Treating Obsessive Compulsive Disorder in Adolescents and Adults with Down Syndrome: Results from a Scoping Rapid Review.
Only 11 weak case reports support OCD treatment in teens or adults with Down syndrome—act cautiously.
01Research in Context
What this study did
The team hunted for any paper that tried to treat OCD in teens or adults with Down syndrome.
They found only 11 tiny case reports. Each report had one person. No big studies existed.
Drugs, talk therapy, and even yoga were tried. The authors graded every paper as low quality.
What they found
Most people got some relief, but no one was cured. Results ranged from small gains to big gains.
Because each story is just one person, we cannot say what works best. The evidence is too thin.
How this fits with other research
McIntyre et al. (2002) first showed that extreme slowness in daily tasks can be a severe OCD type in Down syndrome. MacFarland et al. (2025) still include those old cases, proving the problem has been seen for decades.
Glenn et al. (2007) found that repetitive routines are common in kids with Down syndrome and can turn from helpful to harmful as mental age rises. The new review adds that when these routines become true OCD, we still lack proven treatments.
Reaven et al. (2003) showed one child with Asperger syndrome got much better after adapted CBT. MacFarland et al. (2025) list similar single-case CBT tries in Down syndrome, but none are as clear. The gap shows we have hopeful hints, not a roadmap.
Why it matters
If a teen or adult with Down syndrome shows washing, checking, or extreme slowness, do not rush to generic ERP or meds. Start with a full assessment, document baseline, and treat the first case like an experiment. Share your data so the next clinician has more than 11 stories to lean on.
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02At a glance
03Original abstract
PURPOSE: Adolescents and adults with Down syndrome are noted to display symptoms and behaviors consistent with a diagnosis of Obsessive Compulsive Disorder. While evidenced-based interventions, including psychopharmacology and therapeutic interventions including exposure and response prevention, exist and effectively treat obsessive-compulsive symptoms in neurotypical populations, less is known about effective treatments for similar presentations in persons with Down syndrome. METHODS: A scoping rapid review was conducted in April 2023 to determine what treatments are being used to target obsessive-compulsive symptoms and related behaviors in adolescents and adults with Down syndrome, the quality of those treatments, and their alignment with current evidenced-based interventions. RESULTS: A total of eleven articles, all single case or case series, published between 1992 and 2017 were identified describing the treatment of 32 adolescents and adults with Down syndrome and obsessive-compulsive traits and behaviors including: hoarding, cleaning, gross motor compulsions, and food, hygiene, dressing, and checking rituals. Interventions used most often aligned with evidenced-based guidelines for treating obsessive compulsive disorder and included psychopharmacology, psychotherapy, and complementary and alternative medicine. CONCLUSIONS: While the outcomes of most interventions yielded partial or significant reduction in symptoms, poor research quality and limited generalizability noted across all studies make it difficult to inform guidelines for caring for this high-needs population. In the future, we believe it is necessary to perform more rigorous research focused on treating obsessive compulsive symptoms in individuals with Down syndrome with sufficient follow-up to fully assess treatment effectiveness.
Journal of autism and developmental disorders, 2025 · doi:10.1111/jppi.12156