Acute neuropsychiatric disorders in adolescents and young adults with Down syndrome: Japanese case reports

Abstract

Background:The aim of this study was to evaluate acute neuropsychiatric disorders in adolescents and young adults with Down syndrome. We report 13 Japanese adolescents or young adults with Down syndrome who developed acute neuropsychiatric disorders including withdrawal, depression, obsessive-compulsive behaviors, and occasional delusions or hallucinations.Methods:The following information was collected from each patient: age at onset of acute neuropsychiatric disorder, complications, signs and symptoms, personality traits before the onset of the acute neuropsychiatric disorder, prescribed medications with their respective doses and the response to treatment, and senile changes observed on magnetic resonance imaging or computed tomography.Results:The mean age at onset of these disorders was 21.2 years. Brain imaging showed almost senile changes; patients responded well to low-dose psychotropic therapy. Patients had an onset at a young age and presented with treatable conditions, although the average age of the onset of Alzheimer’s disease is generally over 40 years of age in patients with Down syndrome.Conclusion:These findings suggest that the pathology of acute neuropsychiatric disorder in patients with Down syndrome may be related to presenile changes; however, these disorders present features and a clinical course that is different from those presented in typical Alzheimer’s disease with Down syndrome.

Catatonia in Down syndrome; a treatable cause of regression

“…Recently, Akahoshi et al in Japan, reported 13 DS individuals with good premorbid function who developed acute neuropsychiatric symptoms as adolescents or young adults. 5 Their symptoms, including psychomotor slowness in 100% and stupor or catatonia in 15%, strongly suggest catatonia syndrome. Their official diagnoses were major depressive (54%), obsessive, psychotic NOS, anxiety, and adjustment disorders.…”

Rapid clinical deterioration in an individual with Down syndrome

“…Some are referring to this condition as "Down Syndrome Disintegrative Disorder," [Prasher, 2002;Devenny and Matthews, 2011;Worley et al, 2014] "Newonset Autistic Regression," [Worley et al, 2014] "Catatonic Psychosis," [Rollin, 1946] "Acute Regression of DS," [Akahoshi et al, 2012] or "Catatonia in DS" [Ghaziuddin et al, 2015]. This sudden process often involves loss of daily living skills, cognitive decline, psychomotor slowing, disordered sleep, loss of speech, unintentional weight loss, uncharacteristic anxiety, depression and/or mood lability, and new-onset or worsening repetitive thoughts and behaviors [Prasher, 2002;Devenny and Matthews, 2011;Worley et al, 2014].…”

Acute Regression in Young People with Down Syndrome

“…He hypothesized that this regression could be a process closely related to the defects of serotonergic and cholinergic systems. The effect of SSRI on acute regression in young adults with DS was also reported (case 2 in the study of Akahoshi et al) [16]. Neurotransmitters play a critical role in brain development and mood regulation.…”