scholarly journals Prevalence of mental health conditions, sensory impairments and physical disability in people with co-occurring intellectual disabilities and autism compared with other people: a cross-sectional total population study in Scotland

BMJ Open ◽  
2020 ◽  
Vol 10 (4) ◽  
pp. e035280 ◽  
Author(s):  
Kirsty Dunn ◽  
Ewelina Rydzewska ◽  
Michael Fleming ◽  
Sally-Ann Cooper
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Intellectual Disabilities ◽  
Visual Impairment ◽  
Hearing Impairment ◽  
Physical Disability ◽  
Health Conditions ◽  
Mental Health Conditions ◽  
Sensory Impairments

ObjectivesTo investigate prevalence of mental health conditions, sensory impairments and physical disability in children, adults and older adults with co-occurring intellectual disabilities and autism, given its frequent co-occurrence, compared with the general population.DesignWhole country cohort study.SettingGeneral community.Participants5709 people with co-occurring intellectual disabilities and autism, compared with 5 289 694 other people.Outcome measuresRates and ORs with 95% CIs for mental health conditions, visual impairment, hearing impairment and physical disability in people with co-occurring intellectual disabilities and autism compared with other people, adjusted for age, sex and interaction between age and co-occurring intellectual disabilities and autism.ResultsAll four long-term conditions were markedly more common in children, adults and older adults with co-occurring intellectual disabilities and autism compared with other people. For mental health, OR=130.8 (95% CI 117.1 to 146.1); visual impairment OR=65.9 (95% CI 58.7 to 73.9); hearing impairment OR=22.0 (95% CI 19.2 to 25.2); and physical disability OR=157.5 (95% CI 144.6 to 171.7). These ratios are also greater than previously reported for people witheitherintellectual disabilitiesorautism rather than co-occurring intellectual disabilities and autism.ConclusionsWe have quantified the more than double disadvantage for people with co-occurring intellectual disabilities and autism, in terms of additional long-term health conditions. This may well impact on quality of life. It raises challenges for staff working with these people in view of additional complexity in assessments, diagnoses and interventions of additional health conditions, as sensory impairments and mental health conditions in particular, compound with the persons pre-existing communication and cognitive problems in this context. Planning is important, with staff being trained, equipped, resourced and prepared to address the challenge of working for people with these conditions.

scholarly journals Prevalence of long-term health conditions in adults with autism: observational study of a whole country population

BMJ Open ◽  
2018 ◽  
Vol 8 (8) ◽  
pp. e023945 ◽  
Author(s):  
Ewelina Rydzewska ◽  
Laura Anne Hughes-McCormack ◽  
Christopher Gillberg ◽  
Angela Henderson ◽  
Cecilia MacIntyre ◽  
...  
Keyword(s):  
Mental Health ◽  
Hearing Loss ◽  
Intellectual Disabilities ◽  
Physical Disability ◽  
Health Conditions ◽  
Adults With Autism ◽  
Age And Gender ◽  
Mental Health Conditions ◽  
Sight Loss ◽  
And Gender

ObjectivesTo investigate the prevalence of comorbid mental health conditions and physical disabilities in a whole country population of adults aged 25+ with and without reported autism.DesignSecondary analysis of Scotland’s Census, 2011 data. Cross-sectional study.SettingGeneral population.Participants94% of Scotland’s population, including 6649/3 746 584 adults aged 25+ reported to have autism.Main outcome measuresPrevalence of six comorbidities: deafness or partial hearing loss, blindness or partial sight loss, intellectual disabilities, mental health conditions, physical disability and other condition; ORs (95% CI) of autism predicting these comorbidities, adjusted for age and gender; and OR for age and gender in predicting comorbidities within the population with reported autism.ResultsComorbidities were common: deafness/hearing loss—17.5%; blindness/sight loss—12.1%; intellectual disabilities—29.4%; mental health conditions—33.0%; physical disability—30.7%; other condition—34.1%. Autism statistically predicted all of the conditions: OR 3.3 (95% CI 3.1 to 3.6) for deafness or partial hearing loss, OR 8.5 (95% CI 7.9 to 9.2) for blindness or partial sight loss, OR 94.6 (95% CI 89.4 to 100.0) for intellectual disabilities, OR 8.6 (95% CI 8.2 to 9.0) for mental health conditions, OR 6.2 (95% CI 5.8 to 6.6) for physical disability and OR 2.6 (95% CI 2.5 to 2.8) for other condition. Contrary to findings within the general population, female gender predicted all conditions within the population with reported autism, including intellectual disabilities (OR=1.4).ConclusionsClinicians need heightened awareness of comorbidities in adults with autism to improve detection and suitable care, especially given the added complexity of assessment in this population and the fact that hearing and visual impairments may cause additional difficulties with reciprocal communication which are also a feature of autism; hence posing further challenges in assessment.

