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Catatonia is increasingly recognised as a comorbid syndrome of Autism Spectrum Disorder (ASDs). The assessment and management of individuals with comorbid ASD and intellectual disability (ID) adds a further dimension to this already complex presentation, with few cases identified in the literature. The paper aims to discuss these issues.

This paper presents four cases of catatonia in individuals with comorbid ASD and ID. The diagnostic challenges, response to treatment and prognosis are discussed whilst comparing with the existing literature.

A high index of suspicion is required to recognise the subtle catatonic features seen in patients with ASD and ID. Clinicians should be particularly vigilant following stressful events in young adults. The assessment of catatonia in ASDs and ID requires a pragmatic approach given the lack of suitable diagnostic tools and difficulties completing investigations. Caution is advised when using rating scales as they are not validated in ID. The mainstay of treatment is lorazepam, although responses vary.

The discussion of these four cases strengthens the existing literature, and highlights the implications a comorbid diagnosis of ID has on the assessment and management of catatonia in ASDs.

The purpose of this paper is to present outcomes of mixed practices including use of ideas from narrative therapy (NT) in a case of mild intellectual disability (ID) and personality disorder. The formulation, therapy adaptation and outcomes are presented.

The study is a single case report describing patient presentation, assessments, psychological formulation and the mixed interventions approaches used, including ideas from NT. Adaptations to meet the needs of patients with ID were described, and therapy outcome measured using Health of the Nation Outcome scale and Psychiatric Assessment Schedule for Adults with Developmental Disorders was presented.

The ideas used from NT suggest this is potentially a useful approach in practice for people with intellectual disabilities and personality disorder. However, adaptation is needed for it to be used successfully in practice as a therapeutic intervention.

A single case study has its limitations, and further work on using ideas from NT, its adaptation and use in this population will be needed.

There is no previous case of use of NT among patients with ID and personality disorder.

The purpose of this paper is to discuss the findings of a service evaluation project of the Specialist Memory Clinic for people with intellectual disabilities in South Wales using the Dementia guidelines published by the British Psychological Society and the Royal College of Psychiatrists (BPS/RCPsych, 2015).

Clinical audit using case notes of patients attending Memory Clinics during 2011 and 2015 benchmarked against best practice guidelines; carers feedback from Memory Clinic attendance; and evaluation of the training sessions to carers.

Audit findings show full compliance with standards (100 per cent) except for the baseline assessment for people with Down syndrome. Carer’s evaluation and feedback was positive and constructive. Training evaluation indicates improvement in knowledge and positively received sessions.

The small number of people included and possibility of high motivated team may affect the service evaluation result.

It is possible for the Community Learning Disability team to meet the standards published (BPS/RCPsych, 2015) through multidisciplinary working.

Initial service evaluation completed after published guidelines for Dementia care by the BPS/RCPsych (2015).

Review of antipsychotic prescribing practices, rationale and follow-up using an internationally standardized audit can be an effective tool to encourage and monitor best practices. The purpose of this study is to audit the current prescribing pattern for people with intellectual disabilities and challenging behaviours in Qatar.

This study was based on the challenging behaviour management guidelines recommended by the Royal College of Psychiatrists. All current electronic medical records in the Mental Health Service-Hamad Medical Corporation were examined to identify patients with intellectual disabilities who received antipsychotics for challenging behaviour. Demographic variables, such as age, sex and nationality, were collected. In addition, details of psychiatric diagnoses, prescribed psychotropic medications and diagnoses of epilepsy were also collected. For patients who were prescribed antipsychotic medication, the clinical rationale for such medication was collected along with evidence of side effect monitoring to allow performance against the audit standards to be measured.

This is the first audit on prescribing practices in people with intellectual disability and challenging behaviour in the state of Qatar. The results of this study regarding the pattern of prescribing practices for patients with intellectual disability and challenging behaviour reflect the limitation in knowledge and experience among non-specialist practitioners within mental health service. The result may be helpful to support the development of specialist service provision to improve the care for such vulnerable group. The result may also help other medical centres and clinicians by providing an improved understanding of possible deviations from the best medical practices.

This is the first audit on prescribing practices in people with intellectual disability and challenging behaviour in the state of Qatar. The study is also noteworthy as, to the best of the authors’ knowledge, it is one of only a few studies on antipsychotic prescribing for patients with intellectual disability and challenging behaviour in the Middle East; therefore, it will be useful in raising awareness and promoting the best practices in the Middle East region. This study is also among the first few studies that were designed based on the four audit standards by the Royal College of Psychiatrists in this area.

People with intellectual disability are subject to increased health morbidity when compared to the general population. This paper assesses the monitoring of metabolic syndrome in people with an intellectual disability who have been prescribed antipsychotic medication.

A pre‐audit analysis was followed by an audit of 32 patients. The height, weight and body mass index was recorded in 34 per cent prior to initiation, which decreased to 22 per cent at the three monthly follow up. Blood pressure was recorded in 6 per cent of the patients at baseline, but there was no record during treatment. The biochemical parameters including plasma glucose and plasma cholesterol were measured in 40 per cent of the patients on initiation which decreased to 33 per cent at three monthly follow up in the first year. In total, 21 per cent of patients received four monthly monitoring of the biochemical parameters, i.e. their height and weight, 25 per cent of the patients had an annual monitoring of all parameters.

The results indicate inconsistent monitoring of metabolic syndrome in people with intellectual disability being treated with antipsychotic medication. While a proportion of patients may have been monitored in primary care, these data indicate the need for remedial action to improve the standard of metabolic syndrome detection in those people with intellectual disability receiving antipsychotic medication.

This study highlights the inadequate monitoring of biochemical and physical parameters of metabolic syndrome in people with an intellectual disability who are prescribed antipsychotic medication. National criteria for monitoring the prescription of antipsychotic medication in people with intellectual disability who are prescribed antipsychotic medication is proposed.

Significance of attachment relationship to the development and impairments among children with autism has been studied. The purpose of this paper is to analyze the literature for studies completed on the attachment and assess the effect of autism on attachment development. Different moderators of attachment are also reviewed.

Systematic reviews were searched for in different databases to establish the necessity and relevance of the current paper. The last systematic review on the topic was published in 2004 so studies done after that year were searched for in electronic databases and experts on the filed were also contacted before choosing the ten studies selected for this review.

Attachment is present among children with Autistic Spectrum Disorders (ASD), however not prevalent as in normally developing children. The security and organization of attachment behavior are affected by the severity of the diagnosis of Autism and the co-morbidities associated. Maternal sensitivity and insightfulness support the development of secure attachment in children with ASD while impairments in joint attention and symbolic play proved to be risk factors for insecurity and disorganization of attachment.

The review contributes to the relatively understudied topic of attachment behavior in autism spectrum disorders focussing on the influence brought to the bonding connection by different influencing factors like: mothers’ sensitivity, insightfulness and attachment style, parenting style and symbolic play levels.