Preventing Sexual Assault in Intellectual Disability.

Prevention of sexual assault in intellectual disability (ID) begins with defining the problem. There are identified risk factors and barriers faced by adults with ID who experience sexual assault. Research shows that individuals with ID are victimized by sexual assault at rates substantially higher than the general population.

Relationship Between Obesity and Intellectual/Developmental Disability in an Ohio Telepsychiatry Clinic: A Retrospective Review.

Co-occurring intellectual/developmental disability (IDD) and overweight/obesity (OW/OB) is an important consideration of IDD psychiatric care. The relationship between OW/OB and comorbid diagnoses of Autism Spectrum Disorder (ASD) and/or IDD remains inadequately described in existing literature. The purpose of this study is to explore these co-occurring diagnoses.

Healthy Lifestyle Interventions Augmenting Psychotherapy in Anxiety and PTSD.

Lifestyle medicine is a new paradigm that shifts much of the responsibility toward the patient. There is increasing evidence that healthy lifestyle interventions can be effective treatment adjuncts for some of the most common mental illnesses. This article gives examples of how to integrate evidence-based, healthy lifestyle interventions into the overall treatment of common psychiatric conditions, including anxiety and posttraumatic stress disorder (PTSD).

Medical Student-patients: Mental Wellness During the Pandemic.

Medical schools around the globe canceled in-person classes and switched to virtual classrooms shortly after the COVID-19 pandemic began. The shift to online platforms posed serious challenges to medical education. During normal conditions, medical school is viewed as a challenging time during which resilience is critically important.

Psychotherapy for Adult ADHD.

The adult patient who presents for psychiatric evaluation with symptoms of attention deficit hyperactivity disorder (ADHD) poses specific challenges to the treating psychiatrist. Symptoms include trouble focusing, hyperactivity, and impulsive behavior. Patients may experience behavioral, mood, and cognitive issues.

Personality Disorders in Patients with Intellectual Disability.

Both individuals with intellectual disability (ID) and individuals with personality disorders represent populations that require unique interactions with healthcare providers and consist of high utilizers of the healthcare system. The intersectionality of these diagnoses poses further considerations in diagnosis and management. This article describes two fictional case studies intended to illustrate, examine, and identify symptomology of individuals with these comorbid diagnoses and establish recommendations for evidence-based management of these individuals.

Psychotherapy for Violent Behavior in Children and Adolescents.

The child patient who presents for psychiatric evaluation due to aggressive behavior poses specific challenges to the treating psychiatrist. Boundary violations, devaluation of relationships and social skills, and transference/countertransference issues are some of the challenges that may arise during the psychiatric treatment of the aggressive child patient. The child who displays aggression may have complex challenges, including major transitions, insomnia, trauma history, custody considerations, and family disruption, among others.

Neurodevelopmental Disorders, Criminality, and Criminal Responsibility.

Although individuals with neurodevelopmental disorders (ND), such as intellectual disability (ID) and autism, are overrepresented in the criminal justice system, most psychiatry training is limited regarding NDs, and forensic psychiatry training tends to focus on psychotic and mood disorders. This article explores the complex interactions between NDs and criminality, including direct etiological explanations and potential mediating variables (e.g.

Bringing It in the Room: Addressing the Impact of Racism on the Therapeutic Alliance.

It is well documented that people of color face disparities in access to and quality of healthcare. There are inequities in healthcare outcomes as well. The biases of healthcare providers are one of the many factors that contribute to healthcare incongruence.

Co-occurring intellectual disability and substance use disorders.

Individuals with intellectual disabilities (ID) are an expanding population that confronts multiple disadvantages from social and environmental determinants of health. Deinstitutionalization and community integration have improved the lives of individuals with ID in many ways. However, deinstitutionalization may increase their access to alcohol and drugs and the potential for developing Substance Abuse Disorders (SUD).

Evaluation of Health Care Disparities for Individuals with Intellectual and Developmental Disabilities in Ohio.

The purpose of the study was to determine the acute and long term services and supports (LTSS) utilization, cost of health care and disparities in access of care for individuals with Intellectual and Developmental Disabilities (IDD). Individuals with IDD on a waiver (receiving Medicaid-funded LTSS in community settings) compared to non-IDD individuals on a waiver control group were compared using Ohio Medicaid claims data from calendar year 2013. Results found the IDD Waiver population had lower utilization rates for emergency department visits, hospital admissions, and hospital readmissions within 30 days compared to the Non-IDD Waiver population and lower PMPM expenditures across all medical service categories except pharmacy.

Psychotherapy with Survivors of Sexual Abuse and Assault.

Sexual assault and abuse can result in severe physical and emotional trauma to the victim. Deploying targeted psychotherapeutic treatment that is individualized for the survivor is important to achieving optimal patient outcomes. There are several valid and evidence-based treatments available for posttraumatic stress disorder (PTSD) and interpersonal difficulties that can result from sexual abuse and assault.

Dismantling Fears Associated with Intellectual Disability Psychotherapy: An Evidence-based Practice.

Individuals with intellectual disability (ID) and traumatic brain injury experience mental health issues at a higher rate than the general population. They are typically more vulnerable to stress, have fewer coping skills, and possess a smaller system of natural supports. It is clear that level of intelligence is not the sole indicator of the appropriateness of psychotherapy and that the full range of mental health services are able to help improve the quality of life for patients with intellectual disability.

