Epidemiology of autism in adults across age groups and ability levels.

Background: The epidemiology of autism in adults has relied on untested projections using childhood research.

Aims: To derive representative estimates of the prevalence of autism and key associations in adults of all ages and ability levels.

Method: Comparable clinical diagnostic assessments of 7274 Adult Psychiatric Morbidity Survey participants combined with a population case-register survey of 290 adults with intellectual disability.

Prevalence and treatment of common mental disorders in the English national population, 1993-2007.

Background: The National Psychiatric Morbidity Surveys include English cross-sectional household samples surveyed in 1993, 2000 and 2007.

Aims: To evaluate frequency of common mental disorders (CMDs), service contact and treatment.

Method: Common mental disorders were identified with the Clinical Interview Schedule - Revised (CIS-R).

Prevalence of psychosis in black ethnic minorities in Britain: analysis based on three national surveys.

Purpose: A considerable excess of psychosis in black ethnic minorities is apparent from clinical studies, in Britain, as in other developed economies with white majority populations. This excess is not so marked in population surveys. Equitable health service provision should be informed by the best estimates of the excess.

The population impact of common mental disorders and long-term physical conditions on disability and hospital admission.

Background: Long-term physical conditions (LTCs) consume the largest share of healthcare budgets. Although common mental disorders (CMDs) and LTCs often co-occur, the potential impact of improved mental health treatment on severe disability and hospital admissions for physical health problems remains unknown. Method A cross-sectional study of 7403 adults aged 16-95 years living in private households in England was performed.

Ethnic inequalities in the use of health services for common mental disorders in England.

Purpose: The purpose of this study is to investigate whether minority ethnic people were less likely to receive treatment for mental health problems than the white population were, controlling for symptom severity.

Method: We analysed data from 23,917 participants in the 1993, 2000 and 2007 National Psychiatric Morbidity Surveys. Survey response rates were 79, 69 and 57 %, respectively.

Increased prevalence of insomnia and changes in hypnotics use in England over 15 years: analysis of the 1993, 2000, and 2007 National Psychiatric Morbidity Surveys.

Study Objectives: To investigate changes over 15 years in the prevalence of insomnia and its association with demographic characteristics and hypnotic medication use.

Design: Analysis of 3 cross-sectional national mental health surveys carried out in 1993, 2000, and 2007, which used comparable sampling methods and identical insomnia assessments.

Setting: Adults living in private households in England.

Age and birth cohort differences in depression in repeated cross-sectional surveys in England: the National Psychiatric Morbidity Surveys, 1993 to 2007.

Background: The National Psychiatric Morbidity Survey (NPMS) programme was partly designed to monitor trends in mental disorders, including depression, with comparable data spanning 1993 to 2007. Findings already published from this programme suggest that concerns about increasing prevalence of common mental disorders (CMDs) may be unfounded. This article focuses on depression and tests the hypothesis that successive birth cohorts experience the same prevalence of depression as they age.

Age and birth cohort differences in the prevalence of common mental disorder in England: National Psychiatric Morbidity Surveys 1993-2007.

Background: There are concerns that the prevalence of mental disorder is increasing.

Aims: To determine whether the prevalence of common adult mental disorders has increased over time, using age-period-cohort analysis.

Method: The study consisted of a pseudocohort analysis of a sequence of three cross-sectional surveys of the English household population.

Cohort differences in disease and disability in the young-old: findings from the MRC Cognitive Function and Ageing Study (MRC-CFAS).

Background: Projections of health and social care need are highly sensitive to assumptions about cohort trends in health and disability. We use a repeated population-based cross-sectional study from the Cambridgeshire centre of the UK Medical Research Council Cognitive Function and Ageing Study to investigate trends in the health of the young-old UK population

Methods: Non-overlapping cohorts of men and women aged 65-69 years in 1991/2 (n = 689) and 1996/7 (n = 687) were compared on: self-reported diseases and conditions; self-rated health; mobility limitation; disability by logistic regression and four-year survival by Cox Proportional Hazards Regression models, with adjustments for differences in socio-economic and lifestyle factors.

Results: Survival was similar between cohorts (HR: 0.

The nature and impact of urinary incontinence experienced by patients receiving community nursing services: a cross-sectional cohort study.

Background: Nurses have played a pivotal role in the delivery of continence services yet little is known about the nature or impact of urinary symptoms experienced by patients in receipt of such care.

Aim: To define the nature and impact of urinary symptoms experienced by patients in receipt of community nursing services.

Method: The Leicestershire Urinary Symptoms Questionnaire was administered to 1078 patients with incontinence identified from 176 community nurses' caseloads in 157 general practices in England.

Carer-held records for dementia: a controlled trial.

Background: A carer-held record (CHR) was developed to enable carers to contribute to care plans for their relatives with dementia, alongside other professionals. The aim of this study was to establish whether CHRs provide any measurable benefits for carers, in the areas of health, stress, knowledge of dementia and locus of control.

Methods: This was a controlled parallel-group trial involving 84 carer/patient pairs, drawn from all new referrals to two community mental health teams (CMHTs).

