Relationship between diagnostic criteria, depressive equivalents and diagnosis of depression among older adults with intellectual disability.
Use both DSM-IV symptoms and behavioral equivalents in the interRAI ID to spot depression in adults with ID—no need to adjust for age.
01Research in Context
What this study did
Matson et al. (2008) checked if two sets of signs point to depression in adults with intellectual disability. One set is regular DSM-IV symptoms. The other set is behavioral equivalents like social withdrawal or irritability. They used the interRAI ID assessment on adults living in the community or in group homes.
What they found
Both DSM-IV items and the behavioral equivalents matched the medical record diagnosis of depression. The link held for younger and older adults. No age group needed special rules.
How this fits with other research
LeBlanc et al. (2003) said challenging behavior is NOT a sign of depression in ID. Matson et al. (2008) now says it CAN be. The difference is method: A et al. used custom scales that kept behavior and mood apart. L et al. used interRAI ID items that blend the two. The new view does not erase the old one; it widens the lens.
Martin et al. (1997) first mapped the shift from classic sadness in mild ID to acting-out signs in severe ID. Matson et al. (2008) confirms that both ends of that spectrum still matter, even in older adults.
Foti et al. (2015) later showed anxiety links to diabetes in the same age group. Together the papers tell us: screen mood first, then watch for medical fallout.
Why it matters
You can trust the interRAI ID depression flags right away. If the client shows sad mood OR social withdrawal OR irritability, count it and follow up. Do not wait for verbal reports of feeling blue. This one change catches more depression in adults with ID of any age and any severity.
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02At a glance
03Original abstract
BACKGROUND: Depression is more common among persons with an intellectual disability (ID) than the general population, and may be expected to increase with age just as in the general population. However, little is known about depression among older adults with ID. The literature has questioned the use of standard diagnostic criteria for depression among both older adults and persons with ID, and behavioural depressive equivalents have been suggested. This study uses the interRAI ID assessment instrument to investigate the relationship between standard diagnostic criteria for depression, depressive equivalents and a diagnosis of depression among older and younger adults with ID in community and institutional settings in Ontario, Canada. METHOD: Items in the interRAI ID assessment instrument that were representative of The Diagnostic and Statistical Manual of Mental Disorders 4th Edition (DSM-IV) criteria and depressive equivalents were examined among persons with ID in institutional (census-level data) and in community-based (sample) residential settings. Bivariate logistic regression was used to examine the relationship between depressive symptoms and a diagnosis of depression. Descriptive statistics were used to examine the prevalence of depressive symptoms among those who did not have a diagnosis of depression. RESULTS: The results indicate that DSM-IV diagnostic criteria and depressive equivalents were significantly related to a diagnosis of depression among older and younger adults with ID, and that both types of symptoms were exhibited by a non-trivial proportion of individuals without a diagnosis of depression. CONCLUSIONS: The depression rating scale embedded in the interRAI ID is helpful in identifying older adults at risk of depression. Contrary to other studies, few significant differences were found in depressive symptoms by age.
Journal of intellectual disability research : JIDR, 2008 · doi:10.1111/j.1365-2788.2008.01041.x