Page 208 - Characterization of genetic neurodevelopmental disorders at adult age, with a focus on 22q11.2 deletion syndrome - Emma Boersma

Chapter 8
Post-traumatic stress
In chapter 7, it was found that adults with 22q11.2DS have a higher
prevalence of PTSD compared to the general population. Based on these
findings clinicians and caregivers are advised to be alert to trauma and
PTSD in 22q11.2DS, and to consider treatment interventions such as eye
movement desensitization reprocessing therapy. Good clinical care early
in life may prevent the onset, or delay progression, of conditions at adult
age. This may also be the case for trauma and PTSD.28, 29 Some traumatic
events reported by adults with 22q11.2DS occurred earlier in life, including
bullying, hospital admissions and surgeries. The study of trauma and PTSD
in adults with 22q11.2DS raises awareness for these potential traumatic
events and PTSD in both adults and children. Discussion within the family
or with care givers about possible traumatic events is important at any age
and may facilitate early intervention. In addition, education about (sexual)
boundaries, relationships or interventions aimed to reinforce resilience may
be helpful in childhood or adolescent age in dealing with, or preventing,
potentially traumatic events and PTSD later in life.28, 29
Predictive markers for late-onset disorders in adults with 22q11.2
deletion syndrome
When considering the adult phenotype of 22q11.2DS, it is important to
realize that its associated conditions may have their roots earlier in life.
Therefore, it is crucial to study conditions over the life course to get a good
understanding of factors contributing to late-onset conditions and in order
to recognize, prevent or treat these conditions timely. It is still unclear which
individuals with 22q11.2DS will develop disorders associated with the adult
phenotype such as Parkinson’s disease. There have been attempts to identify
early predictors, mainly for psychosis, in individuals with 22q11.2DS.30-32
For example, cognitive decline was found to precede the development of
psychosis,30 and olfactory deficit and brain connectivity patterns have been
proposed as potential biomarkers.31, 32 Possible contributors to several late-
onset disorders were studied in adults with 22q11.2DS described in this
thesis.
In chapter 3, age, but not sex, was found to be related to the development of
Parkinson’s disease. In the study on hearing described in chapter 4, age and
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