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Correspondence between self-ratings and key-workers' ratings of depression in adults with mild learning disabilities
- Authors:
- GORDON Michael S., et al
- Journal article citation:
- British Journal of Clinical Psychology, 46(4), November 2007, pp.491-495.
- Publisher:
- Wiley
This study assessed the association between self-ratings and key-worker ratings of depression in people with mild learning disabilities. The Zung Depression Scale was completed by 74 adults with mild learning disabilities and a modified version of the questionnaire was completed by two key-workers at two periods in time. The correlations between ratings of depression by key-workers were high and key-worker ratings correlated significantly with self-rating. The depression scores were found to be temporally stable. The findings suggest that proxy raters appear to be able to make reliable and valid judgements about other people's self-reported levels of depression.
Inter-rater reliability of the diagnoses of psychosis and depression in individuals with intellectual disabilities
- Authors:
- EINFELD S, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 20(5), September 2007, pp.384-390.
- Publisher:
- Wiley
There is a history of over-prescription of antipsychotics to individuals with intellectual disability (ID), while antidepressants may be under-prescribed. However, appropriate treatment is best supported when the diagnosis of psychosis or depression is valid and carries good predictive validity. The present authors report a study examining one aspect of validity, namely whether skilled clinicians can agree on whether an individual with an ID is psychotic or depressed. Pairs of clinicians assessed 52 individuals. Agreement was assessed using Cohen’s kappa statistic and agreement proportion. Overall agreement was high for both psychosis and depression. Whether the individual had mild ID or moderate/severe ID did not have a significant impact on agreement. Experienced clinicians achieved a high level of agreement as to whether a person with ID was psychotic or depressed similar to that found for those without ID. The findings provide some support for treatment interventions based on diagnosis.
The psychometric properties of the hospital anxiety and depressions scale adapted for use with people with intellectual disabilities
- Authors:
- DAGNAN D., et al
- Journal article citation:
- Journal of Intellectual Disability Research, 52(11), November 2008, pp.942-949.
- Publisher:
- Wiley
There is increasing recognition of depression in people with intellectual disabilities (ID). There is a need to develop well-standardised self-report measures for both clinical and research purposes. This paper presents some psychometric properties of the Hospital Anxiety and Depression Scale (HADS) adapted for use with people with ID. The anhedonic emphasis in the depression scale of the HADS may be particularly useful for people with ID who present with high rates of physical co-morbidity. A total of 197 people with ID completed an adapted HADS; 32 participants also completed the Zung Depression Scale and 42 also completed the Glasgow Depression Scale. The obtained factor structure is similar to the original form of the scale used with people without ID. However, the underlying question wording of the HADS, where most depression items are phrased positively and most anxiety items are phrased negatively, makes clear interpretation of the factor structure difficult. The HADS has an adequate internal reliability and correlates well with other self-report measures of depression. The HADS may need further adaptation; however, the measurement of anhedonia is a useful addition to the self-report measures of depression available for people with ID.
The Beck Depression Inventory II and the Beck Anxiety Inventory in people with Intellectual Disabilities: Factor analyses and group data
- Authors:
- LINDSAY William R., SKENE Danielle D.
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 20(5), September 2007, pp.401-408.
- Publisher:
- Wiley
There have been several developments in research on emotional disorders in people with intellectual disability (ID). Although a large amount of work has been completed in mainstream clinical fields on the Beck Anxiety Inventory (BAI) and the Beck Depression Inventory – 2nd Edition (BDI-II), to date there has been little work completed on people with ID. This paper presents several analyses that provide information on the psychometric properties of the BAI and the BDI-II. Data on subsamples of the total cohort are also presented. Both assessments were appropriately revised for use with persons with ID and individually administered. A sample of 108 participants from inpatient and community settings completed the assessments. In supplementary analyses, several subsamples of anxiety referrals, depression referrals, sex offenders, other types of offenders, men and women are also presented. The joint factor analyses of the BAI and BDI-II revealed a two factor solution corresponding closely to a depression and anxiety factor. Results from further factor analyses independently demonstrated that the BAI had three factors corresponding to cognitive–subjective anxiety, somatic temperature and somatic balance symptoms. The BDI-II exhibited a three factor structure: cognitive self, cognitive-affective/loss of functioning and somatic symptoms. In the supplementary analyses anxiety referrals had significantly higher scores on the BAI, depression referrals higher scores on the BDI, sex offenders are significantly lower scores on both the BAI and BDI than other groups. The factor structure of the BAI and BDI conforms specifically to those found in research with the general population. Result suggests that both assessments can be used reliably with individuals who have ID.
Depression and apathy affect functioning in community active subjects with questionable dementia and mild Alzheimer's disease
- Authors:
- LAM Linda C. W., et al
- Journal article citation:
- International Journal of Geriatric Psychiatry, 22(5), May 2007, pp.431-437.
