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Background: Psychotropics are overprescribed for adults with intellectual disabilities; there are few studies in children and young people.Aims: To investigate antipsychotic and antidepressant prescribing in children and young people with and without intellectual disabilities, and prescribing trends.Method: Scotland's annual Pupil Census, which identifies pupils with and without intellectual disabilities, was record-linked to the Prescribing Information System. Antidepressant and antipsychotic data were extracted. Logistic regression was used to analyse prescribing between 2010 and 2013.Results: Of the 704 297 pupils, 16 142 (2.29%) had a record of intellectual disabilities. Antipsychotic and antidepressant use increased over time, and was higher in older pupils; antipsychotic use was higher in boys, and antidepressant use was higher in girls. Overall, antipsychotics were prescribed to 281 (1.74%) pupils with intellectual disabilities and 802 (0.12%) without (adjusted odds ratio 16.85, 95% CI 15.29-18.56). The higher use among those with intellectual disabilities fell each year (adjusted odds ratio 20.19 in 2010 v. 14.24 in 2013). Overall, 191 (1.18%) pupils with intellectual disabilities and 4561 (0.66%) without were prescribed antidepressants (adjusted odds ratio 2.28, 95% CI 2.03-2.56). The difference decreased each year (adjusted odds ratio 3.10 in 2010 v. 2.02 in 2013).Conclusions: Significantly more pupils with intellectual disabilities are prescribed antipsychotics and antidepressants than are other pupils. Prescribing overall increased over time, but less so for pupils with intellectual disabilities; either they are not receiving the same treatment advances as other pupils, or possible overprescribing in the past is changing. More longitudinal data are required. [ABSTRACT FROM AUTHOR]

Background: Psychotic symptoms and psychotic disorders occur at increased rates in adults with intellectual disability, including borderline intellectual functioning, compared with the general population. Little is known about the development of such symptoms in this population.AimsTo examine whether clinical factors predictive of psychotic disorder in a familial study of schizophrenia also apply to those with intellectual disability.Method: Adolescents with special educational needs (SEN) were assessed with the Structured Interview for Schizotypy (SIS) and Childhood Behavioural Checklist (CBCL). These scores were used to prospectively divide participants based on their anticipated risk for psychotic disorder. A subsample were reassessed three times over 6 years, using the Positive and Negative Syndrome Scale (PANSS).Results: The SEN group were more symptomatic than controls throughout (Cohen's d range for PANSS subscale scores: 0.54-1.4, all P < 0.007). Over 6 years of follow-up, those above the SIS and CBCL cut-off values at baseline were more likely than those below to display morbid positive psychotic symptoms (odds ratio, 3.5; 95% CI 1.3-9.0) and develop psychotic disorder (odds ratio, 11.4; 95% CI 2.6-50.1). Baseline SIS and CBCL cut-off values predicted psychotic disorder with sensitivity of 0.67, specificity of 0.85, positive predictive value of 0.26 and negative predictive value of 0.97.Conclusions: Adolescents with SEN have increased psychotic and non-psychotic symptoms. The personality and behavioural features associated with later psychotic disorder in this group are similar to those in people with familial loading. Relatively simple screening measures may help identify those in this vulnerable group who do and do not require monitoring for psychotic symptoms.Declaration of interestNone. [ABSTRACT FROM AUTHOR]

Background: The levels and experiences of harassment of people with mental health problems in the community compared with those of the general population have not been explored.Aims: To measure the levels and experience of harassment experienced by people with mental health problems in the community in Scotland and compare them with the general population.Method: Experiences of harassment were collected by interviewing 165 individuals with mental health problems and a control group of 165 people from the general population.Results: Harassment in the community was found to be twice as common for individuals with mental health problems (41%) than for those in the general population (15%). The harassment commonly involved verbal abuse referring to the individual's mental health problems and was committed primarily by teenagers and neighbours.Conclusions: Harassment has a significantly higher prevalence among individuals with mental health problems living in the community and is believed to have a detrimental effect on mental health. [ABSTRACT FROM AUTHOR]

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One hundred randomly selected residents of a mental handicap hospital originating from Dundee were interviewed using a standardised assessment based on the modified Standardised Clinical Interview Schedule. Information on certain behavioural items and self-care skills was obtained from nursing staff and case records. An ICD-9 diagnosis could be made for 80 individuals, including diagnoses usually reserved for children. Thirty subjects were regarded as needing long-term psychiatric mental handicap hospital care. All but one of the remaining 70 subjects required a staffed residential placement and all but 15 some form of out-patient or short-term in-patient provision from specialist health services. The findings indicate a need for approximately 30 psychiatric mental handicap beds per 100,000 population. [ABSTRACT FROM AUTHOR]

A comparison has been made of costs within in-patient units in a large Scottish psychiatric hospital. Cost differences were found between short- stay, rehabilitation and long-stay psychosis units and beds for the elderly with mental disorder. These differences reflected staffing levels, particularly of nurses. The costs were greater than average for psychiatric hospitals and approximated to geriatric units-a finding in keeping with the high occupancy of beds by the elderly. Existing long-stay elderly patients require to be considered separately in distinguishing elderly in-patient costs without total psychogeriatric care offered by society. [ABSTRACT FROM AUTHOR]

