Epilepsy and challenging behaviour in adults with intellectual disability: A systematic review

Blickwedel, Jessica; Ali, Afia; Hassiotis, Angela

doi:10.3109/13668250.2017.1327039

Cited by 17 publications

(16 citation statements)

References 32 publications

(82 reference statements)

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“…Our finding (based on meta-analysis of pooled data from 10 studies) of a significant intergroup difference differs from that of other systematic reviews, [19][20][21] which found no such difference. Our finding has to be interpreted with caution.…”

Section: Interpretation Of Meta-analyses Findingscontrasting

confidence: 99%

“…Three systematic reviews looked at the association between challenging behaviour and epilepsy in people with intellectual disabilities: none of these found any association. [19][20][21] We decided to carry out an updated systematic review, as important publications either have appeared since the last reviews or were not included in those reviews. Another reason for carrying out this review is to conduct meta-analyses that were not done in any of the previous reviews.…”

Section: Previous Systematic Reviews On the Subjectmentioning

confidence: 99%

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Association between epilepsy and challenging behaviour in adults with intellectual disabilities: systematic review and meta-analysis

Brizard¹,

Limbu

2020

BJPsych open

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Background Previous systematic reviews showed no significant association between epilepsy and challenging behaviours in adults with intellectual disabilities. Aims To identify whether there is an association between epilepsy and challenging behaviour in adults with intellectual disabilities by carrying out a systematic review of published data. PROSPERO registration number: CRD42020178092. Method We searched five databases and hand-searched six journals. Two authors independently screened titles, abstracts and full articles using a standardised eligibility checklist. Several meta-analyses were carried out. Results The narrative analysis of data from 34 included articles (14 168 adults with intellectual disabilities, 4781 of whom also had epilepsy) showed no significant association between epilepsy and challenging behaviour. Meta-analysis was possible on data from 16 controlled studies. This showed no significant intergroup difference but after sensitivity analysis meta-analysis of 10 studies showed a significantly higher rate of overall challenging behaviour in the epilepsy group (effect size: 0.16) compared with the non-epilepsy group. Aggression and self-injurious behaviour both showed a statistically significant higher rate in the epilepsy group, with very small effect sizes (0.16 and 0.28 respectively). No significant intergroup difference was observed in the rate of stereotypy. Conclusions The findings are contradictory and must be interpreted with caution because of the difficulty in pooling data from varied studies, which is likely to introduce confounding. Where significant differences were found, effect sizes are small and may not be clinically significant, and there are major methodological flaws in the included studies, which should be addressed in future large-scale properly controlled studies.

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Section: Interpretation Of Meta-analyses Findingscontrasting

confidence: 99%

Section: Previous Systematic Reviews On the Subjectmentioning

confidence: 99%

Association between epilepsy and challenging behaviour in adults with intellectual disabilities: systematic review and meta-analysis

Brizard¹,

Limbu

2020

BJPsych open

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“…Matson & Boisjoli () found that the majority of CB is sustained by multiple factors. This has been highlighted continuously (Ayres, ; Blickwedel, Ali, & Hassiotis, ; Bromley, Emerson, & Caine, ; Brylewski & Wiggs, ; Chatterton, ; Matson & Neal, ; O’Dwyer & Friedman, ; Taylor, Rush, Hetrick, & Sandman, ).…”

Section: Introductionmentioning

confidence: 98%

Can sensory integration have a role in multi‐element behavioural intervention? An evaluation of factors associated with the management of challenging behaviour in community adult learning disability services

Gill

Breen

2020

Brit J Learn Disabil

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Introduction: Adults with complex needs and severe learning disability present as a serious management problem within the community. Restrictive interventions are often used to manage adults with these issues, even though best practice recommends the use of positive behaviour support. Positive behaviour support involves functional analysis, but it does not specifically focus on sensory integration difficulties as a contributing factor to challenging behaviour. Methods:A systematic search of the literature was completed using a range of electronic databases, an electronic search, hand search and review of reference lists.Seven relevant studies were identified. These studies were critically appraised and analysed. However, the extent of research was limited and the procedural quality variable, some distinct themes, arose.Results: Out of the seven intervention studies included in this review, two studies used sensory integration therapy, three employed multi-element behavioural intervention, one utilised environmental stimulation within a multifactor behavioural intervention approach and one used sensory strategies within a structured behavioural intervention programme. The participants across the final seven papers reviewed | 143

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“…In people with intellectual disability presenting with challenging behaviour, it is important for the treating clinician to rule out seizure activity given the high rate of seizure disorder as a comorbidity in this group (Blickwedel et al, 2017;Roberston et al, 2015). The assessing clinician may need to consider the role of factors such as seizure frequency, peri-ictal events and the role of anti-epileptic drugs (AEDs) additionally in their formulation (Kerr et al, 2016).…”

Section: Seizures Can Present As Symptoms Of Mental Illnessmentioning

confidence: 99%

The neurology–psychiatry interface in epilepsy

Murphy

Hallahan

Connell

et al. 2018

Ir. j. psychol. Med.

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Epilepsy and mental illness have a bidirectional association. Psychiatrists are likely to encounter epilepsy as comorbidity. Seizures may present as mental illness. Equally, the management of psychiatric conditions has the potential to destabilise epilepsy. There is a need for structured epilepsy awareness and training amongst psychiatrists. This paper outlines key considerations around diagnosis, treatment and risk while suggesting practical recommendations.

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Epilepsy and challenging behaviour in adults with intellectual disability: A systematic review

Abstract: The present review is part of a larger study into challenging behaviour supported by an NIHR HTA grant ref 10/104/13.

Cited by 17 publications

References 32 publications

Association between epilepsy and challenging behaviour in adults with intellectual disabilities: systematic review and meta-analysis

Association between epilepsy and challenging behaviour in adults with intellectual disabilities: systematic review and meta-analysis

Can sensory integration have a role in multi‐element behavioural intervention? An evaluation of factors associated with the management of challenging behaviour in community adult learning disability services

The neurology–psychiatry interface in epilepsy

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