Children with intellectual and developmental disabilities have increased risks of depression and anxiety
1. Children who had an intellectual and developmental disabilities (IDD) had significantly higher risks of depression and anxiety compared with those without IDD
2. The association between IDD and having depression and anxiety was strongest among males, those with mild comorbidity burdens, and younger children and urban residents compared to their counterparts who did not have IDD.
Evidence Rating Level: 2 (Good)
Study Rundown: The global prevalence of IDD among children and adolescents in 2019 was 2%. Especially among children and adolescents, neurodevelopmental conditions have significant impacts and implications on their health and wellbeing. In this population based retrospective cohort study, researchers investigated the risks of developing depression and anxiety among children with IDD. The data for the study came from South Korea’s National Health Insurance Service database (NHIS) and National Disability Registration System (NDRS). In total, 236132 children were included as part of the study. The ages ranged from 2-17 years and those diagnosed with IDD were matched in a 1:3 ratio with children without developmental disorders, by sex and birth year. The results of this study demonstrated that children with IDD head significantly higher risk of having depression and anxiety and compared to children without IDD. The study was limited by its reliance on administrative health records, which may have resulted in misclassification of IDD, depression, and anxiety diagnoses, as well as an inability to account for potentially important confounding factors. Additionally, the observational study design limits causal interpretation, and the findings may not be generalizable to populations outside South Korea.
Click to read this study in JAMA
Relevant Reading: Co-Occurring Conditions in Autism: Understanding the Overlap with Anxiety, Depression, and More
In-Depth [retrospective cohort]: In this retrospective cohort, the date of IDD diagnosis was defined as the date of first registration in the National Disability Registration System (NDRS). As such, it is important to note that this may not reflect the exact age at which symptoms first appeared. Children registered with IDD before the age of two were excluded, as were those with a previous diagnosis of depression or anxiety or those who developed either condition within the first year after baseline. These exclusion criteria were applied uniformly to participants with and without IDD, who were matched at a 1:3 ratio. Overall, 25% of the 236,132 children had IDD. Among these children, 20.1% were diagnosed with depression and 21.9% with anxiety during follow-up. Compared with children without developmental disorders, children with IDD had higher relative risks of depression and anxiety, particularly among males (adjusted HR [AHR], 2.46 [95% CI, 2.39–2.54] and 2.06 [95% CI, 2.00–2.12], respectively) and urban residents (AHR, 2.36 [95% CI, 2.25–2.48] and 1.97 [95% CI, 1.88–2.06], respectively). Younger age was also associated with higher relative risks of depression and anxiety among children with IDD compared with children without developmental disorders, particularly among those aged 2–5 years (AHR, 2.83 [95% CI, 2.66–3.01] and 2.41 [95% CI, 2.27–2.55], respectively) and those aged 6–8 years (AHR, 2.51 [95% CI, 2.40–2.64] and 2.12 [95% CI, 2.02–2.22], respectively). The findings of the study highlight the importance of increased mental health screening and targeted interventions based on patients’ sociodemographic backgrounds and existing comorbidities. Improved access to mental health resources may help address the increased risks of depression and anxiety in this population.
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