This study attempted to assess the applicability of the Clinical Interview Schedule (Goldberg et al., 1970) to mentally handicapped patients in a hospital. Twenty-seven patients were rated simultaneously by three raters. Of the 31 items assessed for reliability, 11 were completely satisfactory, 8 were satisfactory, 6 unsatisfactory and 6 'not proven'. Ratings made by all raters for overall severity of psychiatric illness correlated significantly with similar ratings made by the consultants responsible for the patients. [ABSTRACT FROM AUTHOR]

Some conceptual problems in relation to the interaction of genetic influence and social disadvantagement are discussed, and some of the results of a study of 144 families with mentally handicapped children reported. The work of Heber and his associates in Milwaukee is briefly reviewed, and the Edinburgh data discussed in relation to the study in Aberdeen by Birch et al. (1970). Possible strategies for intervention are considered. [ABSTRACT FROM AUTHOR]

The article presents a study that gives an account on the patterns of admission among male schizophrenic patients admitted to Leverndale Hospital in Glasgow, Scotland in 1967-1970. The first admissions and readmissions of the schizophrenics to the hospital are identified from a Kalamazoo card index system. It is stated that 83% of the male patients admitted to the hospital are readmitted and thus suffering from relapsing or continuous illnesses. Moreover, follow-up of the first admissions show an approximately equal numbers concerning the three grades of clinical state living outside while smaller number are long term in-patients.

The Shetland Islands lie in the North Atlantic approximately equi-distant between Scotland, Norway and the Faroes. The earliest known colonizers came from the Mediterranean, but when the Vikings arrived (c. AD 800), there seem to have few or no human inhabitants. The descendants of the west Scandinavians who came to the islands in the early Viking movement still comprise the bulk of the human population, and form a series of isolates unique in the United Kingdom.The paper summarizes the available information on the origins and physical characteristics of the Shetlanders. Much of this is trivial, but in the absence of any other review we have brought together what is known. The only blood group data are ABO frequencies which are similar to those on the other North Atlantic islands (Orkney, Faroe and Iceland). The best estimates of relationship are based on comparisons of non-metrical skull variant frequencies which show that the nearest relatives of the Shetlanders are the inhabitants of Jaeren in southern Norway. The same conclusion comes from independent evidence of linguistic affinities.Shetland has the highest known prevalence of multiple sclerosis in the world, and possibly a high incidence of gastric ulceration. It also has a large number of standard Down's syndrome (trisomy-21) patients. These could be the result of the fathers' periodic absences at sea, resulting in their families being spread over a large span of years. Clearly there are interesting and possibly important morbidity and mortality factors operating in the population—which could give significant information about genetical factors in disease. Data on mental defect and psychiatric disease are also presented. [ABSTRACT FROM PUBLISHER]

The article discusses the study that examines the mental state of all persons accused of murder in Scotland between 1953 and 1964. It provides information on 59 male and 7 female offenders, diagnosed into 4 categories including 30 with no mental abnormality, 18 psychopathic personalities, 14 psychotics, and 4 mentally subnormal. It is found that they were charged in the West of Scotland with the murder of 70 people, and their motive was mostly anger. Moreover, the most common causes for the murder include alcoholic indulgence with 33, psychopathy with 22, and schizophrenia with 11.

The article discusses the changes in the character of admissions to the mental hospitals in Scotland from 1945 to 1959. The records of the 3,151 admissions to Dingleton Hospital from January 1945 to December 1959 were used as samples for examination. Results show that the annual number of admissions tripled, while the number of first admissions doubled. Meanwhile, the proportion of voluntary admissions has reached 80%. Also, the increase in admissions is attributed to all ages, while the proportion of admissions who were married increased to 50%.

The point-prevalence of tardive dyskinesia in schizophrenics from a discrete geographical area (Nithsdale, in Dumfries and Galloway Region) in 1981, 1982, and 1984 was 31%, 27%, and 30% respectively. This suggests that the prevalence of tardive dyskinesia in a community of schizophrenics has reached a plateau. In 12% of patients there was persistent dyskinesia, i.e. abnormal involuntary movements were present at all three assessments. Persistent dyskinesia was more common in older patients. The severity of tardive dyskinesia fluctuated between assessments in 41% of patients, indicating that it is only a transient feature in some cases. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article about the case rate for mental subnormality in the January 1968 issue.

Background: Personalisation in social care services has become a feature of the delivery of long-term care for disabled people in many developed welfare states. Aim: Scotland has used the devolution of health and social care powers to develop a personalisation scheme (known as 'Self-directed Support'). The authors apply a theoretical and empirical framework to understand the experience of contemporary disabled users of personalised services. Methods: The authors use a Scottish data set of six focus groups and a survey of 126 disabled people and family carers. Results: The data showed that flexible funding and the ability to provide services that cross agency boundaries were instrumental in moving towards equitable outcomes. Conclusions: Although there are clear policy and practice barriers to inter-agency working in personalised care services, the evidence suggests that it is worth investing in overcoming these barriers for disabled people and family carers. [ABSTRACT FROM AUTHOR]