European Psychiatry - Volume 33 - March 2016

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S590 24th European Congress of Psychiatry / European Psychiatry 33S (2016) S349–S805
EV750
Challenging behaviour in people with
intellectual disabilities: The
assessment and intervention team
K. Courtenay ∗, S. Jaydeokar
1 UCL, Department Mental Health Sciences, London, United Kingdom
2 Barnet Enfield Haringey Mental Health NHS Trust, Intellectual
Disabilities, London, United Kingdom
∗ Corresponding author.
Objectives People with intellectual disabilities (ID) present with
behaviours that challenge community services. Community mod-
els of care as alternatives to hospital care exist but are often
vary in their function. Certain strategies have been developed to
manage challenging behaviour in peoplewith ID. Data froma three-
year period on a community-based service for people with ID and
challenging behaviour that uses an objective, multi-disciplinary
approach is presented.
Methods A case note survey of adultswith IDunder the care of the
Assessment and Intervention Team (AIT), a challenging behaviour
service in the London Borough of Haringey.
Results Over the three-year period, 65 adults were managed by
AIT. Forty-four were male and 21 were female. The age range was
21–64 years of age. The level of ID was mild ID 61%, moderate
39%. Diagnoses included psychotic disorder (25%); mood disorder
(20%); developmental disorder (40%); dementia (10%); challenging
behaviour (45%). Six people (11%) were admitted to hospital during
their time with AIT. The length of care under AIT ranged from four
to fourteen months.
Conclusions AIT managed effectively people with ID living in the
community who presented with complex problems putting their
placement at risk. The rate of hospital admissionwas reduced in this
period compared with the previous three years. The length of stay
in in-patient services was reduced. The most common reasons for
the behaviours includedmental illness and ‘challenging behaviour’.
People with developmental disorders were a large proportion.
Community alternatives are effective with positive benefits to the
person.
Disclosure of interest The authors have not supplied their decla-
ration of competing interest.
EV751
Evaluation of DBT manual adapted for
people with intellectual and
developmental disabilities (IDD): First
results
S. Elstner
Ev. Krankenhaus Königin Elisabeth Herzberge, Psychiatry,
Psychotherapy and Psychosomatics, Berlin, Germany
Introduction In contrast to psychopharmacological treatment,
the current evidence base in psychotherapy for people with IDD
is limited. But psychotherapeutic approaches offer an alternative
treatment modality in people with IDD.
Objectives Orientated on the “Dialectic-Behaviour-Therapy” con-
cept, we developed an adapted manual for people with IDD and
impulsive behaviour.
Aims This study presents the first results of an evaluation our
adapted DBT manual.
Methods Three closed groups with 11 patients in total were
prospectively included in a six-week in-patient psychotherapeu-
tic DBT-programme. There was no randomisation or control group.
Typical borderline symptoms (BS) were recorded using the “Bor-
derline Symptom List” (BSL) and a short screening version for
personality disorders (PSS-K). Impulsivity and behaviour in gen-
eral were observed with the scale for impulsiveness and emotional
deregulation (IES) and the German Developmental Behavioural
Checklist (VFE). Special tendencies to self-harm were assessed
using the scale for self-harm behaviour (IEFAS). From these scales,
the means were observed during the course of our hospital therapy
program over 6 weeks.
Results There were 19 patients in total in 3 different groups.
Eight dropped out for a variety of reasons. The mean scores for the
remaining 11 patients in the BSL and PSS-K reduced significantly.
The scores for impulsivity and self-harm improved. Overall, there
was no significant change in behaviour.
Conclusion This study presents the results of a trial of a DBTman-
ual for people with IDD and BS. In general the BS declined, the
impulsivity improved. The study is limited by the small numbers
in the patient sample and the absence of a control group.
Disclosure of interest The author has not supplied his/her decla-
ration of competing interest.
EV752
Psychotherapy for ADHD in people
with IDD
S. Elstner
Ev. Krankenhaus Königin Elisabeth Herzberge, Psychiatry,
Psychotherapy and Psychosomatics, Berlin, Germany
Introduction Psychopharmacology and psychotherapy in chil-
dren with ADHD is still well established and has been studied
for many years. There has been a growing interest in treat-
ment of ADHD in adults for some years. Whereas meanwhile the
psychopharmacological treatment is well studied, the psychother-
apeutic interventions are still to optimize.
Objective Since the acceptance of the diagnosis of “ADHD” in
adults, there has been a growing interest in using medication as
the first-line therapy. There is an established evidence base for psy-
chopharmacological treatment in ADHD. The current therapeutic
recommendations for the general population apply to people with
ADHD and IDD. The study is a review of psychotherapeutic inter-
ventions in the treatment of ADHD in adults with and without IDD
supported by a case study.
Methods A literature search was conducted in “Pubmed” and
“PsycInfo” using the keywords “Psychotherapy”, “ADHD”, “Adults”
and further “Psychotherapy”, “ADHD”, “Adults”, “intellectual”, “dis-
abilities”. Exclusion criterion was ADHD as a sub-syndrome in the
presence of other syndromes.
Results Only 2–3 publications on psychotherapy in adults with
ADHD were found. Very little was found on people with IDD, and
these were especially combined with the Fragile X Syndrome.
Conclusion Psychotherapy in adults with ADHD is not yet well
elaborated in the scientific literature. There are some com-
mon used intervention strategies like psycho-education, cognitive
behavioural therapy, and attention focusing interventions such
as mindfulness-strategies. Using the principles of Easy-to-Read
language and modifying the general therapeutic settings as rec-
ommended by NICE, an adaptation of these interventions in the
treatment of adults with ADHD and IDD has potential.
Disclosure of interest The author has not supplied his/her decla-
ration of competing interest.
EV753
Think fast, treat faster – a case of a
treatable rapidly progressive
dementia
V. Espirito Santo ∗, A.R. Figueiredo , R. Almendra , A. Almeida ,
P. Guimaraes , A.G. Velon
1 Centro Hospitalar Trás-os-Montes e Alto Douro, Servic¸ o de
Neurologia, Vila Real, Portugal