Challenging behaviour, epilepsy and intellectual disability: A secondary analysis of findings from a randomised controlled trial

Abstract

ABSTRACT Background: As both epilepsy and challenging behaviour are highly prevalent in adults with intellectual disability (ID) it is important to explore any potential relationships between the two to inform patient care. The aim of the present study was to investigate the relationship between epilepsy factors and challenging behaviour in adults with ID. Method: The sample was drawn from a clinical trial cohort (n = 246), with all participants displaying challenging behaviour across the range of ID. We described sociodemographic and clinical status (seizure types, seizure frequency and drug burden) in 70 participants with epilepsy (EP). We investigated differences in and predictors of challenging behaviour and mental ill-health, measured by the Aberrant Behaviour Checklist-Community and the Mini Psychiatric Assessment Schedule for Adults with Developmental Disabilities respectively, between participants with and without epilepsy (NEP). Results: More male participants were identified with epilepsy (EP = 76% and NEP = 61%, p = .026) and the EP group had lower adaptive behaviour scores than their NEP counterparts (Mean (SD) EP = 44.4 (24.1), NEP = 51.7 (25.0), p = .04). EP participants showed significantly less lethargy as measured by the Aberrant Behaviour Checklist-Community than NEP participants (Mean (SD) EP = 11.9 (7.4) and NEP = 15.1 (9.9); t-test p = .02). Younger age and poorer adaptive functioning were associated with challenging behaviour (beta=−.520, p < .001 and beta=−0.30, p < .001, respectively). Conclusions: These findings indicate that epilepsy does not appear to be associated with challenging behaviour in adults with ID. Therefore, while management of epilepsy is very important in a clinical context, it is essential that professionals should further elucidate reasons for the presentation of such behaviours in order to provide timely and targeted interventions.