Psychiatry of Disability

Question 1

What are the IQ levels of learning disability?

Answer 1

• Mild (70-50)
• Moderate (49-35)
• Severe (34-20)
• Profound (<20)

Question 2

What is the prevalence of depression, anxiety disorders, and psychosis in people with intellectual disability compared to the general population?

Answer 2

• Depression same
• Anxiety disorders greater
• Psychosis 3-4 times higher

Question 3

What are the physical health considerations in intellectual disability?

Answer 3

• Some conditions have specific physical health symptoms (e.g. hypothyroidism in Down’s)
• Physical health issues more common and more medicated
• Epilepsy

Question 4

What are the features of epilepsy in intellectual disability?

Answer 4

Occurs in 25% of patients, more difficult to treat and diagnose, more resistant to treatment, more prone to psychiatric side effects of anti-epileptic drugs.

Question 5

What are the behavioural phenotypes for Down’s, Fragile X, DiGeorge, Lesch-Nyan, and Autism?

Answer 5

Down’s - ASD (10%), late adolescence depression, Alzheimer’s
Fragile X - 60% have autism
DiGeorge - psychosis
Lesch-Nyan - self-injurious behaviours
Autism - obsessive compulsive traits, anxiety, depression

Question 6

What is diagnostic overshadowing?

Answer 6

Blaming symptoms on a previous diagnosis