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Learning Disability > Psychiatric syndromes in LD > Flashcards

Psychiatric syndromes in LD Flashcards

1
Q

Self-talk

A
  • a developmental phenomenon that is not psychosis

- common in children with Downs and autism

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2
Q

Schizophrenia in LD

A
  • 3x increase in prevalence- 3-3.5%

- age of onset is earlier

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3
Q

Usher’s syndrome

A

-syndrome of retinitis pigmentosa, congenital deafness, vestibulocochlear ataxia, LD (23%) and psychosis (schizophrenia) in 15% cases

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4
Q

Velocardiofacial syndrome

A

-associated with high prevalence of severe psychiatric disorders

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5
Q

Prader Willi syndrome

A
  • this condition is associated with a high rate of psychotic disorders
  • associated with chromosome 15 maternal uniparental disomy
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6
Q

BPAD in LD

A
  • greater prevalence than in the general population (2-12%)

- you can use the biological symptoms of mania

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7
Q

Depression in LD

A
  • prevalence is 2-4%

- biological symptoms seen

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8
Q

Suicide in LD

A
  • very rare

- suicidal thoughts and acts may occur in borderline-moderate LD

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9
Q

Anxiety

A
  • likely to be more common

- OCD more common

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10
Q

Fragile X

A

-associated with social anxiety disorder

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11
Q

Prader Willi syndrome

A

-associated with OCD

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12
Q

Rubinstein-Taybi

A

-associated with OCD

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13
Q

Williams syndrome

A

-associated with anxiety disorder and phobias

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14
Q

Cornelia de Lange

A

-associated with compulsive behaviour

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15
Q

ADHD

A

increasingly common in those with higher severity of LD

-stimulants may help in mild LD with clear symptoms of ADHD but have no clear efficacy in severe-profound LD

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16
Q

Conduct disorder

A
  • affects 30% of young people with mild/borderline mental retardation, particularly in males
  • there is an association between antisocial behaviour and low verbal intelligence skills which is strongly influenced by family and sociocultural deprivation
17
Q

Pervasive developmental disorders

A
  • 75-80% of children with autism also have LD

- autism spectrum disorder is estimated in 10% of people with mild LD and 40% with severe LD

18
Q

Dementia

A
  • Downs is strongly associated

- Alzheimers is 3x more common

19
Q

Dementia in Downs

A
  • 1 in 50 of those aged 30-39
  • 1 in 10 of those aged 40-49
  • 1 in 3 of those aged 50-59
  • > 50% of those over 60
20
Q

Challenging behaviour

A

-culturally abnormal behaviours of such intensity, frequency or duration that the physical safety of the person or others is likely ti be put at risk, or behaviour which is likely to seriously limit the use of or result in the person being denied access to ordinary community facilities.

21
Q

Criteria for clinically significant challenging behaviour

A
  • at some time the behaviour has caused more than minor injuries to themselves or others or destroyed their immediate living environmnet
  • at least weekly behaviours requiring intervention by staff and placed them in danger, causing 1 hr of disruption
  • behaviour causing over a few minutes of disruption on at least a daily basis
22
Q

Predisposing factors for behavioural problems in LD

A
  • sensory disabilities
  • poor communication
  • epilepsy
  • physical illness-ear infections, dental problems and constipation
  • medication
  • limited range of coping strategies
  • abuse
  • environmental factors
23
Q

Challenging behaviour occurrence

A
  • in at least 7% of all people with LD
  • in hospital this increases to 14%
  • challenging behaviour is more common in people with severe LD
  • it is more common in men
  • more common 15-34
24
Q

Aggressive behaviour

A
  • often a feature of an associated mental disorder such as psychosis, depression and antisocial PD
  • seen in fragile X, Prader-Willi and Klinefelters
25
Q

Self-injurious behaviour

A
  • 10-50% of people with LD may show elf-injurious behaviour
  • higher rates in hospitals
  • living at home has lowest incidence
  • more common in patients with epilepsy and autism
26
Q

Conditions with self-injury

A
  • Prader-Willi (skin picking)
  • Fragile X
  • Tourettes
  • Smith Magenis
  • Cornelia de Lange
  • Lesch-Nyan
27
Q

Theories for self-injurious behaviour

A
  • Wiseley identified endogenous opioids to produce morphine-like effect that can account for the development of some forms of self-injurious behaviour
  • may stimulate endorphins
  • may help with other pains
  • pleasurable feels and euphoria
28
Q

Naltrexone and Naloxone

A
  • can help in LD self-injurious behaviour

- dopamine and serotonin also help

29
Q

Prader willi and self-injury

A
  • mild
  • reported in 81%
  • skin picking is the most prevalent form
  • front of legs are preferred sites
30
Q

Lesch-Nyhan and self-injru

A
  • more violent self-injury

- biting of lips and/or fingers

31
Q

Pica

A
  • more common
  • 20-30% of LD patients in hospital
  • 5% in community
  • more common in males
  • more common in poor functioning, autism and non-verbal
  • less common with advancing age

Learning Disability (12 decks)

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