Factors associated with depression and anxiety in children with intellectual disabilities.
D G Whitney, D N Shapiro, M D Peterson and 1 others
PMID 30588708WHAT IT FOUND
Children with intellectual disability who also had autism, ADHD, frequent pain, or bullying were more likely to have depression or anxiety.
Hispanic children with intellectual disability and children with Down syndrome were less likely. This cannot show cause.
Key findings
01Depression or anxiety problems were reported in 35.4% of children with intellectual disability aged 6 to 17 years in the weighted national survey sample.
02Autism, ADHD, pain, and bullying were associated with higher odds of depression or anxiety problems, while Hispanic race and Down syndrome were associated with lower odds; intellectual disability severity, epilepsy, cerebral palsy, physical activity, sleep duration, and activity participation were not.
03Comorbid autism and ADHD had an adjusted odds ratio of 24.4 for depression or anxiety problems compared with children without either condition.
STILL TO COME
How it was doneWhat they foundWhat it means for OTs
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What it does not show
The study was cross-sectional, so it cannot show whether autism, ADHD, pain, bullying, Down syndrome, or Hispanic race caused depression or anxiety, or whether depression or anxiety influenced these factors. Parent or guardian proxy report was not validated against medical records, and children with intellectual disability may have difficulty recognising or communicating feelings, increasing misreporting. Depression and anxiety were combined into one outcome, so the study cannot separate factors that relate to depression from factors that relate to anxiety. Intellectual disability severity was based on subjective parent report as mild or moderate/severe. Physical activity, sleep duration, and activity participation were measured broadly and did not capture type, intensity, sleep quality, or quality of social inclusion. The analysis did not adjust for geographic location or urban/rural location. Several variables were not administered to children younger than 6 years, so the sample was restricted to children aged 6-17 years.
The easy way to misread this
Do not read these associations as proof that treating pain, bullying, autism, or ADHD will reduce depression or anxiety. The study was cross-sectional, used combined depression and anxiety outcomes, and relied on unvalidated parent report, so it cannot establish cause or condition-specific effects.