Childhood risk factors and clinical and service outcomes in adulthood in people with intellectual disabilities
Background Adults with intellectual disability experience increased rates of mental health disorders and adverse mental health outcomes. Aim Explore childhood risk factors associated with adverse mental health outcomes during adulthood as defined by high cost of care, use of psychotropic medication...
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| Format: | Article |
| Language: | English |
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Cambridge University Press
2024-11-01
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| Series: | BJPsych Open |
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| Online Access: | https://www.cambridge.org/core/product/identifier/S2056472424008111/type/journal_article |
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| author | B. Perera S. Mufti C. Norris-Grey A. Baksh V. Totsika A. Hassiotis P. Hurks T. van Amelsvoort |
| author_facet | B. Perera S. Mufti C. Norris-Grey A. Baksh V. Totsika A. Hassiotis P. Hurks T. van Amelsvoort |
| author_sort | B. Perera |
| collection | DOAJ |
| description | Background
Adults with intellectual disability experience increased rates of mental health disorders and adverse mental health outcomes.
Aim
Explore childhood risk factors associated with adverse mental health outcomes during adulthood as defined by high cost of care, use of psychotropic medication without a severe mental illness and psychiatric hospital admissions.
Method
Data on 137 adults with intellectual disability were collected through an intellectual disability community service in an inner London borough. Childhood modifiable and non-modifiable risk factors were extracted from records to map onto variables identified as potential risk factors. Logistic and linear regression models were employed to analyse their associations with adverse outcomes.
Results
We showed that the co-occurrence of intellectual disability with autism spectrum disorder and/or attention-deficit hyperactivity disorder (ADHD) were associated with psychotropic medication use and high-cost care packages. However, when challenging behaviour during childhood was added, ADHD and autism spectrum disorder were no longer significant and challenging behaviour better explained medication prescribing and higher cost care. In addition, the severity of intellectual disability was associated with higher cost care packages. Ethnicity (Black and mixed) also predicted higher cost of care.
Conclusions
Challenging behaviour during childhood emerged as a critical variable affecting outcomes in young adulthood and mediated the association between adult adverse mental health outcomes and co-occurring neurodevelopmental conditions, that is, ADHD and autism. These findings emphasise the need for effective early intervention strategies to address challenging behaviour during childhood. Such interventions for challenging behaviour will need to take into consideration autism and ADHD.
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| format | Article |
| id | doaj-art-33d85fb0f00f425b9edb161feb4e6dad |
| institution | OA Journals |
| issn | 2056-4724 |
| language | English |
| publishDate | 2024-11-01 |
| publisher | Cambridge University Press |
| record_format | Article |
| series | BJPsych Open |
| spelling | doaj-art-33d85fb0f00f425b9edb161feb4e6dad2025-08-20T02:14:35ZengCambridge University PressBJPsych Open2056-47242024-11-011010.1192/bjo.2024.811Childhood risk factors and clinical and service outcomes in adulthood in people with intellectual disabilitiesB. Perera0https://orcid.org/0000-0001-9316-9312S. Mufti1C. Norris-Grey2A. Baksh3https://orcid.org/0000-0001-6596-2145V. Totsika4https://orcid.org/0000-0003-1702-2727A. Hassiotis5https://orcid.org/0000-0002-9800-3909P. Hurks6https://orcid.org/0000-0002-4366-3707T. van Amelsvoort7https://orcid.org/0000-0003-1135-5133Division of Psychiatry, University College London, UKHanringey LD Services, Barnet, Enfield and Haringey MH Trust, London, UKHanringey LD Services, Barnet, Enfield and Haringey MH Trust, London, UKInstitute of Psychiatry, Psychology and Neuroscience, Kings College London, UKDivision of Psychiatry, University College London, UKDivision of Psychiatry, University College London, UKFaculty of Psychology and Neuroscience, Maastricht University, NetherlandsSchool for Mental Health and Neuroscience, Maastricht University, NetherlandsBackground Adults with intellectual disability experience increased rates of mental health disorders and adverse mental health outcomes. Aim Explore childhood risk factors associated with adverse mental health outcomes during adulthood as defined by high cost of care, use of psychotropic medication without a severe mental illness and psychiatric hospital admissions. Method Data on 137 adults with intellectual disability were collected through an intellectual disability community service in an inner London borough. Childhood modifiable and non-modifiable risk factors were extracted from records to map onto variables identified as potential risk factors. Logistic and linear regression models were employed to analyse their associations with adverse outcomes. Results We showed that the co-occurrence of intellectual disability with autism spectrum disorder and/or attention-deficit hyperactivity disorder (ADHD) were associated with psychotropic medication use and high-cost care packages. However, when challenging behaviour during childhood was added, ADHD and autism spectrum disorder were no longer significant and challenging behaviour better explained medication prescribing and higher cost care. In addition, the severity of intellectual disability was associated with higher cost care packages. Ethnicity (Black and mixed) also predicted higher cost of care. Conclusions Challenging behaviour during childhood emerged as a critical variable affecting outcomes in young adulthood and mediated the association between adult adverse mental health outcomes and co-occurring neurodevelopmental conditions, that is, ADHD and autism. These findings emphasise the need for effective early intervention strategies to address challenging behaviour during childhood. Such interventions for challenging behaviour will need to take into consideration autism and ADHD. https://www.cambridge.org/core/product/identifier/S2056472424008111/type/journal_articleIntellectual disabilityrisk factorschallenging behaviourattention-deficit hyperactivity disordermental health outcomes |
| spellingShingle | B. Perera S. Mufti C. Norris-Grey A. Baksh V. Totsika A. Hassiotis P. Hurks T. van Amelsvoort Childhood risk factors and clinical and service outcomes in adulthood in people with intellectual disabilities BJPsych Open Intellectual disability risk factors challenging behaviour attention-deficit hyperactivity disorder mental health outcomes |
| title | Childhood risk factors and clinical and service outcomes in adulthood in people with intellectual disabilities |
| title_full | Childhood risk factors and clinical and service outcomes in adulthood in people with intellectual disabilities |
| title_fullStr | Childhood risk factors and clinical and service outcomes in adulthood in people with intellectual disabilities |
| title_full_unstemmed | Childhood risk factors and clinical and service outcomes in adulthood in people with intellectual disabilities |
| title_short | Childhood risk factors and clinical and service outcomes in adulthood in people with intellectual disabilities |
| title_sort | childhood risk factors and clinical and service outcomes in adulthood in people with intellectual disabilities |
| topic | Intellectual disability risk factors challenging behaviour attention-deficit hyperactivity disorder mental health outcomes |
| url | https://www.cambridge.org/core/product/identifier/S2056472424008111/type/journal_article |
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