Dementia Its Management And Prevention

In the event that the person has an IQ of less than 70 and exhibits significant adaptive function impairment before the age of 18. Also, a combined diagnosis of dementia and intellectual disability is established if the patient fulfills the dementia criteria. Only dementia is diagnosed if the patient is older than eighteen, exhibits recently acquired cognitive impairment, and has an IQ of less than seventy-nine. Intellectual disability usually manifests in the early stages of development, and concomitant dementia is occasionally observed in individuals with intellectual disability. 

Course And Prognosis

When it comes to intellectual disability, the prognosis and course can vary.  A sustained impairment in cognitive function is usually present in cases with intellectual disability. In most situations, intellectual impairment may not get better.  Adaptation levels rise with age and are positively impacted by a nurturing environment. Therefore, a supportive setting could aid in the patient with intellectual disability's improved adaptations. 

People with mild to moderate intellectual disabilities are better at adapting. Typically, their prognosis is better. A coexisting mental illness may be detrimental to the prognosis as a whole. Therefore, it is imperative that the comorbidities be addressed in addition to them.

Information about psychopharmacology, including how specific medications are used to treat symptoms. 

Patients with intellectual disabilities typically respond less well to medications.  Patients with intellectual disabilities are also more susceptible to adverse consequences. As a result, while prescribing medication, caution must be used. A low dose should be started and increased gradually.  Among those with a severe to profound intellectual handicap, the death rate rose. Higher in the early stages of maturity. 

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Treatment

Response to psychopharmacology information about how specific medications are used to treat symptoms. Patients with intellectual disabilities typically experience a diminished response to medications.
Individuals with intellectual disabilities are also more susceptible to adverse reactions. As a result, caution must be used while prescribing medications, starting with a low dosage and increasing it gradually. Those with severe to profound intellectual disabilities experienced an increase in mortality. 

Also Read: Intellectual Disability And Association

Prevention

The majority of intellectual impairment causes can be avoided. For this reason, knowing how to prevent is essential.  The emphasis is on using medicine to treat or eradicate the factors that cause intellectual impairment and related diseases to arise. Additionally, it lessens the related issues for those with intellectual disabilities.Hope you found this blog helpful for your Psychiatric Theory and Specialities Preparation. For more informative and interesting posts like these, keep reading PrepLadder’s blogs.

Primary Prevention

A few instances are: screening newborns for metabolic diseases
PKU screening and low-phenylalanine diets considerably modify the onset of intellectual impairment in patients.  The screening often has the effect of lessening the severity of intellectual disability.  Supplementing with folic acid lowers the chance of neural tube defects. 

Raising awareness Drinking no alcohol while pregnant can help prevent alcohol-related problems in the unborn child, like fetal alcohol syndrome.
If there is a history of genetic problems in the family, family and genetic counseling is crucial. 

Also Read: Communication Disorders In Child Psychiatry

Secondary Prevention and Tertiary Prevention

In secondary prevention, medical and psychiatric consequences can be treated quickly to shorten their duration..  The consequences or ensuing disabilities are reduced in tertiary prevention.  The course of some diseases, such as hypothyroidism or genetic metabolic problems, can be positively impacted by early treatment with dietary modification or hormone replacement therapy. 

Etiology's Effect on Rx

The management is influenced by the etiology.  By altering nutrition, impulsivity and hyperactivity in people with PKU or phenylketonuria with intellectual disability decline.  Research indicates that dopamine agonists may lessen issues with cognition and behavior. Determining the etiology is crucial because the reason or etiology of intellectual disability frequently affects the course of treatment. 

Also Read: Emotion: Components, Emotional Process, Biology, Theories

Psychosocial Intervention

Educational Interventions

The program should help people with intellectual disabilities strengthen their talents and boost their self-esteem.  In addition, it needs to improve living quality and emphasize communication skills. 

Behavioral and Cognitive-Behavioral Interventions

• Barriers to patients with intellectual disability are:
• Limited verbal ability
• Limited cognitive ability
• Limited self-efficacy
• So many times the interventions and approach have to be modified to accommodate the level of understanding of the individuals with intellectual disability. 
• Many times supportive interventions may have a greater role in managing the symptoms. 

Behavior Therapy

It can be used in increasing social behaviors, and controlling or decreasing aggression, or self-injurious behavior. 

• The therapies may comprise:
  • Environmental modification
  •  Caregiver education
  • ABA (applied behavior analysis)
  • Positive reinforcement
  • Punishment (should not be very harsh)

Comprehending the ABC, including its antecedents, repercussions, and actions, is crucial. Situational analysis is required by the ABC before implementing changed actions.  Rewards for excellent behavior should be included in penalties as well as less severe ones when used as a therapeutic tool. This promotes desired conduct and stifles undesirable behavior. 

Cognitive Therapy 

• It comprises relaxation and exercises to manage self-injurious behavior. 
• Treatment for depression in mild intellectual disability can also be used. 
• Skill training such as brief relaxation techniques can be used to reduce anxiety.
• Copying skills
•  Social skills
•  Parent skills training 

Psychodynamic Therapy 

o Expectational disputes should be more frequently raised by the patients and their families.
o By realizing the therapy's limitations, it aids in the control of expectations among family members.
o Interventions in psychoeducation
o Counseling with family 

 Family Education Is Most Important.

Maintaining reasonable expectations and boosting self-esteem through height expression are two of the most crucial aspects of this.  The family should be given all the information necessary to better manage themselves with regard to the interventions and their results. 

Also Read: Human Aggression: A Comprehensive Approach 

Social Intervention

Social isolation is one of the biggest problems that persons with intellectual disabilities face.  People with intellectual disabilities tend to withdraw from social situations due to a lack of social skills.
Thus, developing social competency is essential. One way that interventions can happen is through summer camps. People and their families will gain from it.  Events like games and Special Olympics encourage social interaction and physical conditioning.  For this reason, developing policies to support individuals with intellectual disabilities requires careful consideration. 

Pharmacotherapy

 The number of controlled trials including medication and its intervention is quite few.  Co-occurring disorders, seizure disorders, or heart conditions need to be taken into account while prescribing medication. For this reason, before beginning a medication therapy, a complete medical history is essential. Drug therapy is employed to address co-occurring conditions and their manifestations. 

Management Of Aggression Irritability And Self-Injurious Behavior

Antipsychotics have been shown to play a significant impact, despite certain negative consequences, such as increased EPS vulnerability.
Risperidone and aripiprazole are the two most significant antipsychotics.
Adults and children with intellectual disabilities who exhibit severe disruptive conduct are treated with risperidone. It is advised to start with low doses and raise them gradually.  Other antipsychotic medications include: ₧ GABA analogs, such as piracetam; ₧ Olanzapine, quetiapine, clozapine (use caution due to side effects); ₧ Sulpiride anticonvulsants; NMDA Antagonist: Amantadine (disruptive behavior)

Also Read: Exploring Erik H. Erikson's Psychosocial Theory Of Development

Hope you found this blog helpful for your Psychiatric Theory and Specialities Preparation. For more informative and interesting posts like these, keep reading PrepLadder’s blogs.