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Clinical Usefulness of the Diagnostic Manual-Intellectual Disability for Mental Disorders in Persons With Intellectual Disability: Results From a Brief Field Survey

J Clin Psychiatry 2009;70(7):967-974
10.4088/JCP.08m04429

Objective: The National Association for the Dually Diagnosed, in collaboration with the American Psychiatric Association, adapted the DSM-IV-TR for use with individuals with intellectual disability. This article presents the findings of a study to examine the utility of the Diagnostic Manual-Intellectual Disability (DM-ID) in clinical practice.

Method: In a survey conducted during the summer of 2006, clinicians reported on the extent to which the DM-ID was user friendly, whether it allowed the clinician to arrive at an appropriate diagnosis of the patient, if the clinician was able to arrive at a more specific diagnosis than with the DSM-IV-TR, and if it helped avoid the use of “not otherwise specified” (NOS) diagnostic categories. Demographic information about the clinicians and the patients was obtained.

Results: Data from 63 clinicians and 845 patients with intellectual disability were included in the study. The patients’ level of intellectual disability was approximately evenly divided among the categories of mild, moderate, and severe/profound. The DM-ID was rated as “easy” or “very easy” to use in over 68% of the 845 responses. The positive response to the DM-ID did not vary significantly across levels of intellectual functioning. Clinicians also indicated that the DM-ID helped them avoid the use of the “NOS” diagnosis category, resulting in a more specific diagnosis.

Conclusion: The DM-ID is a useful adaptation of the DSM-IV-TR for persons with intellectual disability. Professionals indicated that it was easy to use, resulted in accurate diagnoses, and can reduce the use of the NOS category. Further research is needed to evaluate the reliability and validity of the DM-ID.