Psychotropic Medication for Challenging Behaviour in People With Intellectual Disability: Results of an Online Survey of Family Carers

2018 ◽  
Author(s):  
Rory Sheehan
Keyword(s):  
Intellectual Disability ◽  
Psychotropic Medication ◽  
Online Survey ◽  
Challenging Behaviour ◽  
Family Carers

scholarly journals Experiences of psychotropic medication use and decision-making for adults with intellectual disability: a multistakeholder qualitative study in the UK

BMJ Open ◽  
2019 ◽  
Vol 9 (11) ◽  
pp. e032861 ◽  
Author(s):  
Rory Sheehan ◽  
Angela Hassiotis ◽  
André Strydom ◽  
Nicola Morant
Keyword(s):  
Decision Making ◽  
Intellectual Disability ◽  
Psychotropic Medication ◽  
Stakeholder Involvement ◽  
Medication Use ◽  
Care Providers ◽  
Family Carers ◽  
Joint Decisions ◽  
The Uk ◽  
Medication Decisions

ObjectivesUnderstanding patient and carer perspectives is essential to improving the quality of medication prescribing. This study aimed to explore experiences of psychotropic medication use among people with intellectual disability (ID) and their carers, with a focus on how medication decisions are made.DesignThematic analysis of data collected in individual semistructured interviews.Participants and settingFourteen adults with ID, 12 family carers and 12 paid carers were recruited from specialist psychiatry services, community groups, care providers and training organisations in the UK.ResultsPeople with ID reported being highly compliant with psychotropic medication, based on a largely unquestioned view of medication as important and necessary, and belief in the authority of the psychiatrist. Though they sometimes experienced medication negatively, they were generally not aware of their right to be involved in medication decisions. Paid and family carers reported undertaking a number of medication-related activities. Their ‘front-line’ status and longevity of relationships meant that carers felt they possessed important forms of knowledge relevant to medication decisions. Both groups of carers valued decision-making in which they felt they had a voice and a genuine role. While some in each group described making joint decisions about medication with psychiatrists, lack of involvement was often described. This took three forms in participants’ accounts: being uninformed of important facts, insufficiently included in discussions and lacking influence to shape decisions. Participants described efforts to democratise the decision-making process by gathering information, acting to disrupt perceived power asymmetries and attempting to prove their credibility as valid decision-making partners.ConclusionsStakeholder involvement is a key element of medication optimisation that is not always experienced in decisions about psychotropic medication for people with ID. Forms of shared decision-making could be developed to promote collaboration and offer people with ID and their carers greater involvement in medication decisions.

scholarly journals An audit of the well-being of staff working in intellectual disability settings in Ireland during the COVID-19 pandemic

2020 ◽  
Vol 25 (4) ◽  
pp. 237-246
Author(s):  
Martin McMahon ◽  
Chris Hatton ◽  
Julie Stansfield ◽  
Gaynor Cockayne
Keyword(s):  
Intellectual Disability ◽  
Independent Living ◽  
Online Survey ◽  
Well Being ◽  
Anxiety And Depression ◽  
Future Research ◽  
Challenging Behaviour ◽  
Content Type ◽  
General Anxiety Disorder ◽  
Work Related

Purpose The severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has infected millions of people worldwide. Individuals with intellectual disability are at a disproportionate risk of mortality, given the health inequalities they experience. This puts a significant burden of responsibility on staff who support these individuals. Consequently, this study aims to establish a baseline of the well-being of staff working in intellectual disability services in Ireland during the COVID-19 pandemic. Design/methodology/approach An online survey was carried out using the Copenhagen Burnout Inventory, a brief measure of depression (Patient Health Questionnaire-9) and a brief measure of anxiety (General Anxiety Disorder-7). Findings In total, 285 staff in the Republic of Ireland completed the survey. These staff reported moderate levels of personal and work-related burnout and mild levels of anxiety and depression. Higher mean scores were recorded across scales from staff who worked in independent living settings and from staff who supported individuals with challenging behaviour. Originality/value This study, an audit, provides initial data on the well-being of staff working with individuals with intellectual disability in Ireland during the COVID-19 pandemic. It highlights that employers need to consider staff well-being, given the levels of personal and work-related burnout, and anxiety and depression that were found. This is particularly true for staff who work in independent living settings and with adults with challenging behaviour. Future research should focus on proactive strategies for improving staff well-being in the short term, given the current resurgence of COVID-19 in Ireland.

