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The present paper describes a cross-sectional study of the psychosocial adjustment of 143 children with severe disability and their families identified from a regional case register for children with special needs. Thirty-eight per cent of the children had significant psychiatric morbidity. By contrast, the overall level of distress in carers was not that different from probable community prevalence figures. Nevertheless, distress among carers was consistently associated with increased disability in the child. Although respite care is a valuable resource for many carers, its use is indicative of underlying distress in the carer. [ABSTRACT FROM AUTHOR]

Objective: To determine the prevalence of frequent absence (>20% of the school year) for reasons recorded as "medical" in secondary schools; to test the hypothesis that it is associated with physical symptoms and psychiatric disorder and not with serious organic disease; to assess unmet need for psychiatric management., Design: Survey using routinely collected data and case-control study, Setting: Local authority secondary schools in Edinburgh, UK., Participants: School students in the first 4 years of secondary school: cases were those with frequent medical absence and controls those with a good attendance record (best 10% of year group), matched for age, gender and school class., Measures: Period prevalence of frequent absences. Cases and controls (students and their parents) completed questionnaires about the students' symptoms. Students were given a psychiatric diagnostic interview and a medical examination. The records of specialist medical services used by the students were reviewed., Results: A substantial minority (2.2%) of students had frequent medical absences. Only seven of 92 (8%) cases had a serious organic disease and 10 of 92 (11%) had symptom-defined syndromes; the remainder had physical symptoms and minor medical illness. Frequent medical absence was strongly associated with psychiatric disorder (45% in cases vs 17% in controls, p<0.001, 95% CI for odds ratio 1.37 to 4.02). Only 14 of the 41 cases (34%) with a psychiatric diagnosis had attended NHS psychiatric services., Conclusions: Frequent absence for medical reasons is common, and more comprehensive management, including psychiatric assessment, is required to prevent long-term adverse consequences.

Background: There is evidence to suggest that among young people with mild intellectual disability there are those whose cognitive difficulties may predict the subsequent manifestation of a schizophrenic phenotype. It is suggested that they may be detectable by simple means., Aims: To gain adequate cooperation from educational services, parents and students so as to recruit a sufficiently large sample to test the above hypothesis, and to examine the hypothesis in the light of the findings., Method: The sample was screened with appropriate instruments, and groups hypothesised as being likely or not likely to have the phenotype were compared in terms of psychopathology and neuropsychology., Results: Simple screening methods detect a sample whose psychopathological and neuropsychological profile is consistent with an extended phenotype of schizophrenia., Conclusions: Difficulties experienced by some young people with mild and borderline intellectual disability are associated with enhanced liability to schizophrenia. Clinical methods can both identify those with this extended phenotype and predict those in whom psychosis will occur.

The aim of this study was to identify the risk of injury for children with attention deficit hyperactivity disorder. Children with attention deficit hyperactivity disorder were matched with controls and attendances at the Accident and Emergency department and injury rates were compared. Children with attention deficit hyperactivity disorder are at a greater risk of injury and also attend the Accident and Emergency department more frequently. The pattern and causation of injury is also different. This paper identifies attention deficit hyperactivity disorder as a predisposing cause of injury.

This paper describes a study to determine the effectiveness of a group programme for parents designed to reduce the psychosocial morbidity among children with epilepsy and their families. The participants were the parents of 108 children attending the seizure clinic at a children's hospital. The first part of the project had shown that half of the children and their families had considerable morbidity. Despite the high rate of psychosocial morbidity among these children and their families, only 35% of the parents expressed an interest in participation in the intervention programme, with only 12% attending any meetings. The latter were mainly the small number of parents whose children had severe intractable epilepsy as well as educational and family problems. Many parents did, however, request more information about epilepsy and for the provision of a counselling service. The latter is likely to be most beneficial in the months following diagnosis.