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Spectrum of cognitive, behavioural and emotional problems in children and young adults with Down syndrome

  • R. Nicham
  • R. Weitzdörfer
  • E. Hauser
  • M. Freidl
  • M. Schubert
  • E. Wurst
  • G. Lubec
  • R. Seidl
Part of the Journal of Neural Transmission Supplement 67 book series (NEURAL SUPPL, volume 67)

Summary

In comparison to most other groups with intellectual disability individuals with Down syndrome are at lower risk for significant psychopathology, although relative to their typically developing peers they have higher rates of behavioural and emotional problems. A total of 43 Down syndrome patients (21 females and 22 males), who ranged in age from 5.33 to 30.58 years, were examined for the presence of age-related changes in the spectrum of externalizing and internalizing problems. Intelligence tests included Hamburg-Wechsler-Intelligenz Test für Kinder III (HAWIK-III), HamburgWechsler-Intelligenz Test für Erwachsene (HAWIE-R) and KaufmanAssessment-Battery for Children, German Version (K-ABC). Behavioural and emotional problems were assessed by the the Strengths and Difficulties Questionnaire for Parents, German Version (SDQ) and the Clinical Assessment Scale for Child and Adolescent Psychopathology (CASCAP). IQ was significantly inversly related to the age of patients. Externalizing behaviours (dominant, opposing/refusing, impulsiveness, inattention and increased motor activity) were significantly higher in the 5–10 years old group, whereas internalizing behaviours (shy/insecure, low selfconfidence, decreased motor activity) where more prevalent in adolescents and adults (10–30 years). Possible relationships between this age-related changes and increased risks of later-onset psychopathology (depression and dementia) are discussed.

Keywords

Down Syndrome Intellectual Disability Emotional Problem Maladaptive Behaviour Down Syndrome Patient 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

