Psychiatry of Intellectual Disability

Patients with intellectual disability (ID) can benefit from thefull range of mental health services. To ensure that psychiatricassessment, diagnosis and treatment interventions are relevant andeffective; individuals with ID should be evaluated and treatedwithin the context of their developmental framework. Behaviorshould be viewed as a form of communication.Individuals with ID often present with behavioral symptomscomplicated by limited expressive language skills and undiagnosedmedical conditions. Many training programs do not include focusedstudy of individuals with ID, despite the fact that patients withID will be seen by virtually every mental health practitioner. Inthis book, the authors present a framework for competent assessmentand treatment of psychiatric disorders in individuals with ID.Psychiatry of Intellectual Disability is aresource guide for psychiatrists, nurse practitioners, and otherprescribers treating patients with ID. It is a supplemental textfor psychiatry residents, medical students, psychology graduatestudents, psychotherapists, counselors, social workers, behaviorsupport specialists and nurses. To assist the practicing clinicianthe book includes:* Clinical vignettes* Clinical pearls* Charts for quick reference* Issues concerning medications and poly-pharmacy* Altered diagnostic criteria specific for use with individualswith IDThere are no evidence-based principles dedicated to psychotropicmedication use in ID, but consensus guidelines address the highprevalence of poly-pharmacy. Altered diagnostic criteria have beenpublished which accommodate less self-report and incorporatecollateral information; this book reviews the literature onpsychotropic medications, consensus guidelines, andpopulation-specific diagnostic criteria sets.Psychiatry of Intellectual Disability alsoincludes:* Interviewing techniques and assessment tips for all levels ofcommunicative ability as well as for nonverbal individuals* Assessment of aggression to determine etiology and formulate atreatment plan* Overview of types of psychotherapy and suggested alterationsfor each to increase efficacy* Relevant legal issues for caregivers and treatmentprovidersThe detective work involved in mental health assessment ofindividuals with ID is challenging yet rewarding. The highestquality mental health treatment limits hospital days, improvesquality of life and often allows individuals to live in the leastrestrictive environments. Psychiatry of IntellectualDisability is a must have resource for clinicians treatingthe ID population.

Dedications viiEditor biographies ixList of contributors xiList of abbreviations xiiiForeword xv1 Overview 1Allison E. Cowan, MD and Julie P. Gentile, MD2 Psychiatric Assessment 14Ann K. Morrison, MD and Paulette Marie Gillig, MD, PhD3 Medical Assessment 26Julie P. Gentile, MD and Michelle A. Monro, DO4 Neurologic Conditions 51Paulette Marie Gillig, MD, PhD and Richard Sanders, MD5 Traumatic Brain Injuries and Co-occurring Mental Illness 75Gretchen N. Foley, MD6 Interviewing Techniques 90Julie P. Gentile, MD and Paulette Marie Gillig, MD, PhD7 Mood Disorders 125Ann K. Morrison, MD and Christina Weston, MD8 Anxiety Disorders 146Kelly M. Blankenship, MD9 Psychotic Disorders 161Allison E. Cowan, MD10 Personality Disorders 191Julie P. Gentile, MD and Allison E. Cowan, MD11 Aggression 210Julie P. Gentile, MD and Paulette Marie Gillig, MD, PhD12 Psychotropic Medications 250Christopher T. Manetta, DO and Julie P. Gentile, MD13 Psychotherapy 278Carroll S. Jackson, LISW-S and Julie P. Gentile, MD14 Behavioral Assessment and Interventions 309Betsey A. Benson, PhD15 Legal Issues for Treatment Providers and Evaluators 325Jeannette Cox, JD16 Syndromes of Intellectual Disability 338Kelly M. Blankenship, MD and Christina Weston, MDIndex 366