There was no restriction on the type of study design included in this review. Challenging behaviour is defined using a variety of methods in different studies. Although we used a stringent method for literature search, it is still possible that we missed some relevant articles. This goes from the front tip of the brain to about halfway back (just in front of your ears). It is the center for outgoing words. Ready for help? Plekanchuk, Vladislava S. Antiepileptic polypharmacy, psychosocial behaviour and locus of control orientation among mentally handicapped adults living in the community, The development of a psychosocial behaviour scale for the assessment of mentally handicapped people, The Behavior Problems Inventory: an instrument for the assessment of self-injury, stereotyped behavior, and aggression/destruction in individuals with developmental disabilities, Challenging behavior in adults with epilepsy and intellectual disability: an analysis of epilepsy characteristics, Adults with intellectual disabilities: prevalence, incidence and remission of self-injurious behaviour, and related factors, Adults with intellectual disabilities: prevalence, incidence and remission of aggressive behaviour and related factors, DC-LD (Diagnostic Criteria for Psychiatric Disorders for Use with Adults with Learning Disabilities/Mental Retardation), Autism Spectrum Disorders-Comorbidity-Adult Version, Behavior problems: differences among intellectually disabled adults with co-morbid autism spectrum disorders and epilepsy, Reliability and factor structure of the Autism Spectrum Disorders Behavior Problems for Adults (ASD-BPA) with intellectual disabilities and autism, Research Methods and Statistics in Psychology, Bias in meta-analysis detected by a simple, graphical test, Self-injurious behaviour as part of genetic syndromes, The measurement of aggressive behaviour: reflections on the use of the Overt Aggression Scale and the Modified Overt Aggression Scale, Epilepsie als Anfallsleiden und als Psychose-Uber alternative Psychosen paranoider Pragung bei forcierter Normalizierung (Landolt) des Elektoencephalogramms Epileptischer, Some clinical electroencephalographical correlations in epileptic psychosis, Evidence-based guidelines for treating bipolar disorder: revised third edition recommendations from the British Association for Psychopharmacology, Epilepsy, antiepileptic drugs, and aggression: an evidence-based review, Levetiracetam for the treatment of epilepsy among adults with intellectual disabilities, National Institute for health and Care Excellence, The Epilepsies: The Diagnosis and Management of the Epilepsies in Adults and Children in Primary and Secondary Care (NICE Clinical Guideline CG137), Handbook of Evidence-Based Practices in Intellectual and Developmental Disabilities. screened bibliographies and extracted data and completed risk-of-bias checklist. and S.D. 7 Cochrane risk-of-bias summary for the 19 controlled studies.+, bias present; , bias absent; ?, bias possible. Fig. It will be necessary to conduct a much larger randomised controlled trial to recruit a reasonable number of participants in each subgroup to provide adequate power to detect clinically significant intergroup differences. Each area has developed over time to become very good at performing it. 1 The flowchart of the paper selection process. Bethesda, MD 20894, Web Policies Burke, Eilish Fig. ABC-C, Aberrant Behaviour Checklist-Community version; ABS-II, Adaptive Behaviour Scale Part II; ANOVA, analysis of variance; ANCOVA, analysis of covariance; ASD-CA, Autism Spectrum Disorders-Comorbidity-Adult version battery; DAS, Disability Assessment Schedule; DASH-II, Diagnostic Assessment for the Severely Handicapped-Part 2; MANOVA, multivariate analysis of variance; MANCOVA, multivariate analysis of covariance; PAA, Profile of Abilities and Adjustment schedule; PBS, Psychosocial Behaviour Scale; SIB, self-injurious behaviour. and The quality of the overall systematic review was assessed using AMSTAR 2 criteria (see Appendix 3; supplementary material).Reference Shea, Reeves, Wells, Thuku, Hamel and Moran35. Your attention may drift much sooner than before. Federal government websites often end in .gov or .mil. We also aimed to include studies that involved adults with intellectual disabilities and epilepsy but no one without epilepsy. Broca's area is located just above the front of the temporal lobe. Are you concerned about changes you see in yourself? The