Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-18T04:46:05.989Z Has data issue: false hasContentIssue false

Psychiatric disorders amongst adults with learning disabilities - prevalence and relationship to ability level

Published online by Cambridge University Press:  13 June 2014

Sally-Ann Cooper
Affiliation:
Department of Psychological Medicine, University of Glasgow, Academic Centre, Gartnavel Royal Hospital, 1055 Great Western Road, Glasgow G12 OXH, Scotland
Nicola M Bailey
Affiliation:
Oxford Deanery Higher Training Scheme, England

Abstract

Objectives: To determine the prevalence of psychiatric disorders in adults with learning disabilities, and the relationship with severity of learning disabilities.

Method: The study is population-based. Detailed psychiatric assessments on 207 adults with learning disabilities living in Leicestershire, UK. were conducted by a learning disabilities psychiatrist, using the Present Psychiatric State - Learning Disabilities; and Disability Assessment Schedule. Diagnostic criteria are clearly defined. Developmental assessments were undertaken using the Vineland Scale (survey form).

Results: Psychiatric disorders were found in 49.2%, and rates for most individual disorders were higher than those found in the general population. Comparison with the two previous population-based studies shows the ascertained rates were broadly similar to those reported by Corbett but higher than those reported by Lund. Adults with more severe learning disabilities had higher rates of additional psychiatric disorders.

Conclusions: The results may be explained by a combination of the genetic, physical, psychological and social factors associated with learning disabilities also being aetiological to psychiatric disorders. The high prevalence rates of psychiatric disorders demonstrate the importance of health service provision for adults with learning disabilities.

