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In this paper, we present guidelines for researchers working with individuals with mild intellectual disability (MID) based on the challenges and learnings from our University of Wollongong (UOW) Community Engagement Grant (2010) project where we collaborated with representatives from the Disability Sector, Cancer Council NSW and the vulnerable community of people with MID to overcome the difficulties that they face in interpreting mainstream cancer prevention messaging and take ownership of their skin cancer checking behaviour by using co-created resources that could be easily understood and acted upon by the target audience. As a result of our project, nearly 20% of our vulnerable population sample (employees of Greenacres, a disability employment provider) checked themselves for skin cancer spots for the first time after having been given a "What's that Spot?" book and accompanying resources (bathroom mirror stickers, hand held mirrors). The successful uptake can be directly attributed to the researchers putting aside their assumptions and overcoming the biases (conscious and unconscious) from their academic training to partner with the target population in a respectful manner and genuinely embrace the concept of inclusive research, ensuring that this overlooked and vulnerable group are afforded cancer prevention resources that work for them. This inclusive approach is evidenced by the co-creation of our "thumbs up scale" to overcome the limitations of traditional Likert scale use for our target population. Further, the generation of "trust" between researchers, participants and necessary carers should be at the forefront of all research methodology designs for those wishing to conduct research with members of the MID community. [ABSTRACT FROM AUTHOR]

Information and Communication Technology (ICT) tools and Assistive Technologies (AT) can support people with Down Syndrome (PDS) and Intellectual Disabilities (PID) in increasing their self-confidence and independence, enhancing skills, and competences, participating in leisure activities. For families of PDS/PID, professionals, non-formal caregivers and volunteers, the challenge is to appreciate the benefits of ICT Tools in promoting inclusion. The aim of this study is to present the interdisciplinary and multidimensional scope of the DS Leisure project aiming at promoting the inclusion of PDS/PID through innovative ICT tools and their participation in inclusive leisure activities. Particularly, 24 individuals were asked to assess the global satisfaction and performance of PDS/PID, as well as the exploitation of ICT tools. Findings suggested that PDS/PID specific social, decision-making, and communication skills were significantly improved after their participation in the Experiential Activity and the e-Training platform was positively rated and considered a constructive learning experience. [ABSTRACT FROM AUTHOR]

Objectives: Relatively little is known about how health-care utilization differs among individuals with psychological distress compared to those with major depressive disorder (MDD).Methods: Ontario participants of the Canadian Community Health Survey Cycle 1.2 (2002) were linked to health administrative data to follow their health-care utilization patterns for up to 15 years. Based on their survey responses, we classified individuals hierarchically into Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, criteria MDD, psychological distress (Kessler-6: 8 to 24), or an unexposed group with neither condition. We compared the rates of outpatient and acute care mental and nonmental health-related visits across the 3 groups over time using Poisson regression.Results: Among the 430 individuals with MDD, 668 with psychological distress, and 9,089 in the unexposed group, individuals with MDD and psychological distress had higher rates of health-care utilization than the unexposed overall and across time. The rates of psychiatrist visits for the MDD group were significantly higher than the other groups initially but declined over the follow-up. Conversely, the rates of psychiatrist visits among the psychological distress group increased over time and converged with that of the MDD group by the end of follow-up (rate ratioMDD vs. psychological distress at 1 year: 4.20 [1.97 to 11.40]; at 15 years: 1.53 [0.54 to 4.08]). Acute care visits were similar between the MDD and psychological distress groups at all time points.Conclusions: Individuals with psychological distress required mental health care rivalling that of individuals with MDD over time, suggesting that even a cross-sectional assessment of significant psychological distress is a serious clinical concern. [ABSTRACT FROM AUTHOR]

The identification and representation of Persons with Disabilities (PwDs) has been a contentious issue due to the lack of methodological standardization. This study scrutinizes the methodological innovation made by the Indian state of Kerala for identifying PwDs in its special census on disability in 2015. The study used disability data from the 15th Census of India and the Disability Census (DC) of Kerala and used descriptive statistics to compare the two on demographic, health, social, and economic dimensions. The prevalence of disability in Kerala was found to be around 2.2% in both the censuses. However, between the two data sources, the share of different disabilities varied from 1% in the case of mental retardation to as much as 10% in the case of locomotor disability. Robust data collection in two stages by trained health professionals, incorporation of detailed categories of disabling conditions, and inclusion of a large number of dimensions in DC made it an effective survey. It is important to improve the identification of PwDs to properly address their unique needs and promote an inclusive development. Defining ''mental retardation'' to capture disability can be derogatory to many; however, disability in mental health has been defined as ''mental retardation'' and ''mental illness'' in the 15th round of the Census of India. As a result, these are the terms that will be used throughout the article. [ABSTRACT FROM AUTHOR]

The article discusses a community-based participatory research (CBPR) study on sexual health practices among lesbian, gay, bisexual, trans, queer, and questioning (LGBTQ) young people with intellectual disabilities in Toronto. Managing the risk of coercion, consent to participate in the study, and issues of confidentiality were identified as some of the ethical concerns. It was noted that incorporating disability perspectives into CBPR practices can promote sexual health initiatives.