frontal lobe has the final say in your social behavior. This arbitrary cut-off was used in accordance with our previous systematic reviews.Reference Deb, Kwok, Bertelli, Salvador-Carulla, Bradley and Torr10. It regulates how you interact with other people. using the same eligibility checklist that was used for screening the abstracts. J Intellect Disabil Res. Supplementary material is available online at http://doi.org/10.1192/bjo.2020.96. Your doctor may test Sclerosis of the hippocampus is the most frequent cause of temporal lobe epilepsy (TLE). "coreDisableSocialShare": false, Given the small number of studies involving small numbers of participants in the subgroups, lack of matching of the groups, and different types of challenging behaviour rated in these studies, it is difficult to draw any definitive conclusion about any association between challenging behaviour and seizure type. Data on subgroup comparisons according to different types of seizure, seizure frequency and different pharmacological regimes (e.g. Epub 2019 Mar 21. van Ool JS, Snoeijen-Schouwenaars FM, Tan IY, Schelhaas HJ, Aldenkamp AP, Hendriksen JGM. Vocational Success: Consider referral to Vocational rehabilitation program/system as available in patients region.Evaluate extent of ability to work affected by adverse effects of: Behavioral/psychological/psychiatric problems: Screen for symptoms of depression and anxiety and otherbehavioral problems, including suicidal thoughts or wishes and treat or refer accordingly. We included 34 articles in our systematic review that met the eligibility criteria. Faculty of Medicine, Department of Brain Sciences, Imperial College London, UK, Institut de Psychologie, Laboratoire de Psychopathologie et Processus de Sant, Paris, France, Reference Clarke, Deb, Gelder, Andreasen, Lpez-Ibor and Geddes, Reference Berney, Deb, Shorvon, Guerrini, Cook and Lahtoo, Reference Shankar, Watkins, Alexander, Devapriam, Dolman and Hari, Reference Shankar, Eyeoyibo, Scheepers, Dolman, Watkins and Attavar, Reference Kerr, Mensah, Besag, De Toffol, Ettinger and Kanemoto, Reference Deb, Kwok, Bertelli, Salvador-Carulla, Bradley and Torr, Reference Smith, Branford, Collacott, Cooper and McGrother, Reference Hemmings, Deb, Chaplin, Hardy and Mukherjee, Reference Deb, Deb, Faruqui, Bodani and Agrawal, Reference Deb, Bethea, Havercamp, Rifkin, Underwood, Fletcher, Barnhill and Cooper, Reference Sjgafoos, Elkins, Kerr and Attwood, Reference Deb, Unwin, Rojahn, Cooper, Bertelli, Deb, Munir, Hassiotis and Salvador-Carulla, Reference van Ool, Snoeijen-Schouwenaars, Schelhaas, Tan, Aldenkamp and Hendriksen, Reference Moher, Shamseer, Clarke, Ghersi, Liberati and Petticrew, Reference Lefebvre, Glanville, Briscoe, Littlewood, Marshall, Metzendorf, Higgins, Thomas, Chandler, Cumpston, Li and Page, Reference Deb, Farmah, Arshad, Deb, Roy and Unwin, Reference Li, Higgins, Deeks, Higgins, Thomas, Chandler, Cumpston, Li and Page, Reference Deeks, Higgins, Altman, Higgins, Thomas, Chandler, Cumpston, Li and Page, Reference Sterne, Savovi, Page, Elbers, Blencowe and Boutron, Reference Shea, Reeves, Wells, Thuku, Hamel and Moran, Reference Blickwedel, Vickerstaff, Walker and Hassiotis, Reference Creaby, Warner, Jamil and Jawad, Reference O'Dwyer, McCallion, Burke, Carroll, O'Dwyer and McCarron, Reference McGrother, Bhaumik, Thorp, Hauck, Branford and Watson, Reference Collacott, Cooper, Branford and McGrother, Reference Tyrer, McGrother, Thorp, Donaldson, Bhaumik and Watson, Reference Espie, Pashley, Bonham, Sourindhrin and O'donovan, Reference Nihira, Foster, Shellhaas and Leland, Reference Matson, Bamburg, Mayville and Khan, Reference Matson, Gardner, Coe and Sovner, Reference Matthews, Weston, Baxter, Felce and Kerr, Reference Espie, Watkins, Curtice, Espie, Duncan and Ryan, Reference Folch, Corts, Salvador-Carulla, Vicens, Irazbal and Muoz, Reference Rojahn, Matson, Lott, Esbensen and Smalls, Reference van Ool, Snoeijen-Schouwenaars, Tan, Schelhaas, Aldenkamp and Hendriksen, Reference Cooper, Smiley, Allan, Jackson, Finlayson and Mantry, Reference Cooper, Smiley, Jackson, Finlayson, Allan and Mantry, Reference Egger, Smith, Schneider and Minder, Reference Goodwin, Haddad, Ferrier, Aronson, Barnes and Cipriani, Reference Brodie, Besag, Ettinger, Mula, Gobbi and Comai, Reference Young, Shankar, Palmer, Craig, Hargreaves and McLean, Epidemiology and treatment of epilepsy in patients who are mentally retarded, Characteristics of epilepsy in a