Psychiatric services for people with learning disabilities

Specialist knowledge and services are needed

Psychiatric disorder is more common in people with learning disabilities than in the general population. Organic, social, and educational reasons account for this increase. Nearly all adults with severe mental retardation have structural brain disease, and epilepsy is more common in this population.1 In their study in the Isle of Wight, Rutter and colleagues showed very clearly the association among neurological abnormality, epilepsy, learning disability, and psychiatric disorders.2 In addition to these organic factors, educational failure; rejection and lack of social acceptance; reduced or no job opportunities, with correspondingly diminished self esteem; difficulties in finding acceptable sexual outlets despite normal sexual drives; and the problems of dysmorphic appearance all combine to increase the liability to psychiatric disorder.3

These psychiatric disorders include schizophrenic and paranoid syndromes, although diagnosing them may be difficult.4 For example,schizophrenia cannot be reliably diagnosed in …