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References

  1. Aylward E, Burt D, Thorpe L, Lai F, Dalton A (1997) Diagnosis of dementia in individuals with intellectual disability: report of the task force for development of criteria for diagnosis of dementia in individuals with mental retardation. J Intellect Disabil Res 41: 152–164PubMedCrossRefGoogle Scholar
  2. Bazelon M, Paine RS, Coeiw VA, Hunt P, Houck JC, Mahanand D (1967) Reversal of hypotonia in infants with Down’s syndrome by administration of 5hydroxytryptophan. Lancet i: 1130–1133Google Scholar
  3. Burt D, Loveland K, Primeaux-Hart S, Chen Y, Phillips N, Cleveland L, Lewis K, Lesser J, Cummings E (1998) Dementia in adults with Down Syndrome: diagnostic challenges. Am J Ment Retard 103: 130–145PubMedCrossRefGoogle Scholar
  4. Coe DA, Matson JL, Russell DW, Slifer KJ, Capone GT, Baglio C, Stallings S (1999) Behavior problems of children with Down syndrome and life events. J Autism Dev Disord 29: 149–156PubMedCrossRefGoogle Scholar
  5. Coleman M (1971) Infantile spasms associated with 5-hydroxytryptophan administered in patients with Down’s syndrome. Neurol 21: 911–919CrossRefGoogle Scholar
  6. Collacott RA (1999) People with Down syndrome and mental health needs. In: Bouras N (ed) Psychiatric and behavioural disorders in developmental disabilities and mental retardation. Cambridge University Press, Cambridge, pp 200–211Google Scholar
  7. Collacott RA, Cooper S, McGrother C (1992) Differential rates of psychiatric disorders in adults with Down’s syndrome compared to other mentally handicapped adults. Br J Psychiatry 161: 671–674PubMedCrossRefGoogle Scholar
  8. Collacott RA, Cooper SA, Branford D, McGrother C (1998) Behaviour phenotype for Down’s syndrome. Br J Psychiatry 172: 85–89PubMedCrossRefGoogle Scholar
  9. Cooper SA, Prasher VP (1998) Maladaptive behaviours and symptoms of dementia in adults with Down’s syndrome compared with adults with intellectual disability of other aetiologies. J Intellect Disabil Res 42: 293–300PubMedCrossRefGoogle Scholar
  10. Cuskelly M, Dadds M (1992) Behavioural problems in children with Down’s syndrome and their siblings. J Child Psychol Psychiatry 33: 749–761PubMedCrossRefGoogle Scholar
  11. Cuskelly M, Gunn P (1997) Behavior concerns. In: Pueschel SM, Sustrova M (eds) Adolescents with Down Syndrome. Paul H. Brookes, Baltimore London Toronto Sydney, pp 111–127Google Scholar
  12. Dalton A (1992) Dementia in Down syndrome: methods of evaluation. In: Nadel L, Epstein C (eds) Down Syndrome and Alzheimer disease. Wiley-Liss, New York, pp 51–76Google Scholar
  13. Döpfner M, Berner W, Flechtner H, Lehmkuhl G, Steinhausen H-C (1999) Clinical Assessment Scale for Child and Adolescent Psychopathology. Hogrefe, Göttingen Bern Toronto SeattleGoogle Scholar
  14. Dykens EM, Kasari C (1997) Maladaptive behaviour in children with Prader-Willi syndrome, Down syndrome, and non-specific mental retardation. Am J Ment Retard 102: 228–237PubMedCrossRefGoogle Scholar
  15. Dykens EM, Hodapp RM, Evans DW (1994) Profiles and development of adaptive behavior in children with Down syndrome. Am J Ment Retard 98: 580–587PubMedGoogle Scholar
  16. Dykens EM, Shah B, Sagun J, Beck T, King BH (2002) Maladaptive behaviour in children and adolescents with Down’s syndrome. J Intellect Disabil Res 46: 484–492PubMedCrossRefGoogle Scholar
  17. Einfeld SL, Tonge BJ (1996) Population prevalence of psychopathology in children and adolescents with intellectual disability. II. Epidemiological findings. J Intellect Disabil Res 40: 99–109PubMedCrossRefGoogle Scholar
  18. Epstein CJ (1995) Down Syndrome (Trisomy 21). In: Scriver SR, Beaudet AL, Sly WS, Valle D (eds) The metabolic and molecular bases of inherited disease. McGraw-Hill, New York, pp 749–794Google Scholar
  19. Frankenburg WK, Dodds JB (1990) Denver II developmental screening test. In: Stanhope M, Knollmueller RN (1992) Handbook of community and home health-nursing: tools for assessment intervention and education. Mosby, St. Louis, pp 317–319Google Scholar
