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Article
Publication date: 2 July 2014

Anne Louise Tveter, Trine Lise Bakken, Jørgen G. Bramness and Jan Ivar Røssberg

Patients with intellectual disabilities (ID) and additional psychiatric disorders are often treated with psychotropic medication. However, examinations of side effects among these…

Abstract

Purpose

Patients with intellectual disabilities (ID) and additional psychiatric disorders are often treated with psychotropic medication. However, examinations of side effects among these patients are scarce. The purpose of this pilot study is to examine the most frequently used side effect scale, UKU Side Effect Rating Scale (UKU-SERS), in this patient population.

Design/methodology/approach

The aim of the present study is to explore whether the UKU-SERS is feasible for patients with ID. The UKU-SERS consists originally of 48 items, measuring side effects of psychotropic medication. In the study, UKU-SERS was used to score a group of 13 adults with ID admitted to a specialised inpatient psychiatric unit. First, an expert panel of seven psychiatrists and five psychiatric nurses independently evaluated the UKU-SERS and decided which items they considered possible to score after observation alone. Second, a total of 26 staff members, based on observation, scored the 13 patients on the ward. These results were used as the basis for recommending items from UKU-SERS to be used. Items scored differently by the two groups were examined more thoroughly.

Findings

The expert panel and the ward staff agreed on 24 of the original 48 UKU-SERS items. The other 24 items were examined more thoroughly based on clinical meaningfulness. Consequently, 11 more items were included despite disagreement in the scorer groups. As expected, items that are based on observations seem more feasible than items based on the patients’ subjective experiences.

Originality/value

The revised checklist comprises 35 items and seems applicable for further research and for use in clinical settings for this patient population. It is possible to observe important side effects using the UKU Side Effect Scale, but adjustment of the scale is desirable to make it more appropriate for the specific purpose and target group.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 8 no. 4
Type: Research Article
ISSN: 2044-1282

Keywords

Article
Publication date: 3 May 2016

Anne Louise Tveter, Trine Lise Bakken, Jan Ivar Røssberg, Egon Bech-Pedersen and Jørgen G. Bramness

The UKU side effect rating scale for adults with intellectual disabilities (UKU-SERS-ID) was developed to detect side effects among patients with intellectual disabilities (ID)…

Abstract

Purpose

The UKU side effect rating scale for adults with intellectual disabilities (UKU-SERS-ID) was developed to detect side effects among patients with intellectual disabilities (ID). The purpose of this paper is to examine the reliability and face validity of the UKU-SERS-ID.

Design/methodology/approach

UKU-SERS-ID comprises 35 items. In total, 22 patients with ID were included from two specialized services for adults with ID and comorbid mental illness. All patients were rated on three different occasions by three clinicians; two nurses and one medical doctor. Reliability was estimated with Cohen’s κ. A focus group discussed the face validity of the items comprising the UKU-SERS-ID.

Findings

Respectively ten (nurse-nurse scores) and eight (nurse-doctor scores) items were considered difficult to score due to low prevalence of the symptoms. For the other items the reliability was acceptable. Through discussion in a focus group, with the reliability scores in mind, only one of the items of the UKU-SERS-ID was discarded.

Practical implications

The authors have developed a feasible side effect instrument for clinical practice. It is easy to score and relevant regarding important side effects.

Originality/value

The UKU-SERS-ID seems to be a feasible tool. Further investigations are mandatory in order to gain knowledge about distribution and phenomenology of side effects from psychotropic medication for individuals with ID.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 10 no. 3
Type: Research Article
ISSN: 2044-1282

Keywords

Article
Publication date: 27 September 2010

Shoumitro Deb and Ajit Gomez

Antipsychotic drugs are often used outside their licensed indication to manage aggression in adults with intellectual disabilities in the absence of a diagnosed psychiatric…

