Psychiatric Services for Individuals with Intellectual and Developmental Disabilities: Medication Management

Russell, Andrew; Hahn, Joan Earle; Hayward, Katharine

doi:10.1080/19315864.2011.603107

Cited by 4 publications

(3 citation statements)

References 39 publications

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“…While this number is much higher than the national average for both typically developing children (~7%) and adults (~11%) [2011; Jonas et al, 2013a; Zito, 2012], it is much lower than the prevalence of psychiatric medication use in intellectual and developmental disorders (81%) [Deb et al, 2009; Howie et al, 2014; Jonas et al, 2013b; Russell et al, 2011; Zito, 2012]. This relatively low rate of psychiatric medications in individuals with JS may be encouraging to caregivers, indicating that psychiatric and behavioral concerns in JS are much lower than in many other disabilities.…”

Section: Discussionmentioning

confidence: 99%

Neuropsychological phenotypes of 76 individuals with Joubert syndrome evaluated at a single center

Summers

Snow

Wiggs

et al. 2017

American J of Med Genetics Pt A

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Objectives Joubert Syndrome (JS) is a genetically heterogeneous ciliopathy characterized by hypo-dysplasia of the cerebellar vermis, a distinct hindbrain/midbrain malformation (molar tooth sign), and intellectual disability. We evaluated the neuropsychological profiles of 76 participants with JS in the context of molecular genetics and clinical covariates. Methods Evaluations included neuropsychological testing, structured parental interviews, DNA sequencing, brain magnetic resonance imaging (MRI), electroencephalography (EEG), ophthalmologic examination, and assessment for renal and hepatic disease. Results On average, participants manifested Full Scale Intelligence Quotients (FSIQ) in the moderately to profoundly low range (M=64.3±15.3). Of the Wechsler index scores, verbal comprehension was least affected and processing speed was most affected. Receptive language was rated as better than expressive language on the Vineland Adaptive Behavior Scales-Second Edition. Those with abnormal EEG had a significantly lower FSIQ (n=15; M=50.7±12.9) compared to participants with normal EEG (n=39; M=64.7±16.3; p=.004). Participants taking psychiatric medications manifested a lower FSIQ (n=20; M=54.8±13.2) than those not taking them (n=42; M=65.0±17.2; p=.022). These correlations were also present in the TMEM67-related JS sub-cohort (n=14). Based on parental assessment, psychiatric and behavioral problems were significantly more common than in the general population for all measures (p<.004 for all). Conclusions The majority (65%) of individuals with JS have some degree of intellectual disability. Abnormal EEG is associated with lower neuropsychological function. Processing speed is a weakness, while verbal comprehension and receptive language are relative strengths. These findings may guide parents, teachers, therapists, and doctors to determine appropriate therapies, accommodations and academic goals for individuals with JS.

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Section: Discussionmentioning

confidence: 99%

Neuropsychological phenotypes of 76 individuals with Joubert syndrome evaluated at a single center

Summers

Snow

Wiggs

et al. 2017

American J of Med Genetics Pt A

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“…Overall, 70.2% (n = 139) were male and 29.8% (n = 59) were female. Their mean APACHE II score was 14.5 ± 8.7 (median 14, IQR [8][9][10][11][12][13][14][15][16][17][18][19]. Additional characteristics are presented in Table 1.…”

Section: Description Of the Cohort As A Wholementioning

confidence: 99%

“…They are admitted more frequently after surgical procedures, have more complications [7,8] and are also more likely to die during hospitalization [9,10]. Moreover, three of every four patients with ID receive chronic psychoactive drug therapy and half are treated with more than one medication [11]. Weaning un-cooperative adults from mechanical ventilation presents unique difficulties.…”

Section: Introductionmentioning

confidence: 99%

Intellectually disabled patients’ intensive care admission characteristics, weaning from mechanical ventilation, and sedative drug use: a single-center retrospective case-control study

Bineth

Barel

Bdolah‐Abram

et al. 2022

J Anesth Analg Crit Care

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Background Intellectually disabled (ID) patients present unique therapeutic challenges. We aimed to describe the characteristics of ID patients admitted to a general intensive care unit (ICU). Results We conducted a retrospective cohort study comparing critically ill adult ID patients to matched patients without ID (1:2 ratio) in a single ICU (2010–2020). The main outcome measure was mortality. Secondary outcomes included complications during admission and characteristics of weaning from mechanical ventilation. The study and control groups were randomly selected based on similar age and sex. ID patients nonetheless had an average APACHE score of 18.5 ± 8.7 vs. 13.4 ± 8.5 in controls (p < 0.001). ID patients had more hematological (p = 0.04), endocrinological (p < 0.001) and neurological (p = 0.004) comorbidities and used more psychiatric medication before admission. No difference was found in mortality rates. Differences were found as there were more secondary complications, such as pulmonary and sepsis (p < 0.03), frequent requirement of vasopressors (p = 0.001), significantly higher intubation rates with more weaning attempts, tracheostomies and longer ICU and hospital admissions (p < 0.019). Conclusions Critically ill adult ID may have more comorbidities and be sicker at the time of admission compared to their age- and sex-matched counterparts. They require more supportive treatment and their weaning from mechanical ventilation may be more challenging.

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Lake¹,

McMorris²,

Lunsky³

2015

Psychiatric and Behavioral Disorders in Intellectual and Developmental Disabilities

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Psychiatric Services for Individuals with Intellectual and Developmental Disabilities: Medication Management

Cited by 4 publications

References 39 publications

Neuropsychological phenotypes of 76 individuals with Joubert syndrome evaluated at a single center

Neuropsychological phenotypes of 76 individuals with Joubert syndrome evaluated at a single center

Intellectually disabled patients’ intensive care admission characteristics, weaning from mechanical ventilation, and sedative drug use: a single-center retrospective case-control study

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