Eating disorders in adults with intellectual disability.
There is an increasing focus on the nutrition of people with intellectual disability (ID), but less interest in the range of eating disorders (EDs) that they may exhibit and the bio-psycho-social impact of these conditions. Despite diagnostic and methodological difficulties, psychopathology and ED research studies suggest that 3-42% of institutionalized adults with ID and 1-19% of adults with ID in the community have diagnosable EDs. Weight surveys indicate that 2-35% of adults with ID are obese and 5-43% are significantly underweight, but the contribution of diagnosable EDs is unknown. Such data and case reports suggest that EDs are associated with considerable physical, behavioural, psychiatric and social comorbidity. Review papers have focused on the aetiology and treatment of pica, rumination, regurgitation, psychogenic vomiting and food faddiness/refusal. Emerging clinical issues are the development of appropriate diagnostic criteria, multimodal assessment and clinically effective treatment approaches. Key service issues include staff training to improve awareness, addressing comorbidity and access issues, and maintaining support for adults with ID and EDs, and their carers. Research should confirm the multifaceted aetiology and comorbidity of EDs. Then multicomponent assessment and treatment models for EDs can be developed and evaluated.
Gravestock
S
S
Oxleas NHS Trust/GKT Medical Schools, University of London, London, UK.
D000328:Adult; D000367:Age Factors; D001315:Australia / Q000453:epidemiology; D001835:Body Weight; D015897:Comorbidity; D001068:Feeding and Eating Disorders / Q000453:epidemiology* / Q000503:physiopathology / Q000523:psychology / Q000628:therapy; D005387:Finland / Q000453:epidemiology; D006801:Humans; D007297:Inpatients; D008607:Intellectual Disability / Q000453:epidemiology / Q000523:psychology*; D007494:Ireland / Q000453:epidemiology; D019989:Persons with Intellectual Disabilities / Q000706:statistics & numerical data*; D015995:Prevalence; D012720:Severity of Illness Index; D006113:United Kingdom / Q000453:epidemiology; D014481:United States / Q000453:epidemiology