Case study identifies need for better evidence base for alternative strategies in treatment resistant psychosis


People with learning disabilities with schizophrenia and related psychoses have been found to be more likely to be treatment resistant than those without learning disabilities. This paper describes a case study which highlights many of the issues faced when carrying out assessments and developing management plans for such individuals.

The authors point out that Clozapine, used as the best available intervention for treatment-resistant schizophrenia at the moment, is being used far more frequently with people with learning disabilities, although it is not at all clear that it is effective with this group.

There is range of strategies for the management of treatment resistant psychosis, but the authors suggest that the evidence base for the use of these strategies in people with learning disabilities is insufficient currently and they suggest further research to improve this.

Treatment-resistant schizophrenia in intellectual disabilities: a case study, Hemmings C et al., in Advances in Mental Health and Intellectual Disabilities, 5, 2, 35-40

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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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