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Psychiatric Morbidity in Older People with Moderate and Severe Learning Disability

I: Development and Reliability of the Patient Interview (PAS-ADD)

Published online by Cambridge University Press:  02 January 2018

Steve Moss*
Affiliation:
Hester Adrian Research Centre, University of Manchester, Oxford Road, Manchester M13 9PL
Pradip Patel
Affiliation:
Hester Adrian Research Centre, University of Manchester, Oxford Road, Manchester M13 9PL
Helen Prosser
Affiliation:
Hester Adrian Research Centre, University of Manchester, Oxford Road, Manchester M13 9PL
David Goldberg
Affiliation:
Institute of Psychiatry, London
Neill Simpson
Affiliation:
Central Manchester Health Authority
Steve Rowe
Affiliation:
Olive Mount Hospital, Liverpool
Ron Lucchino
Affiliation:
Institute of Gerontology, Utica College of Syracuse University, Utica, New York
*
Correspondence

Abstract

This paper describes the development of the PAS-ADD, a semistructured clinical interview for use specifically with patients with learning disabilities, based on items drawn from the PSE. The PAS-ADD includes a number of novel features including: parallel interviewing of patient and informant; a three-tier structure to provide a flexible interview appropriate to the patient's intellectual level; use of a memorable ‘anchor event’ in the patient's life to improve time focus; and simplified wording, improved organisation and lay out. Inter-rater reliability was investigated using an experimental design in which two raters viewed and re-rated videotaped PAS-ADD interviews which had been conducted by an experienced clinician. Reliability results compared favourably with those obtained in a major study of PSE reliability with a sample drawn from non-learning disabled individuals. Mean kappa for all items was 0.72. Other indexes of reliability were also good. In the current phase of development, the PAS-ADD is to be expanded to include further diagnostic categories, including schizophrenia and autism. The new version will be updated for use with ICD–10 criteria.

