UC Irvine

Prader-Willi syndrome (PWS) is a rare multisystemic disorder characterized by distinct physical, cognitive, behavioral, and psychiatric phenotypes. The purpose of this study was to describe the effects of growth hormone treatment (GHT) in 172 individuals on the following psychiatric categories: depressive disorders (depressed mood and anxiety), compulsions (skin picking, nail picking, compulsive counting, compulsive ordering, and plays with strings), and psychoses (visual hallucinations and delusions).

Hypotheses include 1) GHT contributes to a lower risk for psychiatric phenotypes in individuals with PWS, 2) Earlier age at initiation of GHT results in lower risk for psychiatric phenotypes, 3) Longer duration of GHT results in lower risk for psychiatric phenotypes, and 4) Risk of psychiatric outcomes associated with GHT differs for those with 15q11.2-q13 deletions versus those with maternal uniparental disomy (mUPD) of chromosome 15.

After controlling for the effects of confounding variables (psychiatric medication and age), the data suggests that growth hormone use is associated with an increased risk for delusions. Growth hormone use was also shown to have a greater effect on increased risk for anxiety for those with mUPD than for those with deletions. Duration of GH treatment did not show a significant association with psychiatric phenotype. Age at growth hormone initiation could not be considered as a good measure because it was strongly correlated with age at visit 1.

As growth hormone treatment is currently the standard of care for individuals with Prader-Willi syndrome, having a better understanding of the psychiatric risks is important for management. Prospective studies in which all individuals start growth hormone at the same age are suggested to test these findings.