{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T03:30:29Z","timestamp":1791862229787,"version":"4.3.4"},"reference-count":28,"publisher":"Royal College of Psychiatrists","issue":"5","license":[{"start":{"date-parts":[[2018,3,15]],"date-time":"2018-03-15T00:00:00Z","timestamp":1521072000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Br J Psychiatry"],"published-print":{"date-parts":[[2018,5]]},"abstract":"<jats:sec id=\"S0007125018000120_sec_a1\"><jats:title>Background<\/jats:title><jats:p>Incidence and determinants of affective disorders among adults with intellectual disabilities are unknown.<\/jats:p><\/jats:sec><jats:sec id=\"S0007125018000120_sec_a2\"><jats:title>Aims<\/jats:title><jats:p>To investigate affective disorder incidence, and determinants of unipolar depression, compared with general population reports.<\/jats:p><\/jats:sec><jats:sec id=\"S0007125018000120_sec_a3\" sec-type=\"methods\"><jats:title>Method<\/jats:title><jats:p>Prospective cohort study measuring mental ill health of adults with mild to profound intellectual disabilities living within a defined community, over 2 years.<\/jats:p><\/jats:sec><jats:sec id=\"S0007125018000120_sec_a4\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>There was 70% cohort retention (<jats:italic>n<\/jats:italic>= 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.<\/jats:p><\/jats:sec><jats:sec id=\"S0007125018000120_sec_a5\" sec-type=\"conclusion\"><jats:title>Conclusions<\/jats:title><jats:p>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.<\/jats:p><\/jats:sec><jats:sec id=\"S0007125018000120_sec_a6\"><jats:title>Declaration of interest<\/jats:title><jats:p>None.<\/jats:p><\/jats:sec>","DOI":"10.1192\/bjp.2018.12","type":"journal-article","created":{"date-parts":[[2018,3,15]],"date-time":"2018-03-15T06:15:21Z","timestamp":1521094521000},"page":"295-300","source":"Crossref","is-referenced-by-count":28,"title":["Incidence of unipolar and bipolar depression, and mania in adults with intellectual disabilities: prospective cohort study"],"prefix":"10.1192","volume":"212","author":[{"given":"Sally-Ann","family":"Cooper","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elita","family":"Smiley","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Allan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jillian","family":"Morrison","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"170","published-online":{"date-parts":[[2018,3,15]]},"reference":[{"key":"S0007125018000120_ref5","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.185.4.350"},{"key":"S0007125018000120_ref4","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291798008058"},{"key":"S0007125018000120_ref3","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291707009968"},{"key":"S0007125018000120_ref2","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.329.7463.414"},{"key":"S0007125018000120_ref17","volume-title":"A Revision of the Vineland Social Maturity Scale by E A Doll","author":"Sparrow","year":"1984"},{"key":"S0007125018000120_ref7","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.107.044461"},{"key":"S0007125018000120_ref10","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2788.1998.00116.x"},{"key":"S0007125018000120_ref8","unstructured":"Scottish Learning Disabilities Observatory. What are Learning Disabilities? How Common are Learning disabilities? Scottish Learning Disabilities Observatory, 2016 (https:\/\/www.sldo.ac.uk\/media\/1610\/what-are-learning-disabilities-how-common-are-learning-disabilities.pdf)."},{"key":"S0007125018000120_ref9","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.bp.106.022483"},{"key":"S0007125018000120_ref28","doi-asserted-by":"publisher","DOI":"10.1046\/j.1365-2788.2001.00374.x"},{"key":"S0007125018000120_ref20","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.186.2.126"},{"key":"S0007125018000120_ref26","doi-asserted-by":"publisher","DOI":"10.1017\/S0790966700006315"},{"key":"S0007125018000120_ref16","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.299.6704.886"},{"key":"S0007125018000120_ref6","doi-asserted-by":"publisher","DOI":"10.1192\/bjp.179.6.523"},{"key":"S0007125018000120_ref1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.39490.543137.80"},{"key":"S0007125018000120_ref18","unstructured":"Cooper S-A. Epidemiology of Psychiatric Disorders in Elderly People with Intellectual Disabilities. MD Thesis. University of London, 1998."},{"key":"S0007125018000120_ref11","unstructured":"Glasgow UCEDD. The C21st Health Check. Glasgow UCEDD, 2001 (http:\/\/www.gla.ac.uk\/media\/media_62785_en.pdf)."},{"key":"S0007125018000120_ref12","volume-title":"DC-LD: Diagnostic Criteria for Psychiatric Disorders for Use with Adults with Learning Disabilities\/Mental Retardation (OP48)","year":"2001"},{"key":"S0007125018000120_ref14","volume-title":"Diagnostic and Statistical Manual of Mental Disorders (4th edn Revised)","year":"2000"},{"key":"S0007125018000120_ref19","doi-asserted-by":"publisher","DOI":"10.1007\/s00127-005-0956-4"},{"key":"S0007125018000120_ref15","unstructured":"Simpson NJ. Psychiatric Disorders in People with Learning Disabilities: Measuring Prevalence and Validating a Screening Instrument. PhD Thesis. 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