Objective: Mental health issues in late life are a growing public health challenge as the population aged 65 and older rapidly increases worldwide. An updated understanding of the causes of mood disorders and their consequences in late life could guide interventions for this underrecognized and undertreated problem. We undertook a population-based analysis to quantify the prevalence of mood disorders in late life in Ontario, Canada, and to identify potential risk factors and consequences.Method: Individuals aged 65 or older participating in 4 cycles of a nationally representative survey were included. Self-report of a diagnosed mood disorder was used as the outcome measure. Using linked administrative data, we quantified associations between mood disorder and potential risk factors such as demographic/socioeconomic factors, substance use, and comorbidity. We also determined associations between mood disorders and 5-year outcomes including health service utilization and mortality.Results: The prevalence of mood disorders was 6.1% (4.9% among males, 7.1% among females). Statistically significant associations with mood disorders included younger age, female sex, food insecurity, chronic opioid use, smoking, and morbidity. Individuals with mood disorders had increased odds of all consequences examined, including placement in long-term care (adjusted odds ratio [OR] =2.28; 95% confidence interval [CI], 1.71 to 3.02) and death (adjusted OR = 1.35; 95% CI, 1.13 to 1.63).Conclusions: Mood disorders in late life were strongly correlated with demographic and social/behavioral factors, health care use, institutionalization, and mortality. Understanding these relationships provides a basis for potential interventions to reduce the occurrence of mood disorders in late life and their consequences. [ABSTRACT FROM AUTHOR]

A university setting offers a unique opportunity to address physical activity for individuals with disabilities. The purpose of this case series was to highlight the development of a formal student-assisted exercise program and examine its impact on the perceived quality of life, exercise confidence, and functional mobility of college-aged individuals with intellectual and physical disabilities. Data from twelve participants was analyzed. Seven participants demonstrated an improvement in scores on the Self-Efficacy to Exercise scale and eight improved in functional measures associated with strength. Thus, a collaborative assisted exercise program in a university setting may positively impact health and physical activity, and exercise participation in young adults with physical and/or intellectual disabilities. [ABSTRACT FROM AUTHOR]

Background & aims: Echolalia, the repetition of one's or others' utterances, is a behavior present in typical development, autism spectrum disorder, aphasias, Tourette's, and other clinical groups. Despite the broad range of conditions in which echolalia can occur, it is considered primarily through a disorder-specific lens, which limits a full understanding of the behavior. Method: Empirical and review papers on echolalia across disciplines and etiologies were considered for this narrative review. Literatures were condensed into three primary sections, including echolalia presentations, neural mechanisms, and treatment approaches. Main contribution: Echolalia, commonly observed in autism and other developmental conditions, is assessed, observed, and treated in a siloed fashion, which reduces our collective knowledge of this communication difference. Echolalia should be considered as a developmental, transdiagnostic, and communicative phenomenon. Echolalia is commonly considered as a communicative behavior, but little is known about its neural etiologies or efficacious treatments. Conclusions: This review is the first to synthesize echolalia from a transdiagnostic perspective, which allows for the direct comparisons across and within clinical groups to inform assessment, treatment, conceptualization, and research recommendations. Implications: Considering echolalia transdiagnostically highlights the lack of consensus on operationalization and measurement across and within disorders. Clinical and research future directions need to prioritize consistent definitions of echolalia, which can be used to derive accurate prevalence estimates. Echolalia should be considered as a communication strategy, used similarly across developmental and clinical groups, with recommended strategies of shaping to increase its effectiveness. [ABSTRACT FROM AUTHOR]

The article discusses research on the underlying meaning of the term irremediability when used in the context of metal disorders. It references to a study by S. van Veen and colleagues in the 2020 issue of the "Canadian Journal of Psychology". It examines different issues emerging from this challenge such as the possible effect of medical assistance in dying (MAiD) on people's hope of assessing irremediability and the uncertainty with forecasting a patient condition's irremediability.

Down syndrome is the most common genetically mediated intellectual disability. Although many physiologic and pathologic features of Down syndrome are discussed at length in the literature, the ocular manifestations of Down syndrome have seldom been discussed in a comprehensive fashion. Given that Down syndrome has ocular manifestations from the front to the back of the eye, it is important for physicians to become familiar with these manifestations, especially given the prevalence of Down syndrome. This review aims to discuss the varied ophthalmologic manifestations of Down syndrome – including strabismus, amblyopia, nystagmus, accommodation deficits, nasolacrimal duct obstruction, keratoconus, optic nerve pathology, neoplastic disease, and retinal pathology – to facilitate better care and visual outcomes in this important patient population. [ABSTRACT FROM AUTHOR]

