Intended for healthcare professionals


Illness in people with intellectual disabilities

BMJ 2008; 336 doi: (Published 13 March 2008) Cite this as: BMJ 2008;336:570
  1. Afia Ali, specialist registrar in psychiatry of intellectual disability1,
  2. Angela Hassiotis, senior lecturer in intellectual disability2
  1. 1Hackney Learning Disability Service, St Leonard’s, London N1 5LZ
  2. 2Department of Mental Health Sciences, Faculty of Biomedical Sciences, University College Medical School, London W1W 7EY

Is common, underdiagnosed, and poorly managed

This week a report published report by the Joint Committee on Human Rights highlights the widespread denial of fundamental human rights to people with intellectual disabilities by mainstream public services.1 One reason why people with intellectual disabilities receive suboptimal care is diagnostic overshadowing, whereby a presenting symptom of mental illness or physical illness is incorrectly attributed to the person’s intellectual disability.2 Although people with intellectual disability have a higher prevalence of mental illness than people with a normal IQ,3 medical professionals are less likely to diagnose psychiatric problems in this group.2 People with intellectual disability are also more likely to have chronic disorders such as epilepsy, cerebral palsy, and genetic syndromes.4 5 However, their health needs are often unmet.5

Two recent reports by the Disability Rights Commission and MENCAP have highlighted the importance of diagnostic overshadowing in people with intellectual disability in England and Wales.6 7 They highlight the widespread inequalities encountered by people with …

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