Diagnosing depression in people with intellectual disabilities

Monash University researchers are developing checklists to help general practitioners and support workers recognise depression in people with an intellectual disability.

Dr Teresa Iacono, research director of the Centre for Developmental Disability Health Victoria, said identifying depression in people who had communication problems was notoriously difficult.

The centre, part of Monash's Department of General Practice, aims to improve the quality of health care available to people with developmental disabilities.

Dr Iacono said people with an intellectual disability were prone to mood disorders because of factors such as higher incidence of illness and brain abnormalities, as well as limited social support and poor social and coping skills.

"Depression in such people has been underestimated as there have long been problems with diagnosing their depression due to communication impairment, atypical presentations and lack of reliable and valid diagnostic criteria," Dr Iacono said.

De-institutionalisation had meant GPs were increasingly seeing patients with intellectual disability - but often did not have the training or knowledge to deal with them, she said.

"Problems in accessing assessment and intervention services result from the lack of appropriate assessment tools, the fact that GPs are rarely knowledgeable about intellectual disabilities, and that access to specialist psychiatrists is limited in Australia," Dr Iacono said.

The centre's $50,000 funding to develop the screening tools - a checklist for use by support workers and an assessment tool for GPs - has come from the beyondblue Victorian Centre of Excellence in Depression and Related Disorders.

The criteria in the checklists are based on observable signs and symptoms and do not rely on the person having to describe their emotions, which is usually the case in the diagnosis of depression. Support workers and doctors need to look for depressive mood, sleep and appetite disturbance, weight loss or gain, social isolation, and loss of energy and interest, Dr Iacono said.

The centre hopes to recruit up to 75 people throughout Victoria with intellectual disabilities who live in community residential units, and their support workers and GPs to help refine the screening tools.

"We hope the checklist will help support workers decide if a visit to a GP is warranted because of suspected depression and will also be useful to the doctor," Dr Iacono said.

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