Conditions Associated with LD

Question 1

Outline Down syndrome

Answer 1

Trisomy 21

1/660 live births

Mild-moderate ID

Features = flat face, short nose, big tongue, heart defects, intestinal blockage

Associations = depression, dementia, hypothyroidism

Question 2

Outline Williams syndrome

Answer 2

Gene deletions on chromosome 7

Not passed on from parent to child

Mild-moderate LD

Features = wide mouth with a pronounced bottom lip, slightly high and rounded cheeks, and widely-spaced teeth

Associations = anxiety, depression

Question 3

Outline fragile X syndrome

Answer 3

CGG triplet repeat on FMR-1 gene (fragile x mental retardation 1) on X chromosome

Mild-moderate ID

Features = high forehead, large ears, large testes, CT weakness

Associations = social anxiety, aggression, hyperactivity, attention deficit, self-injury

Question 4

Define intellectual disability

Answer 4

IQ <70

Significant impairment of adaptive functioning

Before 18y

• mild = IQ 69-50
• moderate = IQ 49-35
• severe = IQ <34

Question 5

What are the causes of ID?

Answer 5

Prenatal = Downs, fragile X, spina bifida, CP, malnutrition, drugs, chromosomal abnormalities, metabolic disorders (mucopolysaccharide - storage disorders), teratogenic exposure

Perinatal = toxoplasmosis, asphyxia, hypoxia, prem birth

Postnatal = epilepsy, meningitis/encephalitis, measles, infection, head injury, social deprivation, head injury

Question 6

Outline a ID psychiatric hx

Answer 6

Demographic details
HPC
ID hx
PMH
FH
DH, allergies
Developmental hx
Forensic hx
Personal hx
SH
Risk assessment

Question 7

What psychiatric disorders and behavioural problems are common in people with learning disabilities?

Answer 7

• depression
• anxiety
• psychosis
• bipolar
• dementia (22%)
• schizophrenia (3%)
• challenging behaviour (15%) - aggression, destruction, self-injury

Question 8

What are the common disorders that effect people with learning disabilities?

Answer 8

• GI cancer - oesophagus, stomach, gall bladder
• Coronary heart disease
• DM
• Dental probs
• Epilepsy
• Swallowing and eating probs

Question 9

Describe the effects and use of psychotropic medication in people with learning disability

Answer 9

Use = typically for challenging behaviour (reduce excitation/aggression)

• should be offered only in combination with psychological intervention
• e.g. antipsychotics, antidepressants, mood stabilisers, sedatives