Schizophrenia in Individuals with ID/DD

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Schizophrenia in Individuals with ID/DD Allison Cowan, MD David Dixon, DO

Disclosures Allison Cowan, MD has nothing to disclose Employed by Wright State University Coleman Professional Services, Montgomery Co Board of DDS, and Access Ohio (Ohio’s Telepsychiatry Project for ID) David Dixon, DO has nothing to disclose Employed by United State Air Force and Wright State University Wright State University, Clinical Chief Resident

Warning Active participation is expected Pop quizzes will happen

Schizophrenia Two of the following: delusions, hallucinations, disorganized speech, disorganized behavior, and negative symptoms Significant impact on daily life Continuous signs of the disturbance for at least 6 months

Schizophrenia DM-ID-2 criteria, reviewed

Delusions The government’s spy satellites are following me. I’m married to Justin Timberlake. My intestines have been stolen by space aliens, and they probe me at night. The people in the apartment above me are controlled by Russia and move in the exact same steps as me. People watch me for nefarious reasons.

What aren’t delusions Imagination “Magical thinking” Fantasy life “I’m a sheriff” “I’m a firefighter” “I’m a superhero who saves people” Aggression

Hallucinations Whispers Talking from speakers, television Two voices commenting on the individual

What isn’t a hallucination? “I can’t believe my supervisor SAID that to me.” That perfect come-back in the shower three days later Hearing your own voice or that of your family members “You’re worthless” “I love you” Aggression

Schizoaffective Disorder DM-ID-2/DSM 5 criteria, reviewed

Other Psychotic Symptoms Disorganized speech Disorganized behavior Negative symptoms

Brief Psychotic Disorder, Schizophreniform Disorder DM-ID-2/DSM 5 criteria, reviewed

Delusional Disorder DM-ID-2/DSM 5 criteria, reviewed

Schizotypal Personality Disorder Now officially considered part of the Schizophrenia Disorders Fully described in personality disorders

Other disorders that co-exist with Schizophrenia Obsessive Compulsive Disorder Mood Disorders Trauma-related Disorders Substance Use Disorders Other disorders

Case 1 Treatments for schizophrenia CHOOSE YOUR OWN ADVENTURE

Case 2 Treatments

Other Medications Social Engagement Supportive Psychotherapy Case Management Employment

References American Psychiatric Association. Diagnostic and statistical manual of mental disorders (DSM-5®). American Psychiatric Pub, 2013. Fletcher, Robert Jonathan, Jarrett Barnhill, Sally-Ann Cooper. DM-ID-2: diagnostic manual-intellectual disability: a textbook of diagnosis of mental disorders in persons with intellectual disability. National Assn for the Dually Diagnosed, 2017.