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Background: The aim of this study was to investigate the prevalence of and the factors associated with psychiatric symptoms (PS) and challenging behaviour (CB) in adults with intellectual disabilities, and the utilization of psychiatric services in Turkey. Method: Psychiatric Assessment Schedule for Adults with Developmental Disorders Checklist-Revised was used for PS and a structured form for other variables in 771 participants. Results: Of the participants, 50.1% had PS and 36.4% presented with CB. Multivariate analysis revealed that a higher level of needs, better verbal ability, residential living, incontinence and CB, and lifetime suicidal ideation/attempt were independently associated with PS. For CB, it emerged as male carer, PS, lifetime suicidal attempt/ideation, lower level of verbal ability and autism spectrum disorder. Barriers were experienced by 64.7% of participants within the previous year. Conclusions: Psychiatric symptoms and CB seem to be problems for a significant proportion of adults with intellectual disabilities in Turkey, and there are certain barriers to psychiatric services.

Objective: Binge eating is a common behavior among individuals with obesity. The Binge Eating Scale (BES) is a widely utilized tool to assess binge eating behavior. Originally created in English, it has been validated in various languages. The aim of this study is to present psychometric evidence supporting the Turkish version of the BES in diagnosing Binge Eating Disorder (BED) in individuals with obesity. Method: The Turkish version was developed through translation and back translation from the original English version. The binge eating behavior of 188 obese adult patients, who sought treatment at an obesity outpatient clinic, was assessed using the BES and a psychiatric assessment with the Structured Clinical Interview for the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) - Clinician Version. Metrics such as internal consistency, test-retest reliability, predictive validity, factor analysis, and diagnostic measures were calculated. Results: The Turkish version of the BES demonstrated a one-factor structure with high internal consistency (Cronbach alpha: 0.843). At a cut-off point of 18, the BES showed a sensitivity of 72.09%, specificity of 79.31%, a positive predictive value of 50.80%, and a negative predictive value of 66.7%. The test-retest reliability indicated significant agreement between the BES scores (Intraclass Correlation Coefficient (ICC)=0.875 p<0.001). Conclusion: These results suggest that the Turkish version of the BES is a valid and reliable screening instrument for BED in adults with obesity. [ABSTRACT FROM AUTHOR]

AbstractObjectiveMethodsResultsConclusionThe current study aims to examine the efficacy of an add-on dialectical behavior therapy skills training (DBT-ST) on adult attention-deficit/hyperactivity disorder (ADHD). The DBT-ST was applied online under the pandemic conditions that occurred after the study had started.The current randomized controlled trial consists of an intervention group to whom the DBT-ST was applied in online setting and a waitlist control group who received treatment as usual (TAU). Data were collected pre-, post-, and mid-treatment. ADHD symptoms (with the sub-dimensions of inattention and hyperactivity), impulsivity, mindfulness, difficulty with emotion regulation, interpersonal effectiveness, distress tolerance, life satisfaction, functionality in daily life, and general psychological symptom levels were measured with self-report scales. The data were analyzed using mixed-design ANOVA.The global ADHD, inattention, and hyperactivity symptoms of the DBT-ST group significantly decreased more than those in the TAU control group. The DBT-ST group also showed a significant decrease regarding difficulty with emotion regulation and increases in life satisfaction and functionality, though the group × time effect was not significant.DBT-ST was found effective against the participants’ ADHD symptoms. The treatment was additionally found to improve their emotion regulation and quality of life. Further investigation is needed to investigate DBT-ST in an online setting. [ABSTRACT FROM AUTHOR]

