Adults with Autism Spectrum Disorders using psychiatric hospitals in Ontario: Clinical profile and service needs
ABSTRACT BackgroundAdults with Autism Spectrum Disorders (ASD) represent a small, but challenging sub-group of patients within Ontario's mental health care system. However, few studies have documented the clinical characteristics of this population and examined how such individuals differ from other psychiatric patients, with or without intellectual disabilities (ID).MethodA secondary analysis of data from the 2003 Comprehensive Assessment Projects from three psychiatric hospitals in Ontario was conducted to describe patients with ASD and ID and to determine how their profile compared to other hospital users.ResultsTwenty-three patients with ASD and ID were matched on gender and patient status (inpatient/outpatient) to individuals with and without ID. Individuals with ASD and ID were similar in terms of demographics to patients with and without ID. However, individuals with ASD and ID were younger, spent more days in hospital and were less likely to have a psychotic disorder diagnosis than both patients with and without ID. Inpatients with ASD and ID were recommended for a higher level of care than hospital service users without ID.ConclusionsClearly, this small sub-group of individuals within the hospital population has high clinical needs that are not always well met.
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ABSTRACT: The present study examined rates of co-morbid psychopathology and clinical management/care pathways in adult females (N = 50) and males (N = 100) with autism spectrum disorders (ASD) and intellectual disability (ID) living in community settings. We also compared a sub-sample (N = 60) with ASD to an age-, gender- and ID-matched control group (N = 90) on ratings of psychopathology and autism-related symptoms. All participants were referrals to specialist mental heath services for people with ID. Clinical diagnoses of psychopathology and ASD were based on ICD-10 criteria. Key informants also completed the Psychopathology Assessment Schedule for Adults with Developmental Disabilities (PAS-ADD) checklist. The analysis showed that there were statistically significant differences in rates of co-morbid psychopathology and clinical management between males and females with ASD, although there were no significant differences in level of ID and age. More specifically, personality disorder and schizophrenia were more common among males, where as dementia was more common among females. Regarding clinical management, males were more likely to be prescribed a combination of medication and females were more likely to receive sedation. Overall, the results suggest that male and female patients with ASD have, at least to some extent, different mental health needs.Research in Autism Spectrum Disorders 01/2011; 5(2):803-808. · 2.96 Impact Factor
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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.Advances in Mental Health and Intellectual Disabilities. 11/2011; 5(6):4-18.