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Behaviour disorders in adults with learning disabilities: Effect of age and differentiation from other psychiatric disorders

Published online by Cambridge University Press:  13 June 2014

Sally-Ann Cooper
Sally-Ann Cooper*
Affiliation:
Rockingham Forest NHS Trust, St Mary's Hospital, London Road, Kettering, Northants NN15 7PW, England.
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Abstract

Objective: To clarify the effect of age on behaviour disorders in adults with learning disabilities, and the differentiation of behaviour disorders from other psychiatric disorders.

Method: Detailed assessments, measuring maladaptive behaviours, psychiatric disorders and demographic factors were completed on 93.7% of all people with learning disabilities aged 65 years and over, living in Leicestershire, UK (n = 134), and also a random sample of adults with learning disabilities aged 20-64 years (n = 73). Behaviour disorders were distinguished from other psychiatric disorders. Descriptive and inferential statistics were calculated.

Result: Equal rates (15%) and types of behaviour disorder were found in the two groups. The presence of behaviour disorder was associated with the severity of learning disabilities, but age was not associated, and nor was presence of epilepsy or gender. In many cases, positive scores on the behavioural assessment, which carers attributed to challenging behaviour/ behaviour disorder, were actually symptoms of psychiatric illness.

Conclusion: Behaviour disorders persist into old age, and therefore require management from the appropriate services. This need will increase, due to increasing lifespan. The accurate interpretation of behaviour scales requires that a comprehensive psychiatric assessment is also undertaken, particularly in elderly people where rates of psychiatric disorders are higher than for younger adults.

Keywords

Mental retardation (learning disabilities)Behaviour disorderPsychiatric illnessOld age.
Type
Original Papers
Information
Irish Journal of Psychological Medicine , Volume 15 , Issue 1 , March 1998 , pp. 13 - 18
Copyright
Copyright © Cambridge University Press 1998

