Geoff Marston - Academia.edu (original) (raw)

Papers by Geoff Marston

Research paper thumbnail of Caring for the Physical and Mental Health of People with Learning Disabilities

Journal of Applied Research in Intellectual Disabilities, 2011

Research paper thumbnail of Trainee attitudes within the Faculty of the Psychiatry of Learning Disability

Psychiatric Bulletin, 1999

Research paper thumbnail of Collegiate Trainees' Committee: guidance for trainees having interpersonal problems with their educational supervisor

Psychiatric Bulletin, 1999

Research paper thumbnail of People with intellectual disability, sensory impairments and behaviour disorder: a case series

Journal of Intellectual Disability Research, 2002

Background Sensory impairments (SIs) are more prevalent in people with intellectual disability (I... more Background Sensory impairments (SIs) are more prevalent in people with intellectual disability (ID). Both conditions lead to higher rates of emotional and behavioural problems than in the general population. The identification of psychiatric disorders in this group can be difficult, particularly in those with severe ID and limited communication skills. Method The present paper presents a series of  case reports of individuals with ID, SI and behavioural problems. Results The majority of cases were young male caucasians with congenital rubella syndrome and autistic spectrum disorder, referred because of selfinjurious behaviour (SIB) or aggression. Nine cases were treated with autidepressants, five underwent environmental changes and two had medication reduced. All showed some improvement. Conclusions The benefits of comprehensive assessments, the use of standardized assessment tools and trials of treatments are discussed in the context of making psychiatric diagnoses.

Research paper thumbnail of Trends in admissions to an intellectual disability hospital

Psychiatric Bulletin, 2009

Aims and MethodLong-term admission trends in a large specialist National Health Service (NHS) hos... more Aims and MethodLong-term admission trends in a large specialist National Health Service (NHS) hospital were examined over a 3-year period. These were compared with three earlier 3-year periods. the medical records were examined for admission numbers, source of admissions, length of stay, legal status, reason for admission and readmission rate.ResultsThe percentage of patients admitted from home decreased over time, whereas the admissions from group homes increased threefold. Long-stay admissions decreased in the second and third periods followed by an increase in the fourth period. There was a progressive increase in formal admissions and a decrease in informal ones. There was an increase in admissions of people with psychiatric illness and a decrease in admissions because of social difficulties. the percentage of first admissions gradually increased and the percentages of readmissions gradually decreased.Clinical ImplicationsPeople with intellectual disability are more likely to be...

Research paper thumbnail of Setting priorities for people with intellectual disability/intellectual developmental disorders across the lifespan: a call to action by the World Psychiatric Association

BJPsych International

People with DSM-5 intellectual disability/intellectual developmental disorder (ID/IDD) or ICD-11 ... more People with DSM-5 intellectual disability/intellectual developmental disorder (ID/IDD) or ICD-11 disorders of intellectual development (DID) have multiple healthcare needs, but in many countries these needs are neither recognised nor managed effectively. This paper discusses the negative impact that stigma, discrimination and social exclusion have on the identification and care of persons with ID/IDD in low- and middle-income countries (LMICs). It also reviews different models of care for children, adolescents and adults. In discussing some initiatives in LMICs the emphasis is on early diagnosis, with success in providing locally sourced care for affected people and their families. This is where the medical, social and rights-based models of care intersect and is a premise of the person-centred biopsychosocial framework of the World Psychiatric Association's Presidential Action Plan 2020–2023. The plan invites psychiatrists to take a lead in changing the culture of care, as well...

Research paper thumbnail of Trainee views on active problems and issues in UK psychiatry: Collegiate Trainees' Committee survey of three UK training regions

Psychiatric Bulletin

Aims and Method A questionnaire sent to trainees in three regions of the UK asked them which curr... more Aims and Method A questionnaire sent to trainees in three regions of the UK asked them which current issues they felt were most important in psychiatry. Comments were invited of ways to improve the UK practice of psychiatry. Results Trainees from each of the regions were concerned about inadequate resourcing, public expectations, manpower and quality of training. Solutions to these problems were collated. Clinical Implications The opinion of trainees reflects the recent initiatives undertaken by the Royal College of Psychiatrists to improve recruitment and retention. Consultants and trainees have similar concerns, which need to be addressed and monitored at a local and national level.