  20. Gath A, Gumley D (1986) Behaviour problems in retarded children with special reference to Down’s syndrome. Br J Psychiatry 149: 156–161PubMedCrossRefGoogle Scholar
  21. Gath A, Gumley D (1987) Retarded children and their siblings. J Child Psychol Psychiatry 5: 715–730CrossRefGoogle Scholar
  22. Gedye A (1990) Dietary increase in serotonin reduces self-injurious behaviour in a Down’s syndrome adult. J Ment Defic Res 34: 195–203PubMedGoogle Scholar
  23. Gedye A (1991) Serotonergic treatment of aggression in a Down’s syndrome adult showing signs of Alzheimer’s disease. J Ment Defic Res 35: 247–258PubMedGoogle Scholar
  24. Geldmacher DS, Lerner AJ, Voci JM, Noelker EA, Somple LC, Whitehouse PJ (1997) Treatment of functional decline in adults with Down syndrome using selective serotonin-reuptake inhibitor drugs. J Geriatr Psychiat Neurol 10: 99–104Google Scholar
  25. Gibson D, Groenewez G, Jerry P, Harris A (1988) Age and pattern of intellectual decline among Down Syndrome and other mentally retarded adults. Int J Rehabil Res 11: 47–55PubMedCrossRefGoogle Scholar
  26. Godridge H, Reynolds GP, Czudek C, Calcutt NA, Benton M (1987) Alzheimer-like neurotransmitter deficits in adult Down’s syndrome brain tissue. J Neurol Neurosurg Psychiatry 50: 775–778PubMedCrossRefGoogle Scholar
  27. Goodman R (1997) The strengths and difficulties questionnaire for parents, German version. J Child Psychol Psychiatry 38: 581–586PubMedCrossRefGoogle Scholar
  28. Haxby JV (1989) Neuropsychological evaluation of adults with Down’s syndrome: patterns of selective impairment in nondemented old adults. J Ment Defic Res 33: 193–197PubMedGoogle Scholar
  29. Haxby JV, Schapiro MB (1992) Longitudinal study of neuropsychological functions in older adults with Down syndrome. In: Epstein C, Nadel L (eds) Down syndrome and Alzheimer disease. Wiley Liss, New York, pp 35–50Google Scholar
  30. Helmstaedter C, Lendt M, Lux S (2001) Verbaler Lern-and Merkfähigkeitstest. Beltz, GöttingenGoogle Scholar
  31. Holland AJ, Hon J, Huppert FA, Stevens F, Watson P (1998) Population based study on the prevalence and presentation of dementia in adults with Down’s syndrome. Br J Psychiatry 172: 493–498PubMedCrossRefGoogle Scholar
  32. Holland AJ, Hon J, Huppert FA, Stevens F (2000) Incidence and course of dementia in people with Down’s syndrome: findings from a population-based study. J Intellect Disabil Res 44: 138–146PubMedCrossRefGoogle Scholar
  33. Johnson J, Head E, Kim R, Starr A, Cotman C (1999) Clinical and pathological evidence for a frontal variant of Alzheimer’s disease. Arch Neurol 56: 1233–1239PubMedCrossRefGoogle Scholar
  34. Lai F, Williams R (1989) A prospective study of Alzheimer disease in Down syndrome. Arch Neurol 46: 849–853PubMedCrossRefGoogle Scholar
  35. Lai F, Kammann E, Rebeck GW, Anderson A, Chen Y, Nixon RA (1999) APOE genotype and gender effects on Alzheimer disease in 100 adults with Down syndrome. Neurol 53: 331–336CrossRefGoogle Scholar
  36. Maluck A, Melchers P (1998) Kaufman Assessment Battery for Children. Differential evaluation of (partial) intellectual ability of mentally handicapped adults. Nervenarzt 69: 1007–1014PubMedCrossRefGoogle Scholar
  37. Mann DM, Yates PO, Marcyniuk B, Rawndra CR (1985) Pathological evidence for neurotransmitter deficits in Down’s syndrome of middle age. J Ment Defic Res 29: 125–135PubMedGoogle Scholar
  38. McCarthy J, Boyd J (2001) Psychopathology and young people with Down’s syndrome: childhood predictors and adult outcome of disorder. J Intellect Disabil Res 45: 99–105PubMedCrossRefGoogle Scholar
  39. Melchers P, Preuß U (1991) Kaufman-Assessment-Battery for Children, German Version. Swets & Zeitlinger, AmsterdamGoogle Scholar
  40. Myers BA (1997) Psychiatric disorders. In: Pueschel SM, Sustrova M (eds) Adolescents with Down Syndrome. Paul H. Brookes, Baltimore London Toronto Sydney, pp 129–142Google Scholar