Background and aims: Previous studies suggest that syntactic development in children with intellectual disabilities (ID) is positively correlated with verbal short-term memory (VSTM). This study investigated the characteristics of syntactic development and their relationships of VSTM in children with ID based on type. Methods: The participants were children with ID (N = 34), including 14 children with autism spectrum disorders (ASD), 20 with Down syndrome (DS), with chronological ages from 8 years 10 months to 18 years 4 months and nonverbal mental ages (MA) of over 4 years, and typically developing (TD) children (N = 21) with chronological ages from 5 years 0 months to 5 years 10 months. They were assessed using VSTM, syntactic comprehension, and expression tasks. Results: The results showed that both the ASD and DS groups performed significantly lower on the syntactic comprehension task and the syntactic expression task than the TD group with the same nonverbal MA in the complex aspect of grammatical structure. In the VSTM task, the ASD group showed significantly lower performance in sentence and story repetition tasks than the TD group of the same nonverbal MA. The DS group showed significantly lower performance in forward digit span, and word, nonword, sentence, and story repetition tasks than the TD group of the same nonverbal MA. Conclusions: These results suggest that children with ASD have difficulty in understanding and remembering linguistic information with complex semantic structures, and children with DS have a small capacity for VSTM, affecting their syntactic development. [ABSTRACT FROM AUTHOR]

Background and aims: A high rate of children in mental health services have poor language skills, but little evidence exists on how mental health support is delivered to and received by children with language needs. This study looked at parental experiences, asking parents of children with speech, language and communication needs (SLCN) about their experiences seeking help for their children's mental health. We were particularly interested on the experiences of parents of children with Developmental Language Disorder (DLD), a specific SLCN that remains relatively unknown to the general public. Methods: We conducted an online survey of 74 parents of children with speech, language and communication needs (SLCN). Survey respondents included parents of children with a range of difficulties, including DLD, autism, verbal dyspraxia, global intellectual delay, a history of hearing problems, and SLCN without a primary diagnosis. Survey respondents were asked what sources of support they had accessed for their child's mental health and to provide comments on what was good and what was not good about this support. We then conducted 9 semi-structured interviews of parents of children with DLD about their experiences. These were parents of children with DLD aged 7 to 17 years, from across a range of educational settings, and with a range of present mental health concerns. Results: Content analyses of the survey responses from parents of children with SLCN highlighted three broad factors of importance to parents' experiences: relational aspects of care, organisational aspects of care, and professionals' knowledge. Thematic analyses of the interviews of parents of children with DLD identified 5 themes: the effects of language problems on the presentation of distress; the role of the school environment; the role of key professionals; standard approaches to mental health support might not be appropriate; and the role and impact on parents. Parents expressed concerns that their children's mental health problems and need for support would not be recognised, and felt interventions were not accessible, or delivered in a manner that was not comfortable for their children due to high reliance on oral language skills. Some parents were left feeling that there was no provision suitable for their children. Conclusions: Parents of children with SLCN face barriers accessing support for their children's mental health, including a lack of professional knowledge about their children's language needs. Parents argued that language and communication needs can significantly affect the delivery and success of psychological therapies and interventions. Systematic research is needed to understand how to successfully adapt services to make them accessible to children and young people with language needs, and to ensure that mental health problems are detected in children with language difficulties. Increased knowledge about language disorders such as DLD, and access to speech and language therapy expertise, is needed amongst professionals who work to support children's mental health. [ABSTRACT FROM AUTHOR]

Using photo elicitation with participants with intellectual disability is a creative approach to inclusive research as the method promotes research participation. Through the photographs that they take, individuals with intellectual disability convey their thoughts and experiences, without the high cognitive demands that are typical of many other data collection methods. People with intellectual disability rely on environmental support to function optimally in everyday life situations. This is also the case for their functioning in research situations. This article provides a novel contribution to photo elicitation methodology, as we share our experiences from using a semi-structured approach, which offers support and guidance to research participants with intellectual disability in the empirical phase of the research process. We discuss the benefits and challenges such a new approach could introduce. The article concludes that provision of adequate support is a prerequisite for successful research participation for individuals with intellectual disability, and our semi-structured approach offers a suggestion on how to deliver this support. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Psychiatry is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Myiasis is a type of parasitosis caused by the larvae of diptera. It commonly occurs in tropical and subtropical zones. The infestation of nose and ears can be extremely dangerous if the larvae destroy the bone and penetrate into the brain, in which case the fatality rate is reported to be as high as 8%. Here, we report a case of aural myiasis in a patient with congenital mental retardation. Twelve maggots were removed mechanically, and the patient was treated with appropriate antibiotics. [ABSTRACT FROM AUTHOR]

The author reflects on the importance of health insurance in providing welfare benefits to people with disabilities, particularly those with psychiatric disorders, in India.

