Diagnostic overshadowing is increasingly recognised as contributing to health inequalities experienced by the learning disability population. This case is that of a 54‐year‐old male with mild‐to‐moderate learning disability who displayed abnormally aggressive behaviours and self‐neglect. He had multiple transfers between the psychiatric and medical units during an inpatient episode, partly due to his physical health symptoms being misattributed to learning disability and challenging behaviour.

The aim of a positive behaviour support (PBS) plan is to improve the quality of a person's life by supporting the person to lead a meaningful life and learn new skills without unnecessary restrictions. PBS uses person‐centred values as well as behavioural science and evidence to inform how to work with people who are at risk of displaying behaviour that challenges. Here, the authors describe how a PBS was effectively used to reduce anxiety and challenging behaviour in a person with autism.

STOMP (stopping overmedication of people with a learning disability (LD), autism or both with psychotropic medicines) aims to review psychotropic medicines regularly, inform everyone about non‐pharmacological therapies and, most importantly, to involve patients, support staff and their families in decisions about medications. This exploratory study by Dr Javaid and team examines whether the NICE guidelines are implemented in line with STOMP when managing patients with challenging behaviours.

Gastrointestinal symptoms are common in the presentation of some psychiatric disorders such as somatisation disorder, anxiety disorders, eating disorders and substance abuse. Gastrointestinal (GI) disorders can also present with psychological symptoms. Furthermore, medications prescribed for GI disorders can cause psychiatric side‐effects. To better understand this complex relationship in the context of intellectual disability, we present 10 adult patients who had accompanying functional gastrointestinal disorders with adverse impact on their mental health.

Opioids have been regarded as among the most effective medications for the treatment of acute, chronic severe pain and cancer pain. However, the longterm administration of opioids continues to be controversial. There are concerns surrounding misuse, abuse and addiction.1 Dr Javaid et al report of a case of a woman with Down's syndrome and severe learning disability presenting with symptoms of dementia, due to the possible likelihood of prolonged use of buprenorphine patches, over the five years. These findings highlight the need for regular medication reviews for individuals with learning disabilities.