Abstract

Antipsychotic drugs are often used outside their licensed indication to manage aggression in adults with intellectual disabilities in the absence of a diagnosed psychiatric disorder. The current case series shows that antipsychotics could be effective, but they are often used with non‐drug measures and sometimes cause sideeffects. Clinicians did not always carry out a thorough assessment followed by a formulation before prescribing medications, as recommended in the national and international guides (Deb et al, 2009; Unwin & Deb, 2010). It is also apparent that clinicians did not carry out tests to detect sideeffects of risperidone such as metabolic syndrome. Clinicians should use psychotropic medication for a minimum period of time and at the lowest possible dose, and should consider non‐drug management of aggression at the outset and at a regular interval.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 4 no. 3
Type: Research Article
ISSN: 2044-1282

Keywords

Content available
Article
Publication date: 2 July 2014

Steve Hardy and Jean O'Hara

99

Abstract

Details

Advances in Mental Health and Intellectual Disabilities, vol. 8 no. 4
Type: Research Article
ISSN: 2044-1282

Article
Publication date: 4 February 2020

Dominic Burke and Angela Cocoman

Examining the education and training needs of forensic nurses is paramount as services move from the older institutions to new care settings. The purpose of this study was to…

1301

Abstract

Purpose

Examining the education and training needs of forensic nurses is paramount as services move from the older institutions to new care settings. The purpose of this study was to identify Irish Forensic nurses perceived deficits in their knowledge and skills to assist them to provide effective seamless care for individuals with an intellectual disability within their forensic mental health service, so that appropriate training could be provided.

Design/methodology/approach

Training needs analysis (TNA) procedures are used as a way of establishing the continuing processional development of staff, as they seek to identify the gaps between the knowledge and skills of an individual and the need for further training. A training needs tool developed by Hicks and Hennessy (2011) was used and completed by nurses working in an Irish forensic mental health service. A total of 140 surveys were circulated and 74 were completed (51 per cent response).

Findings

The top priority training needs identified were for additional training in research and audit and in the use of technology. Other self-identified training needs included additional training in behavioural management for challenging behaviour, understanding mental health and intellectual disability and dual diagnosis, training in enhancing communication skills and how to work with patients who have an intellectual disability patients specific training on autistic spectrum disorders and a guide and template for advance individual care planning and for caring for the physical health needs and promoting the physical health needs of these patients.

Originality/value

Despite there being a vast range of training issues identified, the majority of nurses appear to have a clear idea of their training needs to ensure the provision of seamless care for individuals with an intellectual disability within a forensic mental health setting. This TNA has identified the specific needs of nursing staff working at different positions across the interface of intellectual disability and forensic mental health care.

Details

Journal of Intellectual Disabilities and Offending Behaviour, vol. 11 no. 1
Type: Research Article
ISSN: 2050-8824

Keywords

Article
Publication date: 11 December 2017

Lauren Rolph and Ken McGarry

The purpose of this paper is to review the efficacy of atypical antipsychotics in combination with clozapine. Previous meta-analyses have assessed the use of both typical and…

Abstract

Purpose

The purpose of this paper is to review the efficacy of atypical antipsychotics in combination with clozapine. Previous meta-analyses have assessed the use of both typical and atypical antipsychotics in combination with clozapine, combination treatment being withheld only for those patients deemed treatment resistant.

Design/methodology/approach

Outcomes assessed included: positive, negative and overall symptom score. The total numbers of participants (n=588) were scored using the Positive and Negative Symptom Scale/the Brief Psychiatric Rating Scale and effect sizes were used to judge the efficacy of the combination treatments. Data gained from the ten randomized, double blind, placebo controlled trials were analysed using the R statistical software.

Findings

The effect sizes gained from analysis showed a small benefit of combination therapy over clozapine monotherapy. Therefore, it is the recommendation of this analysis that alternative avenues be sought in order to treat patients who have a sub-optimal response to clozapine with a combination other than two second generation antipsychotics.

Research limitations/implications

The initial trials search unveiled 1,412 studies. After the inclusion and exclusion criteria were applied, ten trials were used in this meta-analysis.

Practical implications

The recommendation of this analysis that alternative medications be sought in order to treat patients who have a sub-optimal response to clozapine with a combination other than two second generation antipsychotics. This route should only be used once all other treatment options have been exhausted.

Originality/value

This meta-analytical study looks specifically at the combination of atypical antipsychotics with clozapine in comparison to clozapine monotherapy. This work extends existing meta-analysis by incorporating data from more recent trials.

