PubMed Health⌕ Search

Biomedical subjects

R A Collacott

Publications and source records attributed to R A Collacott.

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

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↗
PubMed1996

Psychiatric disorder in Asian adults with learning disabilities: patterns of service use.

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.

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↗
PubMed1995

Urine fetish in a man with learning disabilities.

Urine fetishes are uncommon. A 30-year-old man with learning disabilities and a fetish for observing women urinate is described, and the possible dynamic aspects of his paraphilia are discussed.

Adult↗
PubMed1995

The effect of age on language in people with Down's syndrome.

It has been previously suggested, in a small-sized study of 60 people with Down's syndrome, that receptive language skills were lower, the older the individual, whereas expressive language skills did not correlate with age (Carter-Young & Kramer 1991). By assessing language skills on 345 Down's syndrome adults living in Leicestershire (91% of the total population), the present authors have been able to confirm this finding, using the AAMD Adaptive Behaviour Scale. This may have clinical relevance with regard to communication with older people with Down's syndrome, and also for estimation of an individual's skill level when he or she was younger.

Adult↗
PubMed1995

Adaptive behaviour after schizophrenia in people with Down's syndrome.

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. The skill level of the subject group was found to be the same as for the control group, which rejects the notion of a 'defect state' occurring post-schizophrenia in Down's syndrome. The importance of accurate diagnosis and treatment for this group is stressed.

Adaptation, Psychological↗
PubMed1995

Histrionic personality disorder as pseudo-learning disability.

The case of a 20-year-old woman with a histrionic personality disorder is described. She claims to have a mild learning disability, and indeed, is receiving special college education for people with learning disabilities and has a specialist learning disability social worker, despite being of above average intelligence. Aetiologically, her persona is viewed as a psychological defence, rather than a deliberate attempt at deception. A process of 'institutionalization' appears to have occurred and compounded the problems with further regression. Psychiatrists and professionals in allied disciplines should not accept that a person has a learning disability purely because that person tells you that he or she has one.

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

Late onset mania in Down's syndrome.

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.

Activities of Daily Living↗
PubMed1994

Multi-infarct dementia in Down's syndrome.

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. It is suggested that such cases are under-reported.

Brain↗
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↗
PubMed1994

Clinical features and diagnostic criteria of depression in Down's syndrome.

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. The clinical features are reported. RESULTS: All episodes were diagnosed as depression. DSM-III-R criteria for major depressive episode were met by 50% of the episodes. DCR for depressive episode of at least mild severity were fulfilled by 68%. CONCLUSIONS: These criteria were unduly restrictive for this group. Commonly occurring symptoms are not included in the criteria, while certain criteria items never occurred. Criteria should be modified to facilitate future research.

Adolescent↗