Cluster randomized controlled trial of the effectiveness of audit and feedback and educational outreach on improving nursing practice and patient outcomes.

Background: Current understanding of implementation methods is limited, and research has focused on changing doctors' behaviors.

Aim: Our aim was to evaluate the impact of audit and feedback and educational outreach in improving nursing practice and patient outcomes.

Methods: Using a factorial design, cluster randomized controlled trial, we evaluated 194 community nurses in 157 family practices and 1078 patients with diagnosis of urinary incontinence (UI) for nurses compliance with evidence-linked review criteria for the assessment and management of UI and impact on psychologic and social well-being and symptoms.

Factors affecting completion of the SF-36 in older people.

Objective: to examine the influence of specific clinical impairments and disabilities on the completion of the SF-36 health status measure among older people.

Design: Prospective observational study.

Setting/participants: An SF-36 was administered to 245 subjects aged 65 years and older.

Standard of living in the retirement survey: a predictor of six-year functional limitation onset and mortality in women, but not in men from ages 55 - 69 years.

Purpose: To investigate the predictive validity for health decline of a standard of living, a measure that combines basic necessities and consumer durables.

Method: A nationally representative sample of those aged 55-69 years was interviewed at home in the Great Britain Retirement and Retirement Plans Survey, (1988; n=3,541). In 1994, 2,247 were re-interviewed, response rate being 70% of survivors.

The role of sensory and cognitive function in the onset of activity restriction in older people.

Background: Extending healthy active life expectancy is a priority if we are to achieve gains in both the quality and quantity of life lived at older ages. We investigated the role of sensory (vision and hearing) and cognitive function on the onset of activity restriction in older people.

Methods: A survey of a total population (N = 1579) of people aged 75 years and older, registered with a large general population in Melton Mowbray, Leicestershire, England, was undertaken in 1988 and linked with subsequent routine health assessments (up to a maximum of five) over 10 years.

Socioeconomic factors associated with the onset of disability in older age: a longitudinal study of people aged 75 years and over.

Although the association between socioeconomic status and mortality is well documented, there is less work focusing on the association with morbidity in older people. This is partly due to the difficulties of measuring socioeconomic status at older ages. The work that does exist tends to use cross-sectional data and objective measures of socioeconomic status such as education, social class or income.

Diseases and impairments as risk factors for onset of disability in the older population in England and Wales: findings from the Medical Research Council Cognitive Function and Ageing Study.

Background: This paper reports the association between self-reported diseases and impairments and 2-year onset of disability in a prospective study of people aged 65 years or older in five urban and rural centers in England and Wales (Medical Research Council Cognitive Function and Ageing Study; MRC-CFAS).

Methods: We initially reviewed risk factors for onset of disability in 35 prospective studies of functional decline in older people published in 1998-2001. In the present study, disability was defined as requiring help from another person at least several times a week and was assessed by dependency in activities of daily living.

Validity and reliability of a questionnaire to measure the impact of lower urinary tract symptoms on quality of life: the Leicester Impact Scale.

Aims: To develop a condition specific quality of life measure for males and females with urinary storage symptoms of urgency, frequency, nocturia and incontinence.

Materials And Methods: A sample of community dwelling males and females aged 40 years or more who were taking part in an epidemiological study provided data for development and validation of the scale. Questions were developed from literature review and discussions with clinicians and patients.

Performance of hospital-at-home after a randomised controlled trial.

Objective: To compare the performance of an admission-avoidance hospital-at-home scheme one year after the end of a randomised trial with its performance during the trial.

Methods: Observational study of patients admitted to the scheme during a period of 12-19 months after the trial ended. In addition to routine data from service records, patients were interviewed at three days, two weeks and three months after admission, using the same instruments as used in the trial.

Are gender differences in the relationship between self-rated health and mortality enduring? Results from three birth cohorts in Melton Mowbray, United Kingdom.

Purpose: The purpose of this study was to assess whether there is an enduring gender difference in the ability of self-rated health to predict mortality and investigate whether self-reported physical health problems account for this difference.

Design And Methods: Cox models for 4-year survival were fitted to data from successive cohorts aged 75-81 years registered with a primary care practice in the U.K.

Does Helicobacter pylori eradication reduce the long-term requirements for acid suppressants in patients with a history of peptic ulcer disease in general practice? Results from a four-year longitudinal study.

Background: Acid suppressants, especially proton-pump inhibitors, are major contributors to the drug costs in primary care. Although Helicobacter pylori eradication reduces peptic ulcer relapse, some studies suggest that patients may remain symptomatic and continue to require acid-suppressant therapy.

Methods: We identified all patients taking long-term acid suppressants in a large primary health care clinic to determine the proportion who had peptic ulcer disease and to examine the effect of H.

Patterns of onset of disability in activities of daily living with age.

Objectives: To investigate the order in which activities of daily living (ADLs) are lost and whether the order is invariant between the sexes and age groups.

Design: Longitudinal data from the first five rounds of a routine health assessment by a nurse in participant's own home.

Setting: One large UK general practice with a list size of 32,500.