The poor physical health faced by people with mental illness has been the subject of growing attention, but there has been less focus on the issue of oral health even though it is an important part of physical health. This article discusses the two-way association between oral and mental health. In one direction, the prospect of dental treatment can lead to anxiety and phobia. In the other, many psychiatric disorders, such as severe mental illness, affective disorders, and eating disorders, are associated with dental disease: These include erosion, caries, and periodontitis. Left untreated, dental diseases can lead to teeth loss such that people with severe mental illness have 2.7 times the likelihood of losing all their teeth, compared with the general population. Possible interventions include oral health assessments using standard checklists that can be completed by nondental personnel, help with oral hygiene, management of iatrogenic dry mouth, and early dental referral. [ABSTRACT FROM AUTHOR]

Logistic regression–based predictive models are widely used in the healthcare field but just recently are used to predict comorbidities in children with cerebral palsy. This article presents a logistic regression approach to predict health conditions in children with cerebral palsy and a few examples from recent research. The model named PredictMed was trained, tested, and validated for predicting the development of scoliosis, intellectual disabilities, autistic features, and in the present study, feeding disorders needing gastrostomy. This was a multinational, cross-sectional descriptive study. Data of 130 children (aged 12–18 years) with cerebral palsy were collected between June 2005 and June 2015. The logistic regression–based model uses an algorithm implemented in R programming language. After splitting the patients in training and testing sets, logistic regressions are performed on every possible subset (tuple) of independent variables. The tuple that shows the best predictive performance in terms of accuracy, sensitivity, and specificity is chosen as a set of independent variables in another logistic regression to calculate the probability to develop the specific health condition (e.g. the need for gastrostomy). The average of accuracy, sensitivity, and specificity score was 90%. Our model represents a novelty in the field of some cerebral palsy–related health outcomes treatment, and it should significantly help doctors' decision-making process regarding patient prognosis. [ABSTRACT FROM AUTHOR]

Copyright of Canadian Journal of Psychiatry is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The article discusses the position of the Canadian Psychiatric Association in the medical assistance in dying (MAiD) law passed in Canada. It examines the focus of the legislation on the welfare of those who are diagnosed with irremediable medical conditions that have declining health status. It discusses how the law will impact Canadian psychiatrists especially during clinical encounters with patients who have psychiatric illness.

Inahalant abuse is of increasing interest in India. The age of onset is typically during adolescence. Gasoline inhalant use is rarely reported in adolescents with intellectual deficit. We report a case of petrol dependence in a 10-year-old child with mental retardation. Possible effect of petrol huffing on behavior and cognition is discussed. [ABSTRACT FROM AUTHOR]

Objective: In the Netherlands, patients with borderline intellectual functioning are eligible for specialized mental health care. This offers the unique possibility to examine the mix of psychiatric disorders in patients who, in other countries, are treated in regular outpatient mental health care clinics. Our study sought to examine the rates of all main Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, Text Revision, Axis I psychiatric diagnoses in outpatients with borderline intellectual functioning of 2 specialized regional psychiatric outpatient departments and to compare these with rates of the same disorders In outpatients from regular mental health care (RMHC) and outpatients with mild intellectual disabilities (IDs). Method: Our study was a cross-sectional, anonymized medical chart review. Ail participants were patients from the Dutch regional mental health care provider Rivierduinen. Diagnoses of patients with borderline intellectual functioning (borderline intellectual functioning group; n = 235) were compared with diagnoses of patients from RMHC (RMHC group; n = 1026) and patients with mild ID (mild ID group; n = 152). Results: Compared with the RMHC group, psychotic and major depressive disorders were less common in the borderline intellectual functioning group, while posttraumatic stress disorder and V codes were more common. Compared with the mild ID group, psychotic disorders were significantly less common. Conclusion: Mental health problems In people with borderline intellectual functioning may not be well addressed in general psychiatry, or by standard psychiatry for patients with ID. Specific attention to this group in clinical practice and research may be warranted lest they fall between 2 stools. [ABSTRACT FROM AUTHOR]

The purpose of this mixed-methods study was to identify and define the conditions that facilitate learning in music among students with special needs. Children with special needs met once a week for 10 consecutive weeks and received instruction in primarily music as well as the other arts. The children completed pre- and posttest evaluations that served as measurements of musical ability and growth. A paired-samples t test revealed a significant difference between pre- and posttest scores. Additionally, all of the study participants (the children, each child’s parent and/or guardian, university students serving as mentors, and professionals who supervised the program) completed semistructured interviews in order to determine the conditions that may have led to the children’s musical growth. Qualitative results corroborated the quantitative results and indicated that repetition, student choice, and increased response time were considered important teaching strategies that led to student growth and learning. Likewise, having in place clear directions and expectations, a behavior plan, and fostering a positive atmosphere that was free of distractions were identified by the participants as important conditions that must be met for learning to take place. A model for including children with special needs in public school music programs is discussed. [ABSTRACT FROM PUBLISHER]

