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Psychiatric symptoms in adults with learning disability and challenging behaviour

  • Steve Moss (a1), Eric Emerson (a2), Chris Kiernan (a2), Steve Turner (a2), Chris Hatton (a2) and Alison Alborz (a2)...
Extract
Background

In people with learning disability one of the most frequent reasons for psychiatric referral is challenging behaviour.

Aims

To determine what proportion of people with challenging behaviour actually have psychiatric symptoms.

Method

Using an instrument specifically designed for use by informants, a sample of 320 people with administratively defined learning disability, with and without challenging behaviour, was surveyed for the presence of psychiatric symptoms.

Results

Increasing severity of challenging behaviour was associated with increased prevalence of psychiatric symptoms, depression showing the most marked association. Anxiety symptoms were associated with the presence of self-injurious behaviour.

Conclusions

There is clearly the potential for reducing challenging behaviour by improved identification and treatment of coexisting psychiatric disorders. The possibility of modifying diagnostic criteria for depression in people with learning disability, by including aspects of challenging behaviour, merits attention.

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Copyright
Corresponding author
Steve Moss, Institute of Psychiatry, Department of Health Services Research, De Crespigny Park, Denmark Hill, London SE5 8AF, UK
Footnotes
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Declaration of interest

The project was funded by grants from the Department of Health.

Footnotes
References
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Borthwick-Duffy, S. A. (1994) Prevalence of destructive behaviors. In Destructive Behavior in Developmental Disabilities: Diagnosis and Treatment (ed. Thompson, T. & Gray, D. B.), pp. 323. Thousand Oaks, CA: Sage.
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Emerson, E., Kiernan, C., Alborz, A., et al (1997) The HARC Challenging Behaviour Project. Summary. Manchester: Hester Adrian Research Centre.
Emerson, E., Moss, S. C. & Kiernan, C. K. (1999) The relationship between challenging behaviour and psychiatric disorders in people with severe intellectual disabilities. In Psychiatric and Behavioural Disorders in Mental Retardation (ed. Bouras, N.), pp. 3848. Cambridge: Cambridge University Press.
Felce, D., Lowe, K., Perry, J., et al (2000) Service support to people with severe intellectual disabilities and the most severe challenging behaviours in Wales: prevalence, outcome and costs. Journal of Intellectual Disability Research (in press).
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Kiernan, C. & Qureshi, H. (1993) Challenging behaviour. In Research to Practice? Implications of Research on the Challenging Behaviour of People with Learning Disabilities (ed. Kiernan, C.). Kidderminster: British Institute of Learning Disabilities.
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Meins, W. (1995) Symptoms of major depression in mentally retarded adults. Journal of Intellectual Disability Research, 39, 4145.
Moss, S. C., Prosser, H., Costello, H., et al (1998) Reliability and validity of the PAS-ADD Checklist for detecting psychiatric disorders in adults with intellectual disability Journal of Intellectual Disability Research, 42, 173183.
Patel, P., Goldberg, D. & Moss, S. (1993) Psychiatric morbidity in older people with moderate and severe learning disability II: The prevalence study. British Journal of Psychiatry, 163, 481491.
Prosser, H., Moss, S. C., Costello, H., et al (1998) Reliability and validity of the Mini PAS-ADD for assessing psychiatric disorders in adults with intellectual disability. Journal of Intellectual Disability Research, 42, 264272.
Qureshi, H. & Alborz, A. (1992) Epidemiology of challenging behaviour. Mental Handicap Research, 5, 130145.
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The British Journal of Psychiatry
  • ISSN: 0007-1250
  • EISSN: 1472-1465
  • URL: /core/journals/the-british-journal-of-psychiatry
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Psychiatric symptoms in adults with learning disability and challenging behaviour

  • Steve Moss (a1), Eric Emerson (a2), Chris Kiernan (a2), Steve Turner (a2), Chris Hatton (a2) and Alison Alborz (a2)...
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