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DC-LD Framework — MRCPsych Paper B MCQ

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ModerateIntellectual DisabilityDC-LD FrameworkMRCPsych Paper B

A 35-year-old man with moderate intellectual disability and limited verbal communication is undergoing assessment for a possible psychiatric disorder. The psychiatrist wishes to use an operationalised diagnostic classification framework specifically adapted for adults with intellectual disabilities and intended to complement standard diagnostic systems. Which framework is most appropriate?

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Correct answer: C — Diagnostic Criteria for Psychiatric Disorders for Use with Adults with Learning Disabilities (DC-LD)

DC-LD is an operationalised psychiatric diagnostic framework developed specifically for adults with intellectual disabilities, particularly where cognitive and communication limitations can alter the presentation of mental disorders. NICE identifies DC-LD as an example of a classification system adapted for people with learning disabilities. ICD-11 and DSM-5-TR are general diagnostic classifications and are not specifically adapted for this population, although they may still contribute to assessment. PAS-ADD is a structured psychiatric assessment schedule rather than the diagnostic classification framework requested. Mini PAS-ADD is a shorter screening and assessment instrument and likewise does not replace a diagnostic framework. Diagnosis should still follow a comprehensive biopsychosocial assessment, including collateral history, physical health, developmental level, environmental factors and formulation.

Reference: National Institute for Health and Care Excellence. Mental health problems in people with learning disabilities: prevention, assessment and management (NG54), recommendation 1.7.4. 2016; last reviewed 2024. https://www.nice.org.uk/guidance/NG54/chapter/Recommendations