Background: Attention-deficit hyperactivity disorder (ADHD) is higher in people with intellectual disability (ID) compared to the general population. Available limited evidence suggests this population has increased psychological problems, diagnostic overshadowing and psychotropic prescribing. This audit Identifies and analyzes real-world characteristics, diagnostic practices, treatment, and management of ADHD in adults with ID. Research Design and Methods: Pooled retrospective case note data for people with ID and ADHD, collected from 30 organizations across the UK, were analyzed. Patients were classified into mild and moderate-profound ID groups. Associated mental health and neurodevelopmental co-morbidity, Demographics, concomitant psychotropics, and mental and behavioral concerns were collected. Group differences were reported using logistic regression models. Results: Of 445 participants, 73% had co-occurring autism spectrum disorder (ASD) and 65% were prescribed ADHD medications. Those on ADHD medication were less likely to be prescribed antipsychotics (p < 0.001) and antidepressants (p < 0.001). Multiple significant differences were found in ADHD medication response between ID groups and those with/without co-morbid ASD but not associated with challenging behavior reduction. Conclusions: High levels of neurodevelopmental and psychiatric comorbidity were found. ID severity and the presence of ASD appear to influence the use of certain psychotropic medications. Appropriate use of ADHD medication appears to reduce psychotropic polypharmacy. Q7 � ARTICLE HISTORY

Purpose The purpose of this paper is to illustrate the possible basis of challenging behaviour (CB) can lie in a treatable neurodevelopmental disorder. Design/methodology/approach Two case studies were used to illustrate the clinical characteristics of attention deficit hyperactivity disorder (ADHD) presenting as CB in people with intellectual disability (ID). Findings The findings of this paper show that the appropriate use of drug therapy for ADHD effectively reduced the behavioural challenges. Research limitations/implications Limited by two cases. Application of the findings of this paper is limited given it is a case study. This paper highlights an important clinical implications which need to be studied in a larger scale to make clinical recommendations. Practical implications Findings from the two case studies may be used when making decisions in clinical practice. Originality/value The paper explores the possibility of ADHD presenting as CB in people with ID.

Sleep is vital for our physical and mental health. Studies have shown that there is a high prevalence of sleep disorders and sleep difficulties amongst adults with intellectual disabilities. Despite this, sleep is often overlooked or its disorders are considered to be difficult to treat in adults with intellectual disabilities. There is a significant amount of research and guidance on management of sleep disorders in the general population. However, the evidence base for sleep disorders in adults with intellectual disabilities is limited. In this review paper, we look at the current evidence base for sleep disorders in adults with an intellectual disability, discuss collaborative working between intellectual disabilities psychiatrists and sleep medicine specialists to manage sleep disorders, and provide recommendations for future directions.

No abstract

No abstract