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25th European Congress of Psychiatry / European Psychiatry 41S (2017) S106–S169



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.


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).


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.


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.


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



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.


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


S. Sajith

1 ,

, W. Wong


, J. Chiu


, P.C. Chiam



Institute of Mental Health, General Psychiatry, Singapore, Singapore


Institute of Mental Health, Community Psychiatry, Singapore,



Institute of Mental Health, Geriatric Psychiatry, 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.


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



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



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.


Does a bespoke intellectual disability

(ID) epilepsy service reduce mortality?

A 11 year study of sudden unexpected

death in epilepsy (SUDEP) in Cornwall


R. Shankar

Cornwall Foundation NHS Trust, ID neuropsychiatry, Truro, United



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



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.


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



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.