Assessment of depression

Depression is under-recognised and undertreated in people with developmental disability.

Note: Depression is under-recognised and undertreated in people with developmental disability.

Diagnosis of depression is discussed in the Psychotropic guidelines. Depressed mood may encompass feelings of numbness, anxiety, irritability and anger. Additional observable features that may aid in the diagnosis of depression in a person with developmental disability are listed in Observable features that may indicate depression in a person with developmental disability.

Assessment of a person with developmental disability presenting with features of depression should take into consideration recent bereavement or grief, and current or past exposure to abuse and trauma.

Table 1. Observable features that may indicate depression in a person with developmental disability
Core symptoms	Observable features
depressed mood	tearful appearing sad smiling or laughing less or not at all wailing, increased vocalisation restricted facial expression
irritable mood	short tempered verbally or physically aggressive, including damaging property
loss of interest or pleasure	refusing to, or needing prompting to, participate in routine activities no longer enjoying favourite activities unable to be cheered up
increased anxiety	seeking reassurance questioning repetitively increasing repetitive behaviours
general features	spending more time alone talking to, or interacting with, others less losing skills no longer completing tasks disorganised behaviour suicidal ideation or attempts self-injurious behaviour
biological manifestations	changing sleep pattern getting up during the night getting up early difficult to wake up in the morning eating more or less losing or gaining weight showing psychomotor agitation or retardation low energy
exaggeration of pre-existing behaviours	changes to baseline challenging behaviour, repetitive behaviours, aggression
loss of baseline level of daily function	decline in self-care, communication