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1 – 5 of 5Anna M. Palucka, Miti Modi and Yona Lunsky
The purpose of this paper is to study the profiles of adults with autism spectrum disorder (ASD) requiring an inpatient psychiatric admission.
Abstract
Purpose
The purpose of this paper is to study the profiles of adults with autism spectrum disorder (ASD) requiring an inpatient psychiatric admission.
Design/methodology/approach
This paper examines profiles of 27 inpatients with intellectual disability (ID) and ASD who were admitted to a specialized inpatient unit in two time periods (January 2005 to June 2009 and July 2009 to December 2013) to explore changes over time in patient profiles.
Findings
Findings suggest that individuals who were admitted more recently between July 2009 and December 2013, were younger and more likely to come from other ethnic backgrounds than those admitted between January 2005 and June 2009. There was a trend for recent admissions to come from family homes, have moderate to profound ID and have longer hospital stay.
Originality/value
This is the first study to compare profiles of adults with ASD receiving inpatient services over time. The value of the study lies in illustrating that the needs of this growing patient group are changing which has implications for the treatment provision including specialized inpatient treatment.
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Yona Lunsky, Ami Tint, Jonathan A. Weiss, Anna Palucka and Elspeth Bradley
Past research has shown individuals with autism spectrum disorder (ASD) visit hospital emergency departments (ED) at high rates. In order to assist individuals with ASD, their…
Abstract
Purpose
Past research has shown individuals with autism spectrum disorder (ASD) visit hospital emergency departments (ED) at high rates. In order to assist individuals with ASD, their families and health care providers to improve ED care, it is important to understand these encounters in greater detail. The purpose of this paper is to provide a descriptive summary of the ED experiences of adolescents and adults with ASD, from the perspective of their families.
Design/methodology/approach
A subset of data from a larger prospective cohort study was used. Specifically, 46 parents of adolescents and adults with ASD provided details concerning 49 ED visits over a 12-month period.
Findings
Results suggest a range of presentations requiring ED use, and also diverse profiles of those with ASD who visited the ED, in terms of age, gender, and ASD severity. While overall degree of satisfaction with care received in the ED was high, parents provided recommendations to improve the ED experiences for their family members with ASD.
Originality/value
This is the first study to provide detailed accounts of ED visits from the perspective of parents of adolescents and adults with ASD. Families play an important role in the lives of individuals with ASD across the lifespan and it is important to include their perspective to improve hospital-based care for those with ASD.
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Elspeth Bradley, Yona Lunsky, Anna Palucka and Soula Homitidis
The purpose of this paper is to determine: the extent to which an intellectual disability diagnosis meets current diagnostic and statistical manual of mental disorders (DSM…
Abstract
Purpose
The purpose of this paper is to determine: the extent to which an intellectual disability diagnosis meets current diagnostic and statistical manual of mental disorders (DSM) diagnostic criteria; the prevalence of reported autism spectrum disorders (ASD); and the extent to which assessment of developmental issues is central to the diagnosis of psychotic disorder, in patients discharged with a diagnosis of psychotic disorder and intellectual disabilities.
Design/methodology/approach
Of all patients discharged with psychotic disorder during a four‐year period (n=3339), chart reviews were completed on those also diagnosed with intellectual disability or borderline IQ.
Findings
The findings if this paper are threefold: only 39 percent of the 41 individuals discharged with a diagnosis of psychotic disorder and intellectual disability met documented DSM criteria for intellectual disability; the prevalence of reported ASD was much lower than expected; and the average number of different discharge diagnoses per individual over time was 4.8. Schizophrenia diagnoses were made early in the diagnostic process and tended to persist even when ASD concerns were documented.
Originality/value
The results support the need to systematically assess the developmental issues of patients with intellectual disability as part of the psychiatric diagnostic formulation. Differential diagnoses of psychotic‐like behaviours seen in people with intellectual disability, and alternative frameworks for understanding these behaviours, which in turn should guide more effective interventions and treatment, are discussed.
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Anna M. Palucka, Poonam Raina, Shi‐Kai Liu and Yona Lunsky
Individuals with intellectual disability (ID), mental health needs and criminal justice system involvement are likely to be admitted to forensic units; however, not all of those…
Abstract
Purpose
Individuals with intellectual disability (ID), mental health needs and criminal justice system involvement are likely to be admitted to forensic units; however, not all of those individuals are served in that system. It is, therefore, important to understand the profile of those admitted to non‐forensic specialized units for individuals with ID and mental health issues. This paper aims to address this issue.
Design/methodology/approach
Demographic, clinical and criminal profiles of individuals discharged over nine years from a specialized dual diagnosis program were reviewed to delineate clinical subgroups.
Findings
A total of 20 out of 84 total discharges were identified as having past or current criminal justice system involvement. The most common offence was assault and 60 per cent of these individuals had admissions longer than one year. Subgroups by psychiatric diagnosis differed in their age, legal status, offence history, and length of hospital stay, as well as in therapeutic interventions and discharge process.
Research limitations/implications
The results suggest that inpatients with ID and criminal justice system involvement present with unique treatment, support and risk management needs based on psychiatric diagnosis. The number of individuals in clinical subgroups was low, thus further research is needed to determine if the observed patterns hold true in bigger samples.
Originality/value
The study delineates the complexity and heterogeneity of treatment and supports needs of individuals with intellectual disabilities and offending behaviour.
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