The current international classification manuals have limitations when used with persons with intellectual disabilities (PWID), and cannot be applied in severe and profound cases. Misdiagnosis is due to self-report unreliability, limitations in cognitive skills and ability to articulate complex concepts such as depressed mood, and eagerness to please, different symptom expression, behavioural equivalents, and problems in classifying behavioural phenotypes.

The National Association for the  Dually Diagnosed (NADD), has developed a diagnostic manual for PWID to facilitate psychiatric diagnosis in this population group based on DSM-IVTR. A major feature of the Manual is that it provides detailed instructions on how to apply DSM-IV-TR criteria to people with intellectual disability using modified criteria where applicable.  The Manual provides a guide for the clinician in ways to assess and diagnose people who have limited verbal skills. The manual is based on a consensus adaptation of those diagnostic criteria that could not be applied in ID, follows available scientific evidence and has incorporated in the review process an international panel including several  WPA section members, who also participated in the usability testing of the manual. This activity followed previous cooperation between NADD and the WPA ID section.  This initiative provides a framework to facilitate research and progress in the area and it will certainly increase awareness on ID and facilitate the diagnostic process to clinicians.

Luis Salvador-Carulla, MD
Section “Psychiatry of Intellectual Disability (Mental Retardation)
World Psychiatric Association
Cadiz, Spain

[The DM-ID Textbook is]  a major contribution to the field . . .  . I am sure that it will be of great help to those involved in Dual Diagnosis for PWID for years to come.

Nick Bouras, MD, PhD, FRCPsych
Professor of Psychiatry
Institute of Psychiatry - King's College London

As a practitioner resource, the Diagnostic Manual-Intellectual Disability (DM-ID) provides state of the art guidance to accurately diagnose and treat a significant consumer population in need of appropriate mental health services-persons with intellectual disability. This resource will help to advance the quality of mental health services to this often overlooked consumer population. 

Brian J. Boon, Ph. D., President/CEO, CARF.

The mental health service providers in the I/DD field have been looking forward to an organized approach to applying diagnostic rigor.  While the APA's Diagnostic and Statistical Manual (DSM) has provided the starting point, the Diagnostic Manual:  Intellectual Disabilities (DM:ID) text book and clinical guide provide the opportunity for clinicians to improve reliability and validity in their practice with this complex population.  Recognition that people with I/DD experience mental illness has only been a relatively recent development, but the capacity of the general mental health system to understand the diagnostic challenges has generally been overwhelming.

The publication  of the DM:ID begins the opportunity to examine needs and services in ways that have been unattainable thus far, but it will depend upon implementation as well.  With the goal of improving the quality of life for people who are the most vulnerable, clinical and research tools will now have the potential to take a great step forward.  Tremendous efforts have been put into these publications, bringing together research and expert-consensus to build on the contributions of Frank Menolascino, Robert Sovner, and other pioneers in our specialized field.

Paul D. Kolstoe, PhD
Clinical Director/Licensed Psychologist
Chair - AAIDD Mental Health Services SIG

The "Diagnostic Manual - Intellectual Disability" (DM-ID) is a significant step forward in support of the fact that individuals with intellectual disability can and do have mental disorders. It is a culmination of a vision by the leaders of NADD and many years of work by experienced professionals dedicated to providing a more organized way to recognize and diagnose mental disorders in individuals with intellectual disability. Collaboration with the American Psychiatric Association (APA) further legitimizes the correlation of the symptoms seen in individuals with intellectual disability  and those in the APA's "Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition ,Test Revision" (DSM IV - TR) . It should be used by all mental health clinicians as the most up to date tool available to guide their work.

Nancy N. Cain, MD, DLFAPA
Associate Professor of Clinical Psychiatry
Strong Behavioral Health Adult Ambulatory Clinic
Rochester, New York 

As a clinician who evaluates and treats a large number of individuals with severe/profound IDD, I find the adaptation of diagnostic criteria in the DM-ID to be of immense benefit. The comments and literature searches are also quite helpful, providing a concise and focused review of recent literature on each criterion set. The edition is a must for any clinician working in the field of dual diagnosis.

Jarrett Barnhill MD DFAPA, FAACA; Professor 
Department of Psychiatry Director,
Developmental Neuropharmacology Clinic
University of North Carolina School of Medicine
Chapel Hill NC

As a primary care physician with more than forty years' experience working with people with intellectual disability and psychiatric behavioral problems, I really feel that the new DM-ID will be particularly helpful for primary health care providers who serve this population and for interdisciplinary teams-not just psychiatrists and psychologists. We all really want to know that we have a reasonably feasible diagnostic postulate when we begin, continue, change, or discontinue psychotropic medications as well as other treatment modalities. 

Ann R. Poindexter, M.D.

The DM-ID is a must read for any clinician who provides mental health services to people who have intellectual disabilities (ID).  Both versions of the DM-ID instructs the reader on how to apply DSM-IV-TR diagnostic criteria or adaptive criteria and teaches how to identify signs and symptoms of specific psychiatric disorders in persons who have ID. 

Dr. Robert J. Fletcher
Chief Executive Officer

Rob, Congratulations on the DM - ID.  It is truly a work of art and science and I know it will be a monumental contribution to the field.

Fondly,  Marklyn P. Champagne