  41. Myers BA, Pueschel SM (1991) Psychiatric disorders in population with Down syndrome. J New Ment Dis 179: 609–613CrossRefGoogle Scholar
  42. Nelson LD, Orme D, Osann K, Lott IT (2001) Neurological changes and emotional functioning in adults with Down Syndrome. J Intellect Disabil Res 45: 450–456PubMedCrossRefGoogle Scholar
  43. Pietrini P, Alexander GE, Furey ML, Hampel H, Guazelli M (2000) The neurometabolic landscape of cognitive decline: in vivo studies with positron emission tomography in Alzheimer’s disease. Int J Psychophysiol 37: 87–98PubMedCrossRefGoogle Scholar
  44. Pueschel SM, Bernier JC, Pezzullo JC (1991) Behavioural observations in children with Down’s syndrome. J Ment Defic Res 35: 502–511PubMedGoogle Scholar
  45. Risser D, Lubec G, Cairns N, Herrera-Marschitz M (1997) Excitatory amino acids and monoamines in parahippocampal gyrus and frontal cortical pole of adults with Down syndrome. Life Sci 60: 1231–1237PubMedCrossRefGoogle Scholar
  46. Rutter M, Tizard J, Yule W, Graham P, Whitmore K (1976) Research report: Isle of Wight Studies, 1964–1974. Psychol Med 6: 313–332PubMedCrossRefGoogle Scholar
  47. Seidl R, Kaehler ST, Prast H, Singewald N, Cairns N, Gratzer M, Lubec G (1999) Serotonin (5-HT) in brains of adult patients with Down syndrome. J Neural Transm [Suppl] 57: 221–232Google Scholar
  48. St.Clair DF, Blackwood D (1985) Premature senility in Down’s syndrome. Lancet 6: 34CrossRefGoogle Scholar
  49. Stores R, Stores G, Fellows B, Buckley S (1998) Daytime behaviour problems and maternal stress in children with Down’s syndrome, their siblings, and non-intellectually disabled and other intellectually disabled peers. J Intellect Disabil Res 42: 228–237PubMedCrossRefGoogle Scholar
  50. Tewes U (1994) Hamburg-Wechsler-Intelligenztest für Erwachsene. Huber, Bern Göttingen Toronto SeattleGoogle Scholar
  51. Tewes U, Rossmann P, Schallberger U (2000) Hamburg-Wechsler-Intelligenz Test für Kinder I II. Huber, Bern Göttingen Toronto SeattleGoogle Scholar
  52. Turner S, Sloper P (1996) Behaviour problems among children with Down’s Syndrome: prevalence, persistence and parental appraisal. J Appl Res Intellect Disabil 9: 129–144CrossRefGoogle Scholar
  53. Tyrrell J, Cosgrave M, McCarron M, McPherson J, Calvert J, Kelly A, McLaughlin M, Gill M, Lawlor BA (2001) Dementia in people with Down’s syndrome. Int J Geriatr Psychiatry 16: 1168–1174PubMedCrossRefGoogle Scholar
  54. Visser FE, Aldenkamp AP, van Huffelen AC, et al. (1997) Prospective study of the prevalence of Alzheimer-type dementia in institutionalised individuals with Down syndrome. Am J Ment Retard 101: 400–412PubMedGoogle Scholar
  55. Warren AC, Holroyd S, Folstein P (1989) Major depression in Down’s syndrome. Br J Psychiatry 155: 202–207PubMedCrossRefGoogle Scholar
  56. Warren AC, Holroyd S, Folstein MP (1990) Mayor depression in Down’s syndrome. Br J Psychiatry 155: 202–205CrossRefGoogle Scholar
  57. Weise P, Koch R, Shaw KNF, Rosenfeld MJ (1974) The use of 5-HTP in the treatment of Down’s syndrome. Pediatr 54: 165–167Google Scholar
  58. Wisniewski KE, Wisniewski HM, Wen GY (1985) Occurrence of neuropathological changes and dementia of Alzheimer’s disease in Down syndrome. Ann Neurol 17: 278–282PubMedCrossRefGoogle Scholar
  59. Yates CM, Simpson J, Gordon A (1986). Regional brain 5-hydroxytryptamine levels are reduced in senile Down’s syndrome as in Alzheimer’s disease. Neurosci Lett 65: 189–192PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag 2003

Authors and Affiliations

  • R. Nicham
    • 1
  • R. Weitzdörfer
    • 1
  • E. Hauser
    • 1
  • M. Freidl
    • 1
  • M. Schubert
    • 1
  • E. Wurst
    • 1
  • G. Lubec
    • 1
  • R. Seidl
    • 1
    • 2
  1. 1.Department of PediatricsUniversity of ViennaAustria
  2. 2.Department of PediatricsUniversity of ViennaViennaAustria

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