Diagnosis and classification of eating disorders in adults with intellectual disability: the Diagnostic Criteria for Psychiatric Disorders for Use with Adults with Learning Disabilities/Mental Retardation (DC-LD) approach

doi:10.1046/j.1365-2788.47.s1.41.x

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Wiley InterScience

Journal of Intellectual Disability Research

Volume 47 Issue s1, Pages 72 - 83

Published Online: 30 Sep 2003

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Diagnosis and classification of eating disorders in adults with intellectual disability: the Diagnostic Criteria for Psychiatric Disorders for Use with Adults with Learning Disabilities/Mental Retardation (DC-LD) approach

Shaun Gravestock

Oxleas NHS Trust/University of London; on behalf of the Penrose Society/Royal College of Psychiatrists DC-LD Working Group, London, UK

Correspondence to Dr Shaun Gravestock MBBS MRCPsych Consultant/Honorary Senior Lecturer in Mental Health of Learning Disabilities, Civic House, 20 Grand Depot Road, Woolwich, London SE18, UK (e-mail shaun.gravestock@oxleas.nhs.uk).

KEYWORDS

eating disorders • psychiatric assessment • classification/ diagnostic criteria • aetiology/ comorbidity • service research

Abstract

ICD-10, DSM-IV and DC-LD diagnostic approaches

Background Previous classifications of eating disorders [EDs] employed a narrower concept of EDs. They did not include the wide range of abnormal eating behaviours [AEBs], persistent feeding disorders and EDs psychopathology, aetiological and comorbidity factors seen in adults with intellectual disability [ID].

Methods The International Classification of Diseases − 10 [ICD-10], ICD-10-MR, Diagnostic and Statistical Manual − IV [DSM-IV] and Diagnostic Criteria for Psychiatric Disorders for Use with Adults with Learning Disabilities/Mental Retardation[DC-LD] diagnostic approaches to EDs in adults with ID are compared.

Results The DC-LD encourages conceptually clearer and systematic hierarchical differential diagnostic classification of AEBs and EDs. The DC-LD also allows consideration of relevant aetiological and comorbidity issues. DC-LD-based multi-axial case formulation supports the multimodal clinical assessment of AEBs and EDs.

Conclusions Further research should develop similar systematic and evidence-based multicomponent clinical diagnostic, management and service models for adults with ID and EDs.

DIGITAL OBJECT IDENTIFIER (DOI)

10.1046/j.1365-2788.47.s1.41.x About DOI