Characteristics of the Detained and Informal Child and Adolescent Psychiatric In-Patient Populations

Background: This project surveyed the use of the Children Act and the Mental Health Act in in-patient child and adolescent mental health services in England and Wales.
Methods: Data were collected as a day census from child and adolescent psychiatric inpatient units, questionnaire forms completed by consultant psychiatrists or key-workers. Returns were received from 71 of the 80 units.
Results: One hundred and twenty-seven of the 663 patients had been admitted formally, the great majority under a section of the Mental Health Act. Compared with those admitted informally, those admitted formally were older, contained a higher proportion of males and had 'adult-type diagnoses', mainly schizophrenia, mood disorders and personality disorder. The clinical and psychosocial characteristics of formal and informal patients were consistent with these differences.
Conclusions: This study provides a timely and useful snapshot of the use of the Acts in this population.     

Multi-site samples of injecting drug users in Edinburgh: prevalence and correlates of risky injecting practices

Aims. To estimate the frequency of injecting and prevalence of equipment sharing and other risky injecting practices among intravenous drug users (IDUs) and to identify correlates of these behaviours. Design. Three cross-sectional surveys of IDUs by face-to-face interview in the years 1992-94. Setting. Multiple treatment and non-treatment sites throughout the city of Edinburgh, Scotland, UK. Participants. Six hundred and thirty-four interviews of 480 IDUs who reported having injected a drug in the previous six months. Measurements. Self-reports of drug-taking behaviours, service contact, sexual behaviour and HIV knowledge, and anonymous testing of saliva for HIV antibodies. Findings. Only 18% had injected at least daily. Thirty-five per cent had accepted or passed on used equipment. Eighty-five per cent of subjects recruited from non-treatment sites were receiving treatment for their drug taking. Multivariate analyses indicated that risky injecting was associated with a consistent history of sharing, polydrug injecting, injecting in prison, having recently started injecting, and recent experience of methadone detoxification. Conclusions. Injecting frequency and equipment sharing have declined substantially in Edinburgh during the past 10 years and are low compared to other cities in the United Kingdom and elsewhere. These improvements have occurred in the context of remarkably high levels of drug treatment service contact. Our findings support the international evidence indicating that IDUs have modified their injecting habits significantly without completely eliminating this form of HIV risk. High levels of service contact in Edinburgh provide ample opportunities to instigate further HIV prevention measures which target identifiable subgroups of IDUs who persist in risky injecting.     

Hippocampal volume reduction in children with chromosome 22q11.2 deletion syndrome is associated with cognitive impairment

Background  

Previous investigations of individuals with chromosome 22q11.2 deletion syndrome (DS22q11.2) have reported alterations in both brain anatomy and cognitive function. Neuroanatomical studies have reported multiple abnormalities including changes in both gray and white matter in the temporal lobe, including the amygdala and hippocampus. Separate investigations of cognitive abilities have established the prevalence of general intellectual impairment, although the actual extent to which a single individual is affected varies greatly within the population. The present study was designed to examine structures within the temporal lobe and assess their functional significance in terms of cognition in children with DS22q11.2.     

Presurgical Behavioral Medicine Evaluation (PBME) for Implantable Devices for Pain Management: A 1-Year Prospective Study

Abstract:   To reduce poor surgical outcomes, presurgical psychological evaluations are used to better predict prognosis. The current study investigated the utility of a revised Presurgical Behavioral Medicine Evaluation (PBME) algorithm, developed specifically for patients who were candidates for implantable devices. Patients were categorized into a Green, Yellow I, Yellow II, or Red prognosis group, with Green having the best, and Red having the worst, prognosis for good surgical outcomes. Variables, including gender, disability payment status, and involvement in pending litigation, were found to be significantly different among the groups in a sample of 95 consecutive patients. Analysis of data at the initial evaluation indicated that patients within the Red group endorsed significantly more physical/functional limitations, depressive symptomatology, and psychosocial distress than the Green group. In a 12-month follow-up analysis, significant differences among the four groups on various psychosocial measures were found. In addition, post-hoc tests revealed specific significant differences among the groups. A repeated measures analysis of the initial evaluation, 6-month, and 12-month follow-up data revealed that these measures were also significantly affected by the prognostic group. Lastly, nonparametric analysis indicated that there were significant differences among the groups on total risk factor scores as determined by the PBME algorithm.