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Cognitive Profile, Emotional-Behavioral Features, and Parental Stress in Boys With 47,XYY Syndrome

Operto, Francesca F. MD, PhD*; Pastorino, Grazia M.G. MD†,‡; Amadori, Elisabetta MD†,‡; Mazza, Roberta MD*; Bernardo, Pia MD§,∥; Campanozzi, Stella MD*; Margari, Lucia PhD*; Coppola, Giangennaro PhD

Cognitive and Behavioral Neurology: June 2019 - Volume 32 - Issue 2 - p 87–94
doi: 10.1097/WNN.0000000000000193
Original Studies

Objective: To describe (a) the observed cognitive, emotional, and behavioral phenotype in a cohort of male children with 47,XYY syndrome and (b) stress levels in their parents.

Methods: We conducted a cross-sectional observational study of 11 boys diagnosed with 47,XYY syndrome and compared them with 11 age-matched boys with normal karyotype (46,XY). The participants performed standardized assessments of cognitive function, emotional state, and behavioral features; the parents completed a questionnaire evaluating parental stress. All data were analyzed using parametric and nonparametric statistical methods.

Results: All of the boys exhibited a normal cognitive profile. However, emotional-behavioral profiling revealed that internalizing and externalizing problems were more prevalent in the 47,XYY group. In addition, the stress levels of the parents of the 47,XYY group were reportedly higher than those of the parents of the 46,XY group. We also found that the time of the diagnosis had an effect on the mothers’ stress levels; that is, postnatal fetal 47,XYY diagnosis was associated with higher maternal stress, whereas prenatal fetal 47,XYY diagnosis was not.

Conclusions: Generally, 47,XYY syndrome is associated with certain cognitive, emotional, and behavioral features. High stress levels have been reported by the mothers of 47,XYY boys who had been diagnosed postnatally because of unexpected developmental delay and/or learning difficulties. The present study highlights the need to better define the neuropsychiatric phenotype of 47,XYY children; namely, the effect of the chromosomal abnormality on their cognitive function and emotional-behavioral (internalizing and externalizing) features. This study could improve prenatal counseling and pediatric surveillance.

*Child Neuropsychiatry Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari, Italy

Child Neuropsychiatry Unit, Department of Medicine, Surgery and Dentistry, University of Salerno, Fisciano, Italy

Department of Mental and Physical Health and Preventive Medicine, University of Campania, Naples, Italy

§Department of Neurosciences, Santobono-Pausilipon Children’s Hospital, Naples, Italy

Department of Translational Medical Sciences, University of Naples Federico II, Naples, Italy

The authors declare no conflicts of interest.

Correspondence: Francesca F. Operto, MD, PhD, Child Neuropsychiatry Unit, Department of Basic Medical Sciences, Neuroscience and Sense Organs, University of Bari Aldo Moro, Bari 70121, Italy (email:

Received August 10, 2018

Accepted February 18, 2019

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