Reliability and validity of the Mini PAS‐ADD for assessing psychiatric disorders in adults with intellectual disability

Prosser, Helen; Moss, Steve; Costello, Helen; Simpson, Neill; Patel, Pradip; Rowe, S.

doi:10.1046/j.1365-2788.1998.00146.x

Cited by 162 publications

(115 citation statements)

References 6 publications

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“…Adult participants were interviewed using the Structured Clinical Interview for Axis I DSM-IV (SCID) 28 in 9 centers and the PAS-ADD clinical interview for adults 29 in one center (Cardiff). Psychiatric diagnoses were established, when appropriate, according to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV).…”

Section: Psychiatric Evaluationmentioning

confidence: 99%

Subthreshold Psychosis in 22q11.2 Deletion Syndrome: Multisite Naturalistic Study

Weisman

Guri

Gur

et al. 2017

Schizophrenia Bulletin

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Nearly one-third of individuals with 22q11.2 deletion syndrome (22q11.2DS) develop a psychotic disorder during life, most of them by early adulthood. Importantly, a fullblown psychotic episode is usually preceded by subthreshold symptoms. In the current study, 760 participants (aged 6-55 years) with a confirmed hemizygous 22q11.2 microdeletion have been recruited through 10 medical sites worldwide, as part of an international research consortium. Of them, 692 were nonpsychotic and with complete measurement data. Subthreshold psychotic symptoms were assessed using the Structured Interview for Prodromal Syndromes (SIPS). Nearly one-third of participants met criteria for positive subthreshold psychotic symptoms (32.8%), less than 1% qualified for acute positive subthreshold symptoms, and almost a quarter met criteria for negative/disorganized subthreshold symptoms (21.7%). Adolescents and young adults (13-25 years) showed the highest rates of subthreshold psychotic symptoms. Additionally, higher rates of anxiety disorders and attention deficit/hyperactivity disorder (ADHD) were found among the study participants with subthreshold psychotic symptoms compared to those without. Full-scale IQ, verbal IQ, and global functioning (GAF) scores were negatively associated with participants' subthreshold psychotic symptoms. This study represents the most comprehensive analysis reported to date on subthreshold psychosis in 22q11.2DS. Novel findings include age-related changes in subthreshold psychotic symptoms and evidence that cognitive deficits are associated with subthreshold psychosis in this population. Future studies should longitudinally follow these symptoms to detect whether and how early identification and treatment of these manifestations can improve long-term outcomes in those that eventually develop a psychotic disorder.

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Section: Psychiatric Evaluationmentioning

confidence: 99%

Subthreshold Psychosis in 22q11.2 Deletion Syndrome: Multisite Naturalistic Study

Weisman

Guri

Gur

et al. 2017

Schizophrenia Bulletin

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“…The more recent Psychiatric Assessment Schedule for Adults with a Developmental Disability (PAS-ADD; Moss et al, 1993b), developed by the Hester Adrian Research Centre, has been shown to have both reasonable reliability and validity (Costello et al, 1997;Moss et al, 1997Moss et al, , 1998Prosser et al, 1998). This makes it one of the most useful tools currently available for the identification and diagnosis of psychiatric disorder in adults with learning disability.…”

Section: The Pas-addmentioning

confidence: 99%

Epidemiology of mental health problems in adults with learning disability: an update

Smiley¹

2005

Adv. psychiatr. treat

141

100

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Epidemiological studies measuring prevalence rates and factors associated with mental health problems in adults with learning disability have produced very different and sometimes contradictory results, mainly because of methodological problems. Consequently, much of the epidemiology of mental health problems in this population is still unknown, although improved methodology and additional information are emerging. This article describes the methodological difficulties of studies, the reported prevalence rates in the context of these difficulties and what is currently known about the factors associated with mental health problems in this population.

