McCarthy, J. (2011), "Editorial", Advances in Mental Health and Intellectual Disabilities, Vol. 5 No. 6. https://doi.org/10.1108/amhid.2011.54205faa.001Download as .RIS
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Copyright © 2011, Emerald Group Publishing Limited
Article Type: Editorial From: Advances in Mental Health and Intellectual Disabilities, Volume 5, Issue 6
The theme for this edition is a focus on neuropsychiatric and neurodevelopmental conditions that impact on the mental health needs of people with intellectual disabilities.
The first paper is a research paper from colleagues in Canada by Bradley, Lunsky, Palucka and Homitidis highlighting the need for further understanding of neurodevelopmental disorders in those with intellectual disabilities presenting with psychiatric disorders. The constant difficulty for the clinician is identifying which symptoms and behaviours are explained by the psychotic illness and which are part of the neurodevelopmental disorder. This has relevance in understanding response to treatment and outcome. This paper provides preliminary evidence that developmental need, level of functioning and presence of autism spectrum disorder are unrecognised and such inadequately assessed which has implications for ongoing management. The author highlights that patients with intellectual disabilities who have access mainly to mainstream inpatients services need to be assessed by psychiatrist trained in the assessment of mental illness in adults with neurodevelopmental disorders.
The second paper by Jordan and Murphy provides an excellent update on the advances in neuroimaging and the increased understanding of brain abnormalities in autism spectrum disorders. Practitioners will benefit from this new knowledge in developing their future practice in assessing and diagnosing adults with autism spectrum disorders presenting with mental illness.
The third paper is a case study by Radley describing the interplay in the complex presentation of an adult with autism spectrum disorders, comorbid mental illness and alcoholic abuse so adding to the clinical risk leading to the offending behaviour.
The next two papers are relevant to the neuropsychiatric needs of people with intellectual disabilities. The paper by Winterhalder is a review of the classification of seizure disorders and the understanding of epileptic syndromes. The impact of routinely assessing and classifying the nature of the seizure disorder is important to ensure the optimal treatment for individuals with intellectual disabilities. This is in keeping with a personalised approach to health care.
The paper by Pickard, McDonald and Lilliard describes a specialist neuropsychiatry clinic for people with intellectual disabilities. The authors advocate the assessment of comorbid neurological and psychiatric conditions requires close working across a number of clinicians to ensure the best expertise is available hopefully leading to improved outcomes. Epilepsy along with respiratory disorder are the main conditions resulting in significantly reduced life expectancy for people with intellectual disabilities.
The final paper by Willner explores the concept of capacity and how this differs from the concept of competence; this is very helpful paper in guiding practitioners to what these concepts mean for our day-to-day practice in supporting people with intellectual disabilities.
This is certainly an informative edition with a strong emphasis on the importance of ensuring our assessments of people with intellectual disabilities whether for those with epilepsy, autism spectrum disorders or when considering capacity that our practice is informal by the very latest and best evidence.