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Seminars in the Psychiatry of Intellectual Disability
  • 3rd edition
  • Edited by Mark Scheepers, Mike Kerr
  • Published online:
    14 January 2019
    Print publication:
    31 January 2019
  • Now in its third edition, this high-quality, informative textbook presents intellectual disability and psychiatric presentation through the ages, to present a clear focus on issues relevant to psychiatric aspects for children and adults, at different stages of life. An ideal text for all psychiatrists, in training and in practice, this up-to-date, comprehensive guide to the understanding of intellectual disability features links to specific psychiatric competencies, vital for those undergoing training. Covering the breadth of psychological, service and biological factors affecting people with intellectual disability, this edition includes updates on a wide range of issues: from psychiatric diagnosis and management, through genetic causation, behaviour, health issues, mortality to delivery of services (historic and current). Key for multiple professional groups, and authored by leading specialists, this text provides the definitive collection of cutting-edge research on the psychiatry of intellectual disability.

  • 12 - Improving the general health of people with disorders of intellectual development

  • from Part 4 - Service provision
    • By Mike Kerr, Professor of Learning Disabilities and Honorary Consultant in Neuropsychiatry at the Welsh Centre for Learning Disabilities, Penny Blake, Consultant Psychiatrist in the field of Intellectual Disability Psychiatry and Honorary Lecturer for Cardiff University
  • Edited by Marc Woodbury-Smith
  • Book:
    Clinical Topics in Disorders of Intellectual Development
    Published online:
    01 January 2018
    Print publication:
    01 October 2015, pp 239-248

  • Summary

    People with disorders of intellectual development (DID) have higher rates of common morbidity, communication difficulties and serious conditions such as epilepsy; they also have specific patterns of health needs associated with the aetiology of their disability. Unfortunately, this combination of need is mirrored by a consistent picture of poor uptake of health promotion initiatives, inadequate care for serious morbidity, unrecognised health needs and poor access to healthcare. Consequently, there is a disparity between the health of people with DID and that of the general population. Psychiatrists can address this disparity in clinical practice by focusing on these patients’ mental health, epilepsy management and the impact of behaviour on health. They can also influence health planning and service development.

    Inequalities in health status

    The achievement of good health is an appropriate goal for all, including, of course, people with DID. This brings particular challenges, as this is a heterogeneous population with varying needs, who receive a similarly complex array of healthcare provision. Furthermore, the impact of societal and environmental factors on health status is arguably greater in this group. The imperative to remove the disparity between the health of people with DID and that of the general population is strong, because improved health is likely to improve quality of life, both of individuals and of their families. In this chapter we make the premise that the general health of people with DID can be improved by addressing those areas in which disparities in health and in healthcare provision are evident. These include:

    • a difference in health because of

  • • increased mortality

  • • increased morbidity

  • • more commonly experienced negative determinants of health such as poverty;

    • • a difference in healthcare because of

  • • unequal access to services

  • • inequality of services.

    • To focus on how health improvements can be made, we consider here the following five areas: the disparity in health; health needs; barriers to healthcare; healthcare provision in primary care; and addressing the disparity.

  • Chapter 3 - Genetic disorders associated with intellectual disability

  • Edited by Michael R. Trimble, Institute of Neurology, London, Bettina Schmitz
  • Book:
    The Neuropsychiatry of Epilepsy
    Published online:
    07 October 2011
    Print publication:
    09 June 2011, pp 14-23

  • Summary

    This chapter looks at the management of epilepsy in people with an intellectual disability, which has gained increasing importance over recent years, and the interface between the genotype causing the intellectual disability and potential behavioral and epilepsy phenotypes associated with this genotype. It uses a working definition of the pattern of seizure type, seizure syndrome and treatment response characterized by a specific genotype. An evaluation of a population of individuals with an intellectual disability, or global developmental delay, is likely to yield a potential diagnostic category in approximately 40-60%. The prevalence of epilepsy amongst the population of people with an intellectual disability varies between studies from as low as 13% to as high as 40%. The chapter also gives some examples of common genetic causes of intellectual disability, and outlines the physical, behavioral, and epileptic phenotypes associated with them.

  • What is the core expertise of the psychiatrist?

  • Nick Craddock, Mike Kerr, Anita Thapar
  • Journal:
    The Psychiatrist / Volume 34 / Issue 11 / November 2010
    Published online by Cambridge University Press:
    02 January 2018, pp. 457-460
    Print publication:
    November 2010
    • Article
      • You have access
      • Open access
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  • Psychiatrists make important and specific contributions to the care of those with mental health problems and high-quality services should enable patients to benefit optimally from a psychiatrist's distinctive skills. In this article we seek to identify and consider the core expertise of the psychiatrist.

  • Antidepressant use in adults with intellectual disability

  • Prem R. Rai, Mike Kerr
  • Journal:
    The Psychiatrist / Volume 34 / Issue 4 / April 2010
    Published online by Cambridge University Press:
    02 January 2018, pp. 123-126
    Print publication:
    April 2010
    • Article
      • You have access
      • Open access
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  • Aims and method

    To study the use of antidepressants in adults with intellectual disability, focusing on medication type, indication, retention and clinical outcome. Case notes of all service users in a learning disability service were hand-searched to identify antidepressant usage, and those who had been treated with antidepressants and in whom at least 1 year of follow-up was possible were included in the study.

    Results

    A total of 241 treatment episodes were identified. The rates of positive outcome in terms of clinical improvement at 6 weeks, 6 months and 12 months were 49.4%, 48.1% and 49% respectively, and only 29 (12%) episodes of side-effects had been noted.

    Clinical implications

    Antidepressants are commonly prescribed in adults with intellectual disability. Approximately half did well in terms of clinical improvement.

  • Improving the general health of people with learning disabilities

  • Mike Kerr
  • Journal:
    Advances in Psychiatric Treatment / Volume 10 / Issue 3 / May 2004
    Published online by Cambridge University Press:
    02 January 2018, pp. 200-206
    Print publication:
    May 2004
    • Article
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  • People with learning disabilities suffer an increase in common morbidity, communication difficulties, a high prevalence of serious conditions such as epilepsy, and specific patterns of health needs associated with the aetiology of their disability. Unfortunately, this combination of need is mirrored by a consistent picture of poor health promotion uptake, inadequate care for serious morbidity, unrecognised health need and poor access to health care. Consequently, there is a great disparity between the health of learning-disabled people and that of the general population. Psychiatrists can address this disparity in clinical practice by focusing on these patients' mental health, epilepsy management and the impact of behaviour on health. They can also influence health planning and service development.

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