P01-308-Pervasive developmental disorders and inpatient admission in adolescents: Psychiatric co-morbidity and challenges in clinical and community interventions

Abstract

Introduction

Co-morbidity is to be expected in autistic spectrum disorders directly or indirectly (1). 65% of children and adolescents with Asperger's suffer from an additional psychiatric disorder (2). Misdiagnosis or delayed diagnosis is a serious problem, and the average age at diagnosis of Aspergers is several years later than for autism (3).

A small yet significant number of offenders with autism who engage in illegal behaviour find themselves socially excluded or detained in secure provisions for prolonged periods(4).

Aims

Wider understanding of factors leading to inpatient admission in young people with Pervasive developmental disorder.

Early detection and management of mental disorder and risks, in order to meet complex needs in community.

Objectives

Innovative and comprehensive assessment of mental health, psychological and social needs.

Risk assessment and management shared by multidisciplinary team and Community teams.

Method

Retrospective case notes study of 11 patients admitted over 2 years.

Results

81.8% presented with risk to others.54.5% had diagnosis of ASD on admission. 36.3% had forensic history. Average age of diagnosis was 14 years. 18.1%were misdiagnosed.

Conclusion

The review confirms that misdiagnosis and delayed diagnosis remains a problem. Also co-morbid substance misuse and risk taking behaviour get admitted to secure inpatient units. Inpatient assessment can in significant number of cases divert trajectory away from criminal justice system.