Psychopathology in tuberous sclerosis: an overview and findings in a population-based sample of adults with tuberous sclerosis.
Check adults with tuberous sclerosis for depression, especially if they speak and live independently.
01Research in Context
What this study did
Eisenhower et al. (2006) looked at every adult with tuberous sclerosis (TSC) in one English region.
They asked each person about past and present mental-health problems.
Doctors also checked IQ and medical charts to see who had seizures or learning disability.
What they found
Four out of ten adults had at least one mental illness during their life.
Mood disorders like depression were the most common.
Surprise: the risk was higher in people with IQ above 70 than in those with more severe disability.
How this fits with other research
Barthelemy et al. (1989) saw a similar 36 % rate in general adults with intellectual disability, so TSC adds little extra risk.
Vereenooghe et al. (2013) later showed CBT can cut depression and anger in this same group, giving you a tool once you spot the problem.
Casey et al. (2009) explain why: mTOR brain changes in TSC may drive both mood swings and memory trouble, so the same pathway could link epilepsy, thinking, and depression.
Why it matters
If you serve adults with TSC, screen for depression even when IQ looks "high." Use simple mood charts or the PIMRA depression subscale validated by Alsop et al. (1995). Early CBT referral can lift mood and maybe cut seizure stress.
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02At a glance
03Original abstract
BACKGROUND: Tuberous sclerosis (TS) is a multi- system disorder with complex genetics. The neurodevelopmental manifestations of TS are responsible for considerable morbidity. The prevalence of epilepsy and intellectual disabilities among individuals with TS have been well described. Ours is the first study that explores the prevalence and pattern of psychopathology in a population-based sample of adults with TS. METHODS: Sixty subjects were identified through a capture-recapture analysis of TS. Information was gathered as to seizure history, cognitive functioning (WISC-III) and psychopathology (SADS-L, SAPPA). Lifetime psychopathology was categorized according to Research Diagnostic Criteria. The overall pattern of mental illness (MI) was examined as well as how this varied with IQ and seizure history. RESULTS: Twenty-four (40.0%) subjects had a history of MI. The most common diagnosis was that of an affective disorder [18 (30.0%)], the majority of which were major depressive episodes. Alcoholism [4 (6.7%)] and anxiety disorders [3 (5.0%)] were the next most common diagnoses. Two (3.3%) subjects had had a tic disorder. Only one individual had a diagnosis of schizophrenia. MI was found in 75.0% of those with a history of epilepsy and 37.5% of those without epilepsy. MI was significantly more prevalent in those with a full-scale IQ above 70. CONCLUSIONS: A significant proportion of adult with TS experience MI. MI was significantly more [corrected] prevalent in subjects with a full-scale IQ above 70. Reasons for such a finding are explored, and related methodological considerations for future research outlined.
Journal of intellectual disability research : JIDR, 2006 · doi:10.1111/j.1365-2788.2006.00828.x