Mood disorders in intellectual disability.
OBJECTIVE
This article examines reviews and research on the diagnosis and treatment of mood disorders in people with intellectual disability published from September 2004 to December 2005.


RESULTS
Patients with intellectual disability have limitations in verbal ability, and with increasing levels of disability may have an atypical clinical presentation. Thus, methods to diagnose mood disorders were a major research focus. Informant-rating scales and two self-report instruments provided data on thought patterns, aberrant behavior, appetite, and suicidality. Behavioral symptoms such as aggression were frequently associated with mood disorders. Pharmacotherapy and electroconvulsive therapy were found to be effective treatments. Mood disorders were frequently identified in people with intellectual disability, although suicide was still quite rare.


CONCLUSIONS
Patients with milder levels of disability can use self-report measures and can be diagnosed using standard criteria with little modification. For those with more severe disability, diagnosis is challenging and often requires the use of residual categories. Atypical clinical presentation, including maladaptive behaviors, lent support for 'behavioral equivalent' substitutes of standard criteria. Typical pharmacological agents were effective for depression and electroconvulsive therapy for treatment-resistant bipolar disorder.
Hurley
Anne D
AD
Tufts University School of Medicine, Harvard Vanguard Medical Associates, Wellesley, Massachusetts 02481, USA. hurleyannd@aol.com
D000374:Aggression / Q000523:psychology; D004358:Drug Therapy / Q000379:methods; D004565:Electroconvulsive Therapy / Q000379:methods; D006801:Humans; D008607:Intellectual Disability / Q000453:epidemiology* / Q000523:psychology*; D019964:Mood Disorders / Q000453:epidemiology* / Q000628:therapy; D019989:Persons with Intellectual Disabilities / Q000706:statistics & numerical data; D015995:Prevalence; D013406:Suicide, Attempted / Q000706:statistics & numerical data