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Psychiatric assessment in adults with autism spectrum disorder (ASD) and intellectual disability (ID) is complex and challenging. With co-occurring congenital blindness, this complexity is increased. Systematic knowledge about psychiatric assessment in this combination of challenges is virtually non-existing, and there is little guidance available for clinicians faced with this task. The paper aims to discuss these issues.

Experiences from comprehensive psychiatric assessments in two adults with congenital blindness, ASD, and ID are explored and discussed.

Adaptation of assessment procedures usually employed for individuals with ASD and ID involved no major alteration, but co-operation between mental health and visual impairment professionals was important, as was the involvement of the families of the individuals in question. In both cases, the patient met criteria for an anxiety disorder, underlining the vulnerability and the challenges involved in living with this combination of challenges.

There is an urgent need for research into mental health issues for this group, including case studies describing successful treatment or intervention for these issues.

Psychiatric assessment in individuals with this combination of challenges may be feasible, but requires involvement of professionals specializing in mental health in developmental disabilities, and professionals in visual impairment. Assessments need to be individually adapted.

This is the first study systematically describing psychiatric assessment in this group involving the use of checklists and assessment tools. Strategies and tools that were useful are described and discussed to aid other clinicians faced with similar challenges.

People with autism spectrum disorders (ASD) have been associated with criminal acts and affiliation with groups and organisations with violent ideology and practice. The purpose of this paper is to present patients in mental health services with both ASD and psychosis, who are affiliated with such groups.

Three vignettes are used as examples. Some of the information is combined for the three participants for presentation. They were scored for mental health symptoms and behaviour problems on admission and discharge from inpatient care.

The combination of ASD and psychosis aggravates the problems of both conditions, which may elicit a collapse of both cognitive functioning and especially impulse control, and of the ability to judge whether situations are dangerous or offensive or not.

The present paper may contribute to a better understanding of the combination of ASD, psychosis and affiliation with groups and organisations as described, especially regarding the importance of identifying psychosis.

There are few publications on personality disorder in adults with intellectual disability (ID), and on borderline personality disorder (BPD) specifically. Publications concerning treatment are sparse, despite the high symptom burden in these patients. This paper aims to discuss these issues.

Six patients with BPD and ID were recruited from the same inpatient unit. Behaviour problems and mental health symptoms were scored on admission and discharge. Information about treatment, length of stay, etc. was taken from case files.

Both mental health symptoms measured by the SCL-90-R, and behaviour problems measured by the Aberrant Behaviour Checklist were significantly reduced on discharge. In the active treatment period, the two main aspects of treatment were validation and practicing new solutions when emotional and behavioural problems occur, i.e. skills training.

The limitations related to this study are that the study is conducted in one milieu only. Another limitation is that the patients were admitted over a five-year period, where, some changes were made in the treatment approach.

Inpatient treatment of this patient group seems to be effective if individually adjusted to the patient’s psychopathology, ID and communication style. Close co-operation between the individual therapist and milieu therapists is essential.

There is a need for intervention studies on BPD in ID. This study may be a valuable contribution.