scholarly journals Older Adult Peer Specialists’ Role in Reducing Loneliness Among People With Mental Health Conditions

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 662-662
Author(s):  
Karen Fortuna ◽  
George Mois ◽  
Jessica Brooks ◽  
Amanda Myers ◽  
Cynthia Bianco
Keyword(s):  
Mental Health ◽  
Older Adults ◽  
Real World ◽  
Smartphone Application ◽  
Interactive Effects ◽  
Health Conditions ◽  
Self Management ◽  
Potential Effectiveness ◽  
Mental Health Conditions ◽  
Management Intervention

Abstract PeerTECH is a peer-delivered and technology-support integrated medical and psychiatric self-management intervention developed by peers. A pre/post trial by our group has shown PeerTECH is associated with statistically significant improvements in self-efficacy for managing chronic disease and psychiatric self-management skills. This presentation will discuss the feasibility and potential effectiveness of using ecological momentary assessments (EMA) with older adults with mental health conditions to allow us to recognize early signs of loneliness and intervene as early as possible in real-world settings. EMA involves repeated sampling of an individual’s behaviors and experiences in real time, real-world environments on the smartphone application. Then, we will discuss the main and interactive effects of loneliness and factors linked to mortality. In conclusion, we will discuss potential effectiveness of PeerTECH with older adults with SMI.

scholarly journals Using the patient activation measure to examine the self-management support needs of a population of UK workers with long-term health conditions

2021 ◽  
pp. 174239532110434
Author(s):  
Sally Hemming ◽  
Fehmidah Munir
Keyword(s):  
Mental Health ◽  
Patient Activation ◽  
Health Conditions ◽  
Self Management ◽  
Support Needs ◽  
Management Support ◽  
Long Term Conditions ◽  
Mental Health Conditions ◽  
Patient Activation Measure

Objectives To examine differences in patient activation and self-management support needs in a population of UK workers with long-term health conditions. Methods Demographic, health and activation information were taken from the data of participants with long-term conditions, collected via an online cross-sectional survey of workers. The 13-item British patient activation measure measured workers knowledge, skills and confidence towards self-managing. Results Three hundred and seven workers with mental health, musculoskeletal and other conditions completed the patient activation measure. Mental health conditions were most prevalent (36.8%). Workers were higher activated, however workers with mental health conditions were significantly less activated ( p = 0.006). Differences in activation by condition severity and age were revealed. Discussion This study provides insight to the activation of UK workers with long-term conditions. Whilst workers with mental health conditions need more training and education to self-manage, workers are variably activated indicating broader support needs. There is a gap for workplace self-management support. The patient activation measure is used in healthcare to improve people’s self-management and should be considered to be included in the workplace, and could form part of interventions to support workers self-management. More rigorous studies, including the patient activation measure, are needed to identify the best approaches to identifying workers self-management support needs.

scholarly journals Vocational interventions to help adults with long-term health conditions or disabilities gain and maintain paid work: an overview of systematic reviews

BMJ Open ◽  
2021 ◽  
Vol 11 (12) ◽  
pp. e049522
Author(s):  
William Mark Magnus Levack ◽  
Joanna Kirstin Fadyl
Keyword(s):  
Mental Health ◽  
Systematic Reviews ◽  
Health Conditions ◽  
Paid Work ◽  
High Quality ◽  
Mental Health Conditions ◽  
Moderate Quality ◽  
Overview Of Systematic Reviews ◽  
Quality Evidence

