Challenging Behavior and Psychiatric Symptoms among Adults with Intellectual Disability: Epidemiological Aspects and Family Burden

Background: Challenging behavior and psychiatric symptoms may be a major problem in adults with intellectual disability. Aims: The current study assessed the rate of challenging behavior among adults with intellectual disability and investigated the associated family burden. Subjects and methods: Two hundred and fifty adults with intellectual disability were recruited. The Structured Clinical Interview for Diagnosis of psychiatric disorders, according to DSM-IV criteria, Checklist of Challenging Behavior, Psychiatric Assessment Schedule for Adults with Developmental Disabilities and Wechsler Adult Intelligence Scale. Zarit caregiver Burden Interview was performed to assess the associated family burden. Results: One hundred and eighteen subjects (47%) had challenging behavior. Challenging behavior was significantly positively correlated with males (p 0.001) and negatively correlated with hearing impairment (p 0.001). Schizophrenia and urinary incontinence were significantly found in subjects with challenging behavior (p 0.01 and p 0.05 respectively). Ten items of Psychiatric Assessment Schedule were significantly higher among subjects with challenging behavior. Family burden of patients with challenging behavior were significantly higher in fourteen items of Zarit Caregiver Burden Interview. Conclusion: Challenging behavior was common among adults with intellectual disability. Psychiatric symptoms and the degree of family burden increased especially when associated with challenging behavior.