R. A. Collacott

Depressive episodes in adults with learning disabilities

Objective: In view of the Royal College of Psychiatrists Defeat Depression campaign, to review the existing literature on depressive episodes in people with learning disabilities. Methods: Review of all papers identified to cover this area. Papers were identified by Medline search and also by direct checking of the contents in the preceding five years of eight key learning disabilities journals, the British Journal of Psychiatry, Psychiatric Bulletin and bibliography in Current Opinions in Psychiatry. Papers about children or odd ‘depressive’ symptoms (rather than the syndrome of depression) were excluded. Findings: For over a century it has been recognised that depression can occur in people with learning disabilities. However, the number of studies in this area is very limited. There remain many unanswered questions, such as those of prevalence, clinical presentation and diagnostic criteria, associated social factors, and the evaluation of treatments. Suitable rating scales have yet to be evaluated or devised. The authors propose diagnostic criteria for future use. Conclusions: Research in this important area is very limited. Advances are yet to be made in the clinical assessment and management of the illness.

A five-year follow up study of adaptive behaviour in adults with down syndrome

Follow up Adaptive Behaviour Scale (ABS) assessments were undertaken on a population of people with Down syndrome, after a mean period of five years. Participlants were randomly selected within age stratified groups: 20 people from the original age bands 20–29 years, 30—39 years, 40–29 years, 50–59 years, and all 12 people in the original age band 60+ years. Examinations were successfully completed in 83 cases. Loss of skills was found to increase with age, and was common over the age of 40 years. The study examines age-related deterioration in ABS scores and subscores.

Schizophrenia and Down's syndrome

There are few reports in the literature of schizophrenia in individuals with Downs syndrome, but a suggestion that such individuals may be protected from schizophrenia. We report six cases of schizophrenia fulfilling ICD-10 guidelines, occurring in people with Downs syndrome. In one case, hypothyroidism was associated. Response to neuroleptic treatment was good. Reasons for the paucity of previous reports on this association are discussed.