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Psychiatric review of the former Kew Residential Services residents data
The Centre for Developmental Disability Health Victoria (CDDHV) conducted independent psychiatric reviews of former residents of Kew Residential Services (KRS) between 27 and 30 November 2008, at the request of the Senior Practitioner. The report outlines the findings and recommendations of the independent reviews.

Sheet 1 (Sheet1)

Table 1.0: Original and revised diagnoses, medication changes and medical co morbidities generated by the independent psychiatric assessments
Name Age Sex ID Original diagnoses Psych meds at R/V Medical issues inc side effects Diagnosis at R/V PDD Changes to medication and recommendations Behaviour
intervention
Client 1 47 M Sev Psychosis Risperidone 1m bd Deafness Autism Y Minimum dose risperdal
OC(P)D Overweight Metabolic screen
Client 2 44 M Mod Psychotic features Olanzapine 15 mg NS Anxiety disorder Y Wean olanzapine
Trial SSRI
Client 3 52 M Mod Psychosis Olanzapine 5mg Epilepsy NS Y Wean olanzapine
Somnolence Start SSRI
Metabolic workup
Client 4 57 M Mod BPAD LiC03 500mg bd Constipation BPAD Y Drug levels
Psychosis Olanzapine 15mg Metabolic screen
Valproate 200mg bd
Client 5 51 M Sev Childhood psychosis Olanzapine 20mg Epilepsy Bipolar 1 NS Wean olanzapine
Organic mental disorder Valproate 1500mg Stroke Start aripiprazole
OCD Diazepam PRN Obesity Mood and behaviour charts
Diabetes Needs endocrine review
Client 6 47 F Prof NS Citalopram 20mg Epilepsy NS Y Continue citalopram
Client 7 52 F Sev Anxiety Anafranil 125mg Epilepsy OCD Y Wean anafranil
OCD Constipation Start sertraline
Asthma Metabolic screen
Vit D Weight loss
Obesity
Client 8 38 M Sev NS Fluvoxamine 100mg bd Nil OCD Y Nil
Spitting
Tearing clothes
Client 9 62 M Prof Psychosis NOS Ripseridone 0.5mg bd TD Nil Nil
Mobility issues
Client 10 43 M Mod Psychosis NOS Olanzapine 5mg Low Na+ Ddx schizophrenia N Metabolic monitoring
Modecate 6.25mg monthly BPAD
Paroxetine 20mg
Client 11 49 F Sev OCD  repetitive rubbing of genitals Fluvoxamine 50mg Hysterectomy Rubbing thought to be self-stimulatory Wean fluvoxamine and risperidone
Risperidone 0.5mg bd
More information needed for Rx
Client 12 28 F Mod Generalised anxiety disorder Alprazolam 0.5mg bd PKU GAD Change alprazolam to diazepam then wean
Sertraline 50mg Hep B carrier Trial of wean sertraline
Client 13 53 M Prof Bipolar affective disorder LiCo3 3.5mg daily Nil BPAD Y Ongoing psychiatric care BIST referral
OCD Olanzapine 5mg nocte OCD Need for paroxetine
Paroxetine 20mg mane
Client 14 49 M Sev Manic depression ? ? ? ? ?
Client 15 57 M Sev Childhood psychosis Risperidone 3mg bd Blind Atypical autism Y Wean anafranil and risperidone
Autism Anafranil 150mg Deaf Colonoscopy
OCD Obese
Constipation
Client 16 60 F Mod Self-harming behaviours Lexapro 10mg Constipation Autism Y Colonoscopy
Self-stimulation Aripiprazole 10mg Osteoporosis
Client 17 41 M Sev Anxiety disorder Olanzapine 15mg Constipation PDD Y Monitor constipation Consistent and predictable environment
Chlorpromazine PRN Underweight Impulse control disorder Metabolic monitoring
Medication monitoring
Client 18 54 F Mild Intermittent explosive disorder Fluoxetine 40mg Epilepsy BPAD Metabolic monitoring
Olanzapine 2.5mg Optimising mood stablisation
Client 19 50 F Prof Autistic features Olanzapine 2.5mg bd Epilepsy NS Wean olanzapine Environmental and behavioural interventions
Psychosis NOS Constipation Metabolic screen
Karyotype and fragile X
Liver function
Client 20 70 M Mod Autistic tendencies Mirtazapine 30mg Skin picking Paranoid schizophrenia N Medication review and rationalisation Structure and routine
Schizophrenia Risperidone 0.5mg bd Elbow splints
Anxiety
