Additional considerations for mood disorders in people with

intellectual disability

People with mild or moderate intellectual disability experience similar symptoms of depression as the general population, although the symptoms may not be pervasive. The symptoms may not be as obvious in settings that are less stressful or have higher levels of positive support. Modified criteria are recommended for people who have severe or profound intellectual disability as symptoms can be very different in this population. Behavioural symptoms are increasingly common with increasing severity of intellectual disability and these include screaming, disruptive or destructive behaviour, verbal and physical aggression and self-injurious behaviour. New behaviour problems can emerge and longstanding problem behaviours may increase in severity or frequency. Depressed mood or loss of enjoyment in activities may not be evident and irritability may be more prominent than depressed mood. Eating and appetite changes may not be noticeable, particularly when people are highly supported at mealtimes. People with intellectual disability may find it difficult to understand or communicate about complex themes, such as guilt and significant negative thinking may not be a feature. Alternatively some people with intellectual disability may have felt helpless and have had low self-image for a long time, due to stigma, limited social opportunities and differences in physical appearance.
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