PubMed Health⌕ Search

Biomedical subjects

D Branford

Publications and source records attributed to D Branford.

At least 19 recordsLinked to original sources
PubMed1998

A follow-up study of adults with learning disabilities and epilepsy.

A programme to review the drug treatment of 215 adults with epilepsy and learning disabilities occurred in Leicestershire between 1982 and 1985. In 1997, a Leicestershire-wide study of epilepsy suffered by adults with learning disabilities was undertaken. The study sought information about many aspects of the epilepsy including the prescribing of medicines. One hundred and thirty-eight adults were common to both studies. A greater proportion was suffering active epilepsy in 1997 than in 1985. The deterioration in seizure control occurred despite an increase in polypharmacy, the introduction of new antiepileptic drugs and in some cases increases in dosage.

Adult↗
PubMed1998

Epilepsy in adults with learning disabilities.

Epilepsy is a common problem of adults with learning disabilities. Despite the high prevalence there have been few studies of the epilepsy suffered by adults with learning disabilities. The findings of a Leicestershire study are that multiple seizure types are a common presentation, and that for many (75%) the seizures remain refractory to treatment. Those who suffer tonic-clonic seizures are most likely to achieve remission, whereas for those with simple or complex partial seizures the prognosis is poor. For a significant proportion, status epilepticus, emergency admission to hospital and injuries occur on a regular basis.

Adolescent↗
PubMed1998

Selective serotonin re-uptake inhibitors for the treatment of perseverative and maladaptive behaviours of people with intellectual disability.

A retrospective case-note analysis was undertaken of 37 adults with intellectual disability who lived in Leicestershire, England. The subjects were prescribed one of two selective serotonin re-uptake inhibitor (SSRI) antidepressants, i.e. fluoxetine or paroxetine, for perseverative and maladaptive behaviours. The SSRIs proved to be of no benefit for 15 subjects (40%) and led to a deterioration in a further nine cases (25%). However, some reduction of perseverative and maladaptive behaviours was achieved in 13 cases (35%). There was no difference in the responses to fluoxetine or paroxetine.

Adult↗
PubMed1998

Behaviour phenotype for Down's syndrome.

BACKGROUND: For more than a century, the idea of particular personality/behavioural characteristics being associated with people with Down's syndrome has been explored, but with inconclusive results. METHOD: The Disability Assessment Schedule was used to ascertain the behavioural profiles of 360 adults with Down's syndrome and 1829 adults with learning disabilities of other aetiologies, who were the whole identified population within a defined geographical area. Comparison was made between the two total groups and additionally for the subgroups aged < 35 years and aged > or = 35 years. Comparison was also made with regards to cluster analysis findings. RESULTS: Despite an equal age and developmental quotient, the Down's syndrome group were less likely to demonstrate maladaptive behaviours. The behaviour characteristics of the adults with Down's syndrome remained constant in the younger and older age groups. Cluster analysis demonstrated adults with Down's syndrome to have an increased prevalence in cluster groupings with lower rates of maladaptive behaviours. CONCLUSIONS: This study confirms there to be a behaviour phenotype among adults with Down's syndrome. The reasons for this (e.g. genetic/psychological/social) require further research. Such research may establish a better understanding of the aetiologies of maladaptive behaviours among people with learning disabilities in general.

Adult↗
PubMed1998

Epidemiology of self-injurious behaviour in adults with learning disabilities.

BACKGROUND: There have been few epidemiological studies of the disabling and poorly understood disorder self-injurious behaviour among adults with learning disabilities. METHOD: Interviews were undertaken with the carers of adults known to the Leicestershire Learning Disabilities Register (n = 2277). The Disability Assessment Schedule was used and information was also collected on demographic characteristics, developmental and physical status. RESULTS: Self-injurious behaviour was present in 17.4% of the population. In 1.7% self-injurious behaviour occurred frequently and was severe. There was no gender difference between those with and without self-injurious behaviour. Both the chronological age and developmental quotient of individuals with self-injurious behaviour were lower than those of individuals without self-injurious behaviour. Autistic symptoms were more common among those with self-injurious behaviour. The association of self-injurious behaviour with a wide range of other maladaptive behaviours was highly significant. Logistic regression analysis retained age, developmental quotient, hearing status, immobility and number of autistic symptoms as explanatory variables for self-injurious behaviour. CONCLUSIONS: Self-injurious behaviour is a prevalent and disabling disorder among adults with learning disabilities.

Adjustment Disorders↗
PubMed1997

A naturalistic study of the use of vigabatrin, lamotrigine and gabapentin in adults with learning disabilities.

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. The information obtained from the casenote analysis was used to both compare the efficacies of the three drugs and also the side-effects and drop-out rates, including reasons for drop-out. The total number of patients involved was 51 who underwent 71 treatment episodes. All three AEDs had similar efficacies. Although vigabatrin was found to be associated with a higher incidence of behaviour problems, behaviour problems occurred with the other drugs as well. Lamotrigine caused increased seizures in 24% of patients, especially when prescribed at a higher dose. Gabapentin appeared to be associated with fewer serious side-effects.

