# Self‐Esteem and Psychopathology Differentially Relate to Real‐Life and Social Functioning in People With 22q11.2 Deletion Syndrome

## TL;DR

The study explores how self-esteem and psychopathology affect real-life and social functioning in individuals with 22q11.2 deletion syndrome.

## Contribution

The study reveals that self-esteem and psychopathology have distinct relationships with functioning in 22q11.2DS.

## Key findings

- Self-esteem levels are similar in individuals with and without psychosis in 22q11.2DS.
- Psychopathology is strongly linked to reduced social functioning in 22q11.2DS.
- Self-esteem correlates with overall real-life functioning but not social functioning in 22q11.2DS.

## Abstract

The 22q11.2 deletion syndrome (22q11.2DS) represents a genetic condition at higher risk of transition to psychosis. Both self‐esteem (SE), intended as self‐evaluation based on cognitive and affective elements, and psychotic symptoms may be associated with patients' real‐life functioning. We investigated whether these variables differently correlate with real‐life functioning in 22q11.2DS.

We recruited 22 patients with 22q11.2DS (DEL, N = 22) and 10 with 22q11.2DS and psychosis (DEL‐SCZ, N = 10); we administered the Positive And Negative Syndrome Scale (PANSS), the Specific Levels of Functioning scale (SLoF) and the Self Esteem Rating Scale (SERS).

The DEL‐SCZ and DEL groups did not significantly differ on the SERS (p = 0.228). The DEL group scored higher than DEL‐SCZ on the SLoF‐total (p = 0.006) and on the SLoF‐social functioning (p = 0.031). PANSS‐total negatively correlated with SLoF‐total scores (ρ = −0.698; p < 0.001), with the SLoF‐social functioning (ρ = −0.643; p < 0.001) and with SERS (ρ = −0.391; p = 0.036). SERS scores positively correlated with SLoF‐total (ρ = 0.545; p = 0.003) but not with SLoF‐social functioning.

DEL and DEL‐SCZ display similar levels of SE suggesting that this psychological dimension is not associated with psychotic symptoms. Levels of SE and psychopathology differentially relate to real‐life and social functioning in people with 22q11.2DS: Symptom severity is particularly associated with patients' social and interpersonal functioning. Psychological supportive interventions might be useful to improve real‐life functioning in people with 22q11.2DS.

Self‐esteem is not directly associated with psychosis in individuals with the 22q11.2 deletion syndrome (22q11.2DS). Self‐esteem and psychopathology differentially relate to real‐life functioning in individuals with 22q11.2DS: Although the former appears to be associated with total levels of functioning, only the latter is correlated with patients' social functioning.