Behavioural symptoms among people with severe and profound intellectual disabilities: a 26-year follow-up study.
BACKGROUND
Very little is known about the natural history of challenging behaviour and psychiatric disorder in people with severe and profound degrees of intellectual disability.


OBJECTIVE
To clarify the natural history of challenging behaviour and psychiatric disorder in this population through a longterm prospective cohort study over a 26-year period.


METHODS
One hundred individuals with severe or profound intellectual disability were randomly selected in 1975. Their behaviour was recorded through carer and psychiatrist ratings using the Modified Manifest Abnormality Scale of the Clinical Interview Schedule. The presence and severity of psychiatric disorder were also recorded. The study was repeated in 1981/82 and 1992/93. We repeated the study again in 2001, supplementing the original observational data with the Checklist of Challenging Behaviour.


RESULTS
Behavioural symptomatology is remarkably persistent, particularly stereotypy, emotional abnormalities, eye avoidance and overactivity, although the severity of overall psychiatric disorder does show some abatement through time.


CONCLUSIONS
These findings influence the prospects of success in relocating adults with severe and profound degrees of intellectual disability back into the community.
Thompson
Christina  L
C
Tayside Primary Care NHS Trust, Clinical Psychology Department, Wedderburn House, Dundee.
Reid
Andrew
A
D000293:Adolescent; D000328:Adult; D000368:Aged; D017028:Caregivers; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008607:Intellectual Disability / Q000523:psychology* / Q000534:rehabilitation; D008297:Male; D001523:Mental Disorders / Q000209:etiology; D008875:Middle Aged; D011446:Prospective Studies; D011569:Psychiatric Status Rating Scales; D012720:Severity of Illness Index; D012920:Social Behavior Disorders / Q000209:etiology*