Co-occurring Psychiatric Disorders in Individuals with Intellectual Disability

2013 ◽  
pp. 213-243 ◽  
Author(s):  
Joseph N. Ricciardi
Keyword(s):  
Intellectual Disability ◽  
Psychiatric Disorders

scholarly journals Are we training psychiatrists to develop skills in intellectual disability psychiatry? Current European context and future directions

2020 ◽  
Vol 63 (1) ◽  
Author(s):  
Marisa Casanova Dias ◽  
Bhathika Perera ◽  
Florian Riese ◽  
Livia De Picker ◽  
Mariana Pinto da Costa ◽  
...  
Keyword(s):  
Mental Health ◽  
Intellectual Disability ◽  
Mental Health Services ◽  
Health Services ◽  
Intellectual Disabilities ◽  
Psychiatric Disorders ◽  
Psychiatric Training ◽  
Future Directions ◽  
Education And Health ◽  
People With Intellectual Disabilities

Abstract The majority of people with intellectual disabilities (ID) and psychiatric disorders access mainstream mental health services across Europe. However, only 56% of countries provide postgraduate psychiatric training in ID according to a survey across 42 European countries. We explore the challenges of ID training and make recommendations for education and health policymakers.

scholarly journals Psychiatric illness and regression in individuals with Phelan-McDermid syndrome

2020 ◽  
Vol 12 (1) ◽  
Author(s):  
Teresa M. Kohlenberg ◽  
M. Pilar Trelles ◽  
Brittany McLarney ◽  
Catalina Betancur ◽  
Audrey Thurm ◽  
...  
Keyword(s):  
Bipolar Disorder ◽  
Intellectual Disability ◽  
Psychiatric Disorders ◽  
Psychiatric Illness ◽  
Psychiatric Symptoms ◽  
Structured Interview ◽  
Autism Spectrum ◽  
Scaffolding Protein ◽  
International Registry ◽  
Increased Risk

Abstract Background Phelan-McDermid syndrome (PMS) is a genetic condition characterized by intellectual disability, speech and language deficits, hypotonia, autism spectrum disorder, and epilepsy. PMS is caused by 22q13.33 deletions or mutations affecting SHANK3, which codes for a critical scaffolding protein in excitatory synapses. SHANK3 variants are also known to be associated with an increased risk for regression, as well as for psychiatric disorders, including bipolar disorder and catatonia. This study aimed to further describe these phenomena in PMS and to explore any relationship between psychiatric illness and regression after early childhood. Methods Thirty-eight people with PMS were recruited to this study through the Phelan-McDermid Syndrome Foundation based on caregiver report of distinct development of psychiatric symptoms. Caregivers completed a clinician-administered semi-structured interview focused on eliciting psychiatric symptomatology. Data from the PMS International Registry were used to confirm genetic diagnoses of participants and to provide a larger sample for comparison. Results The mean age of the 38 participants was 24.7 years (range = 13 to 50; SD = 10.06). Females (31 of 38 cases; 82%) and sequence variants (15 of 38 cases; 39%) were over-represented in this sample, compared to base rates in the PMS International Registry. Onset of psychiatric symptoms occurred at a mean age of 15.4 years (range = 7 to 32), with presentations marked by prominent disturbances of mood. Enduring substantial loss of functional skills after onset of psychiatric changes was seen in 25 cases (66%). Symptomst indicative of catatonia occurred in 20 cases (53%). Triggers included infections, changes in hormonal status, and stressful life events. Conclusions This study confirms that individuals with PMS are at risk of developing severe neuropsychiatric illness in adolescence or early adulthood, including bipolar disorder, catatonia, and lasting regression of skills. These findings should increase the awareness of these phenotypes and lead to earlier diagnosis and the implementation of appropriate interventions. Our findings also highlight the importance of genetic testing in the work-up of individuals with intellectual disability and acute psychiatric illness or regression. Future research is needed to clarify the prevalence and nature of psychiatric disorders and regression among larger unbiased samples of individuals with PMS.

