Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-cd9895bd7-q99xh Total loading time: 0 Render date: 2024-12-26T16:48:20.607Z Has data issue: false hasContentIssue false

Chapter 1 - Intellectual Disability

Published online by Cambridge University Press:  07 November 2024

By
Ken Courtenay ,
Tadhgh Lane  and
Indermeet Sawhney
Edited by
David M. L. Branford ,
Satheesh K. Gangadharan ,
Mary Barrett  and
Regi T. Alexander
David M. L. Branford
Affiliation:
Independent Pharmacy Consultant
Satheesh K. Gangadharan
Affiliation:
Leicestershire Partnership NHS Trust
Mary Barrett
Affiliation:
Leicestershire Partnership NHS Trust
Regi T. Alexander
Affiliation:
Hertfordshire Partnership University NHS Foundation Trust
Get access

Summary

An introduction and overview of intellectual disability. The American Psychiatric Association (APA) diagnostic criteria for intellectual disability (DSM-5 criteria) are covered: Deficits in general mental abilities; Impairment in adaptive functioning for individual’s age and sociocultural background which may include communication, social skills, person independence, and school or work functioning; All symptoms must have an onset during the developmental period; The condition may be subcategorised according to severity based on adaptive functioning as mild, moderate, or severe. The chapter also covers the role and evidence base for medication and key issues when prescribing for people with intellectual disability.

Keywords

intellectual disabilitylearning disabilityprescribingguidancemental healthmedicationpsychiatryevidence basedeprescribingoveruse of medication
Type
Chapter
Information
The Frith Prescribing Guidelines for People with Intellectual Disability , pp. 1 - 12
Publisher: Cambridge University Press
Print publication year: 2024

