Book reviewjir_1321 250..251

Intellectual Disability Psychiatry:A Practical Handbook

Angela Hassiotis, Diana Andrea Barron & Ian Hall

Wiley-Blackwell, Chichester. 2010. 288 pp., £34.95. ISBN:978-0-470-74251-8.

The description on the back of this book states thatit was written by practising psychiatrists for psychia-trists and other professionals working with peoplewith intellectual disability (ID). It is likely that thisbook will be most useful for trainees and consult-ants in psychiatry.

The first few chapters are dedicated to communi-cation and assessment including a chapter onassessing mental capacity and best interest deci-sions. This is followed by a number of chapters onspecific psychiatric disorders, including psychoticillness and autism spectrum disorders. The bookthen concentrates on specialist areas within ID psy-chiatry including chapters on older people and themanagement of offenders. The last chapters concen-trate on intervention in its broadest sense includinga chapter on pharmacological interventions and achapter on community care.

In their introduction the editors note that, forpeople with ID, communication can make all thedifference, and it is good to see that the chapter oncommunication is placed at the beginning of thebook. If you read no other chapter in the book,read this one, and recommend it to your colleagues,as it stresses the importance of communicationand includes some helpful suggestions on how toimprove communication.

The next chapter, on clinical assessment, isanother well-written chapter, with a wealth of useful

advice from experience, again stressing the impor-tance of good communication. However, very littleis backed up with references, and this is also anissue with the rest of the book. For instance, in thechapter on anxiety and mood disorders the reader isadvised to ‘start low, go slow and change one medi-cation at a time as there is a higher frequency ofidiosyncratic responses to psychotropic drugs’.Excellent advice, but although in the introductionthe editors state that they have deliberately avoidedmaking the book an exhaustive research guide, afew more references would have been welcome. Thechapter on the mental health of older people is wellwritten and informative with helpful case vignettes,although it would also have benefitted from moreuse of quotes. A definition for the concept ‘ageingin place’ would perhaps have been helpful for theuninitiated (although I could guess what it meantand was easily confirmed using Google). Writing achapter on the management of offenders is fraughtwith difficulties (where do you start?), but thischapter has a very useful paragraph on prevalence.Some issues relating to the English (and presum-ably Welsh) law are discussed. On page 178 thereader is presented with a list of treatment orders,some of which are not explained, and where theyare, a small mistake creeps in regarding the lengthof time a Section 38 treatment order can be madefor (should be up to 12 weeks). I found the chapterson pharmacological interventions and psychologicalinterventions very useful, although more informa-tion on cognitive behavioural group therapy, forinstance for sex offenders may have been helpful.

The book is, on the whole, well written andtightly edited, and although individual chapterswere written by different authors (mostly

Journal of Intellectual Disability Research doi: 10.1111/j.1365-2788.2010.01321.x

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© 2010 The Authors. Journal of Intellectual Disability Research © 2010 Blackwell Publishing Ltd

psychiatrists), the book reads as a whole, ratherthan as a collection of essays. Where appropriate,references are made to earlier or later chapters.Case vignettes are used throughout the book, andsome of these are very useful to illustrate a point,although others are too short to be useful. Someediting problems remain, in that a number of chap-ters include too much use of telegraph style lists,and there are a few grammatical and spelling errors.The use of boxes to summarise information is par-ticularly welcome. Although a book such as thiscannot include every aspect of ID psychiatry, someabsences are puzzling, including the absence of aspecific chapter on the psychiatric aspects ofcommon syndromes and behavioural phenotypes.Two other recent books on psychiatry and ID (Royet al. 2006; Bouras & Holt 2007) both do includesuch chapters.

Most of the authors are from the British Isles,and although the introduction of the book makes areference to ‘many parts of the world’, there is littleor no evidence that the authors have attempted toseparate out issues which may be only relevantfor (parts of) the UK, from topics with a wider

relevance. This is a pity, because, as the editors statein the foreword, in many parts of the world thereare no specific mental health services for peoplewith ID, and a book such as this, therefore, has thepotential to have a much wider audience than justthe UK.

I enjoyed reading this book. The book is a usefulguide for all professionals working with people withID, and is likely to be particularly valuable for psy-chiatric trainees attempting to pass examinationssuch as the membership examination of the RoyalCollege of Psychiatrists.

Harm Boer

Janet Shaw Clinic, Birmingham, UK

References

Bouras N. & Holt G. (eds) (2007) Psychiatric and Behav-ioural Disorders in Intellectual and Developmental Disabili-ties. Cambridge University Press, Cambridge.

Roy A., Roy M. & Clarke D. (eds) (2006) ThePsychiatry of Intellectual Disability. Radcliffe Publishing,Abingdon.

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Book review

© 2010 The Authors. Journal of Intellectual Disability Research © 2010 Blackwell Publishing Ltd