Audit finds symptom rating checklist in clinical practice helps people with learning disabilities and psychosis


This audit of clinical practice in a mental health service for people with learning disabilities looked at the current approach to people with learning disabilities and psychotic disorders.

The researchers looked at clinical practice with 910 people who were patients of the learning disability psychiatrists in Buckinghamshire. The current approach to clinical practice in the area was compared with the published guidelines on the management of schizophrenia from the National Institute for Health and Clinical Excellence (NICE).

The team found that 28% of the 910 participants had a dual diagnosis of psychosis and learning disability and that 40% showed moderately severe psychotic symptoms.

In terms of the treatment responses, they found that oral atypical antipsychotics were used most frequently although 25% of the participants were found to be treatment resistant.

The authors expand upon what they describe as ‘varied presentation’ of psychoses in people with learning disabilities. They suggest a helpful addition to clinical assessments would be the use of a symptom rating checklist or scale which could be used in diagnosis and in monitoring the course of the psychosis. They set out what could be in such a checklist and recommend its use in routine clinical practice.

Psychotic disorders in learning disabilities- outcome of an audit across community teams, Varghese, S &  Banerjee, S,  in British Journal of Learning Disabilities, 39: 148–153.

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John Northfield

After qualifying as a social worker, John worked in community learning disability teams before getting involved in a number of long-stay hospital closure programmes, working to develop individual plans for people moving into their own homes. He worked for BILD, helping to develop the Quality Network and was editorial lead for the NHS electronic library learning disabilities specialist collection. This led him to found the Learning Disabilities Elf site with Andre Tomlin as a way of making the evidence accessible to practitioners in health and social care. Most recently he has worked as part of Mencap's national quality team and also been involved in a number of national website developments, including the General Medical Council's learning disabilities site.

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