- Publisher:
- Wiley
The relationships between apathy, depression and functional impairment in questionable dementia (QD) and Alzheimer's disease (AD) are complex. This study aimed to explore the interactions between severity of apathy, depression and functional performance; and to investigate the effects of apathy alone, depression alone and coexistence of apathy and depression on the functional performance in subjects with QD and AD. One hundred ninety-five subjects with QD and 96 subjects with mild AD were recruited. Apathy and depression were rated using the Neuropsychiatric Inventory and functional disability was measured using the Disability Assessment for Dementia (DAD). Severity of apathy and depression symptoms were associated with poorer functional performance in QD and apathy was associated with poorer functional performance in AD. In QD, subjects with apathy, depression, or coexistence of apathy and depression had poorer functional performance than those with neither apathy nor depression. The coexistence of apathy and depression did not produce more severe functional disability than apathy alone or depression alone. In AD, subjects with apathy had poorer functional performance than those without apathy. Depression in the absence of apathy was not associated with more severe functional disability. Apathy and depression symptoms are common in the early course of AD. Apathy and depression had different effects on functional performances in the subjects with QD from those with AD.
Psychiatric symptoms of dementia among elderly people with learning disabilities
- Author:
- COOPER Sally-Ann
- Journal article citation:
- International Journal of Geriatric Psychiatry, 12(6), June 1997, pp.662-666.
- Publisher:
- Wiley
Reports on the rate of psychiatric symptoms among elderly people with learning disabilities who have dementia by studying the population of Leicestershire in the UK. Concludes that psychiatric symptoms occur commonly in dementia, can cause significant distress and require recognition, understanding and the development of effective managements.
Hidden meanings
- Author:
- RUSSELL Oliver
- Journal article citation:
- Community Care, 6.2.97, 1997, pp.18-19.
- Publisher:
- Reed Business Information
Discusses the problem of diagnosing depression in people with learning difficulties.
Validation of the Mood and Anxiety Semi-structured (MASS) Interview for patients with intellectual disabilities
- Authors:
- CHARLOT L., et al
- Journal article citation:
- Journal of Intellectual Disability Research, 51(10), October 2007, pp.821-834.
- Publisher:
- Wiley
When assessing people with intellectual disabilities (ID), using the DSM-IV-TR can be challenging. Frequently, significant clinical data must be obtained from interviews with key informants. A new semi-structured interview tool was developed including behavioural descriptions of each DSM-IV-TR symptom criterion for a number of mood and anxiety disorders. A goal was to provide mental health clinicians with an instrument easy to use in clinical practice that would increase reliable identification of diagnostically important mood and anxiety symptoms. This is especially important given the fact that many experts believe these ‘internalizing’ clinical syndromes may often be missed in this population, because of characteristic limitations in expressive language skills. To establish validity, the Mood and Anxiety Semi-structured (MASS) Interview-derived diagnoses were compared with clinical DSM-IV diagnoses derived from an extensive inpatient evaluation and classifications based on the Hamilton Depression Rating Scale for 93 psychiatric inpatients served on a specialized unit for people with ID and major mental health disorders. Agreement with the MASS Interview was high yielding significant kappa coefficients ranging from 0.42 to 0.78. The MASS Interview, a semi-structured interview containing behavioural descriptions of DSM-IV symptom criteria, shows promise as a potentially helpful tool in the psychiatric diagnostic evaluation of persons with ID and limited expressive language skills, in the detection of mood and anxiety disorders. The tool also yields a wide breadth of clinical information and is easy for mental health clinicians to use.
Development and psychometric properties of an assessment for persons with intellectual disability - the interRAI ID
- Authors:
- MARTIN Lynn, et al
- Journal article citation:
- Journal of Policy and Practice in Intellectual Disabilities, 4(1), March 2007, pp.23-29.
- Publisher:
- Wiley
This paper describes the development of the interRAI-Intellectual Disability (interRAI ID), a comprehensive instrument that assesses all key domains of interest to service providers relative to a person with an intellectual disability (ID). The authors report on the reliability and validity of embedded scales for cognition, self-care, aggression, and depression. Four provider agencies in Canada volunteered to participate and assessed a total of 160 community-dwelling adults with ID using the interRAI ID, Dementia Questionnaire for Persons with Mental Retardation, and Reiss Screen for Maladaptive Behavior. All scales had acceptable levels of internal consistency and good relationships with the criterion measures. The development of the interRAI ID represents an important and successful first step toward an integrated, comprehensive, and standardized assessment of adults with ID. Use of this instrument may lead to more appropriate support planning, enhanced communication between various professionals supporting persons with ID, and a more seamless approach to supports across the health and social service systems.
Using the Edinburgh Postnatal Depression Scale with learning disabled mothers
- Authors:
- GASKIN Kelly, JAMES Helen
- Journal article citation:
- Community Practitioner, 79(12), December 2006, pp.392-396.
- Publisher:
- Community Practitioners' and Health Visitors' Association
In this small scale study, mothers with a learning disability were asked to complete an Edinburgh Postnatal Depression Scale (EPDS) and take part in a structured interview, which was designed to be more appropriate to their level of intellectual ability. The participants were 13 women with IQs of 73 or below (range 54-73), who had given birth in the last 12 months. The number of symptoms they described was compared with those observed by a significant other person in their lives. The simplified interview, using a visual scale to depict severity of symptoms, seemed to collect more accurate information than the EPDS, giving a higher correlation with observed symptoms. When compared with this interview, the EPDS scores appeared to overestimate symptoms or identify symptoms not observable by those close to the participants. Validation of this scale with a larger group of participants could be a useful development.