An additional case of craniodigital syndrome: variable expression of the Filippi syndrome?

We report on a boy with severe growth and mental retardation, syndactyly of toes and facial anomalies. This phenotype can easily be classified in the group of craniodigital syndromes, but it is difficult to make a more clearly defined diagnosis, based on other minor anomalies, because of the presence of overlapping features. On the basis of various pathognomic features, we conclude that our patient could be an additional case of Filippi syndrome. Moreover, newly recognised features in this patient may be due to variability in phenotypic expression.     

New type of spinocerebellar degeneration syndrome in a northern Swedish population

A follow-up investigation of 24 patients with hereditary spasticity in a geographically isolated northern Swedish population, first examined by Böök (1953), was performed. Fifteen of them were dead. During the period from 1950–1972 five new cases of spastic syndromes were diagnosed in this population. The patterns of clinical symptoms and the genetic associations between the new and 24 previously reported patients with spastic syndromes were analyzed. Three of the five new cases had a specific syndrome. This starts in the first years of life with ataxia, which is followed by dysarthria, spasticity and jerky intention tremor. Initially the patients are mentally normal, but there seems to be slight mental deterioration through the years. The disorder is a progressive spinocerebellar degeneration with autosomal recessive inheritance.     

People with intellectual disability, sensory impairments and behaviour disorder: a case series

Background Sensory impairments (SIs) are more prevalent in people with intellectual disability (ID). Both conditions lead to higher rates of emotional and behavioural problems than in the general population. The identification of psychiatric disorders in this group can be difficult, particularly in those with severe ID and limited communication skills. Method The present paper presents a series of 18 case reports of individuals with ID, SI and behavioural problems. Results The majority of cases were young male caucasians with congenital rubella syndrome and autistic spectrum disorder, referred because of self‐injurious behaviour (SIB) or aggression. Nine cases were treated with autidepressants, five underwent environmental changes and two had medication reduced. All showed some improvement. Conclusions The benefits of comprehensive assessments, the use of standardized assessment tools and trials of treatments are discussed in the context of making psychiatric diagnoses.     

癔症性精神障碍与癫癎性精神障碍临床及脑电图对照分析

目的：观察癔症性精神障碍与癫痫性精神障碍的临床及脑电图特点并对照分析。方法：采用日本光电5214脑电图系统，按照国际10～20系统标准放置电极，进行单极双极、过度换气、闪光试验测试的描记方法检查脑电图。结果：两组病人各30例，癔症性精神障碍组边缘状态2例，轻度异常2例，中度异常及重度异常无1人。而癫痫性精神障碍组边缘状态10例，轻度异常4例，中度异常及重度异常共12例。结论：虽然两组临床发作相似，但有明显差异，癫痫性精神障碍组EEG阳性率明显升高，疗效差。癔症性精神障碍组EEG无一例中度异常或重度异常，治疗效果好。     

武警部队医学生心理健康状况调查

目的　了解武警部队医学生心理健康状况 ,探讨增进武警部队学员心理健康的对策。方法　采用症状自评量表 (SCL - 90 )为工具 ,对随机抽取的 312名武警医学生进行心理健康状况测试。结果　武警医学生SCL - 90各项因子分普遍低于武警军人组和国内常模青年组 (P<0 .0 5 ) ;总均分 1.39± 0 .34,低于武警军人组 (1.4 7± 0 .4 2 ,P <0 .0 1)。结论　武警医学生心理健康状况优于武警军人和国内常模青年组。但仍存在问题 ,部队教育工作者应根据武警院校学员特点 ,积极开展心理卫生教育 ,以提高军校学员整体心理素质     

A nationwide representative sample of treatment-seeking alcoholics: a study of psychiatric comorbidity

In order to elucidate the psychiatric comorbidity of patients in alcohol and other substance use disorder treatment we examined a representative sample of such patients in Iceland (249 men and 102 women). Over 70% of pure alcoholics and over 90% of polysubstance users had comorbid diagnoses, a prevalence higher than in the Epidemiological Catchment Area study in the United States, but similar to clinical studies from North America. The most prevalent disorders were: affective (33%), anxiety (65%), antisocial personality disorder (28%) and psychosexual dysfunction (20%). Pure alcoholics and polysubstance users in studies on psychiatric comorbidity should be separated. Anxiety and affective disorders influence treatment seeking. Findings concerning the impact of psychiatric comorbidity on course should be comparable between North America and Europe.     

Road traffic noise around schools: a risk for pupil's performance?

Summary Noise levels around educational centres can negatively affect the performance of both teachers and pupils. Two public schools in Valencia, Spain, were selected for study. One of these schools was exposed to excessively high road traffic noise levels while the other was located in a relatively quiet area. The socioeconomic level of those attending the schools was very similar. A set of external and internal noise measurements were carried out, along with two different attention tests among the children. Test results were consistently better (both for tests and for children from different classrooms in each school) in the quiet school. Exposure to high traffic noise levels in the noisy school over the whole school year is a plausible determinant of these results.     

Changing helplessness to coping: an exploratory study of social skills training with individuals with long-term mental illness

The primary purpose of this study was to apply an occupational therapy programme for social skills training based on a cognitive-behavioural frame of reference to individuals with long-term mental illness. The goal of the social skills training group was to enable patients to develop verbal and non-verbal communication skills that could be generalised to everyday interpersonal encounters. A case example of the application of social skills training with a 38-year-old single male with a diagnosis of paranoid schizophrenia is described. The Group-Interaction Skills Survey developed by the author served as an outcome measure. Qualitative data confirmed the researcher's hypothesis that individuals with long-term mental illness can benefit from social skills training using a combination of role-playing, sociodrama, videotape recordings and creative media. Copyright © 1996 Whurr Publishers Ltd.     

conference report: Mental health and intellectual disability: an international perspective

The present paper reports on the inaugural meeting of the Mental Health Special Interest Research Group (SIRG) of the International Association for the Scientific study of Intellectual disability which was held at Fitzwilliam College, Cambridge, UK, in March 1998. The meeting was organized in conjunction with the Ninth Annual SIRG on ageing and intellectual disability. Representatives from North America, several European and Scandinavian countries, Australia, and Israel attended. Two broad themes had been determined prior to the meeting: ‘Improving the detection of mental health problems’ and ‘Research strategies for identifying risk factors for mental health problems’. In the presentations and subsequent discussions, it was apparent that there were extrenely diverse perspectives both across and within the different countries represented. Not only were individuals' experiences very different, but most strikingly, the theoretical frameworks were very diverse. This was partly a function of there being understandable differences in perspectives across disciplines, but at its most marked, there were fundamental differences in the way both intellectual disability and mental health were conceptualized.     

The Italian mental health reform nine years on

It is 9 years since the mental health reform was passed by the Italian Parliament. The author presents a data-based evaluation of the effects of the Italian mental health reform. There are still many problems to be resolved: More than 30,000 inpatients are still in psychiatric hospitals and little is known of the fate of those discharged in recent years. District mental health services are still lacking, especially in the south of the country; Psychiatric units in the general hospital function much the same way as the "old" psychiatric hospitals. The pattern of mental health services consumers have changed: They are younger with less severe psychiatric diagnosis and come from a higher social background.