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Neuropsychiatric comorbidities in adults with phenylketonuria: A retrospective cohort study
Journal article   Open access   Peer reviewed

Neuropsychiatric comorbidities in adults with phenylketonuria: A retrospective cohort study

Deborah A. Bilder, Joyce A. Kobori, Jessica L. Cohen-Pfeffer, Erin M. Johnson, Elaina R. Jurecki and Mitzie L. Grant
Molecular genetics and metabolism, v 121(1), pp 1-8
May 2017
DOI: https://doi.org/10.1016/j.ymgme.2017.03.002
PMID: 28285739
Featured in Collection :   UN Sustainable Development Goals @ Drexel
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https://doi.org/10.1016/j.ymgme.2017.03.002View
Published, Version of Record (VoR)CC BY-NC-ND V4.0,  Open

Abstract

Comorbidity Neurodevelopmental Neurologic Neuropsychiatric Phenylalanine hydroxylase deficiency Phenylketonuria
Adults with phenylketonuria (PKU) may experience neurologic and psychiatric disorders, including intellectual disability, anxiety, depression, and neurocognitive dysfunction. Identifying the prevalence and prevalence ratios of these conditions will inform clinical treatment. This nested, case-controlled study used International Classification of Diseases, Ninth Revision (ICD-9) codes from the MarketScan® insurance claims databases from 2006 to 2012 and healthcare claims data for US-based employer and government-sponsored health plans. Prevalence and prevalence ratio calculations of neuropsychiatric comorbidities for adults (≥20years old) with PKU were compared with two groups [diabetes mellitus (DM) and general population (GP)] matched by age, gender, geographic location, and insurance type. Age cohorts (i.e., 20–29, 30–39, 40–49, 50–59, 60–69, and 70+years, and a combined subset of 20–39) were used to stratify data. The PKU cohort experienced significantly higher rates of several comorbid neurologic, psychiatric and developmental conditions. Compared to GP, PKU was associated with significantly higher prevalence for numerous neuropsychiatric conditions, most notably for intellectual disability (PR=7.9, 95% CI: 6.4–9.9), autism spectrum disorder (PR=6.1, 95% CI: 3.6–10.4), Tourette/tic disorders (PR=5.4, 95% CI: 2.1–14.1), and eating disorders (4.0, 95% CI: 3.2–5.0). Rates of fatigue/malaise, epilepsy/convulsions, sleep disturbance, personality disorders, phobias, psychosis, and migraines among those with PKU exceeded rates for the GP but were comparable to those with DM, with significantly lower rates of concomitant disorders occurring in younger, compared to older, adults with PKU. Lifelong monitoring and treatment of co-occurring neuropsychiatric conditions are important for effective PKU management. •Adults with PKU experience higher rates of comorbid neuropsychiatric and developmental conditions.•The youngest adult PKU cohorts have higher than expected rates for intellectual disability, anxiety, and depression.•Results emphasize the need for lifelong treatment for adults with PKU that includes routine neuropsychiatric screening.

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Collaboration types
Industry collaboration
Domestic collaboration
Web of Science research areas
Endocrinology & Metabolism
Genetics & Heredity
Medicine, Research & Experimental
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