Schizophrenia spectrum disorders in people with intellectual disabilities

doi:10.1017/CBO9780511543616.009

8 - Schizophrenia spectrum disorders in people with intellectual disabilities

from Part II - Psychopathology and special topics

Published online by Cambridge University Press: 15 December 2009

David Clarke

Edited by

Nick Bouras and

Geraldine Holt

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David Clarke: Affiliation:
Consultant Psychiatrist, Lea Castle Centre, Kidderminster
Nick Bouras: Affiliation:
King's College London
Geraldine Holt: Affiliation:
King's College London

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Summary

Introduction

This chapter discusses the concept and classification of schizophrenia spectrum disorders, their diagnosis, their relationship to intellectual disabilities (ID), and services appropriate to meet the needs of people with ID who also have psychoses.

It is helpful for those who work with people with ID to have some knowledge of psychoses and their treatment. They will often be better placed than a psychiatrist to communicate with the person concerned and to notice small changes in behaviour or functioning that may indicate the presence of a psychotic disorder. They may also notice benefits from treatment or side effects produced by medication.

Psychosis

Psychosis is a form of mental illness in which contact with reality is lost or seriously impaired. Psychotic disorders are characterized by features such as delusions (false beliefs that are not the result of the person's educational, social or cultural background), hallucinations (perceptions that occur with no external stimulus, such as ‘voices’) and profound changes in mood.

Psychoses are conventionally divided into those for which there is an obvious organic cause (such as delirium related to an infection, or a dementing illness caused by Alzheimer's disease) and ‘functional’ psychoses where an organic cause is not apparent (such as schizophrenia). This distinction between organic and functional psychoses is clinically useful because the symptoms are different, and the treatment of organic psychosis is directed at the underlying cause, whereas the treatment of functional psychoses is directed towards the relief of symptoms.

Type: Chapter
Information: Psychiatric and Behavioural Disorders in Intellectual and Developmental Disabilities , pp. 131 - 142

DOI: https://doi.org/10.1017/CBO9780511543616.009 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2007

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References

Anderson, J. & Adams, C. (1996). Family interventions in schizophrenia: an effective but underused treatment. British Medical Journal, 313, 505–6.Google Scholar

Blackburn, I. M., Bishop, S., Glen, A. I. M., Whalley, L. J. & Christie, J. E. (1981). The efficacy of cognitive therapy on depression: a treatment trial using cognitive therapy and pharmacotherapy, each alone and in combination. British Journal of Psychiatry, 139, 181–9.Google Scholar

Boer, H., Holland, A., Whittington, J.et al. (2002). Psychotic illness in people with Prader–Willi syndrome due to chromosome 15 maternal uniparental disomy. Lancet, 359, 135–6.Google Scholar

Bouras, N. & Holt, G. (1997). Mental Health and Learning Disabilities Training Package, 2nd Edn. Brighton: Pavilion Press.

Bouras, N., Martin, G., Leese, M.et al. (2004). Schizophrenia-spectrum psychoses in people with and without intellectual disability. Journal of Intellectual Disability Research, 48, 548–55.Google Scholar

Brugha, T. S., Collacot, R., Warrington, J., Deb, S. & Bruce, J. (1988). Eliciting and reliably rating delusions and hallucinations in the mildly retarded. Paper read at: Eighth Congress of the International Association for the Scientific Study of Mental Deficiency, August 1988, Dublin, Eire.

Clarke, D. J. (1993). Prader–Willi syndrome and psychoses. British Journal of Psychiatry, 163, 680–4.Google Scholar

Clarke, D., Cumella, S., Corbett, J.et al. (1994). Use of ICD-10 research diagnostic criteria to categorise psychiatric and behavioural abnormalities among people with learning disabilities: The West Midlands field trial. Mental Handicap Research, 7, 273–85.Google Scholar

Feighner, J. P., Robins, E., Guze, S. B.et al. (1972). Diagnostic criteria for use in psychiatric research. Archives of General Psychiatry, 26, 57–63.Google Scholar

Friedlander, R. I. & Donnelly, T. (2004). Early-onset psychosis in youth with intellectual disability. Journal of Intellectual Disability Research, 48, 540–7.Google Scholar

Goldberg, R., Motzkin, B., Marion, R., Scambler, P. J. & Shprintzen, R. J. (1993). Velo cardio facial syndrome: A review of 120 patients. American Journal of Medical Genetics, 45, 313–19.Google Scholar

Greenwood, C. M. T., Husted, J., Bomba, M. D., Hodgkinson, K. A. & Bassett, A. S. (2004). Elevated rates of schizophrenia in a familial sample wth mental illness and intellectual disability. Journal of Intellectual Disability Research, 48, 531–9.Google Scholar

