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The relationship between behaviour disturbance and psychiatric diagnosis in male mentally handicapped adults resident in a long-stay unit

Published online by Cambridge University Press:  13 June 2014

David Walshe ,
Mary O'Kelly ,
Louis Ramsay ,
Tessa Gibson ,
Fiona Mulvanney ,
Ahmed Kara  and
Edan Corcoran
David Walshe
Affiliation:
Adult Psychiatric Services, St. Brendan's Hospital, Rathdown Road, Dublin 7
Mary O'Kelly
Affiliation:
St. John of God Bros, St. Raphael's Celbridge
Louis Ramsay
Affiliation:
Mental Handicap Services, St. John of God Bros, St. Raphael's Celbridge
Fiona Mulvanney
Affiliation:
St. John of God Bros, Provincial Administration, Stillorgan, Co. Dublin
Ahmed Kara
Affiliation:
St. John of God Rotation, St. John of God Child and Family Centre, 59 Orwell Road, Dublin
Edan Corcoran
Affiliation:
St. Vincent's Hospital, Elm Park, Dublin 4
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Abstract

Objective: To investigate the relationship between behavioural disturbance and psychiatric diagnosis in male mentally handicapped adults resident in a long stay unit. Method: The case notes of all 144 residents of St. Raphaels were reviewed. Diagnoses were classified according to the International Classification of Diseases Ninth Revision (ICD-9) and grouped into one of four categories Infantile Autism, Functional Psychoses, Personality/Behavioural Disorder and Emotional Disorders. Carers (Senior Nursing Staff) were interviewed using the Adaptive Behaviour Scale Part 2 (ABS Part 2) as a measure of behavioural disturbance in the preceding year for the 144 residents. Results: 56% of residents had significant psychiatric disorder. Those with a psychiatric diagnosis showed increased behavioural disturbance across a wide range of measures (p<0.001) with Hyperactivity, Self Abuse and Violence showing greatest discriminative power. However there was not a relationship between diagnostic category and pattern of scoring on the ABS Part 2. There was a significant relationship between Degree of Mental Handicap and Psychiatric Diagnostic Category (p<0.001). Neither psychiatric morbidity nor behavioural disturbance was associated with epilepsy, age or duration of stay. Conclusions: Mentally handicapped adults in residential care show high rates of psychiatric disturbance. Those with psychiatric diagnoses exhibit a wide range of disturbed behaviours but similar patterns of maladaptive behaviour occur across the spectrum of psychiatric disorders. These findings refer to a male residential population and cannot be generalised to all mentally handicapped.

Keywords

Mental handicapResidential unitPsychiatric diagnosisBehaviour disturbanceAdaptive behaviour scaleEpilepsyAgeDegree of mental handicap
Type
Original Papers
Information
Irish Journal of Psychological Medicine , Volume 10 , Issue 1 , February 1993 , pp. 16 - 19
Copyright
Copyright © Cambridge University Press 1993

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