Depressive Disorders in People with Intellectual Disability

Depressive disorders are common in people with intellectual disability (ID), and may sometimes pose difficulties in identification and appropriate treatment, mainly due to associated comorbid conditions and significant impairment in communication. This chapter describes both typical and atypical presentations of depression in people with intellectual disability, along with associated aetiopathological factors that might influence the presentation. Depressive disorders are common in people with intellectual disability, causing individual suffering, additional impairments in adaptive behaviour and functioning, disruption of interpersonal relationships, social exclusion, poor physical health outcomes, and sometimes death. The issue of overshadowing and influence of comorbid conditions leading to lack of identification has also been considered. Management approaches, including that of pharmacological and psychological therapies and their applicability to persons with intellectual disability have been highlighted, with case examples. Special consideration, including drug interactions and the effect of treatment on comorbid conditions have been discussed.