, San Francisco, California, USA,Institute for Human Genetics, University of California San Francisco, San Francisco, California, USA
| | - Katherine A Rauen
- Institute for Human Genetics, University of California San Francisco, San Francisco, California, USA,Department of Pediatrics, University of California San Francisco, San Francisco, California, USA
| | - Lauren A Weiss
- Department of Psychiatry and Weill Institute for Neurosciences, University of California San Francisco, San Francisco, California, USA,Institute for Human Genetics, University of California San Francisco, San Francisco, California, USA
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10
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Shriki-Tal L, Avrahamy H, Pollak Y, Gross-Tsur V, Genstil L, Hirsch HJ, Benarroch F. Psychiatric disorders in a cohort of individuals with Prader-Willi syndrome. Eur Psychiatry 2017; 44:47-52. [PMID: 28545008 DOI: 10.1016/j.eurpsy.2017.03.007] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/22/2016] [Revised: 03/17/2017] [Accepted: 03/21/2017] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND Psychiatric manifestations in Prader-Willi Syndrome (PWS) are common and often are the most debilitating problem in these individuals. We present an epidemiological nation-wide survey of psychiatric diagnoses in the PWS population, based on full-range psychiatric interviews. METHODS We studied the distribution of psychiatric diagnoses (as opposed to a symptom-based approach) in the Israel national cohort of adolescents and adults with PWS. There was a total of 53 (32 males) ages 12 years and older. All individuals and their caretakers were interviewed using standardized psychiatric questionnaires. Demographic and clinical variables, Clinical Global Impression (CGI) score, IQ, severity of hyperphagia and quality of life (QOL) were also assessed and correlations with NPD (number of psychiatric diagnoses) calculated. RESULTS An overwhelming majority (89%) of the study participants had at least one psychiatric diagnosis. The most common were disruptive behavior disorders (DBD) (68%), obsessive compulsive disorder (OCD) (45%) and skin picking (35%). Individuals with DBD were at increased risk for OCD and skin picking. Psychotic disorders were found in 11%. NPD had a significant negative influence on QOL. There was no correlation between NPD and BMI, IQ, hyperphagia severity, hormonal profile or genetic subtypes. CONCLUSIONS Psychiatric diagnoses are very frequent in PWS and strongly influence QOL. Furthermore, characterizing the profile of psychiatric comorbidity in PWS is crucial for planning effective interventions. Precise behavioral phenotyping in PWS in combination with a well-defined genetic etiology may aid biological research linking biological correlates to behavior.
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Affiliation(s)
- L Shriki-Tal
- PWS Multidisciplinary Clinic, Child Neurology Unit, Shaare Zedek Medical Center, POB 3235, 9103102 Jerusalem, Israel; Beer-Yaacov Nes-Ziona Mental Health Center, POB 1, 74100 Nes-Ziona, Israel
| | - H Avrahamy
- PWS Multidisciplinary Clinic, Child Neurology Unit, Shaare Zedek Medical Center, POB 3235, 9103102 Jerusalem, Israel
| | - Y Pollak
- PWS Multidisciplinary Clinic, Child Neurology Unit, Shaare Zedek Medical Center, POB 3235, 9103102 Jerusalem, Israel; School of Education, The Hebrew University of Jerusalem, Mount Scopus, 91905 Jerusalem, Israel
| | - V Gross-Tsur
- PWS Multidisciplinary Clinic, Child Neurology Unit, Shaare Zedek Medical Center, POB 3235, 9103102 Jerusalem, Israel; School of Education, The Hebrew University of Jerusalem, Mount Scopus, 91905 Jerusalem, Israel
| | - L Genstil
- PWS Multidisciplinary Clinic, Child Neurology Unit, Shaare Zedek Medical Center, POB 3235, 9103102 Jerusalem, Israel
| | - H J Hirsch
- PWS Multidisciplinary Clinic, Child Neurology Unit, Shaare Zedek Medical Center, POB 3235, 9103102 Jerusalem, Israel
| | - F Benarroch
- PWS Multidisciplinary Clinic, Child Neurology Unit, Shaare Zedek Medical Center, POB 3235, 9103102 Jerusalem, Israel; Herman Dana Division of Child and Adolescent Psychiatry, Hadassah-Hebrew University Medical Center, POB 24035, Mount Scopus, 91240 Jerusalem, Israel.
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11
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Even-Zohar Gross N, Geva-Eldar T, Pollak Y, Hirsch HJ, Gross I, Gross-Tsur V. Attitudes toward prenatal genetic testing and therapeutic termination of pregnancy among parents of offspring with Prader-Willi syndrome. Eur J Med Genet 2017; 60:205-211. [DOI: 10.1016/j.ejmg.2017.01.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Revised: 12/22/2016] [Accepted: 01/15/2017] [Indexed: 10/20/2022]
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