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Mania and Down's Syndrome

Published online by Cambridge University Press:  02 January 2018

Sally-Ann Cooper  and
Richard A. Collacott
Sally-Ann Cooper*
Affiliation:
Frith Hospital, Groby Road, Leicester LE3 9QF
Richard A. Collacott
Affiliation:
Frith Hospital, Leicester
*
∗Correspondence
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Abstract

Until recently, it was considered that Down's syndrome precluded a diagnosis of mania, or gave rise to an atypical presentation. There have been seven case reports of mania in people with Down's syndrome and all these cases are reviewed. The clinical features of mania are noted to be similar to those previously described in individuals with learning disabilities due to other causes. However, all reported cases are male and none has a family history of affective disorder. In two of the seven men reported, the illness followed a rapid cycling pattern. Hypothyroidism and monoamine biochemistry in people with Down's syndrome are discussed in the context of these atypical features.

Type
Review Article
Information
The British Journal of Psychiatry , Volume 162 , Issue 6 , June 1993 , pp. 739 - 743
Copyright
Copyright © The Royal College of Psychiatrists 

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References

Adams, G. L., Kivowitz, J. & Ziskind, E. (1970) Manic depressive psychosis, mental retardation and chromosomal rearrangement. Archives of General Psychiatry, 23, 305–309.CrossRefGoogle ScholarPubMed
Bauer, M. S., Whybrow, P. C. & Winokur, A. (1990) Rapid cycling bipolar affective disorder I: association with grade I hypothyroidism. Archives of General Psychiatry, 47, 427.Google Scholar
Carlson, G. (1979) Affective psychosis in mental retardates. Psychiatric Clinics of North America, 2, 499–510.Google Scholar
Collacott, R. A., Cooper, S.-A. & McGrother, C. (1992) Differential rates of psychiatric disorders in adults with Down's syndrome compared to other mentally handicapped adults. British Journal of Psychiatry, 161, 671–674.Google Scholar
Cook, E. D. & Levanthal, B. L. (1987) Down's syndrome with mania. British Journal of Psychiatry, 150, 249–250.Google Scholar
Cooper, S.-A. & Collacott, R. A. (1991) Manic episodes in Down's syndrome: two case reports. Journal of Nervous and Mental Diseases, 179, 635–636.Google Scholar
Cooper, S.-A. & Collacott, R. A. & Hauck, A. (1993) Late onset mania in Down's syndrome. Journal of Intellectual Disability Research (in press).Google Scholar
Corbett, J. A. (1979) Psychiatric morbidity and mental retardation. In Psychiatric Illness and Mental Handicap (eds James, E. E. & Snaith, R. P.), pp. 11–25. London: Gaskell Press.Google Scholar
Cowdry, R. W., Wehr, T. A., Zis, A. P., et al (1983) Thyroid abnormalities associated with rapid cycling bipolar illness. Archives of General Psychiatry, 40, 414–420.Google Scholar
Day, K. (1985) Psychiatric disorder in the middle-aged and elderly mentally handicapped. British Journal of Psychiatry, 147, 660–667.Google Scholar
Duncan, A. G., Penrose, I. S. & Turnbull, R. C. (1936) A survey of the patients of a large mental hospital. Journal of Neurological Psychopathology, 16, 225–238.Google Scholar
Feighner, J., Robins, E., Guse, S. B., et al (1972) Diagnostic criteria for use in psychiatric research. Archives of General Psychiatry, 26, 57–63.Google Scholar
Glue, P. (1989) Rapid cycling affective disorders in the mentally retarded. Biological Psychiatry, 26, 250–256.Google Scholar
Heaton-Ward, A. (1977) Psychosis in mental handicap. British Journal of Psychiatry, 130, 525–533.Google Scholar
Hucker, S. J., Day, K. A., George, S., et al (1979) Psychosis in mentally handicapped adults. In Psychiatric Illness and Mental Handicap (eds James, E. E. & Snaith, R. P.), pp. 27–35. London: Gaskell Press.Google Scholar
Jerome, H. (1962) Abnormalities of tryptophan metabolism in mongolism. Bulletins et memoires de la Societi Medicate des Hopitaux de Paris, 113, 168–172.Google Scholar
Kadambari, S. R. (1986) Manic-depressive psychosis in a mentally handicapped person: diagnosis and management. British Journal of Psychiatry, 148, 595–596.Google Scholar
Keegan, D. L., Pettigrew, S. & Parker, Z. (1974) Psychosis in Down's syndrome treated with amitriptyline. Canadian Medical Association Journal, 110, 1128–1129.Google Scholar
Kerebeshian, J., Burd, L. & Fisher, W. (1987) Lithium carbonate in the treatment of 2 patients with infantile autism and atypical bipolar symptomatology. Journal of Clinical Psychopharmacology, 7, 401–405.Google Scholar
McCoy, E. E., Anast, C. S. & Naylor, J. J. (1964) The excretion of oxalic acid following deoxypyridoxine and tryptophan administration in mongoloid and non-mongoloid subjects. Journal of Paediatrics, 65, 208–214.Google Scholar
McLaughlin, M. (1987) Bipolar affective disorder in Down's syndrome. British Journal of Psychiatry, 151, 116–117.Google Scholar
Mann, D. M. A., Lincoln, J., Yates, P. O., et al (1980) Monoamine metabolism in Down's syndrome. Lancet, ii, 1366–1367.CrossRefGoogle Scholar
Mann, D. M. A., Yates, P. O. & Hawkes, J. (1982) Plaques, tangles and neurotransmitter deficiencies in dementia. Journal of Neurology, Neurosurgery and Psychiatry, 45, 563.Google Scholar
