Manual versus sonic powered toothbrushing in patients with intellectual disability: a cluster-randomized clinical trial.

OBJECTIVES: To compare the use of sonic powered or manual toothbrush in patients with intellectual disability (ID) in terms of plaque (PlI) and gingival (GI) indices and adverse effects. MATERIAL AND METHODS: Subjects with ID were recruited for this cluster-randomized, single blinded (examiner), 6-month clinical trial, comparing powered versus manual toothbrushing. Outcome variables included PlI and GI, evaluated at baseline and 3 months after supervised toothbrushing and after 3 additional months of unsupervised used. Clinical outcome variables were analysed by repeated measures ANCOVA considering time and group as factors and respective baseline values as covariates (generalized linear model). RESULTS: Sixty-four patients (34 male, mean age 34.5) in six clusters were included in the study. No statistically significant effect of toothbrushing group was observed for PlI or GI. A significant effect of time was identified (p < 0.001) with mean reductions ranging 0.44-0.45 for PlI and 0.30-0.36 for GI from baseline to 3-6 months. No relevant adverse effect or technical problems were observed. CONCLUSION: The tested sonic powered toothbrush was as effective and safe as the manual toothbrush. The use of powered or manual toothbrushes, together with fluoride toothpaste, may improve plaque and gingivitis levels, in patients with mild to limit ID.

Effects of presentation format and instructions on the ability of people with intellectual disability to identify faces.

The aim of this work was to analyze the effect of presentation format and instructions on the ability of people with intellectual disability to identify individuals they did not know and had seen only briefly. With this objective in mind, 2 groups of subjects with mild to moderate intellectual disability were shown a photograph of a person and, after a distracting task, were asked to identify that person in 2 line-ups (target-absent and target-present) with 6 photographs each, where 2 types of instructions (neutral vs specific, between-subject design) and 2 presentation formats (simultaneous vs sequential, within-subject design) for the line-up photographs were used. Each subject completed 4 trials. The results showed that, generally speaking, people with intellectual disability were capable of distinguishing the face of a person previously seen under all these conditions. There was a significantly higher incidence of false alarms, however, when the photographs were presented sequentially and when specific instructions were not given. With specific instructions designed to lessen the social desirability effect and increase motivation for the task, false alarms on the target-absent line-up were reduced. The results were discussed with a view to their applicability in legal and law enforcement contexts.

La salud en personas con discapacidad intelectual en España: estudio europeo POMONA-II / Health among persons with intellectual disability in Spain: the European POMONA-II study

Introducción. Estudios internacionales demuestran que existe un patrón diferenciado de salud y una disparidad en la atención sanitaria entre personas con discapacidad intelectual (DI) y población general. Objetivo. Obtener datos sobre el estado de salud de las personas con DI y compararlos con datos de población general. Pacientes y métodos. Se utilizó el conjunto de indicadores de salud P15 en una muestra de 111 sujetos con DI. Los datos de salud encontrados se compararon según el tipo de residencia de los sujetos y se utilizó la Encuesta Nacional de Salud 2006 para comparar estos datos con los de la población general.Resultados. La muestra con DI presentó 25 veces más casos de epilepsia y el doble de obesidad. Un 20% presentó dolor bucal, y existió una alta presencia de problemas sensoriales, de movilidad y psicosis. Sin embargo, encontramos una baja presencia de patologías como la diabetes, la hipertensión, la osteoartritis y la osteoporosis. También presentaron una menor participación en programas de prevención y promoción de la salud, un mayor número de ingresos hospitalarios y un uso menor de los servicios de urgencia. Conclusiones. El patrón de salud de las personas con DI difiere del de la población general, y éstas realizan un uso distinto de los servicios sanitarios. Es importante el desarrollo de programas de promoción de salud y de formación profesional específicamente diseñados para la atención de personas con DI, así como la implementación de encuestas de salud que incluyan datos sobre esta población (AU)