Type
Research Article
Copyright
Copyright © Royal College of Psychiatrists, 1993 

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References

American Psychiatric Association (1987) Diagnostic and Statistical Manual of Mental Disorders (3rd edn, revised) (DSM—III—R). Washington, DC: APA.Google Scholar
Babor, T. F., De la Fuente, J. R., Saunders, J., et al (1989) Audit — Guidelines for use in Primary Health Care. Geneva: World Health Organization, Division of Mental Health.Google Scholar
Brugha, T. S., Collacot, R., Warrington, J., et al (1988) Eliciting and reliably rating delusions and hallucinations in the mildly mentally retarded. Paper presented at the 8th IASSMD Congress, Dublin.Google Scholar
Cottler, L. B., Robins, L. N. & Helzer, J. E. (1989) The reliability of the CIDI-SAM: a comprehensive substance abuse interview. British Journal of Addiction, 84, 801814.CrossRefGoogle ScholarPubMed
Dean, C., Surtees, P. & Sashidharan, S. P. (1983) Comparison of research diagnostic systems in an Edinburgh community sample. British Journal of Psychiatry, 142, 247256.Google Scholar
Eaton, L. F. & Menolascino, F. J. (1982) Psychiatric disorders in the mentally retarded: types, problems, and challenges. American Journal of Psychiatry, 139, 12971303.Google Scholar
Folgeson, D. L., Neuchterlein, K. H., Asarnow, R. F., et al (1991) Interrater reliability of the Structured Clinical Interview for DSM-III-R, Axis II: schizophrenia spectrum and affective spectrum disorders. Psychiatry Research, 39, 5563.Google Scholar
Gask, L. (1988) The Psychiatric Assessment Schedule (PAS) (revised). Manchester: Department of Psychiatry, Manchester University.Google Scholar
Gillberg, L. C. & Gillberg, C. (1989) Asperger's syndrome - some epidemiological considerations: a research note. Journal of Child Psychology & Psychiatry, 30, 631638.CrossRefGoogle ScholarPubMed
Kendell, R. E., Everitt, B., Cooper, J. E., et al (1968) The reliability of the ‘Present State Examination’. Social Psychiatry, 3, 123129.Google Scholar
Matson, J. L., Kadzin, A. E. & Senatore, V. (1984) Psychometric properties of the Psychopathology Instrument for Mentally Retarded Adults (PIMRA). Applied Research in Mental Retardation, 5, 881889.Google Scholar
Matson, J. L., Kadzin, A. E. & Senatore, V., Gardner, W. I., Coe, D. A., et al (1991) A scale for evaluating emotional disorders in severely and profoundly mentally retarded persons. British Journal of Psychiatry, 159, 404409.CrossRefGoogle ScholarPubMed
Menolascino, F. J., (ed.) (1970) Psychiatric Approaches to Mental Retardation. New York: Basic Books.Google Scholar
Moss, S. C. & Hogg, J. (1989) A cluster analysis of support networks of older people with severe intellectual impairment. Australian and New Zealand Journal of Developmental Disabilities, 15, 169188.CrossRefGoogle Scholar
Moss, S. C. & Hogg, J. & Goldberg, D. P. (1991) The Psychiatric Assessment Schedule for Adults with a Developmental Disability (the PAS-ADD): Interview development and compilation of the clinical glossary (Project proposal to the DOH). Manchester: HARC, University of Manchester.Google Scholar
Moss, S. C. & Hogg, J. & Goldberg, D. P., & Patel, P. (1991) Psychiatric and Physical Morbidity in Older People with Severe Mental Handicap. Manchester: HARC, University of Manchester.Google Scholar
Moss, S. C. & Hogg, J. & Goldberg, D. P., & Patel, P., et al (1992a) Physical morbidity in older people with moderate, severe and profound mental handicap, and its relation to psychiatric morbidity. Social Psychiatry and Psychiatric Epidemiology, 28, 3239.CrossRefGoogle Scholar
Moss, S. C. & Hogg, J. & Goldberg, D. P., & Patel, P., Hogg, J. & Horne, M. (1992b) 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. Journal of Intellectual Disability Research, 36, 387401.CrossRefGoogle ScholarPubMed
Moss, S. C. & Hogg, J. & Goldberg, D. P., & Patel, P., Hogg, J. & Horne, M. (1993) Individual characteristics and service support of older people with moderate, severe and profound learning disability with and without Community Mental Handicap Team support. Mental Handicap Research, 6, 317.CrossRefGoogle Scholar
Philips, I. (1967) Psychopathology and mental retardation. American Journal of Psychiatry, 124, 2935.Google Scholar
Qureshi, H., Alborz, A. & Kiernan, C. (1990) Prevalence of Individuals with Mental Handicap who Show Severe Problem Behaviour: Update of Preliminary Results. Manchester: HARC, University of Manchester.Google Scholar
Reid, A. H. (1972a) Psychoses in adult mental defectives: I. Manic-depressive psychoses. British Journal of Psychiatry, 120, 205212.Google Scholar
Reid, A. H. (1972b) Psychoses in adult mental defectives: II. Schizophrenic and paranoid psychoses. British Journal of Psychiatry, 120, 213218.Google Scholar
Reiss, S. (1982) Psychopathology and mental retardation: survey of a developmental disabilities mental health program. Mental Retardation, 20, 128132.Google ScholarPubMed
Reiss, S. (1987) Reiss Screen for Maladaptive Behavior. Chicago: International Diagnostic Systems, Inc.Google Scholar
Robins, L. N. (1985) The Composite International Diagnostic Interview (CIDR) 1—2, St Louis, Missouri: DIS Training Faculty and Staff, Washington University School of Medicine.Google Scholar
Sigelman, C. K., Budd, E. C., Spanhel, C. L., et al (1981) When in doubt say yes: acquiescence in interviews with mentally retarded persons. Mental Retardation, 19, 5358.Google Scholar
Sovner, R. & Hurley, D. A. (1983) Do the mentally retarded suffer from affective illness? Archives of General Psychiatry, 40, 6167.CrossRefGoogle ScholarPubMed
Spitzer, R. L., Williams, J. & Gibbon, M. (1987) Structured Clinical Interview for DSM-III-R Personality Disorders (SCID-II). New York: New York State Psychiatric Institute.Google Scholar
Sturmey, P., Reed, J. & Corbett, J. (1991) Psychometric assessment of psychiatric disorders in people with learning difficulties (mental handicap): a review of measure. Psychological Medicine, 21, 143155.Google Scholar
Tantam, D. (1986) PhD Thesis. London: University of London.Google Scholar
Tantam, D. (1988) Lifelong eccentricity & social isolation. II: Asperger's syndrome or schizoid personality disorder? British Journal of Psychiatry, 153, 783791.CrossRefGoogle ScholarPubMed
Watson, C. G., Juba, M. P., Manifold, V., et al (1991) The PTSD interview: rationale, description, reliability, and concurrent validity of a DSM-III-based technique. Journal of Clinical Psychology, 47, 179188.Google Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N. (1974) Measurement and Classification of Psychiatric Symptoms: An Instruction Manual for the PSE and catego Program. Cambridge: Cambridge University Press.Google Scholar
Wing, J. K., Cooper, J. E. & Sartorius, N., Nixon, J. M., Mann, S. A., et al (1977) Reliability of the PSE (ninth edition) used in a population study. Psychological Medicine, 7, 505516.CrossRefGoogle ScholarPubMed
Wing, J. K., Cooper, J. E. & Sartorius, N., Nixon, J. M., Mann, S. A., & Gould, J. (1978) Systematic recording of behaviours and skills of retarded and psychotic children. Journal of Autism and Childhood Schizophrenia, 8, 7997.CrossRefGoogle ScholarPubMed
Wittchen, H. U., Robins, L. N., Cottler, L. B., et al (1991) Cross-cultural feasibility, reliability and sources of variance of the Composite International Diagnostic Interview (CIDI). British Journal of Psychiatry, 159, 645653.Google Scholar
World Health Organization (1978) Mental Disorders: Glossary and Guide to their Classification in Accordance with the Ninth Revision of the International Classification of Diseases (ICD-9). Geneva: WHO.Google Scholar
World Health Organization (1992a) The ICD-10 Classification of Mental and Behavioural Disorders. Geneva: WHO.Google Scholar
World Health Organization (1992b) Schedules for Clinical Assessment in Neuropsychiatry. Geneva: WHO.Google Scholar
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