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Adults with intellectual developmental disorder are at considerable risk of somatic as well as psychiatric illness, but seldom have access to services on equal conditions as adults without intellectual developmental disorder. The symptoms of illness are often difficult to interpret, due to communication difficulties, and examinations may be difficult to carry out. Patients with moderate/severe/profound intellectual disability therefore need »interpreters« and to be given sufficient time when making clinic visits. Patients with intellectual disability have excess mortality from somatic illness and are at risk for suboptimal treatment with psychotropic medications.