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Health gain for epilepsy associated with learning disabilities psychiatric care

Published online by Cambridge University Press:  13 June 2014

Elizabeth Beber ,
Nicola M Bailey  and
Sally-Ann Cooper
Elizabeth Beber
Affiliation:
Rockingham Forest NHS Trust
Nicola M Bailey
Affiliation:
Oxford Higher Training Scheme
Sally-Ann Cooper
Affiliation:
Rockingham Forest NHS Trust, St Mary's Hospital, London Road, Kettering, Northants NN15 7PW, England
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Abstract

Objectives: The establishment of a learning disabilities psychiatric service for people living in north Northamptonshire presented the opportunity to measure the clinical effectiveness of epilepsy care provided by learning disabilities psychiatrists.

Method: Baseline and one year outcome health measurements were made on a group of adults with learning disabilities and epilepsy who received learning disabilities psychiatric care (n = 42), and also on a group of adults with learning disabilities and epilepsy who did not receive care from learning disabilities psychiatry -(n = 12). Comparisons were made between baseline and outcome measurements for those who did, compared to those who did not receive psychiatric care. The comparison group was included as conducting a baseline health assessment may itself improve the quality of healthcare by raising awareness of the issue (in a way that is unconnected to care provided by the psychiatrist).

Results: Learning disabilities psychiatric care was found to effect reduced seizure frequency, with a reduced frequency of drug side-effects and reduced frequency of polypharmacy. The type of the person's seizures was more likely to be determined, medical reviews and appropriate blood test monitoring conducted and active interventions made to improve seizure control and to withdraw unnecessary drugs, if the person was receiving learning disabilities psychiatric care. Almost all of these results were highly statistically significant.

Conclusion: It is important that learning disabilities psychiatric care is available to this group, as it has been demonstrated to effect health gain.

Keywords

Mental retardationEpilepsyPsychiatric careLearning disabilities services
Type
Original Papers
Information
Irish Journal of Psychological Medicine , Volume 16 , Issue 2 , June 1999 , pp. 46 - 50
Copyright
Copyright © Cambridge University Press 1999

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References

1.Corbett, JA. Psychiatric morbidity and mental retardation. In: James, FE, Snaith, RP eds. Psychiatric illness and mental handicap. London: Gaskell Press, 1979: 11–25.Google Scholar
2.Lund, J. Epilepsy and psychiatric disorder in the mentally retarded adult. Acta Psychiatr Scand 1985; 72: 557–62.CrossRefGoogle ScholarPubMed
3.Cooper, SA. A clinical study of the effect of age on the physical health of adults with mental retardation. Am J Ment Retard 1988; 102: 582–9.2.0.CO;2>CrossRefGoogle Scholar
4.Cooper, SA. The epidemiology of psychiatric disorders in elderly compared with younger adults with learning disabilities. Br J Psychiatry 1997; 170: 375–80.CrossRefGoogle ScholarPubMed
5.Howells, G. Are the medical needs of mentally handicapped adults being met? JRCGP 1986; 36: 449–53.Google ScholarPubMed
6.RCGP Working Party. Primary care for people with a mental handicap. Occasional paper 47. London: RCGP, 1990,Google Scholar
7.Wilson, DN, Haire, A. Healthcare screening for people with mental handicap living in the community. BMJ 1990; 301: 1379–81.CrossRefGoogle ScholarPubMed
8.Beange, H, Bauman, A. Caring for the developmentally disabled in the community. Aust Fam Physician 1990; 19: 1558–63.Google ScholarPubMed
9.Howells, G. Situations vacant: doctors required to provide care for people with learning disability. Br J Gen Pract 1996; 46: 59–60.Google ScholarPubMed
10.Lennox, NG, Diggens, JN, Ugoni, AM. The general practice care of people with intellectual disability: barriers and solutions. J Intellect Disabil Res 1997; 41: 380–90.CrossRefGoogle ScholarPubMed
11.Lennox, NG, Kerr, MP. Review: primary healthcare and people with an intellectual disability: the evidence base. J Intellect Disabil Res 1997; 41: 365–72.CrossRefGoogle ScholarPubMed
12.Collacott, RA, Dignon, A, Hauck, A, Ward, JW. Clinical and therapeutic monitoring of epilepsy in a mental handicap unit. Br J Psychiatry 1989; 155: 522–5.CrossRefGoogle Scholar
13.McLoughlin, IJ. A study of mortality experiences in a mental handicap hospital. Br J Psychiatry 1988; 153: 645–9.CrossRefGoogle Scholar
14.Strauss, D, Eyman, RK. Mortality of people with mental retardation in California with and without Down syndrome, 1986-1991. Am J Mental Retard 1996; 100: 643–53.Google ScholarPubMed
15.Fischbacher, E. Effect of reduction of anticonvulsants on wellbeing. BMJ 1982; 285: 423–4.CrossRefGoogle ScholarPubMed
16.Amaladoss, ASP, Arumainayagam, M. Epilepsy in the mentally handicapped: a hospital survey. Psychiat Bull 1994; 18: 680–2.CrossRefGoogle Scholar
17.Rowe, D, Routine blood monitoring in epileptic patients with learning disability. Psychiat Bull 1995; 19: 375 (letter).CrossRefGoogle Scholar
18.Wyllie, E, Wyllie, R. Routine laboratory monitoring for serious adverse effects of antiepileptic medications: the controversy. Epilepsia 1991; 32 (Suppl. 5): 575–9.Google ScholarPubMed
19.Pellock, JM, Wilmore, LJ. Rational guide to routine blood monitoring. Neurology 1991; 41: 961–4.CrossRefGoogle ScholarPubMed
20.Carpenter, PK, Kanagaratnam, S. Psychiatry of learning disabilities. Psychiat Bull 1993; 17: 91–2.CrossRefGoogle Scholar
21.Short, C, Carpenter, P. Routine blood monitoring in epileptic patients with learning disability. Psychiat Bull 1995; 19: 375–6 (letter)CrossRefGoogle Scholar