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Mental ill-health in adults with intellectual disabilities: prevalence and associated factors

  • Sally-Ann Cooper (a1), Elita Smiley (a2), Jillian Morrison (a3), Andrew Williamson (a4) and Linda Allan (a4)...
Abstract
Background

Reported prevalence of mental ill-health among adults with intellectual disabilities ranges from 7 to 97%, owing to methodological limitations. Little is known about associations.

Aims

To determine the prevalence of mental ill-health in adults with intellectual disabilities and to investigate factors independently associated with it.

Method

Population-based study (n=1023) with comprehensive individual assessments modelled using regression analyses.

Results

Point prevalence of mental ill-health was 40.9% (clinical diagnoses), 35.2%(DC–LD), 16.6% (ICD–10–DCR) and 15.7% (DSM–IV–TR). The most prevalent type was problem behaviours. Mental ill-health was associated with more life events, female gender, type of support, lower ability, more consultations, smoking, incontinence, not having severe physical disabilities and not having immobility; it was not associated with deprived areas, no occupation, communication impairment, epilepsy, hearing impairment or previous institutional residence.

Conclusions

This investigation informs further longitudinal study, and development of appropriate interventions, public health strategy and policy. ICD–10–DCR and DSM–IV–TR undercount mental ill-health in this population compared with DC–LD.

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Copyright
Corresponding author
Professor Sally-Ann Cooper, Academic Centre, Gartnavel Royal Hospital, 1055 Great Western Road, Glasgow G12 0XH, UK Tel: +44 (0) 141 211 0690; fax: +44 (0) 141 357 4899; email: SACooper@clinmed.gla.ac.uk
Footnotes
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Declaration of interest

None.

Funding detailed in Acknowledgements.

Footnotes
References
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Mental ill-health in adults with intellectual disabilities: prevalence and associated factors

  • Sally-Ann Cooper (a1), Elita Smiley (a2), Jillian Morrison (a3), Andrew Williamson (a4) and Linda Allan (a4)...
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eLetters

Wael Foad, SHO in learning disabilities
29 May 2007

Dear Editors,

Cooper et al1 in their study of the prevalence of mental illness in adults with intellectual disabilities concluded that mental ill-health wasassociated with not having severe physical disability and not having immobility. However, I note from the data presented in table 4, that absence of severe physical disability/ quadriplegia and being fully mobilewas not associated with mental illness, which is in contrast to the study’s conclusion. Clinical experience suggests that the presence of severe physical disability or immobility is associated with mental illnessin our clients.

Looking at the conclusion, it appears that there is some mismatch between the data from the table and the conclusion drawn by the authors.

Declaration of interest-none.

1 Cooper, SA, Smiley E, Morrison J, Williamson A, Allan L, (2007) Br.J. Psychiatry, 190: 27 - 35

Dr Wael Foad. MB ChB, MRCPsych part 1. Senior House Officer, LearningDisabilities. 20 Crosby Road North, Liverpool L22 4QF. Telephone: 01519284107. Fax: 0151 928 6590.
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Conflict of interest: None Declared

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Mental ill health and intellectual disabilities-Role of care programme approach

Lakshmiprabha Ramasubramanian, senior house officer,learning disabilities
01 February 2007

Dear Editors,

Sally-Ann Cooper and colleagues have looked at prevalence of mental ill-health in adults with intellectual disabilities and the factors associated with it in a very comprehensive manner. The use of semistructured instruments and detailed individual assessments add to the quality of the study even though the study has got a few limitations that have been acknowledged. People with learningdisabilities can present with complex behavioural ,emotional and mental health needs that are best understood within a biopsychosocial framework..Comprehensive multidisciplinary and multimodal approach to assessment, care planning and case management is needed in meeting the mental health needs of this client group (O'Hara and Sperlinger, 1997) and the role of care programme approach is vital in acheiving this.Hence we did an audit of effective care coordination in Learning Disability across St.Helens and Knowsley Boroughs and looked the standard and enhanced care plans of all our patients on Care programme approach in December 2006.Even though Care programme in learning disability is complemented by health action plan and person centred plan,we found that if we address specific problems related to employment,housing,social environment and lifestyle in the care plans we could address the factors independently associated with mental illness in this population which theauthors have highlighted in the discussion.Also Joint training for all theprofessionals involved in the CPA process will improve their understandingof specific clinical presentations of mental health problems in people with learning disability and help us derive the maximium benefit out of effective care coordination.

Reference

1.Roy A et al.,The Care programme approach in learning disability psychiatry.Adv Psych Tr(2000)6;380-3872.HigginsS et al.The mental health needs of people with severe learning disabilities.Br J Nurs.2004 Dec9-2005 Jan 12;13(22);1342-63.Valuing People: Moving forward together - The Government's annual reporton learning disability 2004.Department of health.4.Department of Health (1999a) A National Service Framework for Mental Health. London: DoH.

Declaration of interest-none

Dr.Lakshmiprabha Ramasubramanian.MRCPsych.Senior House Officer,Learning Disabilities.Willis House,23,cumber lane,whiston,Merseyside.L35 2YZtelephone:01514265885Dr.Ranasinghe,Consultant Psychiatrist,Learning Disabilities.Willis House,23,cumber lane,whiston,Merseyside.L35 2YZtelephone:01514265885
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Conflict of interest: None Declared

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