Psychiatric disorders in adolescents and young adults with Down syndrome and other intellectual disabilities

Abstract

BackgroundRelative to other aspects of Down syndrome, remarkably little is known about the psychiatric problems experienced by youth and young adults with this syndrome and if these problems differ from others with intellectual disabilities. Yet adolescence and young adulthood are particularly vulnerable time periods, as they involve multiple life transitions in educational, medical, and other service systems.MethodsThis study compared the psychiatric diagnoses of 49 adolescent and young adult patients with Down syndrome to 70 patients with other intellectual disabilities (IDs). The groups were similar in age, gender, and level of intellectual impairment. The 119 participants, aged 13 to 29 years (M = 21) were evaluated in one of two specialized psychiatric clinics.ResultsIn contrast to previous literature, those with Down syndrome versus other IDs had significantly higher rates of psychosis NOS or depression with psychotic features (43% versus 13%). Unlike the ID group, psychosis was predominantly seen in females with Down syndrome. Marked motoric slowing in performing routine daily activities or in expressive language was manifested in 17% of patients with Down syndrome. No group differences were found in anxiety or depressive disorders, and the ID group had significantly higher rates of bipolar and impulse control disorders.ConclusionsThese preliminary observations warrant further studies on genetic, neurological, and psychosocial factors that place some young people with Down syndrome or other IDs at high risk for severe psychiatric illness.

Down Syndrome, Partial Trisomy 21, and Absence of Alzheimer’s Disease: The Role of APP

“…Taken together the clinical and neuropsychological observations in the patient with PT21 confirm the absence of dementia through age 72 years. The patient had a history of auditory hallucinations and delusions consistent with psychotic disorder NOS specified in adults with DS [54, 55] and in adolescents [56]. However, these symptoms occurred late in his life when he was unhappily confined to a nursing home, raising the question as to whether the behaviors observed were situational in origin.…”

Abnormal features of human self-domestication in bipolar disorder

“…An important exception to this rule is Down syndrome (DS), commonly characterized by a happy, sociable demeanor as well as comorbidities—e.g., Hirschsprung disease—and other features possibly suggestive of an underlying neurocristopathy (see DSCAM in Supplemental file 2). DS has been found by Dykens and colleagues (2015) to be unique among intellectual disabilities for higher rates of psychosis (43 percent compared to 13 percent in a pooled group of those with other IDs), and 81 percent of DS patients with psychosis were female ( p < .001, with no significant sex difference among those with psychosis in the pooled group). Further study of the interaction of sex differences and any imprinting effects, then, might be crucial to understanding the varied manifestations of hyperdomestication in humans.…”

Family Caregiving of Aging Adults With Down Syndrome

“…For all individuals with intellectual disabilities, such life events may relate to increased risks of depression (Tsanikos, Bouras, Costello, & Holt, ). Specifically, for adults with Down syndrome, connections have also been noted between depression and lower levels of active engagement in employment and social activities (Mallardo, Cuskelly, White, & Jobling, ; also Dykens et al, ), as well as between bereavement and subsequent behavioral changes and cognitive declines (Fonseca, Oliveira, Guilhoto, Cavalheiro, & Bottino, ). With parents facing increased risks of dying or of experiencing functional‐health declines, adults with Down syndrome in their 40s and 50s may face a cascade of changes to themselves and to their parents.…”