Visual problems in people with severe mental handicap

The incidence of visual problems in people with mental handicaps is very high. Nine severely mentally handicapped patients were studied. Several objective and subjective oprometric tests were performed. The results showed the presence of different kinds of visual problems that were compensated for by optical methods. The subjects showed a general change in their behaviour. It is essential to give optometric care to such people.     

Stigma and the self-concept of people with a mild mental handicap

ABSTRACT. Twelve people with a mild mental handicap, their mothers and members of staff of Adult Training Centres were interviewed to explore their views on the subjects of stigma and handicap, and to establish the facts about the social life and autonomy of people with a mental handicap. It was found that all participants with a mental handicap were aware of the stigma attached to them. A minority of three conceived of themselves as 'essentially different' from non-handicapped people, while the majority of nine conceived of themselves as 'essentially the same'. In contrast, the majority of mothers viewed their sons and daughters as 'essentially different' from non-handicapped people. These findings do not support the claim of the social constructionist theory of the self that people's self-concepts are primarily determined by the ways in which they are treated by the significant others. Rather, people with a mental handicap are aware of their own agency and clearly express their socio-emotional needs.     

QUALITY OF CARE of people with mental handicap

SUMMARY. This project investigated changes in the quality of care given to people with mental handicap between 1971 and 1983. Information from 1971 came from a study by King, Raynes, and Tizard; the present study used the same measures. The people involved lived in hospital wards, hostels, community units, and group homes. It was concluded: that the general pattern of care in hostels was still more resident oriented than in hospital wards, as it was in 1971; that hospitals and hostels had both become far more resident oriented during the 12 years so that, by 1983, hospital wards were almost as resident oriented as hostels had been in 1971, while hostels were even more so.     

Magnetic resonance brain imaging in people with dizziness: a comparison with non-dizzy people

BACKGROUND: Dizziness is a common symptom affecting about 30% of people over the age of 65. OBJECTIVE: To investigate the hypothesis that structural abnormalities of the brain and cervical cord are more common in dizzy than in non-dizzy subjects. METHODS: A case-control study of subjects over the age of 65 with and without dizziness: 125 dizzy subjects and 86 non-dizzy subjects were recruited from the community through articles in the local press. Magnetic resonance imaging (MRI) of the brain and neck was performed, and was read by a consultant neuroradiologist blind to the clinical details. RESULTS: All dizzy subjects and all controls had at least one structural abnormality. Cerebral atrophy was found in 86% of dizzy subjects and 85% controls (p = 1.0) At least one white matter lesion was found in 69% of dizzy subjects and 78% controls (p = 0.21). White matter lesions in the midbrain were more common in dizzy than in non-dizzy subjects (22% v 4%, p < 0.001). There were no significant differences in the prevalence of cord compression, cervical subluxation, facet joint degeneration, vertebral artery compression, or vertebral artery occlusion between dizzy and non-dizzy subjects. CONCLUSIONS: Structural abnormalities of the brain and neck are common in both dizzy and non-dizzy subjects. "Routine" MRI is unlikely to reveal a specific cause for dizziness. The observation of more frequent white matter lesions in the midbrain in dizzy subjects requires further study to determine whether small vessel changes could cause dizziness in older people.     

Age and functional abilities of people with a mental handicap: evidence from the Wessex mental handicap register

ABSTRACT. Funclional behaviours in relation to age were investigated using data from approximately 3000 people on the Wessex Mental handicap Register. The main functional data on the register, the National Development Team's 24-item questionnaire, were cluster and factor analysed to derive a series of client-defining variables. Age-trends were analysed in relation to self and commiiniiy care skills (activities of daily living and instrumental activities of daily living), problem behaviours, chronic medical conditions, mobility and sensory abilities. Generally, it was found that differential mortality leads to an older population In gtwd health and with a high level of functional skills. As with ihe general population, however, people over 70 years old show increasing prevalence of age-related infirmities.     

Leaving home: the experience of people with a mental handicap

ABSTRACT. Open-ended interviews were conducted with 12 people with a mental handicap who had left parental homes in order to live as tenants in community residential hostels. Parents and hostel staff were also interviewed. The nature of life in the family home, and the tenant's role in the move, reasons for leaving home and expectations for the future were explored. It was found that social life, autonomy and opportunities to develop self-help skills had been limited at home. The tenants who had the widest social experience and the greatest use of self-help skills at home were the most active in changing their situation. Tenants hoped to gain more freedom by leaving home, although they were also in agreement with parents and staff about the value of learning new skills.     

Survey of the needs of elderly people with mental handicap in Hong Kong

To date the needs of people in Hong Kong who are both elderly and mentally handicapped have received scant attention despite the increase in size of this population. This paper reports on the first phase of a study designed to locate this client group, determine their clinical characteristics and social resources and, ultimately, to improve their quality of life. Of the 24 elderly mentally handicapped people located, it was found that the majority had well-developed self-help skills. Most, however, had few social contacts and participated minimally in community activities. It is, therefore, suggested that these people urgently need training in community living skills and to participate in social-recreational activities. The implications of findings from this first phase of the study for subsequent phases are discussed.     

Activities and engagement in day services for people with a mental handicap

Policy on the role and function of day services for adults with mental handicaps has changed considerably during the last 2 decades. What such settings offer their users has also changed as services have attempted to evolve in line with policy. However, the impaa of these changes has gone largely unevaluated. This paper describes a study of two day centres to categorize the activity programmes of these services, and to assess service user and staff behaviour prior to a larger scale study of such services in Wales. The two centres were found to differ significantly in their programmes but not in the extent to which activities were organized in the community. Service user participation in activities varied with activity type, group composition and activity location. Whether activities were organized for the fall duration of the timetabled sessions was critical to the interpretation of the extent of service user engagement. Staff showed a commendable orientation to clients and their activities in both services. Differences in the activity programmes of the two centres are discussed in terms of a continuing lack of clarity over the purposes of such day services in general. The relevance of some activities to objectives is questioned. Concem is also expressed about the resulting level of engagement achieved in planned activity.     

