University of Glasgow

Academic Institute

Ewelina Rydzewska - Chief Investigator - University of GlasgowEwelina Rydzewska - Corresponding Applicant - University of GlasgowAngela Henderson - Collaborator - University of GlasgowAnne MacDonald - Collaborator - University of GlasgowCraig Meville - Collaborator - University of GlasgowElita Smiley - Collaborator - GREATER GLASGOW AND CLYDEIain Carey - Collaborator - St George'sUniversity of LondonMichael Fleming - Collaborator - University of GlasgowRichard Hastings - Collaborator - University of WarwickUmesh Chauhan - Collaborator - University Of Central Lancashire

CPRD848

Previous studies have shown that people with intellectual disabilities commonly engage in challenging behaviours such as physically, verbally or sexually aggressive, destructive or self-injurious behaviour, but prevalence rates vary significantly between studies. Association of challenging behaviours with behavioural, psychiatric and psychosocial factors has been established previously, but physical conditions such as pain, sleep problems, constipation, epilepsy, urinary/bowel incontinence and sensory impairments have been less studied and existing evidence in mostly of low quality and inconclusive. In this study, we will investigate the incidence of challenging behaviours in a large nationwide population of primary care patients with intellectual disabilities. We will also examine the association between challenging behaviours and physical conditions in this population, including exploring how different health (e.g. severity of intellectual disabilities, co-occurring autism/genetic syndromes/mental comorbidities), demographic (e.g. age, gender, ethnicity) and socioeconomic (e.g. Practice/Patient Level Index of Multiple Deprivation) factors may affect this relationship. The results of this study will help us understand whether presence of challenging behaviours in patients with intellectual disabilities is affected by their physical health and how other factors may further impact this association.

Challenging behaviours can include physically, verbally or sexually aggressive, destructive or self-injurious behaviour. The estimated prevalence of challenging behaviour problems in intellectual disabilities in large population studies shows considerable variation between 4–22%, with multiple factors likely to underlie challenging behaviours in this population. Risk factors associated with challenging behaviours in people with intellectual disabilities include male gender, severe/profound level of intellectual disabilities, co-occurring autism and deficits in receptive and expressive communication. An association with behavioural, psychiatric and psychosocial factors has also been established, but physical conditions such as pain, sleep problems, constipation, epilepsy, urinary/bowel incontinence and sensory impairments have been less studied and existing evidence is mostly of low quality and inconclusive. In this study, we will investigate the incidence of challenging behaviours in a large nationwide population of primary care patients with intellectual disabilities in England. Using stratified Cox proportional hazard models, we will also examine the association between challenging behaviours and physical conditions (i.e. pain, sleep problems, constipation, epilepsy, urinary/bowel incontinence and sensory impairments) in this population, including exploring how different health (e.g. severity of intellectual disabilities, co-occurring autism/genetic syndromes/mental comorbidities), demographic (e.g. age, gender, ethnicity) and socioeconomic (e.g. Practice/Patient Level Index of Multiple Deprivation) factors may affect this relationship.

16/02/2021

Release