Antipsychotic induced priapism in a man with an intellectual disability

2001 ◽  
Vol 18 (3) ◽  
pp. 106-107 ◽  
Author(s):  
Rubina Anjum ◽  
Ashok Roy ◽  
Geoff Marston
Keyword(s):  
Intellectual Disability ◽  
Antipsychotic Medication ◽  
Psychotropic Medication ◽  
Challenging Behaviour ◽  
Pharmacological Treatments ◽  
Behavioural Disturbance ◽  
Moderate Intellectual Disability ◽  
Urological Emergency

AbstractPriapism is a rare urological emergency, which can be associated with the use of psychotropic medication. The authors were able to find only one brief report of this condition in people with an intellectual disability. A case is reported in a man with moderate intellectual disability, who was receiving antipsychotic medication to manage extreme challenging behaviour. We discuss the condition and its implications for pharmacological treatments of behavioural disturbance in susceptible individuals.

Receipt of psychotropic medication by people with intellectual disability in residential settings

2000 ◽  
Vol 44 (6) ◽  
pp. 666-676 ◽  
Author(s):  
J. Robertson ◽  
E. Emerson ◽  
N. Gregory ◽  
C. Hatton ◽  
S. Kessissoglou ◽  
...  
Keyword(s):  
Intellectual Disability ◽  
Psychotropic Medication ◽  
Residential Settings

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

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.

scholarly journals Clinical and cost evaluation of intensive support team (IST) models for adults with intellectual disabilities who display challenging behaviour: a comparative cohort study protocol

BMJ Open ◽  
2021 ◽  
Vol 11 (3) ◽  
pp. e043358
Author(s):  
Angela Hassiotis ◽  
Athanasia Kouroupa ◽  
Rebecca Jones ◽  
Nicola Morant ◽  
Ken Courtenay ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Cost Effectiveness ◽  
Intellectual Disabilities ◽  
Online Survey ◽  
Service Use ◽  
Cost Evaluation ◽  
Challenging Behaviour ◽  
Health And Social Care ◽  
Adults With Intellectual Disabilities

IntroductionApproximately 17% of adults with intellectual disabilities (ID) living in the community display behaviours that challenge. Intensive support teams (ISTs) have been recommended to provide high-quality responsive care aimed at avoiding unnecessary admissions and reducing lengthy inpatient stays in England. We have identified two models of ISTs (model 1: enhanced provision and model 2: independent provision). This study aims to investigate the clinical and cost-effectiveness of the two models of ISTs.Methods and analysisA cohort of 226 adults with ID displaying behaviour that challenges who receive support from ISTs from each model will be recruited and assessed at baseline and 9 months later to compare the clinical and cost-effectiveness between models. The primary outcome is reduction in challenging behaviour measured by the Aberrant Behaviour Checklist-Community (ABC-C). The mean difference in change in ABC score between the two IST models will be estimated from a multilevel linear regression model. Secondary outcomes include mental health status, clinical risk, quality of life, health-related quality of life, level of functioning and service use. We will undertake a cost-effectiveness analysis taking both a health and social care and wider societal perspective. Semistructured interviews will be conducted with multiple stakeholders (ie, service users, paid/family carers, IST managers/staff) to investigate the experience of IST care as well as an online survey of referrers to capture their contact with the teams.Ethics and disseminationThe study was approved by the London–Bromley Research Ethics Committee (REC reference: 18/LO/0890). Informed consent will be obtained from the person with ID, or a family/nominated consultee for those lacking capacity and from his/her caregivers. The findings of the study will be disseminated to academic audiences, professionals, experts by experience and arm’s-length bodies and policymakers via publications, seminars and digital platforms.Trial registration numberClinicalTrials.gov Registry (NCT03586375).

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