Schizophrenia and Related Psychoses in People with Intellectual Disability

Abstract

Individuals with an Intellectual Disability (ID) have an increased prevalence of Schizophrenia Spectrum Disorders (SSDs). The complex interplay between the symptoms of SSD and the individual’s level of development often give rise to atypical presentations. This is more so in individuals with a significant ID. Current classification systems may not adequately cover all the conditions experienced by individuals and may not be entirely captured under SSDs. It is important that the clinician gathers appropriate information from all relevant sources, including family, carers, educational establishments, and day care providers. Evidence for interventions in ID is sparse and treatment guidelines are based on evidence from the general population, which need to be extrapolated with caution, bearing in mind individual characteristics. The management of SSDs in ID requires a holistic approach, which takes into account their level of ID, sensitivity to medication, side effects and drug interactions and consideration towards other therapeutic modalities such as individual supports or CBT. The social aspects of management play a vital part in the treatment programme and the involvement of family and carers is crucial.