Background: Family care burden among schizophrenia and depressive disorders has not been addressed in the research. Family burden was significantly high in patient with schizophrenia except the effect on physical health of other family member. Comparing burden in these two groups may help in the psychosocial management. Aim: The aim of the study was to examine family care burden in families of schizophrenia patient and compare them with patients having depressive disorders. Materials and Methods: One hundred family caregivers of patient with schizophrenia and 100 family caregivers of patient with depressive disorders were recruited for the study. It was cross sectional study. The patients were diagnosed as having schizophrenia (all types) and depressive disorders using International Classification of Disease-10, Classification of Mental and Behavioral Disorders, Diagnostic Criteria for Research ICD-10 DCR criteria. Pollack and Perlick scale was used to identify the key family caregivers. Patient with 2 or more than 2 years duration of illness were included in the study groups. Family burden was assessed in the both groups by using the Family Burden Interview Schedule (FBIS) of Pai and Kapur. Data was analyzed using the descriptive statistics, Chi-square test. Results: Caregivers of patients with schizophrenia in comparison to depressive disorder has significantly increased mean FBIS score (P<0.001). The family burden was significantly high in family caregivers of patients with the schizophrenia except the effect on physical health of other family members. Conclusion: To conclude caregivers of patient with schizophrenia experience high-level of burden than the caregivers of patients with the depressive disorders. [ABSTRACT FROM AUTHOR]

Objective: Antipsychotic use is controversial in the management of adults with intellectual and developmental disabilities (IDD) because of inconclusive evidence for efficacy in the absence of a comorbid psychiatric condition, and substantial concerns about adverse effects. We aimed to characterize antipsychotic use among Ontario adults with IDD and compare profiles of those with and without a documented psychiatric diagnosis.Method: This population-based study included 51,881 adults with IDD under 65 y as of April 2010 receiving provincial drug benefits in Ontario who were followed until March 2016 to identify those dispensed at least one antipsychotic medication. Profiles of those with and without a psychiatric diagnosis were compared.Results: Overall, 39.2% of adults ( n = 20,316) were dispensed an antipsychotic medication, which increased to 56.4% in a subcohort residing in group homes. Almost one-third (28.91%) of people prescribed an antipsychotic medication did not have a documented psychiatric diagnosis. Those without a psychiatric diagnosis differed considerably from those with a diagnosis. In particular, those without a psychiatric diagnosis were older, less likely to have used antidepressants or benzodiazepines in the year before, and less likely to have used ambulatory and acute care.Conclusions: Antipsychotic use in IDD is common, and occurs frequently without a psychiatric diagnosis. Attention toward how antipsychotics are prescribed and monitored for people with IDD in Canada is warranted to ensure appropriate prescribing. [ABSTRACT FROM AUTHOR]

Objectives: To present the 6-month prevalence and sociodemographic correlates of mental disorders and mental health-related service contacts in a sample of children (4 to 11 years) and youth (12 to 17 years) in Ontario.Methods: The 2014 Ontario Child Health Study is a provincially representative survey of 6537 families with children aged 4 to 17 years in Ontario. DSM-IV-TR mental disorders were assessed using the Mini International Neuropsychiatric Interview for Children and Adolescents (MINI-KID) and included mood (major depressive episode), anxiety (generalized anxiety, separation anxiety, social phobia, specific phobia), and behaviour disorders (attention-deficit/hyperactivity disorder, oppositional-defiant disorder, conduct disorder).The MINI-KID was administered independently to the primary caregiver and youth aged 12 to 17 years in the family's home.Results: Past 6-month prevalence of any mental disorder ranged from 18.2% to 21.8% depending on age and informant. Behaviour disorders were the most common among children, and anxiety disorders were the most common among youth. Among children and youth with a parent-identified mental disorder, 25.6% of children and 33.7% of youth had contact with a mental health provider. However, 60% had contact with one or more of the providers or service settings assessed, most often through schools.Conclusions: Between 18% and 22% of children and youth in Ontario met criteria for a mental disorder but less than one-third had contact with a mental health provider. These findings provide support for strengthening prevention and early intervention efforts and enhancing service capacity to meet the mental health needs of children and youth in Ontario. [ABSTRACT FROM AUTHOR]

We introduce "stigma sentiments" as a way to operationalize the cultural conceptions of the mentally ill. Stigma sentiments are the evaluation, potency, and activity (EPA) associated with the cultural category "a mentally ill person. " We find consistent support for the validity of the evaluation and potency components as measures of these conceptions. We also demonstrate the validity of EPA ratings of self-identities ("myself as I really am") and reflected appraisals ("myself as others see me") as measures of self-meaning among psychiatric patients. Then we assess hypotheses derived from the modified labeling theory of mental illness: we expect each stigma sentiment to be related positively to the corresponding dimension of self-identities and reflected appraisals among psychiatric patients but unrelated to the corresponding dimension among non-patients. We find support for 13 of the 18 components to these hypotheses. We also find three cross-dimensional results that were not anticipated. The results suggest that the cultural conceptions of the mentally ill do affect the self-meanings of individuals diagnosed with a mental disorder, although the connection is sometimes more complex than a one-to-one relationship between a stigma sentiment and its corresponding dimension of self-meaning. [ABSTRACT FROM AUTHOR]