Hallgren, B. (1959). Retinitis pigmentosa combined with congenital deafness; with vestibulo-cerebellar ataxia and mental abnormality in a proportion of cases. A clinical and genetico-statistical study. Acta Psychiatrica Neurologica Scandinavica, 24 (Suppl. 138), 1–101.Google Scholar

Haroldsson, H. M., Ferrarelli, F., Kalin, N. H. & Tononi, G. (2004). Transcranial magnetic stimulation in the investigation and treatment of schizophrenia: a review. Schizophrenia Research, 71, 1–16.Google Scholar

Harrison, P. J. & Weinberger, D. R. (2004). Schizophrenia genes, gene expression, and neuropathology: on the matter of their convergence. Molecular Psychiatry, advance online publication, 20 July 2004, doi: 10.1038/sj.mp.4001558.

Hill, K., Mann, L., Laws, K. R.et al. (2004). Hypofrontality in schizophrenia: a meta-analysis of functional imaging studies. Acta Psychiatrica Scandinavica, 110, 243–56.Google Scholar

Holt, G., Hardy, S. & Bouras, N (2005). Mental Health in Learning Disabilities: A Training Resource. Brighton: Pavilion Publishing.

Hucker, S. J., Day, K. E., George, S. & Roth, M. (1979). Psychosis in mentally handicapped adults. In Snaith, P. & James, P. E. (eds.), Psychiatric Illness and Mental Handicap. London: Gaskell.

Kumar, S. (2003). Psychosis as a state of aberrant salience: a framework linking biology, phenomenology, and pharmacology in schizophrenia. American Journal of Psychiatry, 160, 13–23.Google Scholar

MacCabe, J. H. & Murray, R. M. (2004). Intellectual functioning in schizophrenia: a marker of neurodevelopmental damage?Journal of Intellectual Disability Research, 48, 519–23.Google Scholar

Meadows, G., Turner, T., Campbell, L.et al. (1991). Assessing schizophrenia in adults with mental retardation: a comparative study. British Journal of Psychiatry, 158, 103–5.Google Scholar

Melville, C. (2003). A critique of the Diagnostic Criteria for Psychiatric Disorders for Use with Adults with Learning Disabilities/Mental Retardation (DC-LD) chapter on non-affective psychotic disorders. Journal of Intellectual Disability Research, 47 (Suppl. 1), 16–25.Google Scholar

Moss, S., Patel, P., Prosser, H.et al. (1993). Psychiatric morbidity in older people with moderate and severe learning disability. I: Development and reliability of the patient interview (PAS-ADD). British Journal of Psychiatry, 163, 471–80.Google Scholar

Murphy, K. C. (2004). The behavioural phenotype in velo-cardio-facial syndrome. Journal of Intellectual Disability Research, 48, 524–30.Google Scholar

Nelson, H. E., Thrasher, S. & Barnes, T. R. E. (1991). Practical ways of alleviating auditory hallucinations. British Medical Journal, 302: 327.Google Scholar

O'Dwyer, J. (1997). Schizophrenia in people with intellectual disability: the role of pregnancy and birth complications. Journal of Intellectual Disability Research, 41, 238–51.Google Scholar

Rose, J. (1996). Anger management: a group treatment programme for people with mental retardation. Journal of Developmental and Physical Disabilities, 8, 133–49.Google Scholar

Royal College of Psychiatrists (2001). Diagnostic Criteria for Psychiatric Disorders for Use with Adults with Learning Disabilities/Mental Retardation (DC-LD). London: Gaskell.

Sturmey, P., Reed, J. & Corbett, J. (1991). Psychometric assessment of psychiatric disorders in people with learning disabilities (mental handicap): a review of measures. Psychological Medicine, 21, 143–55.Google Scholar

Os, J., Driessen, G., Gunther, N. & Delespaul, P. (2000). Neighbourhood variation in incidence of schizophrenia. Evidence for person-environment interaction. British Journal of Psychiatry, 176, 243–8.Google Scholar

Vanstraelen, M., Holt, G. & Bouras, N. (2003). Adults with learning disabilities and psychiatric problems. In Fraser, W. & Kerr, M. (eds.), Seminars in The Psychiatry of Learning Disabilities, 2nd edn. London: Gaskell.

Weiss, E. M., Bilder, R. M. & Fleischbacker, W. W. (2002). The effects of second-generation antipsychotics on cognitive functioning and psychosocial outcome in schizophrenia. Psychopharmacology, 162, 11–17.Google Scholar

World Health Organization (1992). The ICD-10 Classification of Mental and Behavioural Disorders: Clinical Descriptions and Diagnostic Guidelines. World Health Organization: Geneva.