ABSTRACT
The prevalence, and incidence, of mental ill-health in adults with intellectual disabilities and autism were compared with the whole population with intellectual disabilities, and with controls, matched individually for age, gender, ability-level, and Down syndrome. Although the adults with autism had a higher point prevalence of problem behaviours compared with the whole adult population with intellectual disabilities, compared with individually matched controls there was no difference in prevalence, or incidence of either problem behaviours or other mental ill-health. Adults with autism who had problem behaviours were less likely to recover over a two-year period than were their matched controls. Apparent differences in rates of mental ill-health are accounted for by factors other than autism, including Down syndrome and ability level.
Subject(s)
Autistic Disorder/epidemiology , Intellectual Disability/epidemiology , Adult , Autistic Disorder/diagnosis , Diagnostic and Statistical Manual of Mental Disorders , Female , Humans , Incidence , Intellectual Disability/diagnosis , International Classification of Diseases , Male , PrevalenceABSTRACT
BACKGROUND: The point prevalence of mental ill-health among adults with intellectual disabilities is 40.9%, but its incidence is unknown. AIMS: To determine the incidence and possible predictors of mental ill-health. METHOD: Prospective cohort study to measure mental ill-health in adults with mild to profound intellectual disabilities. RESULTS: Cohort retention was 70% (n=651). The 2-year incidence of mental ill-health was 16.3% (12.6% excluding problem behaviours, and 4.6% for problem behaviours) and the standardised incidence ratio was 1.87 (95% CI1.51-2.28). Factors related to incident mental ill-health have some similarities with those in the general population, but also important differences. Type of accommodation and support, previous mental ill-health, urinary incontinence, not having impaired mobility, more severe intellectual disabilities, adult abuse, parental divorce in childhood and preceding life events predicted incident ill-health; however, deprivation, other childhood abuse or adversity, daytime occupation, and marital and smoking status did not. CONCLUSIONS: This is a first step towards intervention trials, and identifying subpopulations for more proactive measures. Public health strategy and policy that is appropriate for this population should be developed.
Subject(s)
Intellectual Disability/epidemiology , Mental Disorders/epidemiology , Adolescent , Adult , Aged , Aged, 80 and over , Epidemiologic Methods , Female , Humans , Intellectual Disability/psychology , Male , Mental Disorders/psychology , Middle Aged , Psychiatric Status Rating ScalesABSTRACT
OBJECTIVE: To determine the point prevalence, incidence, and remission over a 2-year period of psychosis in adults with intellectual disabilities, and to investigate demographic and clinical factors hypothesised to be associated with psychosis. METHOD: A population-based cohort of adults with intellectual disabilities (n = 1,023) was longitudinally studied. Comprehensive face-to-face mental health assessments to detect psychosis, plus review of family physician, psychiatric, and psychology case notes were undertaken at two time points, 2 years apart. RESULTS: Point prevalence is 2.6% (95% CI = 1.8-3.8%) to 4.4% (95% CI = 3.2-5.8%), dependant upon the diagnostic criteria employed. Two-year incidence is 1.4% (95% CI = 0.6-2.6), and for first episode is 0.5% (95% CI = 0.1-1.3). Compared with the general population, the standardised incidence ratio for first episode psychosis is 10.0 (95% CI = 2.1-29.3). Full remission after 2 years is 14.3%. Visual impairment, previous long-stay hospital residence, smoking, and not having epilepsy were independently associated with psychosis, whereas other factors relevant to the general population were not. CONCLUSIONS: The study of psychosis in persons with intellectual disabilities benefits the population with intellectual disabilities, and advances the understanding of psychosis for the general population. Mental health professionals need adequate knowledge in order to address the high rates of psychosis in this population.
