Obsessive Compulsive Disorder in a Patient with Down Syndrome

Introduction:

Despite the fact that individuals with intellectual disabilities are at an increased risk for psychiatric problems, a fact that has been well documented in scientific literature for decades, many mental health professionals do not properly recognize the co-occurrence of psychiatric disorders and intellectual disorders . Most mental health professionals do not receive training in the diagnosis and treatment of dual diagnosed individuals, and most clinical treatment studies list intellectual disabilities as exclusion criteria. 

Obsessive Compulsive Disorder (OCD) likewise tends to be under recognized and missed during mental health examinations  and even when it is diagnosed properly, mental health clinicians often do not initiate appropriate, evidence based treatment . Therefore, it is not surprising that little is known about the clinical presentation and treatment of OCD in individuals who haveDown Syndrome. We describe a case of OCD in an individual with Down Syndrome in which the diagnosis of OCD was overlooked for four years after first contact with mental health professionals. The treatment of the patient is reviewed, including medication management as well as the challenges in using evidence based psychotherapy.