Search results for ‘Subject term:"mental health problems"’ Sort:
Results 1 - 10 of 86
The relationship between challenging behaviour and mental ill-health in people with intellectual disabilities: a review of current theories and evidence
- Author:
- ALLEN David
- Journal article citation:
- Journal of Intellectual Disabilities, 12(4), December 2008, pp.267-294.
- Publisher:
- Sage
- Place of publication:
- London
Challenging behaviours and problems of mental ill-health are common amongst people with intellectual disabilities. The article examines conceptual similarities and differences between these conditions, examines the data on comorbidity, and explores possible hypothetical relationships between behavioural and psychiatric disorder in this population. While there is little evidence at present to suggest that many of the challenging behaviours seen in people with intellectual disabilities are underpinned by problems of mental ill-health, only qualified conclusions are possible because of limitations in the quality and scope of existing research. A conceptual model for looking at the risk variables that may contribute to both conditions is suggested, and requirements for future research and current multi-disciplinary practice are outlined.
Improving the detection and assessment of mental health problems in people with learning disability
- Author:
- MOSS Steve
- Journal article citation:
- Focus, 19, October 1996, pp.1-11.
- Publisher:
- RNIB
Ensuring that people with learning disability get appropriate help for their mental health problems is not just a job for psychiatrists. All staff have an essential role in ensuring that people who have psychiatric problems are identified and referred for comprehensive assessment. This article introduces some of the major issues in recognising and assessing mental health problems in this population, and introduces some new developments designed to improve the targeting of psychiatric referrals.
Challenges and responses: report of a seminar 16-17 march 1992, Park Hotel, Cardiff
- Author:
- GREAT BRITAIN. Welsh Office. All Wales Advisory Panel on the Development of Services for People with Mental Handicaps
- Publisher:
- Great Britain. Welsh Office
- Publication year:
- 1992
- Pagination:
- 56p.
- Place of publication:
- Cardiff
Report from a seminar on provision of services to people with learning difficulties, who also have challenging behaviour, mental illness or who offend.
Service responses to people with learning difficulties and challenging behaviour
- Editor:
- HARRIS John
- Publisher:
- British Institute of Mental Handicap
- Publication year:
- 1991
- Pagination:
- 78p.,bibliogs.
- Place of publication:
- Kidderminster
Papers from 3 seminars focusing on service provision for adults with a mental handicap who are mentally ill, who have behaviour problems, or who offend. Examples of service innovation are included.
Challenging behaviour and offending behaviours
- Authors:
- BOER Harm, IYER Anupama
- Journal article citation:
- Tizard Learning Disability Review, 25(3), 2020, pp.117-124.
- Publisher:
- Emerald
Purpose: The purpose of this paper is to explore three main areas in relation to the interface between challenging behaviour and offending. Design/methodology/approach: The first aim is to explore the labelling of behaviours as challenging or offending behaviour in the light of legal definitions, staff knowledge and beliefs and the mental capacity and mental health acts. The second is to explore challenging behaviour as a risk factor for offending in people with Intellectual Disability (ID). The third aim is to discuss the challenging behaviour as a barrier to discharge from secure services. Findings: There is limited research suggesting that challenging behaviour such as physical aggression can lead to longer stay in forensic services, and this warrants further research. Originality/value: This paper aims to promote discussion about the interface of offending and challenging behaviour in people with IDs and to promote best practice. (Edited publisher abstract)
Mental illness, challenging behaviour, and psychotropic drug prescribing in people with intellectual disability: UK population based cohort study
- Authors:
- SHEEHAN Rory, et al
- Journal article citation:
- British Medical Journal, 351(h4326), 2015, Online only
- Publisher:
- British Medical Association
Objectives: To describe the incidence of recorded mental illness and challenging behaviour in people with intellectual disability in UK primary care and to explore the prescription of psychotropic drugs in this group. Design: Cohort study. Setting: 571 general practices contributing data to The Health Improvement Network clinical database. Participants: 33 016 adults (58% male) with intellectual disability who contributed 211 793 person years’ data. Main outcome measures: Existing and new records of mental illness, challenging behaviour, and psychotropic drug prescription. Results: 21% (7065) of the cohort had a record of mental illness at study entry, 25% (8300) had a record of challenging behaviour, and 49% (16 242) had a record of prescription of psychotropic drugs. During follow-up, the rate of new cases of mental illness in people without a history at cohort entry was 262 (95% confidence interval 254 to 271) per 10 000 person years and the rate of challenging behaviour was 239 (231 to 247) per 10 000 person years. The rate of new psychotropic drug prescription in those without a previous history of psychotropic drug treatment was 518 (503 to 533) per 10 000 person years. Rates of new recording of severe mental illness declined by 5% (95% confidence interval 3% to 7%) per year (P<0.001), and new prescriptions of antipsychotics declined by 4% (3% to 5%) per year P<0.001) between 1999 and 2013. New prescriptions of mood stabilisers also decreased significantly. The rate of new antipsychotic prescribing was significantly higher in people with challenging behaviour (incidence rate ratio 2.08, 95% confidence interval 1.90 to 2.27; P<0.001), autism (1.79, 1.56 to 2.04; P<0.001), and dementia (1.42, 1.12 to 1.81; P<0.003) and in those of older age, after control for other sociodemographic factors and comorbidity. Conclusions: The proportion of people with intellectual disability who have been treated with psychotropic drugs far exceeds the proportion with recorded mental illness. Antipsychotics are often prescribed to people without recorded severe mental illness but who have a record of challenging behaviour. The findings suggest that changes are needed in the prescribing of psychotropics for people with intellectual disability. More evidence is needed of the efficacy and safety of psychotropic drugs in this group, particularly when they are used for challenging behaviour (Edited publisher abstract)
Towards the prevention of behavioural and psychiatric disorders in people with intellectual disabilities
- Authors:
- ALLEN David, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 26(6), 2013, pp.501-514.
