title: [Take the time: primary healthcare for people with intellectual disabilities].
abstract: People with intellectual disabilities (ID) have a higher prevalence of health problems than the general population and their health needs are often unrecognized and unmet. In this article we present three cases of patients with ID to illustrate some specific problems. A 22-year-old man, severely intellectually disabled, presented with an unsteady gait. He had recently been diagnosed with Cohen Syndrome. Since he was unable to express himself, it took some time to discover that he had additional symptoms, e.g. frequent infections. Eventually, all his complaints fit with his syndrome. A 54-year-old woman, severely to moderately intellectually disabled, presented with new behaviour, i.e. loss of appetite, weakness in her legs and excessive thirst. Although she was able to speak, she was unable to explain what was wrong with her. Since we were aware of the etiology of her disability, Prader Willi syndrome, we were more aware of the possibility of diabetes mellitus. A 56-year-old man, mildly intellectually disabled, presented with hearing voices for which he received antipsychotic medication. After a conversation in simple language, we discovered that he heard humming sounds rather than voices. He was ultimately diagnosed with tinnitus rather than psychosis. It takes time to discover the health issues that affect patients with ID. This is due to communication problems, the inability to understand bodily functions, symptoms and diseases, multi-morbidity, the atypical presentation of disease at times and the different prevalence rates for certain diseases when compared with the general population.
authors.affiliation: Radboudumc, afd. Eerstelijnsgeneeskunde, Nijmegen.
authors.forename: Esther J
authors.initials: EJ
authors.lastname: Bakker-van Gijssel
authors.forename: Peter L B J
authors.initials: PL
authors.lastname: Lucassen
mesh_terms: D057210:Delayed Diagnosis; D003937:Diagnosis, Differential; D005260:Female; D006301:Health Services Needs and Demand; D006801:Humans; D008297:Male; D008875:Middle Aged; D019989:Persons with Intellectual Disabilities; D015995:Prevalence; D011320:Primary Health Care / Q000379:methods* / Q000592:standards; D055815:Young Adult