Health Technol Assess
March 2018
Centre for Mental Health, Department of Medicine, Imperial College London, London, UK.
Background: Preliminary studies have indicated that training staff in Positive Behaviour Support (PBS) may help to reduce challenging behaviour among people with intellectual disability (ID).
Objective: To evaluate whether or not such training is clinically effective in reducing challenging behaviour in routine care. The study also included longer-term follow-up (approximately 36 months).
Br J Psychiatry
March 2018
Department of Medicine, Imperial College London,UK.
Background: Staff training in positive behaviour support (PBS) is a widespread treatment approach for challenging behaviour in adults with intellectual disability. Aims To evaluate whether such training is clinically effective in reducing challenging behaviour during routine care (trial registration: NCT01680276).
Method: We carried out a multicentre, cluster randomised controlled trial involving 23 community intellectual disability services in England, randomly allocated to manual-assisted staff training in PBS (n = 11) or treatment as usual (TAU, n = 12).
Res Dev Disabil
January 2017
The Hesley Group* Doncaster* U.K. & University of Leicester, 104 Regent Road, Leicester LE1 7LT, UK. Electronic address:
The behavioural phenotype of 22q11.2 deletion syndrome syndrome (22q11DS), one of the most common human multiple anomaly syndromes, frequently includes intellectual disability (ID) together with high risk of diagnosis of psychotic disorders including schizophrenia. Candidate cognitive endophenotypes include problems with retrieval of contextual information from memory and in executive control and focussing of attention.
View Article and Find Full Text PDFDiagnostics (Basel)
December 2015
Loughborough University, School of Sport, Exercise and Health Sciences, Loughborough, Leicestershire LE11 3TU, UK.
A review of 23 studies investigating the prevalence of Behavioural and psychological symptoms of dementia (BPSD) in the general and learning disability population and measures used to assess BPSD was carried out. BPSD are non-cognitive symptoms, which constitute as a major component of dementia regardless of its subtype Research has indicated that there is a high prevalence of BPSD in the general dementia population. There are limited studies, which investigate the prevalence of BPSD within individuals who have learning disabilities and dementia.
View Article and Find Full Text PDFBMC Psychiatry
August 2014
UCL Division of Psychiatry, Charles Bell House, 67-73 Riding House Street, London, W1W 7EY, UK.
Background: Many people with intellectual disability present with challenging behaviour which often has serious consequences such as the prescription of long term medication, in-patient admissions and disruption of normal daily activities. Small scale studies of Positive Behaviour Support (PBS) delivered by paid carers suggest that it reduces challenging behaviour and costs of care and improves quality of life. This study aims to investigate whether professionals training in the delivery of PBS as part of routine practice is clinically and cost effective compared to treatment as usual in community intellectual disability services.
View Article and Find Full Text PDFObesity is more prevalent in people with learning disabilities than the general population, contributing towards health inequalities and higher risk of cardiovascular and cerebrovascular disease. This article discusses possible causes of this higher prevalence and examines interventions to reduce obesity and associated risks. It also outlines key points to consider when dealing with adults with learning disabilities, such as assessing mental capacity to consent to specific interventions.
View Article and Find Full Text PDFJ Intellect Disabil Res
March 2009
Leicestershire Partnership NHS Trust, Leicester Frith Hospital, Leicester, UK.
Background: Aggressive challenging behaviour is common in adults with intellectual disability (ID) in long-term care facilities. The government's commitment to the closure of all facilities in England has led to concerns over how to manage this behaviour in the community. The aim of this study was to assess changes in aggressive challenging behaviour and psychotropic drug use in adults with ID following resettlement using a person-centred approach.
View Article and Find Full Text PDFJ Intellect Disabil Res
April 2008
Learning Disability Service, Leicestershire Partnership NHS Trust, Leicester Frith Hospital, Leicester, UK.
Background: Previous studies of weight problems in adults with intellectual disability (ID) have generally been small or selective and given conflicting results. The objectives of our large-scale study were to identify inequalities in weight problems between adults with ID and the general adult population, and to investigate factors associated with obesity and underweight within the ID population.
Methods: We undertook a population-based prevalence study of 1119 adults with ID aged 20 and over on the Leicestershire Learning Disability Register who participated in a programme of universal health checks and home interviews with their carers.
J Intellect Disabil
June 2007
Dementia Care Mapping is a method for evaluating quality of life in and quality of care of people with dementia and has been used widely in services for older adults. This article presents a report of Dementia Care Mapping for eight adults with learning disabilities and dementia. Trained 'mappers' observed individuals over a set period and recorded their behaviour every 5 minutes.
View Article and Find Full Text PDFBackground: Though contentious, the diagnosis of personality disorders in persons with learning disability is clinically relevant because it affects many aspects of management.
Aims: To examine published literature on the diagnosis of personality disorders in learning disability.
Method: Selective review with computerised (Medline, Embase and PsychInfo) and manual literature searches.
Hum Psychopharmacol
March 2001
University of Leicester, & Leicestershire and Rutland Healthcare NHS Trust, Frith Hospital, Groby Road, Leicester LE3 9QF, UK.
Selective serotonin re-uptake inhibitors are widely used for the treatment of depression suffered by adults with learning disabilities. However, the presentation, time of onset and prevalence of treatment emergent symptoms, have not been extensively studied in adults with learning disabilities. The aim of this study was to determine these aspects of treatment.
View Article and Find Full Text PDFBr J Psychiatry
June 1997
Frith Hospital, Leicester.
