Hostname: page-component-84b7d79bbc-4hvwz Total loading time: 0 Render date: 2024-07-27T23:07:24.994Z Has data issue: false hasContentIssue false
  • English
  • Français

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
Get access Rights & Permissions [Opens in a new window]

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

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.Eaton, J, Menoloscino, FJ. Psychiatric disorders in the mentally retarded. Types, problems and challenges. Am J Psychiatry 1982; 139: 1297–1303.Google ScholarPubMed
2.Gillberg, C, Persson, E, Frufman, M, Themner, U. psychiatric disorders in mildly and severely mentally handicapped children and adolescents; epidemiological aspects. Br J Psychiatry 1986; 149: 68–74.CrossRefGoogle Scholar
3.Lund, J. The prevalence of psychiatric morbidity in mentally retarded adults. Acta Psychiatr Scand 1985; 72: 563–570.CrossRefGoogle ScholarPubMed
4.Croft, JA. Mental disorder in the defective: a psychiatric survey among in-patients. American Journal of Mental Deficiency 1959; 63: 829–834.Google Scholar
5.Reid, AH. Diagnosis of psychiatric disorder in the severely and profoundly retarded patient. Journal of the Royal Society of Medicine 1980; 73: 607–609.CrossRefGoogle ScholarPubMed
6.Craft, M, Bicknell, J, Hollins, S, editors. Mental Handicap: a multi-disciplinary approach. Balliere & Tindall, 1985: 318–319.Google Scholar
7.Corbett, JA. Psychiatric morbidity and menial retardation. In: James, FE, Snaith, RP, editors. Psychiatric illness and mental handicap. London: Gaskell Press, 1979.Google Scholar
8.Day, KA. Service provision for mental handicapped people with psychiatric problems. Report of MIND Annual Conference; 1983; London.Google Scholar
9.Russell, AT, Tanquay, PF. Mental illness and mental retardation: case or coincidence. American Journal Mental Deficiency 1981; 85 (6): 570–574.Google ScholarPubMed
10.Windle, C. Prognosis of mental subnormals. American Journal of Mental Deficiency 1962; 66 (4 Suppl): [monograph].Google Scholar
11.Maney, A, Pace, R, Morrison, D. Factor analysis study of Ihe need for institutionalisation: problems and population for programme development. American Journal of Mental Deficiency 1964; 69: 372–384.Google Scholar
12.Spencer, DA. New long stay patient in a hospital for mentally handicapped. Br J Psychiatry 1976; 128: 467–470.CrossRefGoogle Scholar
13.Keys, V, Boroskin, A, Ross, RT. The revolving door in an M.R. Hospital. A study of returns from leave. Mental Retardation 1973; 11 (1): 55–56.Google Scholar
14.Pagel, SE, Whitling, CA. Readmission to a state hospital for mentally retarded persons: Reasons for community placements failure. Mental Retardation 1978: 16 (2): 164–166.Google Scholar
15.Fraser, WI, Leudar, E, Gray, J, Campbell, I. Psychiatric and behavioural disturbance in mental handicap. Journal of Mental Deficiency Research 1986; 30: 49–57.Google ScholarPubMed
16.Nihera, K, Foster, R, Shellhaas, , Lcland, H. A.A.M.D. Adaptive Behaviour Scale. Washington DC: American Association on Mental Deficiency, 1974.Google Scholar
17.Nihera, K, Foster, R, Shellhaas, M, Leland, H. H: A.A.M.D. Adaptive Behaviour Scale. 1974 revision. Washington DC: American Association on Mental Deficiency, 1974.Google Scholar
18.Clements, PR, Bost, LW, DuBois, YG, Turpin, WE. Adaptive Behaviour Scale, Part Two, relative severity of maladaptive behaviour. American Journal of Mental Deficiency 1980; 84: 465–469.Google Scholar
19.Reid, AH, Naylor, GJ. Journal of Mental Deficiency Research 1976; 20: 67–76.Google Scholar
20.Rutter, M, Gragham, P, Yule, M. A neuropsychiatrie study in childhood. (Clinics in Developmental Medicine, nos 33-35). London: SIMP Heinemann, 1970.Google Scholar
21.Lund, J. Measuring behaviour disorder in mental handicap. Br J Psychiatry 1989; 155: 379–383.CrossRefGoogle ScholarPubMed
22.Deb, S, Hunter, D. Psychopathology of people with mental handicap and epilepsy. 1: Maladaptive behaviur. Br J Psychiatry 1991; 159: 822–826, 833–834.Google Scholar
23.Deb, S, Hunter, D. Psychopathology of people with mental handicap and epilepsy. 2: Psychiatric illness. Br J Psychiatry 1991; 159: 826-830, 833–4.Google Scholar
24.Deb, S, Hunter, D. Psychopathology of people with mental handicap and epilepsy. 3: Personality disorder. Br J Psychiatry 1991; 159: 830–834.CrossRefGoogle Scholar
25.Day, K. Psychiatric disorder in the middle aged and elderly mentally handicapped. Br J Psychiatry 1985; 147: 660–667.CrossRefGoogle ScholarPubMed