Research paper thumbnail of Development of a Multidisciplinary Care Pathway for a Specialist Learning Disability Inpatient Treatment and Assessment Unit

Journal of integrated Care Pathways

Research paper thumbnail of Manifestations of depression in people with intellectual disability

Jidr Journal of Intellectual Disability Research, Dec 1, 1997

The symptoms of 36 people with varying degrees of intellectual disability (ID) who had had an ICD... more The symptoms of 36 people with varying degrees of intellectual disability (ID) who had had an ICD-10 depressive syndrome in the preceding year were compared with 46 non-depressed people with comparable degrees of ID. Throughout the spectrum of ID, symptoms of depressed affect and sleep disturbance were significantly different between the groups. While symptoms in people with mild ID were reflected in the standard diagnostic criteria, this was not the case in people with moderate and severe ID. With increasing disability there was a move towards 'behavioural depressive equivalents' such as aggression, screaming and self-injurious behaviour. Diagnostic criteria for depression among people with severe ID, should place more emphasis on behavioural 'depressive equivalents'.

Research paper thumbnail of Forced marriage: implications for mental health and intellectual disability services

Advances in Psychiatric Treatment, 2013

SummaryThere has been growing media and political awareness of forced marriage in recent years, a... more SummaryThere has been growing media and political awareness of forced marriage in recent years, and individuals in England, Wales and Northern Ireland are now protected by the Forced Marriage (Civil Protection) Act 2007. Victims of forced marriage can experience significant abuse, which may lead to mental health problems. People with severe mental illness or intellectual disability may be at increased risk of forced marriage and more vulnerable to its negative consequences. We review the current literature on forced marriage, focusing on the way it might affect these two groups, touch on its potential mental health consequences and give practical examples of how to manage situations in clinical practice.

Research paper thumbnail of The Phenomenology of Depressive Illness in People with a Learning Disability and Autism

Autism, 2001

People with autism may develop new behaviours in adolescence or early adult life, in addition to ... more People with autism may develop new behaviours in adolescence or early adult life, in addition to those associated with the primary disorder. Some of these behaviours have been postulated to be symptoms of depressive disorder. This article notes the methodological problems of investigating depression in people with autism. The authors also attempt to clarify the symptoms that may be significant

Research paper thumbnail of Antipsychotic induced priapism in a man with an intellectual disability

Irish Journal of Psychological Medicine, 2001

Research paper thumbnail of Psychiatric assessment of HIV in a person with intellectual disability

Irish Journal of Psychological Medicine, 2007

Research paper thumbnail of Depressive symptoms in people with a learning disability

Research paper thumbnail of Risk assessment and the use of restrictive physical intervention in adults with a learning disability

Learning Disability Practice, 2006

Research paper thumbnail of Why Are People With Intellectual Disability Moved "Out-of-Area"?

Journal of Policy and Practice in Intellectual Disabilities, 2007

Some people with intellectual disabilities (ID) continue to be provided with accommodations that ... more Some people with intellectual disabilities (ID) continue to be provided with accommodations that are outside their local area, away from familiar people and places. Although studies have been scarce on this topic, there is evidence to suggest that this does not always provide the best outcome for individuals in terms of quality of life. The authors undertook a survey to look at the personal characteristics of 89 persons with ID originally from the city of Coventry in the UK, and now situated by local health or social services authorities in locations other than the immediate Coventry area. The authors found that the number of people being placed "out-of-area" is increasing; among them are persons with autistic spectrum disorder (particularly those transitioning into adulthood), those with a past history of behavior resulting in action by the criminal justice system, and those with a history of aggression toward others. There are concerns that the commissioning and provision of "out-of-area" services echo the dehumanizing institutionalization policies that dominated the first part of the 20th century, are lacking in coordination, and are proving to be more expensive than locally provided services.

Research paper thumbnail of Problem Behaviors Associated With 15q- Angelman Syndrome

American Journal on Mental Retardation, 2000

Caregivers of persons with Angelman syndrome completed the Aberrant Behavior Checklist and Reiss ... more Caregivers of persons with Angelman syndrome completed the Aberrant Behavior Checklist and Reiss Screen for Maladaptive Behavior. Seventy-three replies were received, and comparisons were made with other published data. Responses indicated that 15q- Angelman syndrome is associated with such problems as lack of speech, overactivity, restlessness, and eating and sleep problems. Episodes of inappropriate laughter were only reported for 57%, despite being considered a cardinal feature of the syndrome; eating problems (64%) and a fascination with water (68%) were reported more frequently. Overactivity was more of a problem for children; Aberrant Behavior Checklist Factor IV (Hyperactivity) was negatively correlated with age. Scores were mostly lower than for previously studied etiological groups. Therapeutic effort should be put into programs to address these problems.