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References

1.Day, KA. Psychiatric disorder in the middle-aged and elderly mentally handicapped. Br J Psychiatry 1985; 147: 660–7.CrossRefGoogle ScholarPubMed
2.Patel, P, Goldberg, D, Moss, S. Psychiatric morbidity in older people with moderate and severe learning disabilities II: The prevalence study. Br J Psychiatry 1993; 163: 81–491.CrossRefGoogle ScholarPubMed
3.Lund, J. The prevalence of psychiatric morbidity in mentally retarded adults. Acta Psychiatr Scand 1985; 72: 563–70.CrossRefGoogle ScholarPubMed
4.Corbett, JA. Psychiatric morbidity and mental retardation. In: FE, James and Snaith, RP, eds. Psychiatric Illness and Mental Handicap. London: Gaskell Press, 1979.Google Scholar
5.Smith, S, Branford, DM, Collacott, RA, Cooper, S-A, McGrother, C. The prevalence and cluster typology of maladaptive behaviours in a defined geographical population of adults with learning disabilities. Br J Psychiatry 1996; 169: 219–27.CrossRefGoogle Scholar
6.Haveman, MJ, Maaskant, MA, van Schrojenstein, Lantman, HM, Urlings, HFJ, Kessels, AGH. Mental health problems in elderly people with and without Down's syndrome. J Intellect Disabil Res 1994; 38: 341–55.CrossRefGoogle ScholarPubMed
7.Cooper, S-A. Epidemiology of psychiatric disorders in elderly compared with younger adults with learning disabilities. Br J Psychiatry 1997; 170: 375–80.CrossRefGoogle ScholarPubMed
8.Hewitt, KE, Fenner, ME, Torpy, D. Cognitive and behavioural profiles of the elderly mentally handicapped. J Ment Deficiency Res 1996; 30: 217–25.Google Scholar
9.James, DH. Psychiatric and behavioural disorders amongst older severely mentally handicapped in-patients. J Ment Deficiency Res 1986; 30: 341–5.Google Scholar
10.Day, KA, Jancar, J. Mental and physical health and ageing in mental handicap: a review. J Intellect Disabil Res 1994; 38: 241–56.CrossRefGoogle ScholarPubMed
11.Reid, AH, Ballinger, BR. Behaviour symptoms among severely and profoundly mentally retarded patients: A 16–18 year follow-up study. Br J Psychiatry 1995; 167:452–5.CrossRefGoogle ScholarPubMed
12.Cooper, S-A. Deficient health and social services for elderly people with learning disabilities. J Intellectual Disability Research 1997; 41: 331–338.CrossRefGoogle ScholarPubMed
13.Holmes, N, Shan, A, Wing, L. The Disability Assessment Schedule. Psychol Med 1982; 12: 879–90.CrossRefGoogle ScholarPubMed
14.World Health Organisation. Schedules for clinical assessment in neuropsychiatry. Geneva: World Health Organisation, 1992.Google Scholar
15.Sparrow, SS, Balla, DA, Cicchetti, DV. A revision of the Vineland Social Maturity Scale by EA Doll. Minnesota: American Guidance Service Inc, 1984.Google Scholar
16.World Health Organisation. The ICD-10 Classification of mental and behavioural disorders: diagnostic criteria for research. Geneva: World Health Organisation, 1993.Google Scholar
17.American Psychiatric Association. Diagnostic and statistical manual of mental disorders, 4th ed. Washington, DC: American Psychiatric Association, 1994.Google Scholar
18.Cooper, S-A, Collacott, RA. Depressive episodes in adults with learning disabilities. Ir J Psych Med 1996; 13: 105–13.CrossRefGoogle Scholar
19.American Psychiatric Association. Diagnostic and statistical manual of psychiatric disorders, 3rd ed, revised. Washington, DC: American Psychiatric Association, 1987.Google Scholar
20.Corbett, JA, Pond, DA. Epilepsy and behaviour disorder in the mentally handicapped. In: James, FE, RP, Snaith eds. Psychiatric Illness and Mental Handicap. London: Gaskell Press, 1979.Google Scholar
21.Deb, S, Hunter, D. Psychopathology of people with mental handicap and epilepsy I: maladaptive behaviour. Br J Psychiatry 1991; 159: 822–826.CrossRefGoogle ScholarPubMed
22.Lund, J. Epilepsy and psychiatric disorder in the mentally retarded adult. Acta Psychiatr Scand 1985; 72: 557–62.CrossRefGoogle ScholarPubMed
23.Bailey, NM, Cooper, S-A. The provision of specialist health services to people with learning disabilities in England and Wales. J Intellect Disabil Res 1997; 41: 52–9.CrossRefGoogle ScholarPubMed
24.Cooper, S-A. The psychiatry of elderly people with mental handicaps. Int J Geriatric Psychiatry 1992; 7: 865–74.CrossRefGoogle Scholar
25.Moss, S, Patel, P. The prevalence of mental illness in people with intellectual disability over 50 years of age, and the diagnostic importance of information from carers. Ir J Psychology 1993; 14: 110–29.CrossRefGoogle Scholar
26.Cooper, S-A. High prevalence of dementia amongst people with learning disabilities not attributed to Down's syndrome. Psychol Med 1997; 27: 609–16.CrossRefGoogle Scholar
27.Moss, S, Patel, P. Psychiatric symptoms associated with dementia in older people with learning disability. Br J Psychiatry 1995; 167: 663–7.CrossRefGoogle ScholarPubMed
28.Cooper, S-A. Psychiatric symptoms of dementia amongst elderly people with learning disabilities. Int J Geriatric Psychiatry 1997; 12: 662–6.3.0.CO;2-T>CrossRefGoogle Scholar
29.Cooper, S-A. A population based study of maladaptive behaviours associated with dementia in elderly people with learning disabilities. J Intellect Disabil Res 1997; 41: 481–7.CrossRefGoogle ScholarPubMed