Aims: This article aims to shed light on the prevalence of problem substance use in individuals with borderline or mild intellectual disability in Norway, the extent to which their problem use warrants multidisciplinary specialist substance treatment (MST) and whether they receive such treatment at present. Method: We employed a scoping review of international and Norwegian literature and made additional informal literature searches. Results: The prevalence of substance use problems among people with intellectual disability in Norway is uncertain. In spite of representing problem complexity of the kind that warrants MST and the entitlement of all population groups to such treatment, Norwegians with mild or borderline intellectual disability seem to receive treatment at this level only to a modest extent. Conclusion: In order to fit better with aims of Norwegian substance policy, there is a need for national research on the prevalence of substance use among people with intellectual disability. We also seem to need both effect studies and action research in order to strengthen screening and assessment routines and collaboration across competence areas and administrative levels and to develop treatment modalities that fit people in this population group. [ABSTRACT FROM AUTHOR]

The article discusses research on the insufficient scientific evidence to prove that physician-assisted deaths of those with mental disorders is putting patients' safety at risk. It references to a study by S. van Veen and colleagues published in the 2020 issue of the "Canadian Journal of Psychiatry." It argues that among the reasons for lack of scientific data is the limited number of high quality accurate research that tackles irremediable and incurable health conditions.

Presents a study which examined the racial disparity in competency to stand trial between White and African American retarded patients. Discussion on the competency of mentally retarded offenders to stand trial; Methodology of the study; Results and discussion.

The present study investigated the requirements for teaching students with moderate and severe intellectual disabilities in inclusive and special education settings, emphasising the skills, knowledge and attitudes that teachers need. Drawing on investigative group discussions with teachers and principals, qualitative content analysis was used to categorise these skills, knowledge and attitudes. Key requirements in teaching this student population include skills to implement individualised and differentiated teaching, as well as creating individually adapted learning materials. Leadership and counselling abilities are also required in order to ensure successful collaboration between different actors by clarifying roles and hierarchies and negotiating work distribution and expectations. The teacher–student relationship should be characterised by an attitude of appreciation, openness and, in particular, a focus on the positive, regardless of the student’s behaviour, requiring a balance between closeness to the student and an appropriate distance. Finally, it is important when teaching this student population to care for one’s own mental and physical health over the longer term. The article concludes by discussing target-oriented strategies and measures for teachers’ work practices and further education to strengthen the requisite skills, knowledge and attitudes, particularly with a view to inclusion. [ABSTRACT FROM AUTHOR]

The term dual diagnosis can refer to the co-occurrence of an intellectual disability and a mental disorder. While such a term may have some advocacy rationale aimed at facilitating improved mental health care for those with intellectual disabilities, it is proposed that the construct has flawed underpinnings, and its application may problematize mental health service delivery. A core concern is the promotion of categorical diagnostic models, whereas dimensional models may more accurately reflect underlying continuums for both cognitive and mental health challenges. A categorical diagnostic approach may also contribute to questionable dichotomization of mental health difficulties in persons with intellectual disabilities into "problem or challenging behaviours" versus "mental disorders." Organizing services based on beliefs that such distinctions and categorical classifications are accurate may contribute to unnecessary and inappropriate fractionation of interventions and create additional service barriers for a vulnerable population. It is proposed that the term dual diagnosis be abandoned and replaced by systematic use of a dimensional approach to help facilitate assessment, intervention evaluation, and equitable service access. [ABSTRACT FROM AUTHOR]

The paper analyses an interview describing how K came to be defined by her friends as mentally ill. The method of analysis assumes that the structure of the conceptual scheme `mental illness' which the reader uses in recognizing 'mental illness' is isomorphic with that organizing the text and hence is discoverable 'in' it. The full text of the interview is presented as the data. The analysis explicates the interpretation of the text as a method of reading. The text is found to provide instructions for its interpretation and for the authorization of its facticity. K's mental illness is to be located in the collection of instances of K's behaviour which the interview records. How is behaviour to be described as `mentally ill type' behaviour? It is suggested that the interview as a whole organizes a `cutting-out' procedure whereby K's behaviour is presented as making sense neither to her friends nor to the reader of the text. The procedure involves showing for each instance of her behaviour as well as for the collection as a whole that K's behaviour is not properly provided for by relevant social rules or definitions of the situation. To be recognizable as 'mentally ill type' behaviour examples of K's actions must be constituted as anomalies rather than as deviations from a norm or rule. [ABSTRACT FROM AUTHOR]

Although advocates for the mentally ill assert that mental patients are inappropriately stigmatized as dangerous, research indicates that former mental patients have higher arrest rates than the general public. Because of the limitations of arrest-rate studies, however, alternative hypotheses have suggested that the apparent dangerousness of mental patients is a methodological artifact. We compare mental patients and never-treated community residents on several official and self-reported measures of violent/illegal conduct. Mental patients have higher rates on all measures of violent/illegal behavior, and these differences cannot be accounted for by sociodemographic and community context variables. A scale of psychotic symptoms is the only variable that accounts for differences in levels of violent/ illegal behavior between patients and never-treated community residents. Although mental patients have elevated rates of violent/illegal behavior compared to nonpatients, the differences are modest and are confined to those experiencing psychotic symptoms. [ABSTRACT FROM AUTHOR]

