Depression in mentally handicapped patients: diagnostic and neuroendocrine evaluation

The dexamethasone suppression test was administered to 12 mentally handicapped depressed patients. One of the four patients with major depressive disorder, but none of those with other diagnoses, failed to suppress cortisol production. The International Classification of Diseases and the Newcastle Diagnostic Index were found to be unreliable for use with severely mentally handicapped patients. Modifications are proposed which would allow the Research Diagnostic Criteria and Hamilton Rating Scale for Depression to be applied to patients with any degree of mental handicap.