Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-586b7cd67f-rdxmf Total loading time: 0 Render date: 2024-11-27T13:32:26.900Z Has data issue: false hasContentIssue false

Chapter 7 - Depression

Published online by Cambridge University Press:  07 November 2024

By
Adelola Idowu  and
David M. L. Branford
Edited by
David M. L. Branford ,
Satheesh K. Gangadharan ,
Mary Barrett  and
Regi T. Alexander
David M. L. Branford
Affiliation:
Independent Pharmacy Consultant
Satheesh K. Gangadharan
Affiliation:
Leicestershire Partnership NHS Trust
Mary Barrett
Affiliation:
Leicestershire Partnership NHS Trust
Regi T. Alexander
Affiliation:
Hertfordshire Partnership University NHS Foundation Trust
Get access

Summary

Depressive disorders are very common and are among the leading causes of disability worldwide. The worldwide prevalence of depression is estimated to be 4.4 per cent and prevalence in the UK is 4.5 per cent . The point prevalence of affective disorder in a large population study with intellectual disability (n=1023) was 6.6 per cent, based upon expert clinical assessment, compared with 5.7 per cent, 4.8 per cent, and 3.6 per cent for diagnoses made according to various standard criteria, respectively (Cooper et al. 2007). However, other authors have suggested higher rates of depression based on a broader criterion for a diagnosis. Depression is a common mental health problem but can be difficult to diagnose in people with intellectual disability. Antidepressants are in many areas the most widely prescribed mental health medication. The chapter presents an overview of the condition, the treatments with medication available, and their relevance.

Keywords

depressionmood disorderantidepressantspsychological treatments
Type
Chapter
Information
The Frith Prescribing Guidelines for People with Intellectual Disability , pp. 87 - 101
Publisher: Cambridge University Press
Print publication year: 2024

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Key Guidelines

National Institute for Health and Care Excellence (2009) Guidance for the treatment of depression in adults with chronic physical health problems (CG91). www.nice.org.uk/guidance/cg91.Google Scholar
British Association for Psychopharmacology (2015) Evidence-based guidelines for treating depressive disorders with antidepressants: A revision of the 2008 guidelines. www.bap.org.uk/pdfs/BAP_Guidelines-Antidepressants.pdf.Google Scholar
American Psychological Association (2019) Clinical practice guideline for the treatment of depression across three age cohorts: Recommendations for the general adult population from the APA Guideline Development Panel for the Treatment of Depression. www.apa.org/depression-guideline.Google Scholar
National Institute for Health and Care Excellence (2016) Guidance NG54: Mental health problems in people with learning disabilities: prevention, assessment, and management. www.nice.org.uk/guidance/ng54.Google Scholar
Taylor, D. M., Barnes, T. R. and Young, A. H. (2021). The Maudsley prescribing guidelines in psychiatry. John Wiley & Sons.CrossRefGoogle Scholar

