Understanding Dual Diagnosis Lecture

Introduction

• Speaker: Kim Shantz
• Coordinator: Danielle Daly, Illinois Crisis Prevention Network
• Duration: 1 PM - 2:30 PM
• Topics: Upcoming trainings, use of chat/Q&A, CE certificates.

Key Initial Points

• Repeat session from last month.
• Encouragement to share experiences on dual diagnosis via chat.

Understanding Dual Diagnosis

• Definition: Intellectual/Developmental Disability (IDD) + Psychiatric Disorder.
• Clarification: IDD ≠ Mental Illness.

History

• 1876: Schooling recommended for mental deficiency.
• 1908: Psychoanalysis excluded people with IDD.
• 1960-1970: Term 'Dual Diagnosis' coined.
• 1981: First publications for providers.
• 1982: National Association for Dual Diagnosis was founded.

Dual Diagnosis Challenges

• Psychiatric Opinion Surveys (1996 & 2007): Reflect challenges in psychiatric care and perceptions.
• Key Statistics (2005):
  • 1% of population with ID.
  • 30-60% with serious mental illness.
  • Anxiety, depression, psychosis common.

Diagnosis and Treatment

• Importance of Accurate Diagnosis:
  • Appropriate medication regime.
  • Empathy and understanding for caregivers.
  • Guides intervention planning.
• Medications:
  • Behavioral management preferred.
  • Avoiding over-medication.

Common Co-occurring Diagnoses

Major Depression

• Symptoms: Sadness, irritability, withdrawal, changes in weight/sleep, worthlessness.
• Adaptation for IDD: Requires fewer symptoms; includes non-verbal signs.

Anxiety Disorders

• Prevalence: Common, especially in autism and fetal alcohol spectrum disorders.
• Adaptation for IDD: Can be observed rather than described.

Schizophrenia

• Symptoms: Delusions, hallucinations, disorganized behavior.
• Adaptation for IDD: Requires multidisciplinary approach, especially for severe cases.

Post-Traumatic Stress Disorder (PTSD)

• Symptoms: Recurrent dreams, reenactment, avoidance.
• Importance: High prevalence of trauma among IDD individuals.

Intermittent Explosive Disorder

• Criteria: Episodes out of proportion to stressors, not explained by other disorders.
• Challenges: Overdiagnosis in IDD population.

Hospitalization Challenges

• Common Issues: Difficult admission, diagnostic overshadowing, Medicaid limitations.
• Advocacy: Importance of accurate diagnostic information when seeking hospitalization.

Conclusion

• Encourage use of DMID for diagnosis.
• Importance of advocacy and accurate diagnosis for proper care and support.
• Contact Information: Available for follow-up and questions.

These notes provide a comprehensive summary of the key topics and insights shared during the lecture on dual diagnosis. It is essential to consider the adaptation of diagnostic criteria for individuals with intellectual and developmental disabilities to ensure accurate diagnosis and treatment.