Research paper thumbnail of Caring for the Physical and Mental Health of People with Learning Disabilities

Journal of Applied Research in Intellectual Disabilities, 2011

Research paper thumbnail of Caring for the Physical and Mental Health of People with Learning Disabilities

Journal of Applied Research in Intellectual Disabilities, 2011

Research paper thumbnail of Trainee attitudes within the Faculty of the Psychiatry of Learning Disability

Psychiatric Bulletin, 1999

Research paper thumbnail of Collegiate Trainees' Committee: guidance for trainees having interpersonal problems with their educational supervisor

Psychiatric Bulletin, 1999

Research paper thumbnail of People with intellectual disability, sensory impairments and behaviour disorder: a case series

Journal of Intellectual Disability Research, 2002

Background Sensory impairments (SIs) are more prevalent in people with intellectual disability (I... more Background Sensory impairments (SIs) are more prevalent in people with intellectual disability (ID). Both conditions lead to higher rates of emotional and behavioural problems than in the general population. The identification of psychiatric disorders in this group can be difficult, particularly in those with severe ID and limited communication skills. Method The present paper presents a series of  case reports of individuals with ID, SI and behavioural problems. Results The majority of cases were young male caucasians with congenital rubella syndrome and autistic spectrum disorder, referred because of selfinjurious behaviour (SIB) or aggression. Nine cases were treated with autidepressants, five underwent environmental changes and two had medication reduced. All showed some improvement. Conclusions The benefits of comprehensive assessments, the use of standardized assessment tools and trials of treatments are discussed in the context of making psychiatric diagnoses.

Research paper thumbnail of Trends in admissions to an intellectual disability hospital

Psychiatric Bulletin, 2009

Aims and MethodLong-term admission trends in a large specialist National Health Service (NHS) hos... more Aims and MethodLong-term admission trends in a large specialist National Health Service (NHS) hospital were examined over a 3-year period. These were compared with three earlier 3-year periods. the medical records were examined for admission numbers, source of admissions, length of stay, legal status, reason for admission and readmission rate.ResultsThe percentage of patients admitted from home decreased over time, whereas the admissions from group homes increased threefold. Long-stay admissions decreased in the second and third periods followed by an increase in the fourth period. There was a progressive increase in formal admissions and a decrease in informal ones. There was an increase in admissions of people with psychiatric illness and a decrease in admissions because of social difficulties. the percentage of first admissions gradually increased and the percentages of readmissions gradually decreased.Clinical ImplicationsPeople with intellectual disability are more likely to be...

Research paper thumbnail of Setting priorities for people with intellectual disability/intellectual developmental disorders across the lifespan: a call to action by the World Psychiatric Association

BJPsych International

People with DSM-5 intellectual disability/intellectual developmental disorder (ID/IDD) or ICD-11 ... more People with DSM-5 intellectual disability/intellectual developmental disorder (ID/IDD) or ICD-11 disorders of intellectual development (DID) have multiple healthcare needs, but in many countries these needs are neither recognised nor managed effectively. This paper discusses the negative impact that stigma, discrimination and social exclusion have on the identification and care of persons with ID/IDD in low- and middle-income countries (LMICs). It also reviews different models of care for children, adolescents and adults. In discussing some initiatives in LMICs the emphasis is on early diagnosis, with success in providing locally sourced care for affected people and their families. This is where the medical, social and rights-based models of care intersect and is a premise of the person-centred biopsychosocial framework of the World Psychiatric Association's Presidential Action Plan 2020–2023. The plan invites psychiatrists to take a lead in changing the culture of care, as well...

Research paper thumbnail of Trainee views on active problems and issues in UK psychiatry: Collegiate Trainees' Committee survey of three UK training regions

Psychiatric Bulletin

Aims and Method A questionnaire sent to trainees in three regions of the UK asked them which curr... more Aims and Method A questionnaire sent to trainees in three regions of the UK asked them which current issues they felt were most important in psychiatry. Comments were invited of ways to improve the UK practice of psychiatry. Results Trainees from each of the regions were concerned about inadequate resourcing, public expectations, manpower and quality of training. Solutions to these problems were collated. Clinical Implications The opinion of trainees reflects the recent initiatives undertaken by the Royal College of Psychiatrists to improve recruitment and retention. Consultants and trainees have similar concerns, which need to be addressed and monitored at a local and national level.