Depression
Client 21 42 M Mod Psychotic disorder Olanzapine 2.5mg nocte Epilepsy Autism Y Wean olanzapine Staff to use MAKATON
Overweight Start carbamazepine
Client 22 45 F Sev OCD Risperidone 0.5mg mane Hypothyroid NS N Wean risperidone Use routines
Depression Communication book
Client 23 42 F Sev Autistic disorder Paroxetine 40mg PKU Autistic disorder Y Wean paroxetine Maximising flexibility and 1:1 support
Trichotillomania Gastric ulcer Trichotillomania Metabolic monitoring
Nutritional deficiency Pica Dietary advice
Client 24 48 F prof Autism Risperidone 2.5mg Hypothyroid Autism Y Wean medication Behaviour approach for PICA
Psychosis NOS Chlorpromazine 75mg bd, 100mg midi Pica Add sertraline
BPAD Pericyazine 10mg midi
Client 25 43 M Sev Manic psychosis Olanzapine 20mg Overweight Autism Y Glucose tolerance test
Citalopram 20mg High cholesterol Cholesterol checked
Olanzapine weaned and replaced with abilify
Client 26 45 M Mod Autism Haloperidol PRN Epilepsy Autism Y Needs predictable environment
Psychosis NOS Obesity
Schizophrenia Ear infection
Client 27 51 M Sev Psychotic Olanzapine 10mg nocte Epilepsy Nil Pathology tests inc fragile X and karyotype Communication review
Autistic features Artane 2mg bd Reflux Metabolic screen
High BSL Urologogical review
High lipids Neurological review
Client 28 50 F Prof NS Olanzapine 15mg Epilepsy Autism Y Metabolic screen
Self-injury Clobazam 7.5mg Overweight Wean olanzapine
Low vit D Increase physical activity
Haema-chromatosis
Client 29 50 F Sev Major depression Olanzapine 30mg Gastritis Bipolar disorder Lithium levels
Mania LiCo3 500mg Constipation Metabolic screen
Low vit D Minimise olanzapine
Parkinsonism Treat Parkinsonism
Client 30 48 M Mod  Atypical psychosis Citalopram 20mg bd Fragile X Psychosis Wean citalopram Graded exposure
Risperidone 4mg Use lowest dose of risperidone
Client 31 51 F Prof Psychotic disorder Olanzapine 10mg Epilepsy Mood disorder NOS Wean olanzapine Mood chart
Citalopram 20mg Constipation Increase citalopram
Menopause Metabolic screen
Cerebral palsy
Somnolence
Client 32 55 F Prof Obsessional disorder Risperidone 2mg Epilepsy Autism Y Needs new GP Healthy eating
Clomipramine 100mg Overweight Wean risperidone
Reflux Replace clomipramine with SSRI
Client 33 61 F Prof Autism mannerisms Risperidone 0.5mg PKU Tic disorder ? Wean risperidone Behaviour modification
Cardiovascular risks
Fragile X screen
Client 34 43 F Prof NS Nil Epilepsy Nil Nil
Client 35 44 M Sev Psychosis NOS Olanzapine 2.5 mg nocte Epilepsy Autism Y Metabolic screen Healthy eating
Client 36 47 M Mod NS Pericyazine 10mg Eczema Autism Y Regular medication review Environmental consistency
Client 37 54 M Sev Autism Olanzapine 10mg Epilepsy Autism Y Metabolic screen
Psychosis Artane 2mg Psychosis NOS Use minimum antipsychotic
Client 38 74 M Mod Schizophrenia Venlafaxine 150mg Constipation Bipolar disorder N Fragile X and karyotype
Olanzapine 15mg Pernicious Metabolic screen
Anaemia Wean effexor
Wean olanzapine
Client 39 49 F Sev Autism Chlorpomazine 200mg daily Constipation Autism Y Fluid charts Behaviour charts
Epilepsy Metabolic screen
Low vit D Monitor Na+
High chol and sugar Review and update antipsychotic
Low Na+
Client 40 48 M Mod Psychosis Anafranil 175mg Oesophagitis Pervasive developmental disorder Y Wean anafranil BIST referral
Pica Risperidone 4mg bd Duodenal-ulcer Wean risperidone
Valproate 800mg Increase valproate
Pathology review
Client 41 53 F Sev Autism Risperidone 0.5mg bd Epilepsy Autism Y Stop risperidone
Blindness Neurology review
Akathisia Metabolic screen
Change antipsychotic
Client 42 54 M Mod NS Olanzapine 10mg tds Asthma Autism Y Change paroxetine to citalopram Consistent routines
Paroxetine Migraine OCD Metabolic screen