Background: Although many adults with learning disabilities show features of autistic syndrome, there have been very few population-based studies. We explored the prevalence of autistic traits and their association with maladaptive behaviours in a geographically defined population of adults with learning disabilities.
Method: The carers of 2201 adults with learning disabilities were interviewed, and information was sought concerning aspects of their behaviour and ability.
Seizure
April 1997
Fosse Health Trust, Leicester Frith Hospital, UK.
Epilepsy is a common condition in people with learning disabilities with many patients continuing to suffer from seizures despite antiepileptic drug (AED) treatment. Although the advent of newer AEDs offers hope for better treatment, there is a need to compare the efficacy of each new AED in adults with both drug-resistant epilepsy and learning disabilities. This retrospective casenote study involves the analysis of the outcome for those adults with learning disabilities treated with either vigabatrin, lamotrigine or gabapentin.
View Article and Find Full Text PDFJ Intellect Disabil Res
August 1996
Department of the Psychiatry of Learning Disabilities, Frith Hospital, Leicester, England.
Asian and white Caucasian adults with learning disabilities seen by the Department of the Psychiatry of Learning Disabilities, Frith Hospital, Leicester, England, in 1991 were studied. Asian adults with learning disabilities were under-represented with respect to the local population (as measured by learning disability register), but not the population of individuals with learning disabilities known to the psychiatric services. Asians were significantly more likely to receive a psychiatric diagnosis, in particular that of psychosis, but there were striking similarities in the routes of referral, the number of contacts with the service and the range of defined disabilities.
View Article and Find Full Text PDFBackground: Maladaptive behaviours are frequently present in individuals with learning disabilities; however, their prevalence varies between studies and the aetiology, classification and most appropriate management of such behaviors remain unclear. The aims of the study were twofold: firstly to determine the prevalence of maladaptive behaviours, and secondly to develop a classification typology.
Method: A population of 2202 adults with learning disabilities was surveyed to determine the prevalence of maladaptive behaviours.
J Intellect Disabil Res
February 1996
Frith Hospital, Leicester, England.
A case report of a male patient with moderate degree of learning disabilities and monosymptomatic hypochondriacal psychosis is described, along with its pathogenic features and response to treatment.
View Article and Find Full Text PDFJ Intellect Disabil Res
June 1995
Department of Psychiatry, University of Leicester, Frith Hospital, England.
Seven individuals with Down's syndrome and a past history of schizophrenia were matched for age, sex and residence to adults with Down's syndrome but no past psychiatric history. The AAMD Adaptive Behaviour Scale was completed for all individuals in both groups, at a mean follow-up period of 6.4 years after the schizophrenic episode.
View Article and Find Full Text PDFBr J Psychiatry
September 1994
Frith Hospital, University of Leicester.
Background: Depression occurs commonly in people with Down's syndrome, although there is little published about this association. This study explores the limitations of Diagnostic Criteria for Research, based on ICD-10 (DCR) and DSM-III-R depressive criteria.
Method: Case not examination identified 42 adults with Down's syndrome who have sustained 56 depressive episodes.
J Intellect Disabil Res
April 1994
Frith Hospital, Leicester, England.
In spite of a burgeoning literature on the association of Down's syndrome with Alzheimer's disease, the occurrence of multi-infarct dementia has largely been overlooked. A 55-year-old woman with Down's syndrome in whom a dementing process was associated with evidence of significant cerebrovascular disease is reported here. It is considered that she sustained both multi-infarct dementia and probable Alzheimer's disease.
View Article and Find Full Text PDFJ Intellect Disabil Res
February 1994
Department of Psychiatry of Leicester University, Frith Hospital, England.
Manic episodes have seldom been reported in individuals with Down's syndrome. The case of an individual with Down's syndrome who developed a manic episode in later life is described. This manic episode was subsequently followed by a first depressive episode.
View Article and Find Full Text PDFJ Intellect Disabil Res
June 1993
Frith Hospital, Leicester, England.
A case report of a male mentally handicapped patient who developed delusions of passion is described. The relationship of this case to de Clerambault's syndrome and its pathogenic features are described.
View Article and Find Full Text PDFUntil recently, it was considered that Down's syndrome precluded a diagnosis of mania, or gave rise to an atypical presentation. There have been seven case reports of mania in people with Down's syndrome and all these cases are reviewed. The clinical features of mania are noted to be similar to those previously described in individuals with learning disabilities due to other causes.
View Article and Find Full Text PDFJ Nerv Ment Dis
March 1993
Frith Hospital, Leicester, England.
Br J Psychiatry
November 1992
Frith Hospital, Leicester.
The total number of adults with Down's syndrome living in Leicestershire, ascertained by widespread enquiry, was found to be 378. Of these, 371 were matched with adults with mental handicap due to other pathologies, on the basis of age, sex, and type of residence. Those with Down's syndrome were found to have a different spectrum of mental disorders from those without the syndrome.
View Article and Find Full Text PDFJ Ment Defic Res
December 1991
Frith Hospital, Leicester, England.
Patients with Down's syndrome are particularly vulnerable to the development of both hypothyroidism and Alzheimer's disease. Both hypothyroidism and Alzheimer's disease may be associated with elevated serum concentrations of thyroid stimulating hormone. In a group of institutionalized Down's syndrome patients with normal thyroid function, global scores of ability were higher than in a group of patients with elevated thyroid stimulating hormone levels in the presence of normal T3 and T4.
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