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“…43 Current mental health status was assessed using the PAS-ADD interviews. 44 The data gathered were used to confirm inclusion and exclusion criteria. If required, clinical review was undertaken for those exceeding thresholds for the ABS (a score that converts to an estimated IQ of > 70 using the method described by Moss and Hogg…”

Section: Screening Measurementioning

confidence: 99%

A pilot randomised controlled trial of community-led ANtipsychotic Drug REduction for Adults with Learning Disabilities

McNamara

Randell

Gillespie

et al. 2017

Health Technol Assess

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Background Data suggest that approximately 50,000 adults with learning disabilities (LDs) in England and Wales are currently prescribed antipsychotic medication. Illness in this population is common, including significant rates of challenging behaviour and mental illness, but there is particular concern over the use of antipsychotics prescribed for reasons other than the treatment of psychosis. Control of challenging behaviour is the primary reason why such medications are prescribed despite the absence of good evidence for any therapeutic effect for this purpose. Objectives To assess the feasibility of recruitment and retention and to explore non-efficacy-based barriers to a blinded antipsychotic medication withdrawal programme for adults with LDs without psychosis compared with treatment as usual. A secondary objective was to compare trial arms regarding clinical outcomes. Design A two-arm individually randomised double-blind placebo-controlled drug reduction trial. Setting Recruitment was through community learning disability teams (CLDTs) in south Wales and south-west England. Participants Adults with LDs who are prescribed risperidone for treatment of challenging behaviour with no known current psychosis or previous recurrence of psychosis following prior drug reduction. Intervention A double-blind drug reduction programme leading to full withdrawal within 6 months. Treatment in the intervention group was gradually reduced over a 6-month period and then maintained at the same level for a further 3 months, still under blind conditions. In the control group, the baseline level of medication was maintained throughout the 9-month period. The blind was broken at 9 months, following final data collection. Main outcome measures Feasibility outcomes were (1) the number and proportion of general practices/CLDTs that progressed from initial approach to recruitment of participants and (2) the number and proportion of recruited participants who progressed through the various stages of the study. Trial arms were also compared regarding clinical outcomes, the Modified Overt Aggression Scale, the Aberrant Behaviour Checklist, the Psychiatric Assessment Schedule for Adults with Developmental Disability checklist, the Antipsychotic Side-effect Checklist, the Dyskinesia Identification System Condensed User Scale, the Client Service Receipt Inventory, use of other interventions to manage challenging behaviour, use of as-required (pro re nata) medication and level of psychotropic medication use. Results Of the 22 participants randomised (intervention, n = 11; control, n = 11), 13 (59%) achieved progression through all four stages of reduction. Follow-up data at 6 and 9 months were obtained for 17 participants (intervention, n = 10; and control, n = 7; 77% of those randomised). There were no clinically important changes in participants’ levels of aggression or challenging behaviour at the end of the study. There were no expedited safety reports. Four adverse events and one serious adverse event were reported during the trial. Limitations Recruitment was challenging, which was largely a result of difficulty in identifying appropriate persons to consent and carer concerns regarding re-emergence of challenging behaviour. Reduced recruitment meant that the full trial became an exploratory pilot study. Conclusions The results indicate that drug reduction is possible and safe. However, concerns about taking part were probably exacerbated by limited availability of alternative (behavioural) interventions to manage behaviour; therefore, focused support and alternative interventions are required. The results of the qualitative study provide important insights into the experiences of people taking part in drug reduction studies that should influence future trial development. Future work We recommend that further work focuses on support for practitioners, carers and patients in reducing antipsychotic medication. Trial registration Current Controlled Trials ISRCTN38126962. Funding This project was funded by the National Institute for Health Research (NIHR) Health Technology Assessment programme and will be published in full in Health Technology Assessment; Vol. 21, No. 47. See the NIHR Journals Library website for further project information.

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Reliability and validity of the Mini PAS‐ADD for assessing psychiatric disorders in adults with intellectual disability

Cited by 162 publications

References 6 publications

Subthreshold Psychosis in 22q11.2 Deletion Syndrome: Multisite Naturalistic Study

Subthreshold Psychosis in 22q11.2 Deletion Syndrome: Multisite Naturalistic Study

Epidemiology of mental health problems in adults with learning disability: an update

A pilot randomised controlled trial of community-led ANtipsychotic Drug REduction for Adults with Learning Disabilities

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