ObjectiveTo conduct an overview of systematic reviews to examine the effectiveness of vocational interventions to help adults with long-term health conditions or disability gain and maintain new paid work and to analyse the spread and quality of evidence in this area.MethodsWe pre-published our protocol in PROSPERO (CRD42019132448). We searched Cochrane Database of Systematic Reviews, MEDLINE, EMBASE, PsycINFO, AMED, CINAHL, Proquest Dissertations and Theses database, NICE and Business Source Complete from inception to 21 August 2020. We included any systematic reviews of clinical trials on vocational interventions for adults with long-term health conditions or disability who were not in work or had recently gained work. We excluded reviews of vocational interventions for employed people on sick leave. Two researchers identified, critically appraised,using A MeaSurement Tool to Assess systematic Reviews (AMSTAR) 2, and extracted data from included reviews. We used Grading of Recommendations Assessment, Development and Evaluation to evaluate strength of evidence underpinning overview findings.ResultsWe identified 26 reviews (5 high-quality and 21 critically low to moderate quality) that focused on vocational interventions for acquired brain injury, autism, intellectual disability, multiple sclerosis, mental health conditions, spinal cord injury and general disability populations. We identified moderate quality evidence that people with moderate to severe mental health conditions who participate in supported employment, particularly individual placement and support, are more likely to gain competitive employment compared with people who receive traditional vocational services (risk ratio 2.07; 95% CI 1.82 to 2.35; 27 studies, 6651 participants). We found only very low-quality to low-quality evidence on vocational intervention for people with any other health condition. We found little to no data on employer or employee satisfaction with work outcomes or the cost effectiveness of interventions.ConclusionGiven the importance placed on work opportunities for people with long-term health conditions or disability, there is urgent need for more high-quality research on vocational interventions for this population.Prospero registration numberCRD42019132448.

scholarly journals Relative influence of intellectual disabilities and autism on mental and general health in Scotland: a cross-sectional study of a whole country of 5.3 million children and adults

BMJ Open ◽  
2019 ◽  
Vol 9 (8) ◽  
pp. e029040 ◽  
Author(s):  
Deborah Kinnear ◽  
Ewelina Rydzewska ◽  
Kirsty Dunn ◽  
Laura Anne Hughes-McCormack ◽  
Craig Melville ◽  
...  
Keyword(s):  
Mental Health ◽  
Intellectual Disabilities ◽  
General Health ◽  
Cross Sectional Study ◽  
Poor Health ◽  
Health Conditions ◽  
Sectional Study ◽  
Cross Sectional ◽  
Poor General Health ◽  
Mental Health Conditions

ObjectivesTo determine the relative extent that autism and intellectual disabilities are independently associated with poor mental and general health, in children and adults.DesignCross-sectional study. For Scotland’s population, logistic regressions investigated odds of intellectual disabilities and autism predicting mental health conditions, and poor general health, adjusted for age and gender.Participants1 548 819 children/youth aged 0-24 years, and 3 746 584 adults aged more than 25 years, of whom 9396/1 548 819 children/youth had intellectual disabilities (0.6%), 25 063/1 548 819 children/youth had autism (1.6%); and 16 953/3 746 584 adults had intellectual disabilities (0.5%), 6649/3 746 584 adults had autism (0.2%). These figures are based on self-report.Main outcome measuresSelf-reported general health status and mental health.ResultsIn children/youth, intellectual disabilities (OR 7.04, 95% CI 6.30 to 7.87) and autism (OR 25.08, 95% CI 23.08 to 27.32) both independently predicted mental health conditions. In adults, intellectual disabilities (OR 3.50, 95% CI 3.20 to 3.84) and autism (OR 5.30, 95% CI 4.80 to 5.85) both independently predicted mental health conditions. In children/youth, intellectual disabilities (OR 18.34, 95% CI 17.17 to 19.58) and autism (OR 8.40, 95% CI 8.02 to 8.80) both independently predicted poor general health. In adults, intellectual disabilities (OR 7.54, 95% CI 7.02 to 8.10) and autism (OR 4.46, 95% CI 4.06 to 4.89) both independently predicted poor general health.ConclusionsBoth intellectual disabilities and autism independently predict poor health, intellectual disabilities more so for general health and autism more so for mental health. Intellectual disabilities and autism are not uncommon, and due to their associated poor health, sufficient services/supports are needed. This is not just due to coexistence of these conditions or just to having intellectual disabilities, as the population with autism is independently associated with substantial health inequalities compared with the general population, across the entire life course.

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