Type
Original Papers
Copyright
Copyright © Cambridge University Press 2001

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

1.Penrose, LS. A clinical and genetic study of 1280 cases of mental defect (The Colchester Survey) Medical Research Council Special Report 229, 1938. Reproduced by Institute for Research into Mental and Multiple Handicap: London 1975.Google Scholar
2.Heaton-Ward, A. Psychosis in mental handicap. The Tenth Blake Marsh Lecture delivered before the Royal College of Psychiatrists, February 2, 1976. Br J Psychiat 1977; 130: 525–33.CrossRefGoogle Scholar
3.Ballinger, BR, Ballinger, BC, Reid, AH, McQueen, E. The psychiatric symptoms diagnoses and care needs of 100 mentally handicapped patients. Br J Psychiat 1991; 158: 251–4.CrossRefGoogle ScholarPubMed
4.Reid, AH. Psychoses in adult mental defectives: I. Manic-depressive psychosis. Br J Psychiat 1972a; 120: 205–12.CrossRefGoogle ScholarPubMed
5.Reid, AH. Psychoses in adult mental defectives: II. Schizophrenia and paranoid psychoses. Br J Psychiat 1972b; 120: 213–8.CrossRefGoogle ScholarPubMed
6.Wright, EC. The presentation of mental illness in mentally retarded adults. Br J Psychiat 1982; 141: 496502.CrossRefGoogle ScholarPubMed
7.Glue, P, Webb, OJ, Surgenor, L. Psychopathology in adult mental handicapped hospital patients. Australian and New Zealand J Psychiat 1988; 22: 312–5.CrossRefGoogle ScholarPubMed
8.Forrest, AD, Ogunremi, OO. The prevalence of psychiatric illness in a hospital for the mentally handicapped. Health Bulletin 1974; 32: 199202.Google Scholar
9.World Health Organisation. Mental disorders: glossary and guide to their classification in accordance with the ninth revision of the International Classification of Diseases (ICD9), Geneva: WHO, 1978.Google Scholar
1O.American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Third edition, Revised, Washington, DC: American Psychiatric Association, 1987.Google Scholar
11.Eaton, L, Menoloscino, FJ. Psychiatric disorders in the mentally retarded: types, problems, and challenges. Am J Psychiat 1982; 139: 1297–303.Google ScholarPubMed
12.Bouras, N, Drummond, C. Behaviour and psychiatric disorders of people with mental handicaps living in the community. J Intellectual Disability Research 1992; 36: 349–57.CrossRefGoogle ScholarPubMed
13.Ballinger, BR, Reid, AH. Psychiatric disorder in an adult training centre and a hospital for the mentally handicapped. Psychol Med 1977; 7, 525–8.CrossRefGoogle Scholar
14.Reiss, S. Prevalence of dual diagnosis in community based day programs in the Chicago metropolitan area. Am J Mental Retardation 1990; 94: 578–85.Google ScholarPubMed
15.Corbett, JA. Psychiatric morbidity and mental retardation. In: Psychiatric Illness and Mental Handicap, Eds James, FE, Snaith, RP, 1979; 1125, London: Gaskell.Google Scholar
16.World Health Organisation 1968. Eighth revision of the International Classification of Diseases: glossary of psychiatric disorders. Geneva: WHO.Google Scholar
17.Lund, J. The prevalence of psychiatric disorder in mentally retarded adults. Acta Psychiatrica Scandinavica 1985; †72, 563–70.CrossRefGoogle ScholarPubMed
18.Wing, L. The MRC handicaps, behaviour and skills (HBS) schedule. Acta Psychiatrica Scandinavica 1980; 285: 241–7.CrossRefGoogle Scholar
19.Feighner, JP, Robins, E, Guze, SB, Woodruff, RA, Winokur, G, Munoz, R. Diagnostic criteria for use in psychiatric research. Archives General Psychiat 1972; 26: 5763.CrossRefGoogle ScholarPubMed
20.American Psychiatric Association. Diagnostic and Statistical Manual of Mental Disorders, Third edition. Washington, DC: American Psychiatric Association, 1980.Google Scholar
21.Jacobson, JW. Do some mental disorders occur less frequently among persons with mental retardation. Am J Mental Retardation 1990; 94: 596602.Google ScholarPubMed
22.Borthwick-Duffy, SA, Eyman, RK. Who are rhe dually diagnosed? Am J Mental Retardation 1990; 94: 586–95.Google Scholar
23.Williams, CE. A study of the patients in a group of mental subnormality hospitals. Br J Subnormality 1971; 17, 2941.CrossRefGoogle Scholar
24.Crews, WD, Bonaventura, S, Rowe, F. Dual diagnosis: Prevalence of psychiatric disorders in a large state residential facility for individuals with mental retardation. Am J Mental Retardation 1990; 98: 688731.Google Scholar
25.Iverson, JC. Fox, RA. Prevalence of psychopathology among mentally retarded adults. Research in Developmental Disabilities 1989; 10: 7783.CrossRefGoogle ScholarPubMed
26.Gostason, R. Psychiatric illness among the mentally retarded — A Swedish population study. Acta Psychiatrica Scandinavica. 1985; 71: suppl, 1117.CrossRefGoogle Scholar
27.Borthwich-Duffy, SA. Epidemiology and prevalence of psychopathology in people wirh mental retardation. J Consult Clinical Psychol 1994; 62: 1727.CrossRefGoogle Scholar
28.Cooper, S-A. Epidemiology of psychiatric disorders in elderly compared with younger adults with learning disabilities. Br J Psychiat 1997; 170: 375–80.CrossRefGoogle ScholarPubMed
