The treatment of challenging behaviour in intellectual disabilities: cost-effectiveness analysis.

@article{Romeo2009TheTO,
  title={The treatment of challenging behaviour in intellectual disabilities: cost-effectiveness analysis.},
  author={Renee Romeo and Martin Knapp and Peter Tyrer and Mike J. Crawford and Patricia C Oliver-Africano},
  journal={Journal of intellectual disability research : JIDR},
  year={2009},
  volume={53 7},
  pages={
          633-43
        }
}
BACKGROUND Antipsychotic drugs are used in the routine treatment of adults with intellectual disabilities (ID) and challenging behaviour in the UK despite limited evidence of their effectiveness. There is no evidence on their cost-effectiveness. METHODS The relative cost-effectiveness of risperidone, haloperidol and placebo in treating individuals with an ID and challenging behaviour was compared from a societal perspective in a 26-week, double-blind, randomised controlled trial. Outcomes… 
A pilot randomised controlled trial of community-led ANtipsychotic Drug REduction for Adults with Learning Disabilities.
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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 and focused support and alternative interventions are required.
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TLDR
The baseline-adjusted cost difference at follow-up would result in a fairly immediate compensation for the excess costs of intervention, provided the difference is not a statistical artefact.
Treatment of Psychopathology in People with Intellectual and other Disabilities
  • P. Sturmey
  • Psychology, Medicine
    Canadian journal of psychiatry. Revue canadienne de psychiatrie
  • 2012
TLDR
Current research supports the use of ABA and other behavioural interventions for some forms of psychopathology, and evidence for the effectiveness of other interventions is limited or absent.
Nidotherapy compared with enhanced care programme approach training for adults with aggressive challenging behaviour and intellectual disability (NIDABID): cluster‐randomised controlled trial
TLDR
Nidotherapy shows promise in the management of aggressive challenging behaviour in care homes, but a delay in its benefit might be expected if given to staff only, and the treatment is worthy of further evaluation and development.
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Summary Applied behaviour analysis by a specialist team plus standard treatment for adults with intellectual disability displaying challenging behaviour was reported to be clinically and
Mental health and challenging behaviour: an overview of research and practice
TLDR
Several studies have highlighted common aetiological factors that are responsible for challenging behaviour and psychiatric disorders in people with intellectual disabilities, and although there is an overlap in the symptoms, both are thought to be different phenomena.
Service use and access in young children with an intellectual disability or global developmental delay: Associations with challenging behaviour
TLDR
Topography of challenging behaviour impacts on the frequency and/or duration (and therefore cost) of community-based health care accessed and Behaviours that have external impact are associated with a higher cost of services used.
Challenging behaviour in children with severe intellectual disabilities: identification and characteristics of those at high risk
TLDR
Theoretical underpinnings of challenging behaviour in this population are examined with emphasis on the interaction between child characteristics and environmental variables and the potential success of early intervention programmes for these children proposed.
Demographic and diagnostic profiles of older people with intellectual disability and prescription of antipsychotics
TLDR
The associations between prescription of antipsychotics and demographic factors and non-psychotic diagnoses, respectively, suggest that older people with ID may be prescribed antipsychotic medication without thorough psychiatric diagnosing.
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References

SHOWING 1-10 OF 20 REFERENCES
Antipsychotic medication for challenging behaviour in people with intellectual disability: a systematic review of randomized controlled trials.
TLDR
There is no evidence as to whether antipsychotic medication does or does not help adults with ID and challenging behaviour and good quality research is urgently needed.
The cost-effectiveness of mirtazapine versus paroxetine in treating people with depression in primary care
TLDR
The results suggest that mirtazapine may be a cost-effective treatment choice compared to paroxetine for depression in a primary care setting.
Reducing antipsychotic medication in people with a learning disability
TLDR
A substantial proportion of people with learning disability prescribed antipsychotic medications for behavioural purposes rather than for treating psychotic illness can have their drugs reduced or withdrawn.
Cost-effectiveness of first- v. second-generation antipsychotic drugs: results from a randomised controlled trial in schizophrenia responding poorly to previous therapy.
  • L. Davies, S. Lewis, H. Lloyd
  • Medicine, Psychology
    The British journal of psychiatry : the journal of mental science
  • 2007
TLDR
Conventional antipsychotics may be cost-saving and associated with a gain in QALYs compared with atypical antipsychotic drugs, according to the primary and sensitivity analyses.
Cost-effectiveness of second-generation antipsychotics and perphenazine in a randomized trial of treatment for chronic schizophrenia.
TLDR
Treatment with perphenazine was less costly than treatment with second-generation antipsychotics with no significant differences in measures of effectiveness, but the trial was limited by a high dropout rate, and longer-term neurological and metabolic side effects require further study.
Zuclopenthixol in adults with intellectual disabilities and aggressive behaviours: discontinuation study.
TLDR
The results indicate that discontinuation of zuclopenthixolin this population of patients with intellectual disabilities leads to an increase in aggressive behaviour.
Challenging behaviour in community services.
TLDR
There was consistency in the types of behaviour which were frequently identified across the three boroughs and the range and number of behaviours suggest that staff need to be very skilled in supporting such individuals, and that effective planning and support are essential if people with challenging behaviour are to be maintained in community settings.
The aberrant behavior checklist: a behavior rating scale for the assessment of treatment effects.
TLDR
The development of a scale to assess drug and other treatment effects on severely mentally retarded individuals was described and the results were compared with empirically derived rating scales of childhood psychopathology and with factor analytic work in the field of mental retardation.
Depression in the Italian community: epidemiology and socio-economic implications
TLDR
Evidence is provided for a higher frequency of under-recognition of depression as a medical illness in Italy compared to other European countries, while confirming the evidence from other countries on the small proportion of subjects with disabling symptoms who receive treatment, particularly specific treatment with antidepressants.
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