Assessment of depression in adults with severe or profound intellectual disability

Abstract

Depression is said to be under-recognised in persons with a severe intellectual disability (ID) as a result of difficulties in diagnosis attributable to the inability of such persons to describe their mood. The main aim of the present study was to examine whether the behavioural criteria for Major Depression (DSM-III-R, American Psychiatric Association, 1987) could be used by nurses to recognise depression in 89 adults with a severe or profound ID living in a large residential centre. Each resident was rated by two nurses (different for each resident). Results indicated that the nurse pairs were reliable in the manner in which they assessed the residents in their care. The study also sought to determine if a relationship existed between total scores on the DSM-III-R checklist of behavioural criteria for depression and other observable behaviours not listed by DSM as symptoms of depression. Results indicated that several behaviours not listed as criteria for major depression in DSM-III-R but listed in the Aberrant Behavior Checklist (Aman & Singh, 1986) and the Developmental Behaviour Checklist (Einfeld & Tonge, 1991) may be associated with the disorder. The suitability of using DSM criteria to diagnose psychiatric disorders in people with a severe or profound ID is discussed.