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The paper reports on a review of assessment scales commonly used for assessment of psychiatric illnesses or behaviour problems in adults with learning disabilities. Initially, a literature search was conducted to identify relevant peer‐reviewed journal publications pertaining to relevant scales. Those scales with more publications were reviewed with reference to the scale composition and psychometric properties. In total, eight behaviour scales, one psychiatric illness scale and three combined behaviour and psychiatric illness scales are reviewed.

Psychiatric care for adult asylum seekers has been an area of conflict and turbulence in Sweden over the last 20 years. Sweden has been criticised for being one of the most restrictive EU countries in providing health care for asylum seekers. Mental health care for asylum seekers is characterised by short‐term emergency measures and inequality. The complex regulatory framework tends to be interpreted in a rather arbitrary fashion, which in many cases may lead to unnecessary restrictions. In this paper we present guidelines for care givers and decision makers aiming to improve psychiatric care for adult asylum seekers in Stockholm, Sweden. In this context it is necessary to highlight and discuss the importance of understanding and implementing human rights among health professionals. The overall goal for these guidelines is mental health care for asylum seekers on the same terms, as far as possible, as for Swedish citizens.

The purpose of this paper is to compare the rates and patterns of comorbid anxiety, depression and ADHD across people with: autism spectrum disorder (ASD) plus intellectual disability (ID), ASD/no ID (AS/HFA) and ID only.

Data were obtained using structured file review and two psychometric screening instruments. File reviews used a modified version of the Case Review Protocol from the Diagnostic Criteria for Psychiatric Disorders for Use with Adults with Learning Disabilities. Screening employed the Reiss Screen for Maladaptive Behaviour and the ASD-Comorbidity-Adults scale.

Levels of anxiety, depression and ADHD were high for all three groups, and greater than in general population studies. Between groups, the AS/HFA sample had significantly higher anxiety, while the ASD/ID group had significantly greater ADHD. Groups did not differ on measures of depression or total psychopathology. Levels of ADHD, but not anxiety or depression, increased with severity of ID and ASD symptoms.

More research is needed on the relationship between ASD and both anxiety and ADHD, particularly the identification of these comorbid conditions and their treatment.

Rigorous screening for comorbid mental health conditions is required to achieve the best outcomes for adults with ASD.

The study used a broader community-based sample than previous comorbidity research. Including adults with ID but without ASD enabled a comparison of types and rates of disorder across three distinct but related groups with neurodevelopmental disorders.

The purpose of this paper is to study the profiles of adults with autism spectrum disorder (ASD) requiring an inpatient psychiatric admission.

This paper examines profiles of 27 inpatients with intellectual disability (ID) and ASD who were admitted to a specialized inpatient unit in two time periods (January 2005 to June 2009 and July 2009 to December 2013) to explore changes over time in patient profiles.

Findings suggest that individuals who were admitted more recently between July 2009 and December 2013, were younger and more likely to come from other ethnic backgrounds than those admitted between January 2005 and June 2009. There was a trend for recent admissions to come from family homes, have moderate to profound ID and have longer hospital stay.

This is the first study to compare profiles of adults with ASD receiving inpatient services over time. The value of the study lies in illustrating that the needs of this growing patient group are changing which has implications for the treatment provision including specialized inpatient treatment.

The purpose of this paper is to assess the prevalence and nature of presentation of unipolar depression in individuals with Down syndrome (DS).

The PRISMA (2009) checklist for systematic review was followed where possible.

Eight studies were included in the qualitative synthesis from a total of 634 records identified. The quality of the studies was then assessed: the studies all scored either 5 or 6 out of 6. The incidence of depression ranged between studies from 5 to 13 per cent. It was found that depression is more common in DS than the general intellectual disability population; this on a background of mental ill health of all causes being less common in DS. It was suggested that, excluding organic disorders, depression is the most common psychiatric problem in DS. In terms of the nature of depression, the evidence was less clear. Various “vegetative” and biological symptoms were observed, with no fixed pattern. There was evidence for withdrawal symptoms and psychosis.

The small number of studies included in this review, and their heterogeneity, highlights the need for further original research in this field.

An increased awareness of the frequency of depression in individuals with DS will aid in a timely diagnosis, therefore reduce psychiatric morbidity. Clinicians should be aware of the varied presentation, with no clear clinical picture, in order to maintain a high index of suspicion in an individual presenting with “atypical” symptoms.