Research paper thumbnail of Development of a Multidisciplinary Care Pathway for a Specialist Learning Disability Inpatient Treatment and Assessment Unit

Journal of integrated Care Pathways

Research paper thumbnail of Manifestations of depression in people with intellectual disability

Jidr Journal of Intellectual Disability Research, Dec 1, 1997

The symptoms of 36 people with varying degrees of intellectual disability (ID) who had had an ICD... more The symptoms of 36 people with varying degrees of intellectual disability (ID) who had had an ICD-10 depressive syndrome in the preceding year were compared with 46 non-depressed people with comparable degrees of ID. Throughout the spectrum of ID, symptoms of depressed affect and sleep disturbance were significantly different between the groups. While symptoms in people with mild ID were reflected in the standard diagnostic criteria, this was not the case in people with moderate and severe ID. With increasing disability there was a move towards 'behavioural depressive equivalents' such as aggression, screaming and self-injurious behaviour. Diagnostic criteria for depression among people with severe ID, should place more emphasis on behavioural 'depressive equivalents'.

Research paper thumbnail of Forced marriage: implications for mental health and intellectual disability services

Advances in Psychiatric Treatment, 2013

SummaryThere has been growing media and political awareness of forced marriage in recent years, a... more SummaryThere has been growing media and political awareness of forced marriage in recent years, and individuals in England, Wales and Northern Ireland are now protected by the Forced Marriage (Civil Protection) Act 2007. Victims of forced marriage can experience significant abuse, which may lead to mental health problems. People with severe mental illness or intellectual disability may be at increased risk of forced marriage and more vulnerable to its negative consequences. We review the current literature on forced marriage, focusing on the way it might affect these two groups, touch on its potential mental health consequences and give practical examples of how to manage situations in clinical practice.

Research paper thumbnail of The Phenomenology of Depressive Illness in People with a Learning Disability and Autism

Autism, 2001

People with autism may develop new behaviours in adolescence or early adult life, in addition to ... more People with autism may develop new behaviours in adolescence or early adult life, in addition to those associated with the primary disorder. Some of these behaviours have been postulated to be symptoms of depressive disorder. This article notes the methodological problems of investigating depression in people with autism. The authors also attempt to clarify the symptoms that may be significant

Research paper thumbnail of Antipsychotic induced priapism in a man with an intellectual disability

Irish Journal of Psychological Medicine, 2001

Research paper thumbnail of Psychiatric assessment of HIV in a person with intellectual disability

Irish Journal of Psychological Medicine, 2007

Research paper thumbnail of Depressive symptoms in people with a learning disability

Research paper thumbnail of Risk assessment and the use of restrictive physical intervention in adults with a learning disability

Learning Disability Practice, 2006

Research paper thumbnail of Why Are People With Intellectual Disability Moved "Out-of-Area"?

Journal of Policy and Practice in Intellectual Disabilities, 2007

Some people with intellectual disabilities (ID) continue to be provided with accommodations that ... more Some people with intellectual disabilities (ID) continue to be provided with accommodations that are outside their local area, away from familiar people and places. Although studies have been scarce on this topic, there is evidence to suggest that this does not always provide the best outcome for individuals in terms of quality of life. The authors undertook a survey to look at the personal characteristics of 89 persons with ID originally from the city of Coventry in the UK, and now situated by local health or social services authorities in locations other than the immediate Coventry area. The authors found that the number of people being placed "out-of-area" is increasing; among them are persons with autistic spectrum disorder (particularly those transitioning into adulthood), those with a past history of behavior resulting in action by the criminal justice system, and those with a history of aggression toward others. There are concerns that the commissioning and provision of "out-of-area" services echo the dehumanizing institutionalization policies that dominated the first part of the 20th century, are lacking in coordination, and are proving to be more expensive than locally provided services.

Research paper thumbnail of Problem Behaviors Associated With 15q- Angelman Syndrome

American Journal on Mental Retardation, 2000

Caregivers of persons with Angelman syndrome completed the Aberrant Behavior Checklist and Reiss ... more Caregivers of persons with Angelman syndrome completed the Aberrant Behavior Checklist and Reiss Screen for Maladaptive Behavior. Seventy-three replies were received, and comparisons were made with other published data. Responses indicated that 15q- Angelman syndrome is associated with such problems as lack of speech, overactivity, restlessness, and eating and sleep problems. Episodes of inappropriate laughter were only reported for 57%, despite being considered a cardinal feature of the syndrome; eating problems (64%) and a fascination with water (68%) were reported more frequently. Overactivity was more of a problem for children; Aberrant Behavior Checklist Factor IV (Hyperactivity) was negatively correlated with age. Scores were mostly lower than for previously studied etiological groups. Therapeutic effort should be put into programs to address these problems.

Research paper thumbnail of Caring for the Physical and Mental Health of People with Learning Disabilities

Journal of Applied Research in Intellectual Disabilities, 2011