Integrative treatment in persons with intellectual disability and mental health problems

Background: People with an intellectual disability (ID) show a great number and complex constellation of support needs. With respect to the planning of services, it is important to assess needs at the population level. ID services need to know to what extent support needs of clients with mental health problems differ from support needs of clients without any mental health problem.Aims: The aim of this study was to compare the prevalence rates of needs in relevant study groups. Methods: Data was generated from the MEMENTA-Study (“Mental health care for adults with intellectual disability and a mental disorder”). The Camberwell Assessment of Need for Adults with Intellectual Disabilities (CANDID) was used to assess met und unmet support needs. Data was available for n=248 adults with mild to moderate ID.Results: Mean total number of needs and unmet needs was associated with mental health status. However, in most particular areas under study, individuals without significant psychiatric symptoms or any behaviour problem needed as much as often help as individuals with such mental health problems. A higher rate of need for care among study participants with significant psychiatric symptoms or any behaviour problem was mainly found with regard to these specific areas (“minor mental health problems”, “major mental health problems”, “inappropriate behaviour”) or with regard to closely related areas (“safety of others”).Conclusions: Differences in prevalence rates mainly occurred in such areas of need that rather fall under the responsibility of mental health services than under the responsibility of ID services. This has implications for service planning.

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Is social camouflaging associated with anxiety and depression in autistic adults?

Molecular Autism ◽

10.1186/s13229-021-00421-1 ◽

2021 ◽

Vol 12 (1) ◽

Author(s):

Laura Hull ◽

Lily Levy ◽

Meng-Chuan Lai ◽

K. V. Petrides ◽

Simon Baron-Cohen ◽

...

Keyword(s):

Mental Health ◽

Intellectual Disability ◽

Social Anxiety ◽

Online Survey ◽

Mental Health Problems ◽

Autistic Traits ◽

Health Problems ◽

Autistic People ◽

Autistic Adults ◽

Anxiety Depression

Abstract Background There is inconsistent evidence for a clear pattern of association between ‘camouflaging’ (strategies used to mask and/or compensate for autism characteristics during social interactions) and mental health. Methods This study explored the relationship between self-reported camouflaging and generalised anxiety, depression, and social anxiety in a large sample of autistic adults and, for the first time, explored the moderating effect of gender, in an online survey. Results Overall, camouflaging was associated with greater symptoms of generalised anxiety, depression, and social anxiety, although only to a small extent beyond the contribution of autistic traits and age. Camouflaging more strongly predicted generalised and social anxiety than depression. No interaction between camouflaging and gender was found. Limitations These results cannot be generalised to autistic people with intellectual disability, or autistic children and young people. The sample did not include sufficient numbers of non-binary people to run separate analyses; therefore, it is possible that camouflaging impacts mental health differently in this population. Conclusions The findings suggest that camouflaging is a risk factor for mental health problems in autistic adults without intellectual disability, regardless of gender. We also identified levels of camouflaging at which risk of mental health problems is highest, suggesting clinicians should be particularly aware of mental health problems in those who score at or above these levels.

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Mental health problems and related issues for people with developmental and intellectual disability

Current Opinion in Psychiatry ◽

10.1097/yco.0b013e328349d249 ◽

2011 ◽

Vol 24 (5) ◽

pp. 365-366 ◽

Cited By ~ 4

Author(s):

Nick Bouras

Keyword(s):

Mental Health ◽

Intellectual Disability ◽

Mental Health Problems ◽

Health Problems

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Mental health in intellectual disability

Oxford Textbook of Public Mental Health ◽

10.1093/med/9780198792994.003.0030 ◽

2018 ◽

pp. 265-272

Author(s):

Sabyasachi Bhaumik ◽

Dasari Mohan Michael ◽

Reza Kiani ◽

Avinash Hiremath ◽

Shweta Gangavati ◽

...

Keyword(s):

Mental Health ◽

Intellectual Disability ◽

Mental Health Problems ◽

Current Knowledge ◽

Premature Mortality ◽

Health Problems ◽

Physical And Mental Health ◽

Middle Income ◽

Middle Income Countries

This chapter focuses on the current knowledge in public health for people with intellectual disability and recognizes the extent of health inequalities these individuals experience. The prevalence of intellectual disability worldwide is discussed with special emphasis on the prevalence of mental health problems. Also highlighted are the population health characteristics, including physical and mental health problems. The issue of barriers to accessibility and the possible reasons are discussed. There is a section on premature mortality of people with intellectual disability and measures to improve the health status for this marginalized population. Recent initiatives, including prevention strategies and health promotional aspects, are discussed and solutions suggested, including those for low-and-middle income countries (LAMICs)emphasized. Training aspects to improve quality of health care in LAMICs is highlighted with the recognition of limitations in creating a sustainable transformation of services unless they are backed by authorities.