Introduction. International studies show that both the pattern of health and the healthcare provided for persons with intellectual disability (ID) and the general population are different. Aims. To obtain data about the state of health of persons with ID and to compare them with data about the general population. Patients and methods. The P15 set of health indicators was used in a sample of 111 subjects with ID. The health data that were found were compared according to the subjects’ type of residence and the 2006 National Health Survey was used to compare these data with those for the general population. Results. The sample with ID presented 25 times more cases of epilepsy and twice as many cases of obesity. Twenty per cent presented pain in the mouth and the presence of sensory and mobility problems, as well as psychosis, was high. We also found, however, a low presence of pathologies like diabetes, hypertension, osteoarthritis and osteoporosis. They also displayed a lower rate of participation in prevention and health promotion programmes, a higher number of hospital admissions and a lower usage of emergency services. Conclusions. The pattern of health of persons with ID differs from that of the general population, and they use healthcare services differently. It is important to develop programmes of health promotion and professional training that are specifically designed to attend to the needs of persons with ID. Likewise, it is also necessary to implement health surveys that include data about this population (AU)

[Health among persons with intellectual disability in Spain: the European POMONA-II study]. / La salud en personas con discapacidad intelectual en España: estudio europeo POMONA-II.

INTRODUCTION: International studies show that both the pattern of health and the healthcare provided for persons with intellectual disability (ID) and the general population are different. AIMS: To obtain data about the state of health of persons with ID and to compare them with data about the general population. PATIENTS AND METHODS: The P15 set of health indicators was used in a sample of 111 subjects with ID. The health data that were found were compared according to the subjects' type of residence and the 2006 National Health Survey was used to compare these data with those for the general population. RESULTS; The sample with ID presented 25 times more cases of epilepsy and twice as many cases of obesity. Twenty per cent presented pain in the mouth and the presence of sensory and mobility problems, as well as psychosis, was high. We also found, however, a low presence of pathologies like diabetes, hypertension, osteoarthritis and osteoporosis. They also displayed a lower rate of participation in prevention and health promotion programmes, a higher number of hospital admissions and a lower usage of emergency services. CONCLUSIONS: The pattern of health of persons with ID differs from that of the general population, and they use healthcare services differently. It is important to develop programmes of health promotion and professional training that are specifically designed to attend to the needs of persons with ID. Likewise, it is also necessary to implement health surveys that include data about this population.

Family impact in intellectual disability, severe mental health disorders and mental health disorders in ID. A comparison.

Family impact (or family burden) is a concept born in the field of mental health that has successfully been exported to the ambit of intellectual disability (ID). However, differences in family impact associated with severe mental health disorders (schizophrenia), to ID or to mental health problems in ID should be expected. Seventy-two adults with intellectual disability clients of the Carmen Pardo-Valcarce Foundation's sheltered workshops and vocational employment programmes in Madrid (Spain), 203 adults diagnosed with schizophrenia from four Spanish Community Mental Health Services (Barcelona, Madrid, Granada and Navarra) and 90 adults with mental health problems in ID (MH-ID) from the Parc Sanitari Sant Joan de Déu Health Care Site in Sant Boi de Llobregat, Barcelona (Spain) were asked to participate in the present study along with their main caregivers. Family impact experienced by caregivers was assessed with the ECFOS-II/SOFBI-II scale (Entrevista de Carga Familiar Objetiva y Subjetiva/Objective and Subjective Family Burden Interview). In global terms, results showed that the higher family impact was found between caregivers to people with MH-ID. The interaction of both conditions (ID and mental health problems) results in a higher degree of burden on families than when both conditions are presented separately. There was also an impact in caregivers to people with schizophrenia, this impact being higher than the one detected in caregivers to people with intellectual disability. Needs of caregivers to people with disability should be addressed specifically in order to effectively support families.

Mental health in adults with mild and moderate intellectual disabilities: the role of recent life events and traumatic experiences across the life span.