Some aspects of organizational theory are related to the functioning of a group of mental patients, who formed sub-organizations of "tine workers" within formal ward organization in several different situations. Each time the group manipulated the "machines" (themselves) in order to protect the main organization and thus insure their own chances of becoming good "products" of it. It is suggested that organized research in this area might show that other concepts advanced by Argyris can be validated in the behavioral reactions of mental patients in institutional settings. [ABSTRACT FROM AUTHOR]

The article presents information on problem-centered versus mental illness self-descriptions. The. negative attitudes of the public toward persons labelled "mentally ill" are well known. Most patients expect to be stigmatized by the public. A number of investigators have noted that psychiatric patients seeking work frequently conceal hospitalization from employers. Employer stereotypes include deep doubts about the curability of "mental illness" and concern about ex-patients' occupational stability. Resistance to hiring "ex-mental patients" took the additional form of reduced job opportunities for ex-patients, i.e., low status, low pay, "low pressure" employment. Three reasons for the results were considered: (a) the criteria for selecting the participants; (b) the value orientation of the laboratory; (c) stereos typed semantic reactions to the concept of mental illness. Several arguments were offered which question the value of the concept of mental illness as a framework for programs which offer help to distressed persons with problems of social living.

The article presents information on variations in the evaluation of the mentally ill. Certain changes in evaluations of the mentally ill by urban dweller were demonstrated to have occurred since 1950. These identified changes were consistently toward a more favorable interpretation of ex-mental patients, of mental ill nesses as phenomena, and of certain treatment facilities. However, accepting and supporting actions toward ex-mental patient could not be interpreted as having increase to the same degree as had the measurable attitudes. The term "action lag" was suggested as an identifying label to refer to the discrepancy. The selection of respondents for the rural sample differed from that used for the urban sample, although the primary control of spatial stratification was maintained for both samples. One further alteration in sampling was necessitated because of our withdrawal of one county from the rural survey. By 1958-1959, when researchers were working in the four selected counties, this one county had experienced a growth of its population to such an extent that the rural non-farm settlements identified in the 1950 census had become urban according to census definitions.

The article presents a study which relates on the class status and the communication of ideas by mentally ill persons. The relationship between class status and communication has been well maintained in its stability in terms of age, marital status, prior psychiatric treatment, and diagnosis. The relationship between class status and disordered speech is marked for solicitants with schizophrenia. Results of the study had also indicated that incoherence in communication could be a social-psychological reaction to sociocultural stress. The afflicted individual moves from an unpleasant world into an unreal world of fictions.

Objective: Although data on publicly available special education are informative and offer a glimpse of trends in autism spectrum disorder (ASD) and use of educational services, using these data for population-based public health monitoring has drawbacks. Our objective was to evaluate trends in special education eligibility among 8-year-old children with ASD identified in the Autism and Developmental Disabilities Monitoring Network. Methods: We used data from 5 Autism and Developmental Disabilities Monitoring Network sites (Arizona, Colorado, Georgia, Maryland, and North Carolina) during 4 surveillance years (2002, 2006, 2008, and 2010) and compared trends in 12 categories of special education eligibility by sex and race/ethnicity. We used multivariable linear risk regressions to evaluate how the proportion of children with a given eligibility changed over time. Results: Of 6010 children with ASD, more than 36% did not receive an autism eligibility in special education in each surveillance year. From surveillance year 2002 to surveillance year 2010, autism eligibility increased by 3.6 percentage points (P = .09), and intellectual disability eligibility decreased by 4.6 percentage points (P < .001). A greater proportion of boys than girls had an autism eligibility in 2002 (56.3% vs 48.8%). Compared with other racial/ethnic groups, Hispanic children had the largest increase in proportion with autism eligibility from 2002 to 2010 (15.4%, P = .005) and the largest decrease in proportion with intellectual disability (–14.3%, P = .004). Conclusion: Although most children with ASD had autism eligibility, many received special education services under other categories, and racial/ethnic disparities persisted. To monitor trends in ASD prevalence, public health officials need access to comprehensive data collected systematically, not just special education eligibility. [ABSTRACT FROM AUTHOR]

Background: Patients present with dissociative disorders as a decompensation to underlying stressful situation. It is clinically important to evaluate the presence, type, and temporal relation of the stressors resulting in dissociation. Further knowing the sociodemographic and psychological profile of the dissociative patient helps in better management. Materials and Methods: The study included 55 dissociative patients aged between 5 to 45 years. Psychiatric diagnosis was made using ICD-10 DCR. Psychosocial stressors and stressful life events were assessed using presumptive stressful life events scale/life events scale for Indian children and clinical interview. Personality and temperament traits were assessed using medico psychological questionnaire and temperament measurement schedule, respectively. Intelligence quotient (IQ) was assessed using standard progressive matrices and colored progressive matrices. Statistical analysis was done using Epi Info 7 software. Results: All patients had significant psychosocial stressors preceding dissociation. Precipitating factor with temporal association was observed in only 83.64%. Family disharmony (41.82%) followed by education-related problems (29.09%) was the most common psychosocial stressors. 61.82% of the dissociative patients had psychiatric comorbidity. Mean IQ of study sample was 92.47. Dissociative children had high emotionality and energy levels but low sociability, rhythmicity, and distractibility. 50% of the adults were neurotic and had emotionally unstable personality. Conclusion: Dissociative disorders are commonly seen in females, adolescents, and in those from lower socioeconomic status and rural areas. They are always preceded by psychosocial stressors. Most of them have comorbid psychiatric disorders such as depression and anxiety. Neuroticism and emotionally unstable personality traits are common in adult patients while temperamental traits such as low sociability, low rhythmicity, low distractibility, high emotionality, and high energy levels are common in children. [ABSTRACT FROM AUTHOR]

