Incidence of unipolar and bipolar depression, and mania in adults with intellectual disabilities: prospective cohort study

Cooper, S.-A. , Smiley, E., Allan, L. and Morrison, J. (2018) Incidence of unipolar and bipolar depression, and mania in adults with intellectual disabilities: prospective cohort study. British Journal of Psychiatry, 212(5), pp. 295-300. (doi:10.1192/bjp.2018.12) (PMID:29540250)

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Abstract

Background: Incidence and determinants of affective disorders among adults with intellectual disabilities are unknown. Aims: To investigate affective disorder incidence, and determinants of unipolar depression, compared with general population reports. Method: Prospective cohort study measuring mental ill health of adults with mild to profound intellectual disabilities living within a defined community, over 2 years. Results: There was 70% cohort retention (n = 651). Despite high mood stabiliser use (22.4%), 2-year incident mania at 1.1% is higher than the general population; 0.3% for first episode (standardised incident ratio (SIR) = 41.5, or 52.7 excluding Down syndrome). For any bipolar episode the SIR was 2.0 (or 2.5 excluding Down syndrome). Depression incidence at 7.2% is similar to the general population (SIR = 1.2), suggesting more enduring/undertreatment given the higher prevalence. Problem behaviours (odds ratio (OR) = 2.3) and life events (OR = 1.3) predict incident unipolar depression. Conclusions: Depression needs improved treatment. Mania has received remarkably little attention in this population, despite high prevalence and incidence (similar to schizophrenia), and given the importance of clinician awareness for accurate differential diagnosis from attention-deficit hyperactivity disorder and problem behaviours.

Item Type:Articles
Status:Published
Refereed:Yes
Glasgow Author(s) Enlighten ID:Allan, Mrs Linda and Smiley, Dr Elita and Morrison, Professor Jillian and Cooper, Professor Sally-Ann
Authors: Cooper, S.-A., Smiley, E., Allan, L., and Morrison, J.
College/School:College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > General Practice and Primary Care
College of Medical Veterinary and Life Sciences > Institute of Health and Wellbeing > Mental Health and Wellbeing
College of Medical Veterinary and Life Sciences > School of Medicine, Dentistry & Nursing
Journal Name:British Journal of Psychiatry
Publisher:Royal College of Psychiatrists
ISSN:0007-1250
ISSN (Online):1472-1465
Published Online:15 March 2018
Copyright Holders:Copyright © 2018 The Royal College of Psychiatrists
First Published:First published in British Journal of Psychiatry 212(5):295-300
Publisher Policy:Reproduced in accordance with the copyright policy of the publisher

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Project CodeAward NoProject NamePrincipal InvestigatorFunder's NameFunder RefLead Dept
337621The incidence of mental health and mental ill-health in adults with learning disabilitiesSally-Ann CooperChief Scientist office (CSO)CZH/4/96IHW - MENTAL HEALTH & WELLBEING