Diagnosing psychiatric disorders in people with intellectual disabilities: issues and achievements
| Published date | 07 September 2015 |
| Pages | 230-242 |
| Date | 07 September 2015 |
| DOI | https://doi.org/10.1108/AMHID-05-2015-0023 |
| Author | Marco O. Bertelli,Michele Rossi,Daniela Scuticchio,Annamaria Bianco |
| Subject Matter | Health & social care,Learning & intellectual disabilities |
Diagnosing psychiatric disorders in people
with intellectual disabilities: issues and
achievements
Marco O. Bertelli, Michele Rossi, Daniela Scuticchio and Annamaria Bianco
Dr Marco O. Bertelli is Scientific
Director at CREA (Research
and Clinical Centre), San
Sebastiano Foundation,
Florence, Italy and EAMHID,
European Association for
Mental Health in Intellectual
Disability, Firenze, Italy.
Dr Michele Rossi, Dr Daniela
Scuticchio and Dr Annamaria
Bianco, all based at CREA
(Research and Clinical Centre),
San Sebastiano Foundation,
Florence, Italy.
Abstract
Purpose –Diagnosing psychiatric disorders (PD) in adults with Intellectual Disability (ID) presents several
issues and need specific skills and tools. The purpose of this paper is to provide a detailed description of the
current status of art through a systematic mapping of the literature.
Design/methodology/approach –The authors reviewed the international literature on the basis of the
following questions: what are the issues in the psychiatric diagnostic process for adults with ID? What
methods and procedures have been used for psychiatric assessment in ID? To date, is it possible to identify
some most effective procedures?
Findings –The analysis of the literature indicates that main issues of the psychiatric diagnostic process in
adults with ID are the following: identification of psychiatric symptoms, behavioural equivalents, diagnostic
criteria, setting, source of information, screening, and diagnostic tools. The evidence base is only emerging
and although many relevant achievements have been reached in the last two decades, no definitive guideline
has been produced. Most recent acquisition also allowed to identify some assessment procedures that are
currently considered the most effective.Individualised assessment remains the best way to meet the needs of
this heterogeneous and variable patient group.
Originality/value –This paper offers a comprehensive and updated description of current achievements
and issues towards the assessment of PD in people with ID.
Keywords Intellectual disability, Assessment, Psychiatric disorders, Tools, Diagnosis, Psychopathology
Paper type Literature review
Introduction
Intellectual Disability (ID) is associated to a high vulnerability to develop mental health problems.
In people with ID the prevalence of mental disorders is up to four times higher than in the general
population (Cooper et al., 2007). Hidden psychiatric morbidity is also very high, there are reports
of prevalence over 50 per cent, even in vocational settings with psychological support (Salvador-
Carulla et al., 2000). In most cases, the causes of this vulnerability are not the same that
determined the condition of ID and rely to a combination of biological, psychological, and social
factors (Luckasson et al., 2002).
For a long time the majority of the scientific community had the opinion that psychiatric disorders
(PD) could not occur in people with ID. Different explanations for this position were offered
including a lack of consensus on which problems in ID should be considered as mental health
problems (Holland and Koot, 1998). The criteria that define a symptoms cluster as a disorder in
the general population are difficult to be used in people with ID without adaptation. People with ID
have a perception and a communicative skill of personal distress different from the norm and are
Received 20 May 2015
Revised 20 May 2015
Accepted 2 July 2015
PAG E 23 0
j
ADVANCESIN MENTAL HEALTH AND INTELLECTUAL DISABILITIES
j
VOL. 9 NO. 5 2015, pp. 230-242, © Emerald Group Publishing Limited, ISSN 2044-1282 DOI 10.1108/AMHID-05-2015-0023
To continue reading
Request your trial