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Effectiveness of interventions for adults with mild to moderate intellectual disabilities and mental health problems: systematic review and meta-analysis

The British Journal of Psychiatry ◽

10.1192/bjp.bp.114.162313 ◽

2016 ◽

Vol 209 (6) ◽

pp. 469-474 ◽

Cited By ~ 24

Author(s):

Nadine Koslowski ◽

Kristina Klein ◽

Katrin Arnold ◽

Markus Kösters ◽

Matthias Schützwohl ◽

...

Keyword(s):

Mental Health ◽

Intellectual Disability ◽

Intellectual Disabilities ◽

Mental Health Problems ◽

Meta Analysis ◽

Health Problems ◽

System Level ◽

Controlled Trials ◽

Moderate Intellectual Disability

BackgroundThere is a lack of available evidence in relation to the effectiveness of interventions for adults with mild to moderate intellectual disability and mental health problems.AimsTo evaluate the efficacy of interventions for adults with mild to moderate intellectual disabilities and co-occurring mental health problems.MethodAn electronic literature search of the databases Medline, EMBASE, PsycINFO and EBM Reviews aimed at identifying randomised controlled trials (RCTs) and controlled trials testing any type of intervention (psychotherapy, biological or system level) for people with mild to moderate intellectual disabilities (IQ score 35–69) targeting comorbid mental health problems. Additionally a meta-analysis was conducted.ResultsTwelve studies met the inclusion criteria. No significant effect was found for the predefined outcome domains behavioural problems, depression, anxiety, quality of life and functioning. The effect size for depression (d = 0.49) was moderate but non-significant. Quality of studies was moderate and heterogeneity was high.ConclusionsThere is no compelling evidence supporting interventions aiming at improving mental health problems in people with mild to moderate intellectual disability. The number of available trials is too low for definite conclusions. Some interventions are promising and should be evaluated further in larger and more rigorous trials.

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Psychiatric Vulnerability in Adults with Intellectual Disability and Autism: A Literature Review

European Psychiatry ◽

10.1016/j.eurpsy.2017.01.1952 ◽

2017 ◽

Vol 41 (S1) ◽

pp. S133-S133

Author(s):

S. Coli ◽

D. Scuticchio ◽

M. Bertelli

Keyword(s):

Mental Health ◽

Intellectual Disability ◽

Psychiatric Disorders ◽

Mental Health Problems ◽

Challenging Behaviors ◽

Diagnostic Procedures ◽

Health Problems ◽

Autism Spectrum ◽

Assessment Tools ◽

Co Morbidity

IntroductionAdults with Intellectual disability (ID) and Autism Spectrum Disorder (ASD) are more vulnerable to mental health problems than the general population.Objectives/aimsThis study investigates presence and rate of psychiatric disorders in comparison with ID or ASD alone, and appropriateness of assessment and diagnostic procedures or tools.MethodsA systematic mapping of the literature was carried out on the basis of the above mentioned issues. The search was conducted using PubMed and ScienceDirect, according to the following keywords: psychiatric comorbidity, psychiatric disorders, autism, ASD, intellectual disability, mental health problems, adults, assessment tools, diagnosis. Twenty-eight papers were selected for pertinence to mapping issues among more than 500.ResultsMany studies show that ASD is an important vulnerability factor for psychiatric co-morbidity and for challenging behaviors (CBs) in adults with ID. Highest rates were reported for psychotic, mood, anxiety, and obsessive-compulsive disorders. Few studies show that the difference between adults with ID plus ASD and adults with only ID are not statistically significant, but for the presence of CBs in those with ID plus ASD. The disagreement of results is based on a variety of factors such as diagnostic over-shadowing, scarcity of specific assessment tools, consideration of the introspective and communication difficulties, incompleteness of medical records, and low reliability of information sources.ConclusionsAlthough low studies concordance, the literature mapping suggests the presence of ASD in ID to be associated with higher rates of psychopathology. Since the relevant implications for prevention and clinical management, further research with high-level evidence is hoped.Disclosure of interestThe authors have not supplied their declaration of competing interest.

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