Mann, D. M. A., Yates, P. O., Marcynuik, B., et al (1985) Pathological evidence for neurotransmitter deficits in Down's syndrome of middle age. Journal of Mental Deficiency Research, 29, 125–135.Google ScholarPubMed
Naylor, G. J., Donald, J. M., Le Poidevin, D., et al (1974) A double-blind trial of long-term lithium therapy in mental defectives. British Journal of Psychiatry, 124, 52–57.Google Scholar
Nyberg, P., Carlsson, A. & Winblad, B. (1982) Alzheimer-like brain monoaminergic deficiency in cases of Down's syndrome. Journal of Neurological Transmission, 55, 289.Google Scholar
O'Brien, D. & Groshek, A. (1962) The abnormality of tryptophan metabolism in children with mongolism. Archives of Disease in Childhood, 37, 17–20.Google Scholar
Payne, R. (1968) The psychotic subnormal. Journal of Mental Subnormality, 14, 25–34.CrossRefGoogle Scholar
Penrose, L. S. (1962) The Biology of Mental Defectives. New York: Grune & Stratton.Google Scholar
Pollock, H. M. (1945) Mental disease among mental defectives. American Journal of Mental Deficiency, 49, 477–480.Google Scholar
Post, R. M. (1987) Carbamazepine and lithium: endocrine and biochemical aspects. Second British Lithium Congress, p. 7. Northampton: Northampton Polytechnic.Google Scholar
Reid, A. H. (1972) Psychoses in adult mental defectives I: manic depressive psychosis. British Journal of Psychiatry, 120, 205–212.Google Scholar
Reid, A. H. & Naylor, G. J. (1976) Short cycle manic depressive psychosis in mental defectives: a clinical and physiological study. Journal of Mental Deficiency Research, 20, 67–76.Google ScholarPubMed
Reynolds, G. P. & Godridge, H. (1985) Alzheimer-like brain monoamine deficits in adults with Down's syndrome. Lancet, ii, 1368–1369.CrossRefGoogle Scholar
Richardson, S. A., Katz, A., Koller, H., et al (1979) Some characteristics of a population of mentally retarded young adults in a British city: a basis for estimating some service needs. Journal of Mental Deficiency Research, 23, 275–286.Google Scholar
Rivinus, T. M. & Harmatz, J. S. (1979) Diagnosis and lithium treatment of affective disorders in the retarded: 5 case studies. American Journal of Psychiatry, 136, 551.Google Scholar
Roith, A. I. (1961) Psychotic depression in a mongol. Journal of Mental Subnormality, 7, 45–47.Google Scholar
Rosner, F., Ong, B. H., Paine, R. S., et al (1965) Blood serotonin activity in trisomic and translocation Down's syndrome. Lancet, ii, 1191–1193.Google Scholar
Rutter, M., Tizard, J. & Whitmore, K. (1970) Education, Health and Behaviour. London: Longman.Google Scholar
Singh, I. & Zolese, G. (1986) Is mania really incompatible with Down's syndrome? British Journal of Psychiatry, 148, 613–614.Google Scholar
Sovner, R. (1989) The use of valproate in the treatment of mentally retarded persons with typical and atypical bipolar disorders. Journal of Clinical Psychiatry, 50 (suppl. 3), 40–43.Google Scholar
Sovner, R. (1991) Divalproex-responsive rapid cycling bipolar disorder in a patient with Down's syndrome: implications for the Down's syndrome-mania hypothesis. Journal of Mental Deficiency Research, 35, 171–173.Google Scholar
Sovner, R. & Desnoyers Hurley, A. (1983) Do the mentally retarded suffer from affective illness? Archives of General Psychiatry, 40, 319–320.Google Scholar
Stancer, H. & Persad, E. (1982) Treatment of intractable rapid cycling manic-depressive disorder with levothyroxine: clinical observations. Archives of General Psychiatry, 39, 311–312.CrossRefGoogle ScholarPubMed
Steingard, R. & Biederman, J. (1987) Lithium responsive manic-like symptoms in two individuals with autism and mental retardation. Journal of American Academy of Child and Adolescent Psychiatry, 26, 932–935.Google Scholar
Storm, W. (1990) Differential diagnosis and treatment of depressive features in Down's syndrome: a case illustration. Research in Developmental Disabilities, 1, 131–137.Google Scholar
Tu, J. B. & Zellweger, H. (1965) Blood serotonin deficiency in Down's syndrome. Lancet, ii, 715–717.CrossRefGoogle Scholar
Van Krevelen, V. D. A. & Van Voorst, J. A. (1959) Lithium in der behandlung einer psychose unklarer genese bei einem jugendlichen. Acta Paediopsychiatr, 26, 148–152.Google Scholar
Warren, A. C., Holroyd, S. & Folstein, M. F. (1989) Major depression in Down's syndrome. British Journal of Psychiatry, 155, 202–205.CrossRefGoogle ScholarPubMed
Wehr, T. A., Sack, D. A., Rosenthal, N. E., et al (1988) Rapid cycling affective disorder: contributing factors and treatment responses in 51 patients. American Journal of Psychiatry, 145, 179–184.Google Scholar
Wright, E. C. (1982) The presentation of mental illness in mentally retarded adults. British Journal of Psychiatry, 141, 496–502.Google Scholar
Yates, C. M., Ritchie, I. M., Simpson, J., et al (1981) Noradrenaline in Alzheimer-type dementia and Down's syndrome. Lancet, ii, 39.Google Scholar
Yates, C. M., Simpson, J., Gordon, A., et al (1983) Catecholamine and cholinergic enzymes in presenile and senile Alzheimer-type dementia and Down's syndrome. Brain Research, 280, 119.CrossRefGoogle ScholarPubMed
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