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Adams, D., Carr, C., Marsden, D., & Senior, K. (2018). An update on informed consent and the effect on the clinical practice of those working with people with a learning disability. Learning Disability Practice, 21(4), 36–40.CrossRefGoogle Scholar
Ali, A., Blickwedel, J., & Hassiotis, A. (2014). Interventions for challenging behaviour in intellectual disability. Advances in Psychiatric Treatment, 20(3), 184–92.CrossRefGoogle Scholar
American Psychiatric Association. (2013). DSM 5 Intellectual Disability. www.psychiatry.org/File%20Library/Psychiatrists/Practice/DSM/APA_DSM-5-Intellectual-Disability.pdf.Google Scholar
Bertelli, M. O., Rossi, M., Scuticchio, D., & Bianco, A. (2015). Diagnosing psychiatric disorders in people with intellectual disabilities: Issues and achievements. Advances in Mental Health and Intellectual Disabilities, 9(5), 230–42.CrossRefGoogle Scholar
Bhaumik, S., Gangadharan, S. K., Branford, D., & Barrett, M. (Eds.). (2015) The Frith Prescribing Guidelines for People with Intellectual Disability. John Wiley & Sons.CrossRefGoogle Scholar
Bigby, C., Whiteside, M., & Douglas, J. (2019). Providing support for decision making to adults with intellectual disability: Perspectives of family members and workers in disability support services. Journal of Intellectual & Developmental Disability, 44(4), 396–409.CrossRefGoogle Scholar
Bowring, D. L., Totsika, V., Hastings, R. P., Toogood, S., & McMahon, M. (2017). Prevalence of psychotropic medication use and association with challenging behaviour in adults with an intellectual disability: A total population study. Journal of Intellectual Disability Research, 61(6), 604–17.CrossRefGoogle ScholarPubMed
Carulla, L. S., Reed, G. M., Vaez-Azizi, L. M., et al. (2011). Intellectual developmental disorders: Towards a new name, definition and framework for ‘mental retardation/intellectual disability’ in ICD-11. World Psychiatry, 10(3), 175–80.CrossRefGoogle Scholar
Carvalho Henriques, B., Yang, E. H., Lapetina, D., et al. (2020). How can drug metabolism and transporter genetics inform psychotropic prescribing? Frontiers in Genetics, 11, 491895. https://doi.org/10.3389/fgene.2020.491895.CrossRefGoogle ScholarPubMed
Centre for Disease Control and Prevention. (2022, April). Developmental disabilities. www.cdc.gov/ncbddd/developmentaldisabilities/index.html.Google Scholar
Daniel, W. A., Bromek, E., Danek, P. J., & Haduch, A. (2022). The mechanisms of interactions of psychotropic drugs with liver and brain cytochrome P450 and their significance for drug effect and drug-drug interactions. Biochemical Pharmacology, 199, 115006.CrossRefGoogle ScholarPubMed
Davies, J., & Read, J. (2019). A systematic review into the incidence, severity and duration of antidepressant withdrawal effects: Are guidelines evidence-based? Addictive Behaviors, 97, 111–21.Google Scholar
de Kuijper, G., Hoekstra, P., Visser, F., et al. (2010). Use of antipsychotic drugs in individuals with intellectual disability (ID) in the Netherlands: Prevalence and reasons for prescription. Journal of Intellectual Disability Research, 54(7), 659–67.CrossRefGoogle ScholarPubMed
Deb, S., Nancarrow, T., Limbu, B., et al. (2020). UK psychiatrists’ experience of withdrawal of antipsychotics prescribed for challenging behaviours in adults with intellectual disabilities and/or autism. BJPsych Open, 6(5), e112.CrossRefGoogle ScholarPubMed
Eady, N., Courtenay, K., & Strydom, A. (2015). Pharmacological management of behavioral and psychiatric symptoms in older adults with intellectual disability. Drugs & Aging, 32(2), 95–102.CrossRefGoogle ScholarPubMed
Emerson, E., & Hatton, C. (2013). Health Inequalities and People with Intellectual Disabilities. Cambridge University Press. https://doi.org/10.1017/CBO9781139192484.CrossRefGoogle ScholarPubMed
English, B. A., Dortch, M., Ereshefsky, L., & Jhee, S. (2012). Clinically significant psychotropic drug-drug interactions in the primary care setting. Current Psychiatry Reports, 14(4), 376–90.CrossRefGoogle ScholarPubMed
Flynn, M. (2012). Winterbourne View Hospital: A Serious Case Review. South Gloucestershire Council. www.southglos.gov.uk/news/serious-case-review-winterbourne-view/.Google Scholar
General Medical Council. (2020). Decision making and consent. www.gmc-uk.org/-/media/documents/gmc-guidance-for-doctors–decision-making-and-consent-english_pdf-84191055.pdf.Google Scholar
General Medical Council. (2021). Good practice in prescribing and managing medicines and devices. www.gmc-uk.org/-/media/documents/prescribing-guidance-updated-english-20210405_pdf-85260533.pdf.Google Scholar
Glover, G., Williams, R., Heslop, P., Oyinlola, J., & Grey, J. (2017). Mortality in people with intellectual disabilities in England. Journal of Intellectual Disability Research, 61(1), 62–74.CrossRefGoogle ScholarPubMed
Grove, N., & Walker, M. (1990). The Makaton vocabulary: Using manual signs and graphic symbols to develop interpersonal communication. Augmentative and Alternative Communication, 6(1), 15–28.CrossRefGoogle Scholar
Gründer, G., Heinze, M., Cordes, J., et al. (2016). Effects of first-generation antipsychotics versus second-generation antipsychotics on quality of life in schizophrenia: A double-blind, randomised study. The Lancet Psychiatry, 3(8), 717–29.CrossRefGoogle ScholarPubMed
Hall, S., & Deb, S. (2008). A qualitative study on the knowledge and views that people with learning disabilities and their carers have of psychotropic medication prescribed for behaviour problems. Advances in Mental Health and Learning Disabilities, 2(1), 29–37.CrossRefGoogle Scholar
Hengartner, M. P., Davies, J., & Read, J. (2020). Antidepressant withdrawal: The tide is finally turning. Epidemiology and Psychiatric Sciences, 29, e52.CrossRefGoogle Scholar
Heslop, P., & Hoghton, M. (2018). The Learning Disabilities Mortality Review (LeDeR) programme. British Journal of General Practice, 68(suppl 1), bjgp18X697313.CrossRefGoogle Scholar
Hollins, S., Bernal, J., & Slowie, D. (1996). Going to the Doctor. Books Beyond Words. https://booksbeyondwords.co.uk/bookshop/paperbacks/going-doctor.Google Scholar