Reaching rural Ohio with intellectual disability psychiatry.

Individuals with intellectual disability experience higher rates of mental illness when compared with the general population, and there is a lack of medical and mental health professionals in rural and under-served areas. With the increase in discharge of individuals from institutional settings back to their home communities into the least restrictive environments, there are more patients with complex needs being added to the schedules of physicians in the outpatient delivery care system. Patients with disabilities may not travel well or tolerate changes in routine so may not have access to psychiatry.

Toward impacting medical and psychiatric comorbidities in persons with intellectual/developmental disabilities: an initial prospective analysis.

Objective: The purpose of this study was to determine the effectiveness of psychiatric medical services, counseling, and behavioral treatments for adult patients with intellectual disabilities plus behavioral disorders and/or emotional distress.

Methods: Behavioral and medical data were collected at six and 12 months for a consecutive series of 141 adult patients with mild, moderate, or severe/profound intellectual disabilities who had been referred to a dual diagnosis mental health clinic, and treatment outcomes were compared.

Results: Most improvement in behavioral problem severity occurred at six months, then plateaued.

STRESS AND TRAUMA: Psychotherapy and Pharmacotherapy for Depersonalization/Derealization Disorder.

Depersonalization/derealization disorder is characterized by depersonalization often co-occurring with derealization in the absence of significant psychosis, memory, or identity disturbance. Depersonalization/derealization is categorized as one of the dissociative disorders, which also includes dissociative amnesia, dissociative fugue, dissociative identity disorder, and forms of dissociative disorder not otherwise specified. Although these disorders may be under-diagnosed or misdiagnosed, many persons with psychiatric illness who have experienced trauma report symptoms consistent with dissociative disorders.

Psychotherapy and pharmacotherapy for patients with dissociative identity disorder.

There is a wide variety of what have been called "dissociative disorders," including dissociative amnesia, dissociative fugue, depersonalization disorder, dissociative identity disorder, and forms of dissociative disorder not otherwise specified. Some of these diagnoses, particularly dissociative identity disorder, are controversial and have been questioned by many clinicians over the years. The disorders may be under-diagnosed or misdiagnosed, but many persons who have experienced trauma report "dissociative" symptoms.

Psychotherapy with women who have worked in the "sex industry".

Psychotherapy is effective for a myriad of mental health symptoms, with the clinical situation dictating the most applicable method. For episodes of severe stress including acute depression and anxiety, supportive mechanisms (crisis interventions and shoring up existing coping skills and strategies) may be the best fit. During periods of relatively milder symptomatology a psychodynamic approach may be utilized with the same patient (focusing on self-reflection and a more in-depth exploration).

Examining the therapeutic relationship and confronting resistances in psychodynamic psychotherapy: a certified public accountant case.

Psychodynamic psychotherapy is effective for a variety of mental health symptoms. This form of psychotherapy uses patient self reflection and self examination, as well as the therapeutic relationship between the patient and psychiatrist, to explore maladaptive coping strategies and relationship patterns of the patient. A thorough understanding of resistance and the core conflictual relationship theme afford the psychiatrist the ability to facilitate this work.

Nonverbal communication in psychotherapy.

The mental status examination is the objective portion of any comprehensive psychiatric assessment and has key diagnostic and treatment implications. This includes elements such as a patient's baseline general appearance and behavior, affect, eye contact, and psychomotor functioning. Changes in these parameters from session to session allow the psychiatrist to gather important information about the patient.

Accurately diagnosing and treating borderline personality disorder: a psychotherapeutic case.

The high prevalence of comorbid bipolar and borderline personality disorders and some diagnostic criteria similar to both conditions present both diagnostic and therapeutic challenges. This article delineates certain symptoms which, by careful history taking, may be attributed more closely to one of these two disorders. Making the correct primary diagnosis along with comorbid psychiatric conditions and choosing the appropriate type of psychotherapy and pharmacotherapy are critical steps to a patient's recovery.

Medical student mental health services: psychiatrists treating medical students.

Medical school is a stressful and challenging time in the academic career of physicians. Because of the psychological pressure inherent to this process, all medical schools should have easily accessible medical student mental health services. Some schools of medicine provide these services through departments of psychiatry or other associated training programs.

Symptom prevalence of ADHD in a community residential substance abuse treatment program.

Objective: ADHD is a common comorbid condition with substance use disorder. This study seeks to examine the discrepancy in the prevalence rate between those previously diagnosed with ADHD and those diagnosed while in treatment. It is hypothesized that clients with ADHD would have earlier unsuccessful terminations from treatment than non-ADHD clients and that the ADHD Self-Report Scale (ASRS Version 1.

Supportive Psychotherapy with the Dual Diagnosis Patient: Co-occurring Mental Illness/Intellectual Disabilities.

Psychiatrists and other mental health professionals can offer much in the care of patients with intellectual disabilities, including state-of-the-art medication regimens, psychotherapy, and other behavior therapies. Individuals with intellectual disabilities experience the full range of mental illnesses, but are often thought to be incapable of participating in or responding to psychotherapy. The following composite cases illustrate some of the psychotherapy techniques employed in a community psychiatry setting that serves patients with intellectual disabilities and co-occurring mental illness.