Cognitive and psychiatric predictors to psychosis in velocardiofacial syndrome: a 3-year follow-up study.

OBJECTIVE To predict prodromal psychosis in adolescents with velocardiofacial syndrome (VCFS). METHOD A total of 70 youth with VCFS, 27 siblings of youth with VCFS, and 25 community controls were followed from childhood (mean age = 11.8 years) into mid-adolescence (mean age = 15.0 years). Psychological tests measuring intelligence, academic achievement, learning/memory, attention, and executive functioning as well as measures of parent and clinician ratings of child psychiatric functioning were completed at both time points. RESULTS Major depressive disorder, oppositional defiant disorder, and generalized anxiety disorder diagnoses increased in the VCFS sample. With very low false positive rates, the best predictor of adolescent prodromal psychotic symptoms was parent ratings of childhood odd/eccentric symptoms and child performance on a measure of executive functioning, the Wisconsin Card Sorting Test. CONCLUSIONS Similar to the non-VCFS prodromal psychosis literature, a combination of cognitive and psychiatric variables appears to predict psychosis in adolescence. A child with VCFS who screens positive is noteworthy and demands clinical attention.