Hsieh, K., Rimmer, J. H., & Heller, T. (2014). Obesity and associated factors in adults with intellectual disability. Journal of Intellectual Disability Research, 58(9), 851–63.CrossRefGoogle ScholarPubMed
Jesner, O., Aref-Adib, M., & Coren, E. (2007). Risperidone for autism spectrum disorder. Cochrane Database of Systematic Reviews, 2007(1), CD005040. https://doi.org/10.1002/14651858.CD005040.Google ScholarPubMed
Karam, S. M., Riegel, M., Segal, S. L., et al. (2015). Genetic causes of intellectual disability in a birth cohort: A population‐based study. American Journal of Medical Genetics Part A, 167(6), 1204–14.CrossRefGoogle Scholar
Kinnear, D., Morrison, J., Allan, L., et al. (2018). Prevalence of physical conditions and multimorbidity in a cohort of adults with intellectual disabilities with and without Down syndrome: Cross-sectional study. BMJ Open, 8(2), e018292.CrossRefGoogle Scholar
Loucks, J., Yost, S., & Kaplan, B. (2015). An introduction to basic pharmacokinetics. Transplantation, 99(5), 903–7.CrossRefGoogle ScholarPubMed
Lukmanji, S., Manji, S. A., Kadhim, S., et al. (2019). The co-occurrence of epilepsy and autism: A systematic review. Epilepsy & Behavior, 98, 238–48.CrossRefGoogle ScholarPubMed
Martin, A.-M., O’Connor-Fenelon, M., & Lyons, R. (2010). Non-verbal communication between nurses and people with an intellectual disability: A review of the literature. Journal of Intellectual Disabilities, 14(4), 303–14.CrossRefGoogle ScholarPubMed
McMahon, M., Hatton, C., & Bowring, D. L. (2020). Polypharmacy and psychotropic polypharmacy in adults with intellectual disability: A cross‐sectional total population study. Journal of Intellectual Disability Research, 64(11), 834–51.CrossRefGoogle ScholarPubMed
Moncrieff, J. (2013). Chemical cosh: Antipsychotics and chemical restraint. In The Bitterest Pills. London: Palgrave Macmillan, pp. 132–51.CrossRefGoogle Scholar
Murphy, J., & Cameron, L. (2008). The effectiveness of Talking Mats® with people with intellectual disability. British Journal of Learning Disabilities, 36(4), 232–41.CrossRefGoogle Scholar
O’Dwyer, C., McCallion, P., Henman, M., et al. (2019). Prevalence and patterns of antipsychotic use and their associations with mental health and problem behaviours among older adults with intellectual disabilities. Journal of Applied Research in Intellectual Disabilities, 32(4), 981–93.Google ScholarPubMed
Osugo, M., & Cooper, S.-A. (2016). Interventions for adults with mild intellectual disabilities and mental ill-health: A systematic review. Journal of Intellectual Disability Research, 60(6), 615–22.CrossRefGoogle ScholarPubMed
Perera, B., Steward, C., Courtenay, K., Andrews, T., & Shankar, R. (2022). Pharmacogenomics: An opportunity for personalised psychotropic prescribing in adults with intellectual disabilities. BJPsych Open, 8(5), e157.CrossRefGoogle ScholarPubMed
Raben, A. T., Marshe, V. S., Chintoh, A., et al. (2017). The complex relationship between antipsychotic-induced weight gain and therapeutic benefits: A systematic review and implications for treatment. Frontiers in Neuroscience, 11, 741.CrossRefGoogle ScholarPubMed
Rajapakse, T., & Pringsheim, T. (2010). Pharmacotherapeutics of Tourette syndrome and stereotypies in Autism. Seminars in Pediatric Neurology, 17(4), 254–60.CrossRefGoogle ScholarPubMed
Reiss, S., & Szyszko, J. (1983). Diagnostic overshadowing and professional experience with mentally retarded persons. American Journal of Mental Deficiency, 87(4), 396–402.Google ScholarPubMed
Rowland, M. T. T. N. (2010). Clinical Pharmacokinetics and Pharmacodynamics: Concepts and Applications, 4th rev. ed. Lippincott Williams and Wilkins.Google Scholar
Shankar, R., Wilcock, M., Deb, S., et al. (2019). A structured programme to withdraw antipsychotics among adults with intellectual disabilities: The Cornwall experience. Journal of Applied Research in Intellectual Disabilities, 32(6), 1389–400.CrossRefGoogle ScholarPubMed
Sheehan, R., Hassiotis, A., Walters, K., et al. (2015). Mental illness, challenging behaviour, and psychotropic drug prescribing in people with intellectual disability: UK population based cohort study. BMJ, h4326.Google Scholar
Sheehan, R., Horsfall, L., Strydom, A., et al. (2017). Movement side effects of antipsychotic drugs in adults with and without intellectual disability: UK population-based cohort study. BMJ Open, 7(8), e017406.CrossRefGoogle ScholarPubMed
Simpson, N., Mizen, L., & Cooper, S.-A. (2020). Intellectual disabilities. Medicine, 48(11), 732–6.CrossRefGoogle Scholar
Sitzmann, A. F., Hagelstrom, R. T., Tassone, F., Hagerman, R. J., & Butler, M. G. (2018). Rare FMR1 gene mutations causing fragile X syndrome: A review. American Journal of Medical Genetics Part A, 176(1), 11–18.CrossRefGoogle ScholarPubMed
Smith, M., Manduchi, B., Burke, É., et al. (2020). Communication difficulties in adults with Intellectual Disability: Results from a national cross-sectional study. Research in Developmental Disabilities, 97, 103557.CrossRefGoogle ScholarPubMed
Social Care Institute for Excellence. (2009). Mental Capacity Act 2005 at a glance. www.scie.org.uk/mca/introduction/mental-capacity-act-2005-at-a-glance.Google Scholar
Sullivan, W. F., & Heng, J. (2018). Supporting adults with intellectual and developmental disabilities to participate in health care decision making. Canadian Family Physician Medecin de Famille Canadien, 64(Suppl 2), S32–S36.Google ScholarPubMed
Sulzer-Azaroff, B., Hoffman, A. O., Horton, C. B., Bondy, A., & Frost, L. (2009). The Picture Exchange Communication System (PECS). Focus on Autism and Other Developmental Disabilities, 24(2), 89–103.CrossRefGoogle Scholar
Valenza, P. L., McGinley, T. C., Feldman, J., et al. (2017). Dangers of polypharmacy. In Vignettes in Patient Safety – Volume 1, InTech. https://doi.org/10.5772/intechopen.69169.Google Scholar
van der Meer, L., Nieboer, A. P., Finkenflügel, H., & Cramm, J. M. (2018). The importance of person-centred care and co-creation of care for the well-being and job satisfaction of professionals working with people with intellectual disabilities. Scandinavian Journal of Caring Sciences, 32(1), 76–81.CrossRefGoogle ScholarPubMed

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×