3.5 Learning disability and psychiatric illness Flashcards
What is the criteria for learning disability?
IQ
What does dual diagnosis mean?
It means a diagnosis of psychiatric disorder in people with learning disability
3x more common to have psychiatric disorder vs. avg
What are some causes of challenging behaviour?
Physical: ear or tooth pain, epilepsy, constipation
Environmental: abuse, deaths/loss, changes
Mental: depression, psychosis
What assessment should you do in Learning disability?
Nature and severity of LD Current problems, and their history Predisposing, ppt and perpetuating factors Full hx, and family hx Physical exam- Full Mental state exam Environmental and social factors
also assess:
Support Network
Reliance on informants
How can antipsychotics be used in LD?
To treat:
- psychosis
- behavioural disturbance
- autism
- ADHD
How can antidepressants be used in LD?
To treat: -depression -anxiety disorders -self injury autism
How can anticonvulsants be used in LD?
To treat:
Bipolar affective disorder
Episodic dyscontrol
What are the cautions against using pharmacotherapy in LD?
Comorbid physical disorders may limit therapeutic use: epilepsy, constipation
Atypical responses- with increased or decreased sensitivity, and paradoxical reactions
Evidence base is often lacking
What are the features of schizophrenia in LD?
3x more common
Avg onset earlier- 23
Negative symptoms more common
PC: behaviour change
In severe LD: unexplained aggression, bizarre behaviour, social withdrawal, mood lability, increased mannerisms or stereotyped
What are the features of depression in LD?
3x more common
++ somatization: sleep/appetite/energy/concentration/anhedonia
Reduced verbal expression of unhappiness or guilt
What are the feautures of Autism Spectrum Disorder in lD?
up to 30% vs 1% avg population risk
70% have IQ
What is the triad of symptoms in autism?
Abnormal social interaction
Communication impairment
Rigid/restricted or repetitive behaviour/ interests and activities
What is the treatment approach in autism?
Structure
Routine
Predictability
Communication