Purpose – Psychiatrists are among the front-line professionals involved in the implementation of Deprivation of Liberty Safeguards (DOLS). This paper aims to explore how the safeguards are perceived and practised amongst psychiatrists. Design/methodology/approach – The authors carried out a postal survey among 519 psychiatrists on their views and experiences on DOLS. Findings – A total of 171 psychiatrists (36 per cent) responded to the survey. Nearly three-quarters of the participants had received DOLS training and 81 per cent of individuals who had training believed that DOLS would protect the rights of vulnerable people. Almost half of both groups agreed that DOLS make a valuable contribution to the provision of necessary care in the least restrictive way possible. The most common concern raised was possible increase in bureaucratic process. Interface between the existing legislations continues to be a grey area for many practitioners with difficulties in interpreting the relevant Code of Practice. In total, 50 per cent of the participants felt DOLS should extend to community placement provisions. Originality/value – The views and concerns expressed by psychiatrists in this paper are relevant to all professionals working with adults who lack capacity to consent to their care or treatment in any setting. As the process continues to widen, it is important to recognise the issues, encourage use of DOLS process to protect human rights, and to address key gaps in training. [ABSTRACT FROM AUTHOR]

Background: Self-injurious behaviour among people with intellectual disability is relatively common and often persistent. Self-injurious behaviour continues to present a challenge to clinicians. It remains poorly understood and difficult to ameliorate despite advances in neurobiology and psychological therapies. There is a strong need for a better evidence base in prescribing and monitoring of drugs in this population, especially since none of the drugs are actually licensed for self-injurious behaviour., Objectives: To determine clinical effectiveness of pharmacological interventions in management of self-injurious behaviour in adults with intellectual disability., Search Methods: We searched the following databases on 19 February 2012: CENTRAL, MEDLINE, EMBASE, PsycINFO, CINAHL, Science Citation Index, Social Science Citation Index, Conference Proceedings Citation Index - Science, Conference Proceedings Citation Index - Social Science and Humanities, ZETOC and WorldCat. We also searched ClinicalTrials.gov, ICTRP and the reference lists of included trials., Selection Criteria: We included randomised controlled trials that examined drug interventions versus placebo for self-injurious behaviour (SIB) in adults with intellectual disability., Data Collection and Analysis: Two review authors independently extracted data and assessed risk of bias for each trial using a data extraction form. We present a narrative summary of the results is presented. We did not consider meta-analysis was appropriate due to differences in study designs, differences between interventions and heterogeneous outcome measures., Main Results: We found five double-blind placebo-controlled trials that met our inclusion criteria. These trials assessed effectiveness and safety of drugs in a total of 50 people with intellectual disability demonstrating SIB. Four trials compared the effects of naltrexone versus placebo and one trial compared clomipramine versus placebo.One of the naltrexone versus placebo trials reported that naltrexone had clinically significant effects (≥ 33% reduction) on the daily rates of three of the four participants' most severe form of SIB and modest to substantial reductions in SIB for all participants; however, this study did not report on statistical significance. Another trial reported that naltrexone attenuated SIB in all four participants, with 25 mg and 50 mg doses producing a statistically significant decrease in SIB (P value < 0.05). Another trial (eight people) indicated that naltrexone administration was associated with significantly fewer days of high frequency self injury and significantly more days with low frequency self injury. Naltrexone had different effects depending on the form and location of self injury. Another trial with only 26 participants found that neither single-dose (100 mg) nor long-term (50 and 150 mg) naltrexone treatment had any therapeutic effect on SIB.Comparison of clomipramine versus placebo found no statistically significant benefit for any outcome measure, which included SIB rate and intensity, stereotypy and adverse events. However, it showed clinically significant improvement in the rate and intensity of SIB and stereotypy.There were very few noteworthy adverse events to report in any of the four trials in which these were reported.All trials were at high risk of bias, apart from one trial (Lewis 1996), which was probably at low risk of bias. The short period of follow-up was a significant drawback in the design of all five trials, as it did not allow long-term assessment of behaviour over time.We were unable to examine the efficacy of antidepressants other than clomipramine, antipsychotics, mood stabilisers or beta-blockers as we did not identify any relevant placebo-controlled trials., Authors' Conclusions: There was weak evidence in included trials that any active drug was more effective than placebo for people with intellectual disability demonstrating SIB. Due to sparse data, an absence of power and statistical significance, and high risk of bias for four of the included trials, we are unable to reach any definite conclusions about the relative benefits of naltrexone or clomipramine compared to placebo.