29.Cooper, S-A. The epidemiology of psychiatric disorders in elderly people with learning disabilities. Doctor of Medicine Thesis, University of London, 1997.CrossRefGoogle Scholar
30.Fitzgerald, B. Reliability and validity of the present psychiatric state learning disabilities (PPS-LD). Abstracts of the Penrose Society Spring Meeting, 7, 1998.Google Scholar
31.Holmes, N, Shan, A, Wing, L. The Disability Assessment Schedule. Psychol Med 1982; 12: 879–90.CrossRefGoogle ScholarPubMed
32.Sparrow, SS, Balla, DA, Cicchetti, DV. A revision of the Vineland Social Maturity Scale by E A Doll. American Guidance Service, Inc., Minnesota, 1984.Google Scholar
33.World Health Organisation. The ICD-10 Classification of Mental and Behavioural Disorders: Diagnostic Criteria for Research. Geneva: WHO, 1993.Google Scholar
34.Cooper, S-A, Collacott, RA. Depressive episodes in adults with learning disabilities. Ir J Psych Med 1996; 13: 105113.CrossRefGoogle Scholar
35.Moss, S, Hogg, J, Horne, M. Demographic characteristics of a population of people with moderate, severe and profound intellectual disability (mental handicap) over 50 years of age: age structure, IQ and adaptive skills. J Intellectual Disability Research 1992; 36: 387401.CrossRefGoogle ScholarPubMed
36.Farmer, R, Rohde, J, Sacks, B. Changing services for people with learning disabilities. Chapman and Hall: London, 1993.CrossRefGoogle Scholar
37.Berney, T. Behaviour phenotypes. In: Seminars in the Psychiatry of Learning Disabilities. Russell, O, Ed. Gaskell Press: Royal College of Psychiatrists, 1997.Google Scholar
38.O'Dwyer, JM. Schizophrenia in people with learning disability: the role of pregnancy and birth complications. J Intellectual Disability Research 1997; 41, 238–51.CrossRefGoogle Scholar
39.Bird, J. Epilepsy and learning disabilities. In: Seminars in the psychiatry of Learning Disabilities. Russell, O, Ed. Gaskell Press: Royal College of Psychiatrists, 1997.Google Scholar
40.Lindsey,], M. Emotional, behavioural and psychiatric disorders in children. In: Seminars in the Psychiatry of Learning Disabilities. Russell, O., Ed. Gaskell Press: Royal College of Psychiatrists, 1997.Google Scholar
41.Hollins, S, Esterhuyzen, A. Bereavement and grief in adults with learning disabilities. Br J Psychiat 1997; 170: 497501.CrossRefGoogle ScholarPubMed
42.Richman, N, Stevenson, J, Graham, P. Prevalence of problem behaviours in three year old children: an epidemiological study in a London borough. J Child Psychol Psychiat 1975; 16: 272–87.CrossRefGoogle Scholar
43.Hollins, S. Counselling and psychotherapy. In: Seminars in the Psychiatry of Learning Disabilities. Russell, O, Ed. Gaskell Press: royal College of Psychiatrists 1997.Google Scholar
44.Tharinger, D, Horton, CB, Millea, S. Sexual abuse and exploitation of children and adults with mental retardation and other handicaps. Child abuse and Neglect 1990; 14: 301–12.CrossRefGoogle ScholarPubMed
45.Williams, C. Vulnerable victims? A current awareness of the victimisation of people with learning difficulties. Disability, Handicap and Society 1993; 8: 161–72.CrossRefGoogle Scholar
46.Brown, H, Stein, J, Turk, V. The sexual abuse of adults with learning disabilities. Mental Handicap Research 1995; 8: 324.CrossRefGoogle Scholar
47.Sinason, V. Mental Handicap the Human Condition: New Approaches from the Tavistock. Free Association Books: London, 1992.Google Scholar
48.Meltzer, H, Gill, B, Petticrew, M, Hinds, K. The prevalence of psychiatric morbidity among adults living in private households. OPCS: Survey of psychiatric morbidity in Great Britain, Report 1. London: HMSO, 1995.Google Scholar
49.Bailey, N, Cooper, S-A. The provision of specialist health services to people with learning disabilities in England and Wales. J Intellectual Disability Research 1997; 41: 52–9.CrossRefGoogle ScholarPubMed
50.Cooper, S-A. Deficient health and social services for elderly people with learning disabilities. J Intellectual Disability Research 1997; 41: 331–8.CrossRefGoogle ScholarPubMed
51.Howells, G. Are the medical needs of mentally handicapped adults being met? J Royal College of General Practitioners 1986; 36: 449–53.Google ScholarPubMed
52.Royal College of General Practitioners Working Party. Primary care for people with a mental handicap: Occasional paper 47. London: RCGP, 1990.Google Scholar
53.Wilson, DN, Haire, A. Health care screening for people with mental handicap living in the community. BMJ 1990; 301, 1379–81.CrossRefGoogle ScholarPubMed
54.Howells, G. Situations vacant: doctors required to provide care for people with learning disability. Br J General Practice 1996; 46: 5960.Google ScholarPubMed
55.Lennox, NG, Kerr, MP. Review: Primary healrh care and people with an intellectual disability: the evidence base. J Intellectual Disability Research 1997; 41: 365–72.CrossRefGoogle Scholar