Hidden psychiatric morbidity in a vocational programme for people with intellectual disability

The aim of the present study was to assess the point-prevalence of psychiat ric disorders according to DSM-III-R criteria and the hidden morbidity in i ndividuals with intellectual disability working in a vocational setting. Th e present study was carried out in a vocational centre in Southern Spain wh ich is considered to be a model for social integration. One hundred and thi rty workers with intellectual disability were interviewed by two experience d clinicians using the Assessment and Information Rating Profile, DSM-III-R criteria, and the General Assessment of Functioning and Clinical Global Im pression scales. The point prevalence of psychiatric morbidity, hidden morb idity and treatment adequacy were estimated. Morbidity was hidden (i.e. not previously diagnosed) in 50% of psychiatric cases. Forty-two (32.3%) subje cts had a psychiatric diagnosis with the following distribution: schizophre nia (17.7%), other psychotic disorders (9.23%), mood disorders (4.61%), ada ptive disorders (2.31%), anxiety disorders (1.54%) and other psychiatric di sorders (6.15%). Treatment was judged inadequate in 30% of subjects. The po int-prevalence of psychiatric problems in a vocational setting in Spain was similar to that found in other environments. Hidden morbidity was similar to that found in primary care. The present study highlights the need for st andardized instruments for psychiatric assessment in non-clinical settings as well as specific training in this area.