References

Aman, M., & Singh, N. (1988) Patterns of drug use, methodological consideration, measurement techniques, and future trends. In Aman, M. and Singh, N. (eds.), Psychopharmacology of developmental disabilities (pp. 1–29). Springer VerlagCrossRefGoogle Scholar
American Psychiatric Association (2013). Diagnostic and statistical manual of mental disorders (DSM-5 ®). 5th ed. American Psychiatric Association Publishing.Google Scholar
American Psychological Association (2019) Clinical practice guideline for the treatment of depression across three age cohorts: Recommendations for the general adult population from the APA Guideline Development Panel for the Treatment of Depression. www.apa.org/depression-guideline.Google Scholar
Beail, N., Warden, S., Morsley, K., & Newman, D. (2005). Naturalistic evaluation of the effectiveness of psychodynamic psychotherapy with adults with intellectual disabilities. Journal of Applied Research in Intellectual Disabilities, 18(3), 245–51.CrossRefGoogle Scholar
Bhaumik, S. & Alexander, R. eds. (2020). Oxford textbook of the psychiatry of intellectual disability. Oxford University Press.CrossRefGoogle Scholar
Bhaumik, S., Branford, D., Naik, B. I. & Biswas, A. B. (2000) A retrospective audit of selective serotonin re-uptake inhibitors (fluoxetine and paroxetine) for the treatment of depressive episodes in adults with learning disability. British Journal of Developmental Disabilities, 46, 131–9.CrossRefGoogle Scholar
Bhaumik, S., Gangadharan, S., Hiremath, A., & Russell, P. (2011) Psychological treatments in disorders of intellectual development: The challenges of building a good evidence base. British Journal of Psychiatry, 198(6), 428–30. https://doi.org/10.1192/bjp.bp.110.085084CrossRefGoogle Scholar
Bhaumik, S., & Alexander, R. (2020) Oxford textbook of the psychiatry of disorders of intellectual development. Oxford University Press.Google Scholar
British Association for Psychopharmacology (2015) Evidence-based guidelines for treating depressive disorders with antidepressants: A revision of the 2008 guidelines. www.bap.org.uk/pdfs/BAP_Guidelines-Antidepressants.pdf.Google Scholar
Cooney, P., Jackman, C., Tunney, C., Coyle, D. & O’Reilly, G. (2018) Computer-assisted cognitive behavioural therapy: The experiences of adults who have an Disorders of intellectual development and anxiety or depression. Journal of Applied Research in Intellectual Disabilities, Nov; 31(6), 1032–1045. https://doi.org/10.1111/jar.12459. Epub 2018 May 3. PMID: 29722919.CrossRefGoogle ScholarPubMed
Cooper, S., Smiley, E., Morrison, J., Williamson, A., & Allan, L. (2007). An epidemiological investigation of affective disorders with a population-based cohort of 1023 adults with intellectual disabilities. Psychological Medicine, 37(6), 873–82.CrossRefGoogle ScholarPubMed
Digital NHS (2021). Health and Care of People with Learning Disabilities Experimental Statistics 2019 to 2020. www.gov.uk/government/statistics/health-and-care-of-people-with-learning-disabilities-experimental-statistics-2020-to-2021.Google Scholar
Glover, G., Williams, R., Branford, D., et al. (2015) Prescribing of psychotropic drugs to people with learning disabilities and/or autism by general practitioners in England. Public Health EnglandGoogle Scholar
Howland, R. H. (1992) Fluoxetine treatment of depression in mentally retarded adults. Journal of Nervous and Mental Disease, 180, 202–5.CrossRefGoogle ScholarPubMed
Jahoda, A., Hastings, R., Hatton, C., et al. (2017) Comparison of behavioural activation with guided self-help for treatment of depression in adults with intellectual disabilities: a randomised controlled trial. Lancet Psychiatry, Dec; 4(12), 909–19. https://doi.org/10.1016/S2215-0366(17)30426-1. Epub 2017 Nov 16. PMID: 29153873; PMCID: PMC5714593.CrossRefGoogle ScholarPubMed
Jones, J., Blinkhorn, A., McQueen, M., et al. (2021) The adaptation and feasibility of dialectical behaviour therapy for adults with intellectual developmental disabilities and transdiagnoses: A pilot community-based randomized controlled trial. Journal of Applied Research in Intellectual Disabilities, 2021 May; 34(3), 805–17. https://doi.org/10.1111/jar.12860. Epub 2021 Feb 17. PMID: 33599087.CrossRefGoogle ScholarPubMed
Kendrick, T. (2021) Strategies to reduce use of antidepressants. British Journal of Clinical Pharmacology Themed Issue: Avoiding Harm from Over‐Prescribing, 87(1), 23–33CrossRefGoogle ScholarPubMed
Langee, H. R. & Conlon, M. (1992) Predictors of response to antidepressant medications. American Journal of Mental Retardation, 97, 65–70.Google ScholarPubMed
McNair, L., Woodrow, C., & Hare, D. (2017) Dialectical behaviour therapy [DBT] with people with intellectual disabilities: A systematic review and narrative analysis. Journal of Applied Research in Intellectual Disabilities, Sep; 30(5), 787–804. https://doi.org/10.1111/jar.12277. Epub 2016 Jul 26. PMID: 27456814.CrossRefGoogle ScholarPubMed
Mehta, H., & Glover, G. (2019). Psychotropic drugs and people with learning disabilities or autism. Public Health England.Google Scholar
National Institute for Health and Care Excellence (2022), NICE Guideline 222: Depression in adults: Treatment and management. Published 29 June 2022. www.nice.org.uk/guidance/ng222/chapter/Recommendations#choice-of-treatments.Google Scholar
National Institute for Health and Care Excellence (2009) Guidance for the treatment of depression in adults with chronic physical health problems (CG91). www.nice.org.uk/guidance/cg91.Google Scholar
NHS Digital (2021) Health and Care of People with Learning Disabilities Experimental Statistics 2020 to 2021. https://digital.nhs.uk/data-and-information/publications/statistical/health-and-care-of-people-with-learning-disabilities/experimental-statistics-2020-to-2021/prescribing.Google Scholar
NHS England (2016) Stopping Over-Medication of People with a Learning Disability (STOMPLD) Pledge. www.england.nhs.uk/learning-disabilities/improving-health/stomp/.Google Scholar
Rai, P., & Kerr, M. (2010) Antidepressant use in adults with disorders of intellectual development. The Psychiatrist, 34(4), 123–6. https://doi.org/10.1192/pb.bp.108.023325CrossRefGoogle Scholar
Richards, M., Maughan, B., Hardy, R., et al. Long-term affective disorder in people with mild learning disability. British Journal of Psychiatry 2001 Dec; 179, 523–7.CrossRefGoogle ScholarPubMed
Royal College of Psychiatrists (2001). DC-LD: Diagnostic criteria for psychiatric disorders for use with adults with learning disabilities/mental retardation, London, Royal College of Psychiatrists, Occasional Paper OP 48.Google Scholar
Fletcher, R., Loschen, E., Stavrakaki, C. & First, M. (2007). DM-ID: diagnostic manual – intellectual disability: A textbook of diagnosis of mental disorders in persons with intellectual disability. National Association for the Dually Diagnosed.Google Scholar
Rush, A. J., Fava, M., Wisniewski, S. R., et al. (2004) Sequenced treatment alternatives to relieve depression (STAR*D): rationale and design. Controlled Clinical Trials, Feb;25(1), 119–42. https://doi.org/10.1016/s0197-2456(03)00112-0. PMID: 15061154.CrossRefGoogle Scholar
Turky, A., Felce, D. J., Jones, G. & Kerr, M. P. (2011). A prospective case control study of psychiatric disorders in adults with epilepsy and disorders of intellectual development. Epilepsia, 52(7), 1223–30. https://doi.org/10.1111/j.1528-1167.2011.03044.x.CrossRefGoogle Scholar
Vereenooghe, L. & Langdon, PE. (2013) Psychological therapies for people with intellectual disabilities: a systematic review and meta-analysis. Research in Developmental Disabilities, Nov; 34(11), 4085–102. https://doi.org/10.1016/j.ridd.2013.08.030. Epub 2013 Sep 18. PMID: 24051363.CrossRefGoogle ScholarPubMed
Verhoeven, W. M. A., Veendrik-Meekes, M. J., Jacobs, G. A. J., van den Berg, Y. W. M. M. & Tuinier, S. (2001) Citalopram in mentally retarded patients with depression: a long-term clinical investigation. European Psychiatry, 16, 104–8.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×