Depression in adults with intellectual disability .1. a review

Objective: To examine the available literature regarding prevalence, clinical features and treatment of depression in adults with intellectual disability (ID). Method: A review of standard texts of ID and available literature examining psychiatric problems of individuals with ID. Results: Few methodologically sound studies of prevalence have been reported. The clinical features of depression in adults with ID appear to vary with level of disability; in those with higher levels of disability in particular, irritability and anger, self-injurious and aggressive behaviour, psychomotor change and loss of activities of daily living skills may be observed rather than 'classic' depressive symptoms. No systematic treatment studies have been reported; case reports support the efficacy of cognitive and behavioural strategies, antidepressants and electroconvulsive therapy. Conclusions: Well designed studies to assess the prevalence and evaluate the treatment of depression in individuals with ID are urgently needed. Design of these studies will need to address the questions of reliability and validity of diagnosis in individuals with ID and examine the appropriateness of available diagnostic criteria.