population based cohort of adults with learning disability, Syndromes causing intellectual disability, Oxford Textbook of Epilepsy and Epileptic Seizures, Prescribing Anti-Epileptic Drugs for People with Epilepsy and Intellectual Disability (College Report CR206), Epilepsy in people with mental retardation, Handbook of Mental Retardation and Developmental Disabilities, Good Psychiatric Practice: Management of Epilepsy in Adults with Intellectual Disability (College Report CR203), International consensus clinical practice statements for the treatment of neuropsychiatric conditions associated with epilepsy, Mental health and epilepsy among adults with intellectual disabilities, Psychiatric and Behavioural Disorders in Intellectual and Developmental Disabilities, International guide to prescribing psychotropic medication for the management of problem behaviours in adults with intellectual disabilities, Prevalence and cluster typology of maladaptive behaviours in a geographically defined population of adults with learning disabilities, Mental disorder in adults with intellectual disability. Then, if the information seems important, it ships it to a different section of the brain for long-term storage. Communication lines formed between different areas so the brain would have a well-developed backup system. Of these three, oneReference Matson, Bamburg, Mayville and Khan41 was at a significant level and the level of significance for other twoReference Espie, Watkins, Curtice, Espie, Duncan and Ryan46, Reference Pawar and Akuffo49 is not known. Even if seizures happen every day for most of your life, you are still able to read, speak, and understand words. Close this message to accept cookies or find out how to manage your cookie settings. government site. A final meta-analysis was carried out after removing data from the studies that produced a high heterogeneity and strong bias, to bring heterogeneity to an acceptable level (I 2<30). 2022 Mar 29;14(1):25. doi: 10.1186/s11689-022-09426-0. For example, a number of studies used the ABC-C total score, which is not valid.Reference Aman, Burrow and Wolford66 Fifth, many studies used an arbitrary cut-off score on behaviour rating scales to define challenging behaviour, and different studies used different scales and different cut-off scores. Another reason for carrying out this review is to conduct meta-analyses that were not done in any of the previous reviews. Fig. Bookshelf Data from studies meeting eligibility criteria were extracted independently by B.A.B. Treatment of behavioral problems in intellectually disabled adult hasContentIssue false, This is an Open Access article, distributed under the terms of the Creative Commons Attribution licence (, Copyright The Author(s), 2020. This strange-looking thing is responsible for receiving new information and storing it. Bertelli, Marco O. Henman, Martin HHS Vulnerability Disclosure, Help Epub 2018 Jan 5. Several meta-analyses were carried out. We included both randomised and non-randomised studies; controlled and non-controlled observational or cross-sectional studies; and controlled studies with both matched and non-matched control groups. Pooled data did not show any significant intergroup difference in the rate of stereotyped behaviour. Tax ID: 52-0856660, Joseph I. Sirven MD / Patricia O. Shafer RN MN, Nutritional Deficiencies as a Seizure Trigger, Focal Bilateral Tonic Clonic Seizures (Secondarily Generalized Seizures), Focal Onset Aware Seizures (Simple Partial Seizures), Focal Onset Impaired Awareness Seizures (complex partial seizures), Childhood Epilepsy Centrotemporal Spikes (Benign Rolandic Epilepsy), Epilepsy Eyelid Myoclonia Jeavons Syndrome, Epilepsy of Infancy with Migrating Focal Seizures, Developmental/Epileptic Encephalopathy with Spike Wave Activation In Sleep, Fires Febrile Infection-Related Epilepsy Syndrome, Self Limited Familial and Non-Familial Neonatal Infantile Seizures, Self Limited Late Onset Occipital Epilepsy Gastaut Syndrome, Epilepsy Generalized Tonic Clonic Seizures Alone, Factores Que Pueden Provocar Crisis Epilpticas, Primeros Auxilios Para Crisis Epilpticas, Sturge Weber Syndrome Encephalotrigeminal Angiomatosis, Periventricular Nodular Heterotopias (PVNH), When to Wean Children Off Medications After Surgery, New-Onset Refractory Status Epilepticus (NORSE), Chronic Disease Self-Management Program (CDSMP), First Aid for Focal Aware (simple partial) Seizures, First Aid for Focal Impaired Awareness (complex partial) Seizures, Seizure First Aid Training and Certification, Childcare Professionals and Babysitters' Guide to Seizure Disorders, Seizure Dogs: Children and Parent Partners. and Even though the meta-analysis of pooled data from a smaller number of studies after sensitivity analysis showed a significantly higher rate of challenging behaviour in the epilepsy group, the effect sizes are small, which may not be clinically significant. CognitiveLinguistic Functions in Adults With Epilepsy: Preliminary Dealing with behavior problems | Epilepsy Foundation Some people claim this is where your personality comes from. Epilepsy | CDC - Centers for Disease Control and Prevention carried out meta-analysis. Also, by log-transforming some data we may have lost some power in the meta-analysis. +, bias present; , bias absent; ?, bias possible. Although we amalgamated data where possible to carry out a number of meta-analyses, the heterogeneity among studies remains high. Deb, Shoumitro This is because seizures can damage the area where the word is stored, as well as the communication lines that carry or transport the word. Compared with previous systematic reviews this review included data for a much higher number of participants (Table 4). and Cognitive and behavioral functions generally improve for individuals who are seizure-free. Previous systematic reviews showed no significant association between epilepsy and challenging behaviours in adults with intellectual disabilities. Also, both antipsychotics and antidepressants are likely to lower seizure threshold (particularly the older generation ones and at a high dose), which may precipitate more seizures and may lead to challenging behaviour. The stereotypy meta-analysis did not show any significant intergroup difference but showed a high heterogeneity value of over 60% (I 2=69%). Prokudina, Olga I. Of the total 19 controlled studies, 13Reference Deb, Thomas and Bright12, Reference Deb, Cowie and Richens36, Reference Espie, Pashley, Bonham, Sourindhrin and O'donovan37, Reference Collacott39, Reference Deb40, Reference Matthews, Weston, Baxter, Felce and Kerr43Reference Prasher45, Reference Turkistani47, Reference Fitzgerald, Matson and Barker50Reference Blickwedel, Vickerstaff, Walker and Hassiotis53 did not show any significant intergroup difference in the overall rate of challenging behaviour, threeReference Gillies, Espie and Montgomery38, Reference Chung and Cassidy42, Reference McGrother, Bhaumik, Thorp, Hauck, Branford and Watson48 showed a significantly higher rate of challenging behaviour in the epilepsy group and threeReference Matson, Bamburg, Mayville and Khan41, Reference Espie, Watkins, Curtice, Espie, Duncan and Ryan46, Reference Pawar and Akuffo49 showed a higher overall rate of challenging behaviour in the non-epilepsy group (Table 1). Render date: 2023-08-22T17:47:06.836Z Data on psychiatric illness without challenging behaviour are not presented in the current paper as they will be included in a separate systematic review article. The majority of the existing research has focused on were compared between the epilepsy and the non-epilepsy groups. The frequency and severity of self-injurious, (motoric) stereotyped, and aggressive/destructive behavior among 189 patients was assessed using the Behavior Problem Inventory. Temporal Lobe Epilepsy and Psychiatric Comorbidity - PMC Also, in the subgroups there is no consistency in the types of challenging behaviour described, as some studies provided the rate of overall challenging behaviour, but others reported the rates of different types of challenging behaviour, such as aggression, self-injurious behaviour and stereotypy, making it difficult to amalgamate data from different studies. 2023. There was no publication bias present for self-injurious behaviour (P=0.307). Many different things need to be considered, such as: Talk with your health care teamif you are concerned about changes in your memory, language, or executive function. The behavioural phenotype of SATB2-associated syndrome: a within-group and cross-syndrome analysis. WebAll types of epilepsy can make children prone to behavior problems: Complex partial seizures, especially of early onsethyperactivity, problems in paying attention or Doran Z, Shankar R, Keezer MR, Dale C, McLean B, Kerr MP, Devapriam J, Craig J, Sander JW. Challenging behavior in adults with epilepsy and Epilepsy and Psychological Disorders | Epilepsy Foundation Clipboard, Search