The effect of patients' beliefs about their illnesses on compliance in psychotherapy

Sixty patients treated in the outpatient psychiatric clinic of a large urban teaching hospital were surveyed regarding their beliefs about the causes of their illness. Patients' beliefs were found to be related to two measures of compliance: number of visits and manner of termination from therapy. Subjects endorsing more medical and fewer nonmedical explanations for their illness made more visits to the clinic and ended treatment in a more compliant manner than did patients who endorsed more nonmedical beliefs about the causes of their illness. Results also showed that, except for age, demographic and diagnostic variables were not related to compliance.     

Lay beliefs about treatments for people with mental illness and their implications for antistigma strategies.

OBJECTIVE: First, to describe factors influencing the public's attitude toward treatment recommendations for people with mental illness; second, to identify coherent belief systems about the helpfulness of specific interventions; and third, to discuss how to ameliorate mental health literacy and antistigma strategies. METHOD: Participants of a representative telephone survey in the general population (n = 1737) were presented with a vignette depicting a person with either schizophrenia or depression. From a list of suggestions, they were asked to recommend treatments for this person. We used a factor analysis to group these proposals and used the factors as the dependent variables in a multiple regression analysis. RESULTS: Treatment suggestions are summarized in 4 groups, each characterizing a specific therapeutic approach: 1) psychopharmacological proposals (that is, psychotropic drugs), 2) therapeutic counselling (from a psychologist or psychiatrist or psychotherapy), 3) alternative suggestions (such as homeopathy), and 4) social advice (for example, from a social worker). Medical treatments were proposed by people who had a higher education, who had a positive attitude toward psychopharmacology, who correctly recognized the person depicted in the vignette as being ill, who were presented with the schizophrenia vignette, who kept social distance, and who had contact with mentally ill people. The variables could explain alternative and social treatment proposals only to a small extent. CONCLUSIONS: The public's beliefs about treatment for people with mental illness are organized into 4 coherent systems, 2 of which involve evidence-based treatments. Medical treatment proposals are influenced by adequate mental health literacy; however, they are also linked to more social distance toward people with mental illness. Additionally, efforts to better explain nonmedical treatment suggestions are needed. Implications for further antistigma strategies are discussed.     

The sterilization of people with a mental handicap: the views of parents

The issue of sterilization in people with mental handicap has re-emerged in recent years. Historical aspects are briefly reviewed, and attention is drawn to the different context in which this issue has been revived. A postal survey of parental views was undertaken. Fifty-three per cent of the respondents indicated that they had or would consider sterilization for their child with mental handicap, and a large majority of the parents felt that they alone, or in conjunction with a doctor, should be able to consent on behalf of the person with mental handicap. Consideration needs to be given to parental anxieties with regard to sexual and reproductive health issues which are surfacing with the current emphasis on community care and the philosophy of normahzation.     

Neuro-otological and psychiatric abnormalities in a community sample of people with dizziness: a blind, controlled investigation

OBJECTIVES—To determine neuro-otological andpsychiatric abnormalities associated with complaints of dizziness in anepidemiological community sample of people of working age, and theextent of comorbidity between neuro-otological and psychiatric dysfunction.
METHOD—A survey of 3884 people randomlyselected from six general practice lists identified 262 people withsignificant dizziness, from which a subsample of 15 men and 22 womenwere recruited for testing. Dizzy subjects were evaluated by blindneuro-otological testing, computerised dynamic posturography, acomputerised psychiatric assessment, neuro-otological and generalmedical examination, and diagnosis. An age matched control group of18 men and 22 women underwent the same evaluation.
RESULTS—Tests of auditory, vestibular, andoculo-motor function did not discriminate between dizzy subjects andcontrols, but dizzy subjects had significantly worse balance onposturographic testing, more diagnoses of medical disorder, and ahigher prevalence of psychiatric morbidity.
CONCLUSIONS—The findings suggest that dizziness inthe community is typically characterised by mild physical disorderaccompanied by some psychiatric disturbance. As the combination ofminor physical and psychiatric disorder is known to be unusuallypersistent and handicapping, treatment programmes must be provided forthis prevalent syndrome, perhaps by a partnership between primary careand neuro-otological and psychiatric hospital outpatient clinics withexperience and expertise in the diagnosis and management of dizzinessand psychiatric disturbance.

     

中医刁氏技法治疗梅尼埃病眩晕症状的DHI量表评估

目的观察中医刁氏技法对治疗梅尼埃病患者眩晕症状的影响。方法将16例梅尼埃病患者分为对照组和实验组,对照组予银杏叶注射液加西药倍他司汀(口服)治疗,实验组在上述药物治疗基础上予中医刁氏技法治疗。两组均在治疗前及治疗1d后应用眩晕残障程度评定量表(DHI)对临床症状进行评价。结果治疗前,实验组和对照组的DHI评分差异无统计学意义(P=0.412)。治疗1d后,实验组DHI评分(7.33±5.48)显著低于对照组(48.33±21.70)(P=0.000)。两组患者在治疗期间及治疗结束后皆无明显不适反应。结论中医刁氏技法治疗梅尼埃病的眩晕症状可能有效。