This review has provided preliminary evidence that depression may be the most commonly experienced psychiatric disorder in DS.

People with an intellectual disability (ID) are more at risk of experiencing adverse childhood events. Moreover, prolonged exposure to ACEs results in enduring changes and impairments in neurological, physiological and psycho-social systems and functioning. In response, van der Kolk et al. (2009) have put forward the concept of developmental trauma disorder (DTD) to reflect the “constellation of enduring symptoms” and complex care needs of this population. The purpose of this paper is to ascertain the level of exposure to adverse childhood events and the prevalence of DTD in an inpatient forensic ID population.

A retrospective file review and consensus approach to diagnosis were used in a sample of adults with an ID detained in a secure forensic service.

Results revealed that 89 admissions (N=123) had been exposed to at least one significant ACE, with 81 being exposed to prolonged ACEs. A total of 58 admissions (47 per cent) met criteria for PTSD and 80 (65 per cent) met the criteria for DTD. Significant gender differences were noted in MHA status, primary psychiatric diagnoses, exposure to ACEs and DTD.

The discussion explores the implications for working with forensic ID populations who report high incidents of childhood trauma and the utility, strengths and weaknesses of the proposed DTD, its relationship to ID diagnoses is explored.

The study outlines the prevalence of DTD and PTSD in ID forensic populations and suggests additional key assessment and treatment needs for this population.

Social and economic trends toward local governance form the context for health and mental health policy and the reorganization of care systems for cost-containment in the United States. Local management of public–private collaborations is promoted by state agencies as a means of rationalizing mental health care and community support services. This chapter analyses the local process of developing public–private partnerships for mental health care, based on an ethnographic case study of county Mental Health/Mental Retardation and behavioral health committees and coalitions in Texas, from 1995 to 2001. Following this period, local service agencies continued collaboration to increase community awareness and resources for care. Findings were that while the rapid transition to local control under conditions of reduced resources impeded implementation of a public–private mental health care system, commitment to a service safety net for persons with mental disabilities was sustained.

The purpose of this paper is to evaluate the impact on recovery and personal goal attainment of a transition intervention service for return to the community following exit from an alternative to psychiatric inpatient admission – a residential recovery house. The services seek to facilitate community reintegration, promote recovery and prevent future mental health crisis. The service was funded by the Stone Family Foundation.

This evaluation employed a within groups design: a single case evaluation follow-up. Analysis of Recovery Star and personal goal achievement data collected at service entry and exit points during routine practice (n=181), at four sites in England. The adults had mental illness diagnoses including depression, schizophrenia, bipolar disorder, personality disorder, and anxiety disorder.

There was a significant increase in overall Recovery Star scores with a large effect size, and significant increases in eight of the ten Recovery Star life domains. There were significant increases in the goal scores linked to “Managing mental health”, “Self-care” and “Living skills”.

A transitional intervention service provided by the third sector for return to community following mental health crisis may contribute to recovery and personal goal achievement. A randomised control trial of this transition intervention service is recommended.

This is first outcome evaluation of an alternative to psychiatric inpatient admission transition intervention service and findings indicate the potential positive effect of having this service incorporated into the design of alternative to admission provision.

During the last few years the prevalence of autism and Autism Spectrum Disorder (ASD) has increased greatly. A recurring issue is the overlap and boundaries between Intellectual Developmental Disorder (IDD), ASD and Schizophrenia Spectrum Disorders (SSD). In clinical practice with people with IDD, the alternative or adjunctive diagnosis of ASD or SSD is particularly challenging. The purpose of this paper is to define the boundaries and overlapping clinical characteristics of IDD, ASD and SSD; highlight the most relevant differences in clinical presentation; and provide a clinical framework within which to recognize the impact of IDD and ASD in the diagnosis of SSD.

A systematic mapping of the international literature was conducted on the basis of the following questions: first, what are considered to be core and overlapping aspects of IDD, ASD and SSD; second, what are the main issues in clinical practice; and third, can key diagnostic flags be identified to assist in differentiating between the three diagnostic categories?

Crucial clinical aspects for the differentiation resulted to be age of onset, interest towards others, main positive symptoms, and anatomical anomalies of the central nervous system. More robust diagnostic criteria and semeiological references are desirable.

The present literature mapping provides a comprehensive description of the most relevant differences in the clinical presentation of ASD and SSD in persons with IDD.