History, and several other advanced features are temporarily unavailable. using the Cochrane risk-of-bias toolReference Sterne, Savovi, Page, Elbers, Blencowe and Boutron33 and the quality of all 32 eligible studies was assessed during the data collection process using the SIGN 50 checklist.34, Publication bias was assessed using a funnel plot, and the studies included were assessed for consistency and precision. It manages how you talk to other people. Feature Flags: { official website and that any information you provide is encrypted Purpose: When different subgroups according to various epilepsy variables were compared for the rate of challenging behaviour no clear picture emerged. doi: 10.1192/bjo.2020.96. http://creativecommons.org/licenses/by/4.0/. We included a comprehensive Cochrane risk-of-bias table, which was not done by any of the previous systematic reviews. 2: The rate of behaviour disorders among a community-based population aged between 16 and 64 years, Prevalence and risk markers of behavior problems among adults with intellectual disabilities: a total population study in rebro County, Sweden, Research for people with intellectual disabilities and mental health problems: a view from the UK, Disruptive, impulse-control, and conduct disorders, Diagnostic Manual Intellectual Disability: A Textbook of Diagnosis of Mental Disorders in Persons with Intellectual Disability, A survey of aggressive behaviour among a population of persons with intellectual disability in Queensland, Textbook of Psychiatry for Intellectual Disability and Autism Spectrum Disorder, Epilepsy and challenging behaviour in adults with intellectual disability: a systematic review, Physical conditions and challenging behaviour in people with intellectual disability: a systematic review, A systematic review of neuropsychiatric comorbidities in patients with both epilepsy and intellectual disability, Guidance Notes for Registering a Systematic Review Protocol with PROSPERO, Centre for Reviews and Dissemination, University of York, Preferred reporting items for systematic review and meta-analysis protocols (PRISMA-P) 2015 statement, The use of medication to manage problem behaviours in adults with a learning disability: a national guideline, Cochrane Handbook for Systematic Reviews of Interventions Version 6.0 (Updated July 2019), The effectiveness of aripiprazole in the management of problem behaviour in people with intellectual disabilities, developmental disabilities and/or autistic spectrum disorder: a systematic review, The effectiveness of methylphenidate in the management of attention deficit hyperactivity disorder (ADHD) in people with intellectual disabilities: a systematic review, Efficacy of atypical antipsychotic medication in the management of behaviour problems in children with intellectual disabilities and borderline intelligence: a systematic review, Analysing data and undertaking meta-analyses, RoB 2: a revised tool for assessing risk of bias in randomised trials, Scottish Intercollegiate Guidelines Network, SIGN 50: A Guideline Developer's Handbook, AMSTAR 2: a critical appraisal tool for systematic reviews that include randomised or non-randomised studies of healthcare interventions, or both, Folate metabolism and problem behaviour in mentally handicapped epileptics, The mentally handicapped person with epilepsy: a comparative study investigating psychosocial functioning, The social and behavioural functioning of people with mental handicaps attending Adult Training Centres: a comparison of those with and without epilepsy, Epilepsy, dementia and adaptive behaviour in Down's syndrome, Mental disorder in adults with mental retardation and epilepsy, Seizure disorders in people with intellectual disability: an analysis of differences in social functioning, adaptive functioning and maladaptive behaviours, A preliminary report on the relationship between challenging behaviour and epilepsy in learning disability, A general practice-based prevalence study of epilepsy among adults with intellectual disabilities and of its association with psychiatric disorder, behaviour disturbance and carer stress, Psychopathology: differences among adults with intellectually disabled, comorbid autism spectrum disorders and epilepsy, Epilepsy and associated effects on adaptive behaviour in adults with Down syndrome, Psychopathology in people with epilepsy and intellectual disability; 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