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Application of DC-LD to an intellectual disability population
- Authors:
- TULLY John, SCHIRLIU Diana, MORAN Maria
- Journal article citation:
- Advances in Mental Health and Intellectual Disabilities, 6(5), 2012, pp.259-264.
- Publisher:
- Emerald
The Diagnostic Criteria for Psychiatric Disorders for Use with Adults with Learning Disabilities/Mental Retardation (DC-LD), introduced in 2003, was designed to improve accuracy of diagnosis in individuals with intellectual disability. An Irish study aimed to investigate its usefulness in a clinical setting. It involved interviews and review of chart notes with a sample of 50 patients within an intellectual disability service. This article describes the study methodology and results, and discusses the findings. It reports that there was considerable discrepancy between the rates of psychiatric diagnoses after application of DC-LD and rates of previously documented diagnoses within the sample, and that use of DC-LD led to the reclassification of many previously documented diagnoses, mainly as behavioural disorders. It concludes that the study adds to the evidence regarding the usefulness of the criteria, and highlights the shortcomings of non-systematic methods of diagnosis.
Low mood and challenging behaviour in people with severe and profound intellectual disabilities
- Authors:
- HAYES S., et al
- Journal article citation:
- Journal of Intellectual Disability Research, 55(2), February 2011, pp.182-189.
- Publisher:
- Wiley
“Diagnostic overshadowing” has been an obstacle for people with intellectual disabilities (ID) exhibiting symptoms of a mental illness. Progress has been made but there remains a tendency to assume that challenging behaviour stems from the ID rather than being symptomatic of mental illness. This study investigated the relationship between low mood and challenging behaviour in people with severe and profound ID, while controlling for the presence of potentially confounding variables such as diagnosis of autism, physical and sensory problems and ill health. The key workers of 52 people with severe and profound ID, living in residential care in Ireland, completed measures of depression, communication, challenging behaviour and provided information on demographic and health variables. Using the Mood, Interest and Pleasure Questionnaire, a significant difference was found between a ‘low mood’ and ‘normothymic’ group in the reported occurrence of challenging behaviour. This difference remained after confounding variables such as the presence of autism, health and sensory difficulties were controlled. The frequency and severity of challenging behaviour was predicted by measures indicating the presence of low mood. The authors conclude that people with severe and profound ID show clear and measurable signs of low mood, and in this relatively small sample of institutionalised individuals, low mood was associated with challenging behaviour.
Caring for mentally ill people in Europe
- Authors:
- VAN OS Jan, NEELEMAN Jan
- Journal article citation:
- British Medical Journal, 5.11.94, 1994, pp.1218-1221.
- Publisher:
- British Medical Association
Despite legislation to harmonise mental health practice throughout Europe and convergence in systems of training there remains an extraordinary diversity of psychiatric practice in Europe. Approaches to tackling substance misuse vary among nations; statistics on psychiatric morbidity are affected by different approaches to diagnosis and treatment of psychiatric disorders; attitudes towards mental illness show definite international differences. Everywhere, though, mental health care for patients with psychotic illness is a "cinderella service", and there is a general move towards care falling increasingly on the family and the community.