Psych Vivas · Intellectual disability psychiatry — Down syndrome
Down syndrome and mental health — structured clinical viva
Fellowship viva on DS mental health: APP mechanism, depression vs dementia, medical mimics, assessment tools, start-low go-slow prescribing.
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Study tools
Target exams
Interpretation
Reveal interpretationShowHide
Open with structure. Baseline versus current function; depression vs dementia vs medical mimics; risk and capacity; multiagency plan.[1][7]
APP link. Extra APP on chromosome 21 → amyloid overproduction → early AD neuropathology and high clinical dementia risk; Fortea maps biomarker continuum; Holland shows population prevalence rising with age.[2][3][4]
Depression vs dementia. Subacute mood/behavioural syndrome with potential recovery versus progressive multi-domain adaptive loss; they can co-exist. Mantry: mental ill-health pattern in DS is not identical to other ID groups.[7][8]
Tools. DSQIID screens; modified CAMDEX informant interview supports structured diagnosis.[5][6]
Treat depression. Medical work-up first; adapted supports + SSRI start-low go-slow; monitor; reassess cognition after mood improves.[7]
Mimics. Thyroid, OSA, sensory loss, pain, medications, delirium — treat these as psychiatric care.[1]
References8ShowHide
- [1]Antonarakis SE, Skotko BG, Rafii MS, et al. Down syndrome Nat Rev Dis Primers, 2020.PMID 32029743
- [2]Zigman WB, Lott IT Alzheimer's disease in Down syndrome: neurobiology and risk Ment Retard Dev Disabil Res Rev, 2007.PMID 17910085
- [3]Holland AJ, Hon J, Huppert FA, et al. Population-based study of the prevalence and presentation of dementia in adults with Down's syndrome Br J Psychiatry, 1998.PMID 9828989
- [4]Fortea J, Vilaplana E, Carmona-Iragui M, et al. Clinical and biomarker changes of Alzheimer's disease in adults with Down syndrome Lancet, 2020.PMID 32593336
- [5]Ball SL, Holland AJ, Huppert FA, et al. The modified CAMDEX informant interview is a valid and reliable tool for use in the diagnosis of dementia in adults with Down's syndrome J Intellect Disabil Res, 2004.PMID 15312062
- [6]Deb S, Hare M, Prior L, Bhaumik S Dementia screening questionnaire for individuals with intellectual disabilities Br J Psychiatry, 2007.PMID 17470960
- [7]Walker JC, Dosen A, Buitelaar JK, Janzing JG Depression in Down syndrome: a review of the literature Res Dev Disabil, 2011.PMID 21392935
- [8]Mantry D, Cooper SA, Smiley E, et al. The prevalence and incidence of mental ill-health in adults with Down syndrome J Intellect Disabil Res, 2008.PMID 18197953