Case reports: an opportunity for early intervention: velo-cardio-facial syndrome and psychosis

Aims and method: Velo-cardio-facial syndrome is the most common micro deletion syndrome in man, with the typically deleted region in the 22q11 area, an area that contains many genes with possible links to mental illnesses. The syndrome phenotype includes multiple physical abnormalities, learning disorders and a greatly increased risk of developing a psychotic disorder. A series of three cases is presented to describe some of the psychiatric manifestations of the velo-cardio-facial syndrome. Results: The three young people presented here all had an illness of long duration that was difficult to treat, with significant side effects of treatment and varying degrees of recovery. Conclusions: As more children with genetic syndromes are identified early and monitored by genetic clinics and other paediatric services, there is an opportunity for psychiatric services to provide early intervention for a group of patients who are likely to have a poor response to treatment if they present with an advanced psychosis. Studying the deletions in the 22q11 area also has great potential for investigating possible causes of a genetic vulnerability to psychotic illness.