- Publisher:
- Wiley
Intervention for behavioural and psychiatric disorders in people with intellectual disabilities often only takes place once these conditions are well established and more resistant to change. As an alternative, this paper promotes a public health prevention model and maps out opportunities for intervention at primary, secondary and tertiary levels. The resulting model is partly derived from generic research into these issues and partly on specific evidence on interventions for people with intellectual disabilities; it also contains more theoretical considerations. The additional research that is necessary to demonstrate the efficacy of the interventions identified is also considered. Central to this proposal is a greater integration of issues for people with intellectual disabilities within much broader policy and research agendas. (Publisher abstract)
Screening for psychiatric disorders in a total population of adults with intellectual disability and challenging behaviour using the PAS-ADD checklist
- Authors:
- ALLEN David, et al
- Journal article citation:
- Journal of Applied Research in Intellectual Disabilities, 25(4), July 2012, pp.342-349.
- Publisher:
- Wiley
The nature of the relationship between psychiatric disorders and challenging behaviour in people with intellectual disabilities is the subject of debate; a picture that is confused by challenging behaviour itself sometimes being classified as a form of psychiatric disorder. The authors explore this relationship in a population sample of adults with challenging behaviour. More than 800 service settings in a defined geographical area in Wales were screened to identify individuals with challenging behaviour. Detailed behavioural data, Psychiatric Assessment Schedule for Adults with a Developmental Disability (PAS-ADD) checklist and Adaptive Behaviour Scale (Part 1) scores were collected for 76% of the 930 adults identified. Just under 17% of participants reached threshold scores on one on more subscales of the PAS-ADD checklist. There was some evidence of increasing behavioural severity being associated with increasing psychiatric symptoms but there were no associations between specific forms of challenging behaviour and individual symptoms. The authors conclude that these data support previous suggestions that it is unlikely that the majority of challenging behaviours in adults with intellectual disability are underpinned by psychiatric disorders.
Adults with intellectual disabilities: prevalence, incidence and remission of aggressive behaviour and related factors
- Authors:
- COOPER S., et al
- Journal article citation:
- Journal of Intellectual Disability Research, 53(3), March 2009, pp.217-232.
- Publisher:
- Wiley
This study investigates point prevalence, 2-year incidence and 2-year remission rates for aggressive behaviour (physically aggressive, destructive and verbally aggressive), and it investigates which factors are independently associated with aggressive behaviour. All adults with ID – within a geographically defined area of Scotland, UK – were recruited to a longitudinal cohort. At baseline, assessments were undertaken of demography, lifestyle, supports, development, problem behaviours, disabilities and physical and mental health. These were repeated for a 2-year period. At baseline, the participation rate was 1023 (65.5%). After 2 years, the cohort retention was 651 adults. The point prevalence of Diagnostic Criteria for Psychiatric Disorders for Use with Adults with Learning Disabilities/Mental Retardation (DC-LD) aggressive behaviour was 9.8%, 2-year incidence was 1.8%, and 2-year remission rate from all types of aggressive behaviour meeting DC-LD criteria was 27.7%. The factors independently associated with aggressive behaviours were lower ability, female gender, not living with a family carer, not having Down syndrome, having attention-deficit hyperactivity disorder and having urinary incontinence. Incidence of aggressive behaviour meeting DC-LD criteria in adult life is similar to that for each of psychotic, anxiety and organic disorders. Aggressive behaviour is common among adults with ID, but contrary to previous suggestions, more than a quarter remit within the short to medium term.
A general practice-based study of the relationship between indicators of mental illness and challenging behaviour among adults with intellectual disabilities
- Authors:
- FELCE D., KERR M., HASTINGS R.
- Journal article citation:
- Journal of Intellectual Disability Research, 53(3), March 2009, pp.243-254.
- Publisher:
- Wiley
The purpose of this study was to explore the association between psychiatric status and level of challenging behaviour, while controlling for adaptive behaviour and occurrence of autistic spectrum disorders. Data were collected on the age, gender, adaptive and challenging behaviour, social impairment and psychiatric status of 312 adults with ID. Challenging behaviour was higher among participants meeting threshold levels on the psychiatric screen. The regression analysis confirmed the association and demonstrated an interaction between total score on the psychiatric screen and level of adaptive behaviour. This moderated effect showed the relationship between psychiatric status and challenging behaviour to be stronger at lower adaptive behaviour. The study reinforces previous findings that psychiatric morbidity among people with ID is associated with higher levels of challenging behaviour and supports predictions that this association is more pronounced for people with severe ID. The precise nature and causal direction of the association requires further clarification. However, the understanding of how psychiatric problems might contribute to challenging behaviour needs to be part of the clinical appreciation of such behaviour.