Oesophagitis Minimise olanzapine
Obesity
Sleep apnoea
Client 43 47 M Sev Psychosis NOS Paroxetine 20mg Oesophagitis Autism Y Wean medications Strict routines
Olanzapine 20mg Metabolic monitoring
Valproate 200mg bd
Chlopromazine PRN
Client 44 52 M Sev Organic mental disorder Paroxetine 20mg Epilepsy Upper GI investigation
Risperidone 3mg PKU Metabolic screen
Upper-GI Use lowest dose of risperidone
Pathology
Client 45 54 F Sev Bipolar affective disorder Citalopram 30mg Epilepsy Bipolar affective disorder Psychiatric and medical review
Oesophagitis
Osteoporosis
Scleroderma
Client 46 43 M Prof Psychosis NOS Olanzapine 10mg bd Epilepsy Autism Y Wean olanzapine
Crohn s Metabolic screen
Client 47 59 M Sev Psychosis NOS 0.5mg bd Epilepsy Psychosis NOS N Epilepsy review
Client 48 56 M Sev Organic mental disorder Nil Spastic Defer N Nil
Quadraplegia
Client 49 59 F Mod Depression Olanzapine 20mg Epilepsy Psychosis NOS Metabolic screen Behavioural interventions
Psychosis NOS Obesity Regular mental state
Client 50 41 F Prof Psychosis due to brain damage Olanzapine 10mg Blindness Nil Metabolic screen Routine adherence
Constipation
Cough
Oesophagitis
Client 51 47 M Mild Childhood psychosis Olanzapine 20mg Duodenitis Autism Y Metabolic screen
Fluoxetine 40mg OCD No medication change
Chlorpromazine PRN
Client 52 43 M Mod Organic personality disorder Escitalopram 20mg Epilepsy Organic personality disorder Metabolic screen Avoid caffeine
OCD Olanzapine 20mg High chol Adequate stimulation
Chlopromazine 150mg
Client 53 50 F Sev Depression Venlafaxine 225mg Constipation Autistic disorder Y Regular physical exam
Anxiety Olanzapine 20mg GAD Metabolic screen
Diazepam 5mg Major depression
Client 54 55 F Sev Organic mental disorder NOS Olanzapine 22.5mg Epilepsy Bipolar disorder Wean olanzapine Diet
Constipation Metabolic screen Exercise
Genetic testing
Client 55 53 M Mod Bipolar disorder Lithium 750mg Epilepsy Organic brain disorder Nil
Schizoaffective disorder Solian 50mg Dysphagia
Benztropine
Client 56 63 M Prof Nil Nil Constipation Nil Nil Nil
Client 57 60 F Mod Autism Anafranil 25mg Vit D Autism Y Monitor for anticholinergic side effects
OCD Hypothyroid OCD
Client 58 58 M Mod BPAD Risperidone 0.5mg Diabetes Bipolar disorder Lithium levels Healthy eating
Prader Willi Lithium 250mg 1.5 nocte Obesity Psychiatric review
Sleep apnoea Physical review
Client 59 50 M Sev Psychosis Risperidone 3mg bd Constipation Autism Y Use lowest dose of risperidone possible Behavioural interventions
Largactil PRN Metabolic screen
Client 60 56 F Mod Childhood SCZ Luvox 150mg Epilepsy Autism Y Genetic testing
OCD Epilim 1500mg Constipation OCD Medical and psychiatric reviews
Reflux
Vit D
Hypothyroid
Client 61 56 M Mod Childhood autism Olanzapine 20mg Epilepsy Autism Y Change times of medication Gardening program
Depression Flouxetine 40mg Lithium levels
LiCo3 750mg Metabolic screen
Largactil 150mg Rationalise and wean antipsychotics
Client 62 42 F Mod Psychosis mental disorder NOS Risperidone 6mg Epilepsy Autism Y Wean risperidone Behavioural strategies
Obesity Metabolic screen
Chol Genetic testing
Client 63 43 M Sev Organic disorder NOS Olanzapine 27.5mg Oesopahgitis PDD Y Minimum doses of medication Behavioural strategies
Depression Sertraline 50mg Poor vision
Client 64 46 M Sev OCD Risperidone 2mg Epilepsy Autism Y Monitor sodium
Sertraline 150mg Medical review
BPAD: bipolar affective disorder; GAD: generalised anxiety disorder; OCPD: obsessive compulsive personality disorder; NS: not stated; PDD: pervasive developmental disorder; PKU: phenylketonuria; TD: tardive dyskinesia
NB: Anticonvulsants used for the treatment of seizures have not been included in the psych meds.

 

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