Acetates↗
PubMed1997

A follow-up study of prescribing for people with learning disabilities previously in National Health Service care in Leicestershire, England.

A 6-year follow-up was undertaken of 486 people with learning disabilities who in 1990 had lived in institutional care. Despite changes to the nature of accommodation and an extensive drug review programme, the overall proportion of people receiving the different categories of psychotropic drugs remained similar in 1990 and 1996. Only the prescribing of antidepressants was markedly changed. Contrary to expectations the prevalence of prescribing of many psychotropic drugs rose in the community settings.

Central Nervous System Agents↗
PubMed1997

Autistic traits in adults with learning disabilities.

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. Individuals were scored according to the number of core autistic traits displayed. The prevalence of autistic traits was examined in respect of aspects of behaviour and ability. RESULTS: Autistic traits were common among adults with learning disabilities. Those with a higher number of autistic traits were more likely to be profoundly learning disabled and demonstrate a wide range of challenging behaviours. CONCLUSION: Many adults with learning disabilities demonstrate autistic traits. The relationship of autistic traits with challenging behaviour has major implications in service planning and delivery.

Adolescent↗
PubMed1996

A review of antipsychotic drugs prescribed for people with learning disabilities who live in Leicestershire.

Antipsychotic drugs are widely prescribed for people with learning disabilities to control challenging behaviour. Concern has been expressed that such prescribing is excessive, inappropriate and potentially harmful. A review of 198 patients with learning disabilities resulted in agreement to reduce or withdraw antipsychotic drug therapy in 123 cases. The antipsychotic drug therapy was totally withdrawn in 43 cases and the dose reduced for the remaining 80. Out of the 43 patients who underwent total drug withdrawal, 31 remained off such therapy and 12 required represcribing within a 12-month period. Out of the remaining 80 who underwent dose reduction, 40 suffered a deterioration in behaviour which resulted in some degree of dose increase, and 40, although maintained on a lower dose, neither achieved total withdrawal nor deteriorated to an extent that a dose increase was required.

Adult↗
PubMed1996

Prevalence and cluster typology of maladaptive behaviors in a geographically defined population of adults with learning disabilities.

BACKGROUND: 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. These were subjected on the basis of 13 behavioural characteristics to cluster analysis. The clusters were further examined in respect of secondary variables. RESULTS: Over 60% of individuals demonstrated the presence of at least one maladaptive behaviour and in 40% this problem was of either severe degree or frequent occurrence. Men were more likely to demonstrate physical aggression, property destruction, tantrums and verbal abuse than women. Although some severe maladaptive behaviours diminished with age, many persisted through all age groups. Six behavioural clusters were devised which demonstrated face validity and which differed in respect of demographic and developmental variables, and the prevalence of maladaptive habits and autistic symptoms. CONCLUSIONS: These findings demonstrate a high prevalence of maladaptive behaviours and 'objectionable habits' among people with learning disabilities. A classification of behavioural symptoms may be possible on the basis of symptom clusters.

Adolescent↗
PubMed1996

Factors associated with the successful or unsuccessful withdrawal of antipsychotic drug therapy prescribed for people with learning disabilities.

Many published accounts of drug review programmes have reported reductions in the prescribing of psychotropic drugs prescribed for people with learning disabilities. Rarely though has the outcome for the patient been reported. The Leicestershire antipsychotic drug review programme resulted in antipsychotic drug dose reduction or withdrawal in 123 patients. Data relating to outcomes were analysed in order to identify factors associated with successful withdrawal. Few such factors were identified. The successful withdrawal of antipsychotic drug treatment (31 patients) was associated with low doses, predominantly of the drug thioridazine, minimal psychopathology, the presence of epilepsy, and the lack of hyperactivity, aggression of stereotypy.

Adult↗
PubMed1995

The prescribing of neuroleptic drugs for people with learning disabilities living in Leicestershire.

Neuroleptics are prescribed for 23% of individuals with learning disabilities resident in Leicestershire, England. The rate of neuroleptic prescription is significantly higher in individuals resident in N.H.S. facilities (44%) than in non-N.H.S. managed community facilities (13%). Significantly higher doses of neuroleptics are prescribed to individuals resident in N.H.S. facilities. However, ratings for the level of behavioural disturbance were significantly higher in N.H.S. facilities. The decision to prescribe neuroleptics was associated with disturbed behaviour, and higher doses of neuroleptic medication prescribed were associated with more disturbed behaviour.

Antipsychotic Agents↗
PubMed1994

Comparison of community and institutional prescription of antiepileptic drugs for individuals with learning disabilities.

The use of antiepileptic agents for individuals with learning disabilities (mental handicap) resident both within National Health Service facilities and the community was surveyed in the UK. There was no difference in rates of polypharmacy, but there were significant differences in choice of antiepileptic agent. In particular, individuals resident in the community were more likely to be in receipt of phenytoin, primidone and phenobarbitone, which are particularly recognized as producing adverse effects on cognition and behaviour.

Adult↗