A guide to psychopharmacological treatment of patients with intellectual disability in psychiatry

2017 ◽  
Vol 52 (2) ◽  
pp. 176-189 ◽  
Author(s):  
Rosa M Molina-Ruiz ◽  
Julia Martín-Carballeda ◽  
Inmaculada Asensio-Moreno ◽  
Francisco Montañés-Rada
Keyword(s):  
Intellectual Disability ◽  
Psychiatric Disorders ◽  
Psychotropic Drugs ◽  
Scientific Evidence ◽  
Future Research ◽  
Review Of The Literature ◽  
Treatment Interventions ◽  
Comorbid Psychiatric Disorders ◽  
Psychopharmacological Treatment ◽  
Increased Risk

Background Subjects with intellectual disability are at increased risk of having comorbid psychiatric disorders and worse response to psychotherapeutic and psychopharmacological treatment interventions. On the other hand, available data on best treatment approach in this population are scarce and lack scientific evidence due to methodological limitations. The present study aims to perform a systematic review of the literature to facilitate the use of psychotropic drugs in clinical practice and better establish future research targets in this field. Objectives To review the available psychopharmacological strategies for patients with intellectual disabilities, psychiatric disorders, and behavioural disturbances. Serve as a quick guide for clinicians working in the field of intellectual disability. Methods We conducted a selective evidence-based review of the literature using Pubmed and EMBASE databases and selected most recent and relevant papers for this review. Results There are several available psychotropic drugs for the treatment of patients with intellectual disability and comorbid psychiatric disorders, although scientific evidence is limited. Treatment should be individualized according to risk–benefit balance. Discussion Further studies are needed and new available drugs should be considered to gain knowledge in effectiveness of different therapeutic approaches available in this population.

Psychiatric Vulnerability in Adults with Intellectual Disability and Autism: A Literature Review

2017 ◽  
Vol 41 (S1) ◽  
pp. S133-S133
Author(s):  
S. Coli ◽  
D. Scuticchio ◽  
M. Bertelli
Keyword(s):  
Mental Health ◽  
Intellectual Disability ◽  
Psychiatric Disorders ◽  
Mental Health Problems ◽  
Challenging Behaviors ◽  
Diagnostic Procedures ◽  
Health Problems ◽  
Autism Spectrum ◽  
Assessment Tools ◽  
Co Morbidity

IntroductionAdults with Intellectual disability (ID) and Autism Spectrum Disorder (ASD) are more vulnerable to mental health problems than the general population.Objectives/aimsThis study investigates presence and rate of psychiatric disorders in comparison with ID or ASD alone, and appropriateness of assessment and diagnostic procedures or tools.MethodsA systematic mapping of the literature was carried out on the basis of the above mentioned issues. The search was conducted using PubMed and ScienceDirect, according to the following keywords: psychiatric comorbidity, psychiatric disorders, autism, ASD, intellectual disability, mental health problems, adults, assessment tools, diagnosis. Twenty-eight papers were selected for pertinence to mapping issues among more than 500.ResultsMany studies show that ASD is an important vulnerability factor for psychiatric co-morbidity and for challenging behaviors (CBs) in adults with ID. Highest rates were reported for psychotic, mood, anxiety, and obsessive-compulsive disorders. Few studies show that the difference between adults with ID plus ASD and adults with only ID are not statistically significant, but for the presence of CBs in those with ID plus ASD. The disagreement of results is based on a variety of factors such as diagnostic over-shadowing, scarcity of specific assessment tools, consideration of the introspective and communication difficulties, incompleteness of medical records, and low reliability of information sources.ConclusionsAlthough low studies concordance, the literature mapping suggests the presence of ASD in ID to be associated with higher rates of psychopathology. Since the relevant implications for prevention and clinical management, further research with high-level evidence is hoped.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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