• Home
  • Store
    • Newsletter Subscriptions
    • Multimedia Subscriptions
    • Books
    • eBooks
    • ABPN SA Courses
  • CME Center
  • Multimedia
    • Podcast
    • Webinars
    • Blog
  • Newsletters
    • General Psychiatry
    • Child Psychiatry
    • Addiction Treatment
    • Hospital Psychiatry
    • Geriatric Psychiatry
  • Log In
  • Register
  • Welcome
  • Sign Out
  • Subscribe
Home » Note From the Editor-in-Chief

Note From the Editor-in-Chief

September 1, 2017
Daniel Carlat, MD
From The Carlat Psychiatry Report
Issue Links: Learning Objectives | Editorial Information | PDF of Issue
Daniel Carlat, MD Editor-in-Chief of TCPR
Greetings to all our subscribers! Thank you for supporting our publications. As Editor-in-Chief of TCPR, I’ll always be here to ensure you get independent and practical content with each issue.

In this month’s issue, we cover a surprisingly neglected topic in psychiatry: How do we interview and treat patients who are intellectually disabled? Personally, when such patients come into my office, I feel at a loss: They are often accompanied by group home staff bearing a stack of forms for me to fill out, and it’s not clear how to approach communicating with patients whose verbal skills are limited. I decided to get some advice, and what better way to do so than to find the country’s best experts to help create a dedicated issue on the topic? The guidance they offer has already helped me in my practice, and I hope you’ll find it useful too—let me know either way. I always love to hear directly from subscribers, so feel free to email me with your thoughts at dcarlat@thecarlatreport.com.
Take Home Points From This Issue

 

Tips for communicating with ID patients

  • Talk directly to patients; they may not be able to talk much, but they can usually understand what’s being said

  • Ask patients’ permission before discussing issues with their collateral contacts

  • Use patients’ mean length of utterance—eg, if a patient communicates in sentences of 6–8 words, you should do the same

  • To get more accurate information, use cross-questioning (ask about something in more than one way). Eg: Ask, “Do you sleep at night?” followed by, “Do you ever have problems sleeping?”

  • Ask one question at a time, avoiding multiple-choice questions and double-barreled questions

  • Link questions to salient events to help jog memory


 

Tips for psychopharmacology treatment Items to assess for

  • Psychosocial issues, such as staff turnover, changes in family contact, or other alterations in routine

  • Medical issues, such as GERD, constipation, infections, dental conditions, or reactions to new medications

  • Psychiatric disorders underlying challenging behaviors, such as anxiety, depression, and psychosis


 

Points to consult with staff/family about

  • Establishing a timeline of medication trials

  • Tracking specific symptoms and behaviors for several weeks after making medication changes


 

Specific medications to recommend for ID patients

  • Antipsychotics: aripiprazole, lurasidone, ziprasidone

  • Antidepressants: escitalopram, sertraline

  • Mood stabilizers for agitation: valproate, lithium

  • Adjunctive agents: alpha agonists, beta blockers, ­naltrexone


 

Psychotherapy tips for working with challenging ­behaviors in ID

Challenging behaviors are common in ID patients and may be related to underlying mood disorders, psychotic disorders, and general difficulty modulating emotions. They may include self-harm or assault, stealing, fire-setting, and sexual offenses. Suggestions include:

  • Use DBT and skill systems training

  • Have clients rate feelings

  • Teach emotion regulation skills, such as mindfulness, on-track thinking and actions, a safety plan, and “new-me ­activities”


General Psychiatry
Carlat 150x150
Daniel Carlat, MD

Treating Alcohol Use Disorder—A Fact Book (2023)

More from this author
www.thecarlatreport.com
Issue Date: September 1, 2017
SUBSCRIBE NOW
Table Of Contents
CME Post-Test - Intellectual Disability, TCPR, September/October 2017
Psychotherapy for the Intellectually Disabled: The Skills System Approach
A Cautionary Consensus on the Use of Ketamine for Depression
Note From the Editor-in-Chief
Psychopharmacology for Patients With Intellectual Disability
Interviewing and Evaluating Patients With Intellectual Disability
DOWNLOAD NOW
Featured Book
  • MFB6eCover.jpg

    Medication Fact Book for Psychiatric Practice, Sixth Edition (2022)

    Guidance, clinical pearls, and bottom-line assessments covering the medications you use in your...
    READ MORE
Featured Video
  • therapist_canstockphoto9201097.jpg
    General Psychiatry

    Using SAMe In Clinical Practice with Garrett Rossi, MD

    Read More
Featured Podcast
  • canstockphoto4921771.jpg
    General Psychiatry

    Psychopharm Commandment #6: MAOIs

    MAOIs rank high in efficacy and are pretty well tolerated too, as long as you watch for two critical interactions.

    Listen now
Recommended
  • Approaches to Autism Intervention

    January 31, 2022
    canstockphoto2240982_child-bubbles_thumb.jpg
  • Currently Available Cannabis Products

    September 1, 2022
  • Interpreting Assessment Discrepancies from Multiple Sources

    October 17, 2022
    ChildAssessment.png
  • Approaches to Autism Intervention

    January 31, 2022
    canstockphoto2240982_child-bubbles_thumb.jpg
  • Currently Available Cannabis Products

    September 1, 2022
  • Interpreting Assessment Discrepancies from Multiple Sources

    October 17, 2022
    ChildAssessment.png
  • Approaches to Autism Intervention

    January 31, 2022
    canstockphoto2240982_child-bubbles_thumb.jpg
  • Currently Available Cannabis Products

    September 1, 2022
  • Interpreting Assessment Discrepancies from Multiple Sources

    October 17, 2022
    ChildAssessment.png

About

  • About Us
  • CME Center
  • FAQ
  • Contact Us

Shop Online

  • Newsletters
  • Multimedia Subscriptions
  • Books
  • eBooks
  • ABPN Self-Assessment Courses

Newsletters

  • The Carlat Psychiatry Report
  • The Carlat Child Psychiatry Report
  • The Carlat Addiction Treatment Report
  • The Carlat Hospital Psychiatry Report
  • The Carlat Geriatric Psychiatry Report

Contact

info@thecarlatreport.com

866-348-9279

PO Box 626, Newburyport MA 01950

Follow Us

Please see our Terms and Conditions, Privacy Policy, Subscription Agreement, Use of Cookies, and Hardware/Software Requirements to view our website.

© 2023 Carlat Publishing, LLC and Affiliates, All Rights Reserved.