European Psychiatry - Volume 41 - April 2017

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25th European Congress of Psychiatry / European Psychiatry 41S (2017) S106–S169 S161
EW0166
Behavioural equivalents as predictors
of psychiatric disorder in people with
intellectual disability
M. Rossi ∗, D. scuticchio , M.O. bertelli
Fondazione San Sebastiano, Misericordia di Firenze, Firenze, Italy
∗ Corresponding author.
Introduction The last decades’ considerable advances of the psy-
chiatric assessment in People with Intellectual Disability (PwID) do
not include the ability to identify Behavioural Equivalents (BE) of
psychiatric symptoms and their relationship with different psychi-
atric syndromes. Recent reports have found BE to be differentially
associated with one or more specific Psychiatric Disorders (PD).
Aims The present study was aimed at evaluating the correlations
between BE and DSM-5 syndromic groups of symptoms, in a wide
multicentric sample of PwID.
Methods An observational cross-sectional analysis was per-
formed for a sample of 843 adults with ID, randomly or
consecutively recruited among those living in residential facilities
of the National Healthcare System, or in private institutes of care, or
those attending psychiatric outpatient clinics. The total sample was
administered with the SPAID-G (Psychiatric Instrument for Intel-
lectual Disabled Adult - General version), which is a checklist for
the detection of significant behavioural changes from the baseline.
The items of the checklist represents BE of the symptoms of the
main psychiatric disorders included in the DSM-5.
Results Many significant correlations were found, some of the
most relevant were for mood disorders. Psychomotor agitation,
aggressivity, disorganised behaviour and distractibility were most
pronounced in bipolar patients; for depressed patients, irritability
and weight loss had higher correlations than in other diagnostic
groups.
Conclusions Although not diagnostically specific, some BE seem
to be more strongly related with specific PD. This line of research
could improve the definition of the specific expression and cluster-
ing of psychiatric symptoms in PwID.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW0167
Perceptions of residents and
non-residents in psychiatry on
training needs and care of patients
with intellectual disability and mental
health problems: A study from
Singapore
S. Sajith ∗, W. Wong , J. Chiu , P.C. Chiam
1 Institute of Mental Health, General Psychiatry, Singapore, Singapore
2 Institute of Mental Health, Community Psychiatry, Singapore,
Singapore
3 Institute of Mental Health, Geriatric Psychiatry, Singapore,
Singapore
∗ Corresponding author.
Background and Objective Psychiatric assessment and care of
people with Intellectual Disability (ID) is complex due to their
cognitive and communication impairments. Demand for further
training in this area by trainees in psychiatry has been well docu-
mented. Themain of aims of this studywere to explore the attitudes
and perceptions of psychiatry residents and non-residents (non-
trainees) with regards to care of patients with ID as well as their
knowledge and training in this area.
Method The study was conducted as an anonymous survey at the
Institute ofMental Health, Singapore. A survey questionnaire devel-
oped by the study team was sent to residents and non-residents in
psychiatry.
Results Forty-eight out of the 76 questionnaires were returned
with a response rate of 63.16%. Twenty-eight participants described
themselves as non-residents and the rest were residents. All par-
ticipants responded that postgraduate training was required in
the area of ID and mental health and majority reported that
available training was inadequate. Ninety percent of respondents
believed that people with ID were vulnerable to exploitation
by other patients in the inpatient unit and 94% of respondents
believed that people with ID should be managed by a specialist
team.
Conclusion Currently residents and non-residents in psychiatry
see that training in ID and mental health as well as services for
people with ID as inadequate. Efforts should be made to include
specialist training in psychiatry of ID in the Singapore psychiatry
curriculumto enhance the confidence and expertise of psychiatrists
in this field.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EW0168
Does a bespoke intellectual disability
(ID) epilepsy service reduce mortality?
A 11 year study of sudden unexpected
death in epilepsy (SUDEP) in Cornwall
UK
R. Shankar
Cornwall Foundation NHS Trust, ID neuropsychiatry, Truro, United
Kingdom
Aim Epilepsy is the second most common cause of premorbid
mortality in the ID population. Rates of SUDEP are considered up
to 9 times higher in the ID population. Cornwall UK (population
600.000 i.e. 1% of UK) runs a specialist ID epilepsy community
service for adults with ID. It delivers reasonable adjustments
and person centered care to this population. We measured how
service outcomes on SUDEP compared to regional and national
averages.
Methods Data of all Cornwall epilepsy deaths 2004–2015 using
the Cornwall Coroner’s database and the Public Health Cornwall
was reviewed systemically. We identified patients with and with-
out ID.
Results Therewere 113 epilepsy deaths of which 57were SUDEPs
of which 3 were identified to have a clinical diagnosis of ID.
In another 2 cases it was not evident if they had an ID or not.
None of the 5 was known to the ID Epilepsy service. Mean
and 95% confidence intervals were calculated using a binomial
calculation, making no prior assumptions about the population
distribution.
Conclusion Cornwall’s specialist ID epilepsy service is a rarity in
the UK. A recent study using the Leicestershire ID Register revealed
26 people with ID of the total deaths of 83 SUDEP. This contrasts
greatly with Cornwall only 5.26% of SUDEP deaths had ID compared
to 23.4% in Leicestershire and similarly when compared to neigh-
boring Plymouth (population 300.000) which had 26% ID deaths
in its SUDEPs between 2004–2012. It is possible that having an ID
dedicated epilepsy service saves lives.
Disclosure of interest The author has not supplied his/her decla-
ration of competing interest.