Details

Mental Health Review Journal, vol. 22 no. 4
Type: Research Article
ISSN: 1361-9322

Keywords

Content available
Article
Publication date: 3 May 2016

Eddie Chaplin and Jean O'Hara

209

Abstract

Details

Advances in Mental Health and Intellectual Disabilities, vol. 10 no. 3
Type: Research Article
ISSN: 2044-1282

Article
Publication date: 1 September 2005

Michael Barr, Ilina Singh and Nikolas Rose

Depressive disorders are a focus of growing social and economic concern. While antidepressant medications are widely accepted, they are ineffective for nearly 40% of users, and…

Abstract

Depressive disorders are a focus of growing social and economic concern. While antidepressant medications are widely accepted, they are ineffective for nearly 40% of users, and cause numerous adverse drug reactions. The pharmacogenomics of depression attempts to better understand the role of genetic variation in antidepressant metabolism in the hope of improving drug efficacy and tolerability. However, the development and delivery of genome‐based antidepressants face many hurdles. In this paper we provide an overview of the potential impact of the pharmacogenomics of depression on public mental health care by focusing on the social and ethical issues at stake. These include questions about genetic testing, informed consent, drug access, and market fragmentation. We end the paper with a brief discussion of the wider context and how the pharmacogenomics of depression relates to broader trends in psychiatry and biomedicine.

Details

Journal of Public Mental Health, vol. 4 no. 3
Type: Research Article
ISSN: 1746-5729

Keywords

Article
Publication date: 5 June 2017

Saturday U. Omeluzor, Gloria O. Oyovwe-Tinuoye and Uche Emeka-Ukwu

This study aimed to assess the rural libraries and information services for rural development in Delta State, Nigeria.

1839

Abstract

Purpose

This study aimed to assess the rural libraries and information services for rural development in Delta State, Nigeria.

Design methodology/approach

The study adopted both descriptive and exploratory research designs. Questionnaire, observation and structured interview guide were the major instruments for data collection. Total enumeration was used to gather data from respondents in 16 functional rural libraries in Delta State.

Findings

The study revealed the challenges that surround the rural people in accessing information in rural libraries. It showed that only 16 rural libraries were established and functional in 16 communities within the 25 local government areas. Findings also showed that the rural libraries were not able to fulfil their roles. It was evident that the information needs of the rural people which made them to access the library were not adequately met because of some hindrances such as inadequate up-to-date information materials, lack of awareness, illiteracy, language barrier, inadequate skilled personnel and inadequate infrastructure and facilities.

Practical implications

The important finding in this study is that rural libraries are the most relevant institution to disseminate information about government policies, inculcating reading habits and developing skill and knowledge of people. Therefore, underdevelopment of rural libraries and inadequate information sources and facilities will hinder access to information and development of the people who need them.

Originality value

This research is the first of its kind to assess rural libraries and information services for the development of rural people in the 16 rural libraries in Delta State of Nigeria.

Article
Publication date: 19 September 2018

Trine Lise Bakken, Olav Ose Evensen, Tale Gjertine Bjørgen, Inger Tove Nilsen, Nina Bang, Unni Pedersen, Kim Berge, Karl Elling Ellingsen, Terje Baasland and Sissel Berge Helverschou

The purpose of this paper is to present and discuss mental health services for people with intellectual disability (ID) in Norway.

Abstract

Purpose

The purpose of this paper is to present and discuss mental health services for people with intellectual disability (ID) in Norway.

Design/methodology/approach

A literature review and a survey were conducted to map services for people with ID and mental health problems in Norway.

Findings

The results were sparse and confirmed what is already known among clinicians working with these patients. The Norwegian services are fragmented and there are geographical differences.

Research limitations/implications

There are no special services for children with ID developing mental illness. For offenders with ID, a national unit assesses and follows up, also when the person is sentenced to compulsory care and services are provided in their home municipality.

Practical implications

More data about both the patients and the services are needed in order to improve mental health services for people with ID in Norway.

Originality/value

This paper describes mental health services for people with ID in Norway.

Details

Advances in Mental Health and Intellectual Disabilities, vol. 12 no. 3/4
Type: Research Article
ISSN: 2044-1282

Keywords

1 – 10 of 15