Dual Diagnosis Flashcards
Dual Diagnosis
Previously has been used to describe people with psychiatric disorders and addictions
Now more commonly refers to people who have a developmental disability and a mental health problem
Distinct from comorbidity- two or more diagnoses of any type
Mental Health Disorders
Psychotic disorders - E.g. Schizophrenia Mood disorders - E.g. Depression, bipolar disorder Anxiety Disorders - E.g. social phobia, panic disorder, OCD, PTSD Personality disorders - E.g. borderline personality disorder Others - E.g. oppositional defiant disorder, substance-related disorders, sexual dysfunctions, sleep-wake disorders
Anxiety
Generalized Anxiety Disorder- excessive anxiety
Social Anxiety Disorder- anxiety being around other people
Panic Disorder- having panic attacks
Obsessive Compulsive Disorder- presence of obsessions and compulsions
Post-traumatic Stress Disorder- symptoms following a traumatic event
Causes of Mental Health Problems
Biological
Genetics, brain injury, common mechanisms
Psychological
Poor coping skills, communication deficits, insight
Social/Environmental
Poverty, abuse, social support
Abuse and Neglect
Higher rates of physical, sexual, and emotional abuse
Potential for neglect from caregivers
DM-ID
Diagnostic Manual- Intellectual Disability
Developed as an alternative to the DSM-IV-TR for use with clients who have intellectual disabilities
Diagnostic Overshadowing
Symptoms are attributed to a known disorder, instead of considering a secondary diagnosis
Behavioural Highlighting
Intense behaviour problems make it difficult to identify underlying health problems
Comorbidity
Co-existence of another medical or psychiatric condition
Challenges in Assessment
Lack of communication
Cognitive impairments
Reliance on caregivers to notice
Medical Issues
Common among individuals with DD
May not be able to communicate concerns
Watch out for chronic disorders, fluctuating pain, and side effects of medications
Important to rule out and treat medical concerns first
BUT it is not appropriate to treat behavioural challenges with psychotropic medication
Expectations and Support Needs
Adaptive functioning
Environmental factors
Expectations from caregivers
Emotional Issues
Ability to cope with stress
Social supports and friendship
Bullying, stigma, self-esteem
Psychiatric Disorders
May meet criteria for a mental health diagnosis
Use classification system such as the DSM-5
Best to have a comprehensive, multidisciplinary assessment
Treatment Principles
Decrease biological contribution and prevent the occurrence of secondary disabilities and handicaps
E.g. treat medical disorders, pay attention to physical/sensory impairments
Decrease stress
Modify the environment and expectations
Increase competence
E.g. teach coping skills, communication, social support
Use a coordinated system approach
Continuity of care and multidisciplinary approach
