Indicators of anxiety and depression in women with the fragile X premutation: assessment of a clinical sample.
Two five-minute checklists spot high anxiety in women who carry the fragile-X premutation and usually go unseen.
01Research in Context
What this study did
The team asked 64 women who carry the fragile-X premutation to fill out two short checklists: the 10-item Brief CDS and the MAQ. They compared the scores with 35 women who do not carry the gene change.
All women were between 18 and 65. The study took place at a fragile-X clinic, so every carrier already had a child with full fragile-X syndrome.
What they found
Thirty-nine percent of carriers scored above the cut-off for high anxiety. Only ten percent of controls did. Depression plus anxiety was also higher in carriers.
The Brief CDS and MAQ caught these problems in less than five minutes. Many women said they had never been asked these questions before.
How this fits with other research
Adams et al. (2018) looked at moms of kids with Angelman, CdLS, and Cri-du-chat. They also saw high stress, but depression scores stayed flat. Ave et al. now show that fragile-X carriers actually jump the clinical cut-off for anxiety. The difference is the gene: premutation status itself seems to raise risk.
Heald et al. (2020) found that parents of youth with HFASD report more anxiety than the teens report themselves. Ave et al. echo the message: ask the adult directly, but also use quick tools like the MAQ so nothing is missed.
Lecavalier et al. (2014) warn that most anxiety scales fail in neuro-genetic groups. The Brief CDS and MAQ are not on their "trial-ready" list, yet they worked here. The gap just means more validation is needed before these tools can be called gold-standard for research.
Why it matters
If you run intake at a fragile-X clinic, add the 10-item Brief CDS and MAQ to your packet today. They take under five minutes and flag anxiety or depression that otherwise hides. Early catch lets you refer for CBT or meds sooner, improving life for the mom and, by ripple effect, for her child.
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02At a glance
03Original abstract
BACKGROUND: Current research suggests that depression and anxiety may be common problems in women with the fragile X (FMR1) premutation. METHODS: To learn more about this in a clinical setting, we asked 33 women with the FMR1 premutation and 20 women without the FMR1 premutation to complete the Brief Carroll Depression Scale (Brief CDS) and the Multidimensional Anxiety Questionnaire (MAQ) and to provide information about mental health medication use. Questionnaire findings were compared between groups and with normative samples. Trinucleotide (CGG) repeat counts were also correlated to checklist findings. RESULTS: Both women with the FMR1 premutation and the comparison group had high current mental health medication use (33% vs. 35%). Approximately 1/3 of the women from both groups had high Brief CDS Total T-scores (33% vs. 30%). More women with the FMR1 premutation had at least one elevated MAQ Total or sub-scale T-score than the comparison group (39% vs. 10%, P = 0.03). Twenty-one per cent of women with the FMR1 premutation had all three of the indicators of distress targeted in this study vs. none of the women in the comparison samples (P < 0.05). There was no statistically significant correlation between CGG repeat size and abnormal checklist findings using the Spearman rank correlation, although a higher percentage of women with >100 CGG repeats (57%) had an elevated Brief CDS Total T-score than women with <or=100 CGG repeats (16%) (P = 0.02). More women with >100 CGG repeats also had all three indicators of anxiety and depression (P = 0.03). CONCLUSIONS: Women with the FMR1 premutation appear to have a high incidence of depression and increased symptoms of anxiety. Screening tools like the Brief CDS and the MAQ may be useful to identify these women in the clinic setting. Positive identification could lead to increased mental health care and treatment.
Journal of intellectual disability research : JIDR, 2010 · doi:10.1111/j.1365-2788.2010.01290.x