Objectives: Family dysfunction is observed in families with children with intellectual disability (ID). We study the prevalence, pattern of dysfunction, and severity of impairment in these special families using Systems approach. Methods: Sixty-two special families (a child with ID) and 62 typical families (all children with typical development) were included in the present study. The presence of ID was confirmed and quantified with the Binet--Kamat Scale of intelligence or Gesell's Developmental Schedule and Vineland Social Maturity Scales among the special families. In the typical families, brief ID scale was used to rule out ID. Prevalence, pattern, and severity of family dysfunction were assessed using Family Apgar Scale, Chicago Youth Development Study Family Assessment Scale and Global Assessment of Relational Functioning Scale, respectively. Appropriate bivariate analyses were used. Results: About 53% of special families and 19% of typical families had family dysfunction. About 21% of special families and 71% of typical families had the satisfactory relational unit. Areas of adaptability, partnership, growth, affection, resolve, beliefs about family, beliefs about development, beliefs about purpose, cohesion, deviant beliefs, support, organization, and communication were significantly different between special and typical families. The functional impairment was significantly more in the special families. Conclusion: Family dysfunction is more prevalent among special families in India using systems approach. These families should be screened for dysfunction, and family therapy be prescribed when required. [ABSTRACT FROM AUTHOR]

Background: Well-functioning care of people with substance use and psychiatric disorders presumes collaboration between different parties such as psychiatric care and substance use treatment centres, as well as social services. According to Swedish law, a collaborative individual plan, i.e., a written action plan to support structured inter-organisational collaboration, should be established. However, there are indications that such action plans are not used to a satisfactory extent. Aim: To explore current inter-organisational collaboration and use of collaborative individual plans among healthcare units and social services in Stockholm County. Design: The study uses a cross-sectional design. Participants (N = 797) in a course specifically aimed at improving the knowledge and use of collaborative individual plans were invited to take part in the study prior to attending the course. A total of 705 participants accepted. Data were collected through an electronic questionnaire sent to each participant's workplace. Non-respondents were offered a paper version to fill out. Results: Respondents reported participating in one to two collaborative individual plans per month and about 70% reported using a particular template. Respondents perceived mainly positive consequences of establishing a collaborative individual plan, for instance that it clarifies what measures are to be performed and who is responsible. Conclusions: Although respondents were generally positive about establishing a collaborative individual plan and the consequences thereof, they reported low use of such action plans. [ABSTRACT FROM AUTHOR]

The article focuses on the recovery-oriented system of care for people with mental disabilities. It discusses the international implications of recovery approach to the health care policy making, to the National Health Services (NHS) commissioning, and to the medical practitioners. It also mentions the interrelation between recovery movement and political agenda.

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Reviews the status of education for learning disabled children as of 2005 in the U.S. and how it compares to three goals of providing free access to education, achieving quality academic, behavioral and social outcomes, and preparing students for a full and productive adult life. Short history of the fight for access to education for all handicapped children; Suggestion that quality outcomes have not been met as shown by scores on standardized tests, graduation rates and dropout rates; Opinion that a unitary inclusive system has not been achieved.

Copyright of Canadian Journal of Psychiatry is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

Copyright of Canadian Journal of Psychiatry is the property of Sage Publications Inc. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)

The author reflects on the effect of culture on using autonomy and self-determination for people with psychiatric disabilities. He mentions that autonomy, competence, and relatedness are three core components of self-determination and further comments on how the concept of autonomy represents the cultural difference between Chinese culture and American culture. Further discussed is a research by H. R. Markus and S. Kitayama which examine how culture may influence how the self is perceived.

Objective. We identified trends in the receipt of preventive health care by adults with intellectual and developmental disabilities by type of residential setting. Methods. We used data from the 2008-2009 collection round of the National Core Indicators (NCI) program. Participating states drew random samples of adults receiving developmental disabilities services. The study was observational, with both self-report and report by proxy. Once the random samples were drawn in each state, data were collected using the NCI Adult Consumer Survey. Trained interviewers administered the survey in person. Results. The likelihood of a person receiving preventive care procedures was related to age, level of intellectual disability, mobility, health status, and state. Type of living arrangement also affected whether a person received these health services, even after controlling for state, level of disability, and other personal characteristics. In general, people living with parents or relatives were consistently the least likely to receive preventive health exams and procedures. Conclusion. With growing numbers of adults being served in the family home, educational and policy-based efforts to ensure access to preventive care are increasingly critical. [ABSTRACT FROM AUTHOR]