Depression in Down syndrome: a review of the literature.
People with Down syndrome show depression through behavior, not words—track skill loss, sleep, and irritability instead of mood reports.
01Research in Context
What this study did
The authors read every paper they could find on depression in Down syndrome. They pulled studies from 1967 to 2010 and wrote a plain-language summary.
The review covers kids and adults. It asks two questions: Do people with Down syndrome get more depression? And how does it look different from typical depression?
What they found
Rates of depression are about the same as in other people with intellectual disability. Having Down syndrome alone does not raise the odds.
But the signs can be tricky. Sad mood is hard to report when speech is limited. You may see more irritability, sleep change, or loss of daily skills instead.
How this fits with other research
McLennan et al. (2008) show that behavior excesses, not memory slips, are what send adults with Down syndrome to dementia clinics. Spanoudis et al. (2011) say the same red-flag rule works for depression: watch what you can see.
Rose et al. (2000) track how frontal-lobe dementia starts with personality change before memory fails. The depression review echoes this sequence—skill loss and social withdrawal can come before clear sadness.
Capio et al. (2013) find that adults who never fully leave pediatric care rack up higher medical bills. The depression paper adds another cost: when depression is missed, behavior problems grow and services expand.
Why it matters
Stop waiting for clients to say 'I feel sad.' Track sleep, appetite, and willingness to start tasks. If those shift for two weeks, screen for depression even if the client cannot name the feeling. Share the checklist with direct-care staff—they spend the most hours watching. Early treatment cuts problem behavior and keeps placements stable.
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02At a glance
03Original abstract
BACKGROUND: Depression has been frequently reported in individuals with Down Syndrome (DS). The aim of this article is to provide a comprehensive, critical review of the clinically relevant literature concerning depression in DS, with a focus on epidemiology, potential risk factors, diagnosis, course characteristics and treatment. METHODS: We searched the PUBMED database (January 2011) using the keywords ("Depressive Disorder [MESH]" OR "Depression [MESH]" OR "depress* [All Fields]") AND ("Down Syndrome [MESH]" OR "Down syndrome [All Fields]" OR "Down's syndrome [All Fields]"). Review articles not adding new information, single case reports and papers focusing on subjects other than depression in DS were excluded. RESULTS: The PUBMED search resulted in 390 articles, of which 30 articles were finally included. Recent information does not support earlier suggestions of an increased prevalence of depression in DS compared to other causes of Intellectual Disability (ID). However, individuals with DS show many vulnerabilities and are exposed to high levels of stressors that could confer an increased risk for the development of depression. Apart from general risk factors, several potential risk factors are more specific for DS, including smaller hippocampal volumes, certain changes in neurotransmitter systems, deficits in language and working memory, attachment behaviours and frequently occurring somatic disorders. Protective factors might play a role in reducing the vulnerability to depression. The diagnosis of depression in DS is mainly based upon observable characteristics, and therefore, the use of modified diagnostic criteria is advised. Although several common treatments, including antidepressants, electroconvulsive therapy and psychotherapy seem effective, there is evidence of undertreatment of depression in DS. CONCLUSIONS: There are important limitations to our current clinical knowledge of depression in DS. Future studies should include systematic evaluations of pharmacotherapeutic and psychotherapeutic interventions.
Research in developmental disabilities, 2011 · doi:10.1016/j.ridd.2011.02.010