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Trajectory and Predictors of Depression and Anxiety Disorders in Mothers With the FMR1 Premutation

      abstract

      Background

      Although the FMR1 premutation is associated with elevated prevalence of psychiatric disorders, the longitudinal course of symptoms has not been established. The present study followed a sample of women with the FMR1 premutation to characterize the incidence, stability, and predictors of mood and anxiety disorders across a 3-year period.

      Methods

      Participants included 83 women with the FMR1 premutation (mean age = 38.35) who completed the Structured Clinical Interview for DSM-IV Axis I Disorders at two time points, 3 years apart. Additional information was obtained regarding demographic, child, and biomedical (e.g., medication, menopause, CGG repeats) factors.

      Results

      We found increased prevalence of major depressive disorder (MDD) and anxiety disorders over time, with adverse outcomes predicted by complex interactions among biological, behavioral, and environmental risk factors. Lifetime MDD increased from 46% to 54% and lifetime anxiety disorders increased from 28% to 35%. Midrange CGG repeats, elevated child problem behaviors, and divorced marital status conveyed elevated risk for psychiatric diagnoses. Primary ovarian insufficiency was highly prevalent (41%) but did not account for elevated rates of psychiatric diagnoses. Medication use was highly reported (41%), particularly in women with MDD or anxiety, with selective serotonin reuptake inhibitors reported as the most commonly used medication across diagnostic groups.

      Conclusions

      The elevated prevalence of depression and anxiety in women with the FMR1 premutation is a clear and pressing concern given the frequent occurrence of the FMR1 premutation in the general community and the adverse outcomes—at both individual and systems levels—associated with psychiatric disorders in this population.

      Keywords

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      Linked Article

      • Psychopathology Increases With Age in Fragile X Carrier Mothers
        Biological PsychiatryVol. 79Issue 10
        • Preview
          The saga of psychiatric problems in FMR1 premutation carriers (55–200 CGG repeats) has come a long way over the last 15 years, informed by advances in molecular biology, neuroimaging, and detailed phenotypic assessments within psychiatric and neuropsychological studies. Initially, in the 1990s, female premutation carriers were considered unaffected by psychiatric problems, although epidemiologic studies demonstrated an increased rate of early menopause in carriers compared with the general population.
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