The aim of the present study is to investigate the association between recent life events and traumatic experiences across the life span and psychiatric disorders in people with ID. One hundred seventy-seven individuals with mild and moderate intellectual disability and their principal carers were assessed. Psychiatric disorders were evaluated with a semistructured psychiatric interview, the Psychiatric Assessment for Adults with Developmental Disabilities. This interview also includes a checklist of life events experienced over the previous 12 months, which was assessed through key informants. Presence of traumas was assessed through Allen's trauma history screen, also administered to key informants. After a descriptive analysis, binary logistic regression was used to see whether traumatic events and life events predicted the presence of ICD-10 disorders. A 75% of the participants had experienced at least 1 traumatic event during their life span, and 50% of the participants had experienced at least 1 life event in the 12 months previous to the study. Binary logistic regression showed that exposure to 1 or more traumatic experiences significantly increased the odds of a mental disorder (OR = 1.8), as did exposure to life events (OR = 1.4). However, when both life events and traumatic experiences were entered together in the model, calculation of odds ratios revealed that traumatic experiences significantly increased the odds of ICD-10 disorders (OR = 1.7) although life events were no longer significant. Though they have been less studied by the literature regarding predictors of mental illness in people with intellectual disability, traumatic experiences seem to play a more important role in psychopathology than life events.

Traumatic experiences and life events in people with intellectual disability.

PURPOSE OF REVIEW: The aim of this article is to present and critically evaluate recent research on life events and traumatic experiences as predictors of psychopathology in people with intellectual disability. RECENT FINDINGS: The area has not developed significantly in the last years. Although life events have been associated with a range of mental health problems, only few studies have tried to clarify their role in psychopathology. It is often the case that differences between life events and traumatic experiences have been overlooked, mainly because establishing a clear cut-off point between the two types of events is not always possible. In addition, traumatic experiences per se, and as potential predictors of psychopathology, have been scarcely investigated in people with intellectual disability. SUMMARY: The role of recent life events and traumatic experiences across the life-span of people with intellectual disability deserves more research. An outstanding question is whether these events are risk factors or triggering factors, as well as how to differentiate between traumatic and life events. Identifying possible protective factors for mental health seems to be a very promising line for future research with important clinical implications.

Intellectual disability: an approach from the health sciences perspective.

Intellectual disability (ID) is a complex condition that has not aroused very much interest in the health sciences and medical fields. As a result, a large part of the responsibility for caring for individuals with ID has fallen in the areas of education, social services and volunteering. Nevertheless, intellectual disability is a very significant health problem, whether because of its prevalence, the costs to the public health system, the families and society in general or due to related health complications. ID should be a priority area of study and action in the health field. This article reviews the conceptual, diagnostic and etiological problems that affect intellectual disability, as well as factors related with the health of the persons who are affected. In addition, some recommendations are outlined for improving health care for this population group.

Intellectual disability: an approach from the health sciences perspective: [review]

Intellectual disability (ID) is a complex condition that has not aroused very much interest in the health sciences and medical fields. As a result, a large part of the responsibility for caring for individuals with ID has fallen in the areas of education, social services and volunteering. Nevertheless, intellectual disability is a very significant health problem, whether because of its prevalence, the costs to the public health system, the families and society in general or due to related health complications. ID should be a priority area of study and action in the health field. This article reviews the conceptual, diagnostic and etiological problems that affect intellectual disability, as well as factors related with the health of the persons who are affected. In addition, some recommendations are outlined for improving health care for this population group.

La discapacidad intelectual (DI) es una condición compleja que no ha despertado gran interés en el campo médico y en el de las ciencias de la salud. Como consecuencia, gran parte de la responsabilidad del cuidado de los individuos con DI ha recaído en las áreas de la educación, el servicio social y el voluntariado. Sin embargo, la discapacidad intelectual es un problema de salud muy significativo, ya sea por su prevalencia, por los costos para el sistema de salud pública, para las familias y para la sociedad en general o debido a las complicaciones de salud relacionadas con ella. La DI debería ser un área de estudio y de acción prioritaria en el campo de la salud. Este artículo revisa los problemas conceptuales, diagnósticos y etiológicos que afectan a la discapacidad intelectual, así como los factores relacionados con la salud de las personas afectadas. Además se delinean algunas recomendaciones para mejorar el cuidado de la salud en este grupo de población.