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Course and outcome of comorbid mood disorders in children and adolescents with intellectual disability [IDD]

Published online by Cambridge University Press:  18 June 2021

Arul Jayendra Pradeep Velusamy ,
Satish Chandra Girimaji  and
John Vijay Sagar Kommu
Arul Jayendra Pradeep Velusamy*
Affiliation:
Former Senior resident, National Institute of Mental Health and Neuro Sciences [NIMHANS], RCPsych MTI Trainee, Central and North West London NHS Trust
Satish Chandra Girimaji
Affiliation:
Professor, Department of Child and Adolescent Psychiatry, National Institute of Mental health and Neuro Sciences [NIMHANS]
John Vijay Sagar Kommu
Affiliation:
Professor, Department of Child and Adolescent Psychiatry, National Institute of Mental health and Neuro Sciences [NIMHANS]
*
*corresponding author.
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Abstract

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Aims

The primary objective of the study is to assess the clinical course and functional outcome of comorbid mood disorders in children and adolescents with Intellectual Disability [IDD]

Method

53 children and adolescents with varying levels of severity of IDD presenting with comorbid mood disorders diagnosed using Kiddie Schedule for Affective Disorder and Schizophrenia-DSM-5 version [KSADS] were recruited by convenient sampling with the exclusion of autism spectrum disorders. Vineland Social Maturity Scale [VSMS] is used to quantify the severity of ID. Developmental Behaviour Checklist-Parent [DBC-P] version is used to measure psychopathology, Clinical Global severity of illness [CGI-S] to quantify the clinical improvement, and Developmental Disabilities Children's Global Assessment of Severity [DD-CGAS] to assess functional improvement. Prospective naturalistic follow-up was done with assessment points at baseline, 1, 3- and 6-month timeline.

Result

40 patients were followed up for 6 months period. Overall significant improvement is observed in the dependent variables like CGI, DDCGAS, and DBC-P from baseline to 3 months and then a plateau of improvement from 3 to 6 months. The diagnostic breakup of mood disorders is mania [N = 19], Depression [N = 12], and mixed affective state [N = 9]. Patients with mania had significant improvement in DBC score [F = 12.69, p < 0.001 in repeated measures ANOVA], DDCGAS [p < 0.001], and CGI score [p < 0.03] with an overall remission rate of 42.10% over 6 months period. Patients with depression had significant improvement in DBC score [F = 15.48, p < 0.001], DDCGAS, and CGI score [p < 0.001] with an overall remission rate of 41.7%. None of the patients with mixed affective states had clinical remission with no significant improvement observed in any of the dependent variables measuring course and outcome.

Conclusion

Comorbid psychiatric disorders in children and adolescents with IDD have a guarded prognosis compared to mood disorders in neurotypical children. Comorbid ADHD and caregiver stress majorly influenced the course and outcome in the current study.

Type
Research
Information
BJPsych Open , Volume 7 , Supplement S1: Abstracts of the RCPsych Virtual International Congress 2021, 21–24 June , June 2021 , pp. S260
Creative Commons
Creative Common License - CCCreative Common License - BY
This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted re-use, distribution, and reproduction in any medium, provided the original work is properly cited.
Copyright
Copyright © The Author(s), 2021. Published by Cambridge University Press on behalf of the Royal College of Psychiatrists
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