Major depression in a small group of adults with Down syndrome.
Adults with Down syndrome may show depression through body signs and hallucinations instead of words.
01Research in Context
What this study did
Doctors looked at nine adults with Down syndrome who were very sad. The adults could not say 'I feel blue.' The team wrote down what they saw instead.
They used a small case-series design. This means they watched each person closely and took notes.
What they found
The adults showed sadness with their bodies, not words. They ate less, moved slower, and saw things that were not there.
Hallucinations stood out. Most people with depression do not have them. These nine adults did.
How this fits with other research
Nasr et al. (2000) later found the same group has high alpha-2 macroglobulin in their blood when they are depressed. This links body signs to lab signs.
McCarron et al. (2002) showed that teens with Down syndrome start to pull away from others. The 1995 adults may keep that quiet style into adulthood.
MacFarland et al. (2025) looked at OCD, not depression, in the same population. Both papers warn that mood and compulsion signs look different than in typical adults.
Why it matters
If your client with Down syndrome stops eating, loses energy, or stares at blank walls, think depression even if they never say they are sad. Track weight, sleep, and any odd visions. Share these clues with the doctor so treatment can start early.
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02At a glance
03Original abstract
The clinical histories and treatment of the nine individuals with Down syndrome (DS) and major depression (MD) previously noted in a report on the psychopathology of a population of 164 adults with DS with and without health disorders from a Down Syndrome Clinic are presented (Myers & Pueschel, 1991). The clinical characteristics including DSM-III-R (1987) criteria of these 9 patients plus 13 individuals with DS and MD described in case reports in the literature are summarized. Depression is rarely verbalized and commonly appears as crying, depressed appearance, or mood lability. Vegetative symptoms of disinterest with severe withdrawal and mutism, psychomotor retardation, decreased appetite, weight loss, and insomnia are prominent. Verbal expression of preoccupations of suicide, death, self-depreciation, and guilt were infrequent and may either be not present or not reported due to mutism or moderate level of mental retardation (MR). Hallucinations were prominent. Family history of depression was infrequent. Psychological stressors were noted mostly in the study sample and not in the 13 from the literature. The pattern of vegetative symptomatology with few verbal complaints and prominent hallucinations may be related to moderate mental retardation in these groups with DS rather than specifically to DS.
Research in developmental disabilities, 1995 · doi:10.1016/0891-4222(95)00015-f