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Are Children With Velocardiofacial Syndrome Prone to Bipolar Disorder?: Presented at AACAP

By Maria Bishop

BOSTON, MA -- October 26, 2007 -- While the prevalence of psychiatric disorders was high in a small-sample study of children with velocardiofacial syndrome (VCFS), determining an association with bipolar disorder and schizophrenia will require long-term follow-up, researchers reported here at the 54th Annual Meeting of the American Academy of Child & Adolescent Psychiatry (AACAP).

VCFS is a chromosomal disorder with common features that include cleft palate, heart defects, characteristic facial appearance, minor learning problems, and speech and feeding problems.

The study enrolled 24 children with a mean age of 9.7 years and a diagnosis of VCFS who were randomly referred for psychiatric assessment by a genetics clinic.

Lead author Edith M. Jolin, MD, MPH, Psychiatrist, Duxbury, Massachusetts, United States, presented the study's findings here on October 24 on behalf of co-authors from the Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, United States.

The children and their parents were interviewed using the Children's Interview for Psychiatric Syndromes (ChIPS), and were diagnosed with the following psychiatric disorders: phobia (42%); attention-deficit/hyperactivity disorder (ADHD), primarily inattentive type (38%); oppositional defiant disorder (38%); separation anxiety disorder (33%); enuresis (21%); and depressive disorders (12.5%).

Thirty-eight percent of the children reported having three or more such comorbidities. Younger age (10 and younger) was significantly associated with the presence of one or more anxiety disorder and high comorbidity (P <.05).

With the onset of bipolar disorder and schizophrenia generally appearing in late adolescence and early adulthood, Dr. Jolin said it would be beneficial to follow these subjects on a long-term basis. One advantage to determining an association naturally would be the ability to consider early treatment intervention.

Recent research purports that children with VCFS are at a higher risk than their nonaffected peers to develop mood disorders, anxiety disorders, and attention-deficit disorders. "Twenty-nine percent of the children [in this study] exhibited a psychotic-like symptom," Dr. Jolin noted. But he offered some perspective on this finding: "Children were asked, for example, if they felt people were against them -- and some of these kids are subject to social issues like bullying, so that reality could affect such a finding."

VCFS is a fairly common condition, Dr. Jolin added, affecting 1 in 4000 children. It goes by several names, including Shprintzen Syndrome, Craniofacial Syndrome and Conotruncal Anomaly Face Syndrome.

[Presentation title: Psychiatric Diagnoses in Children and Adolescents With Velocardiofacial Syndrome. Abstract A22]

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