A study on prescriptions contributing to the risk of high anticholinergic burden in adults with intellectual disabilities: retrospective record linkage study.

Background: People with intellectual disabilities may face a disproportionate risk of experiencing high anticholinergic burden, and its negative sequalae, from a range of medications, and at younger ages than the general population, but there has been little previous study. Our aim was to determine the source of anticholinergic burden from prescribed medication.

Methods: Retrospective matched observational study using record linkage.

Understanding the stigma: a novel quantitative study comparing mental health attitudes and perceptions between young British Muslims and their non-Muslims peers.

Background: A significant proportion of young British Muslims identify themselves by religious identity rather than ethnicity however very few mental health studies have focused on this cohort.

Aims: To explore whether young British Muslims' knowledge, awareness and perceptions of mental illness differ to their non-Muslim peers.

Method: Population based survey of second generation Muslims ( = 83) and non-Muslims ( = 76) aged 18-35.

Risk of anticholinergic burden in adults with intellectual disabilities: a Scottish retrospective cohort study of n = 17 220.

Background: Several drugs have anticholinergic side effects that are associated with adverse health outcomes. Anticholinergic burden studies in adults with intellectual disabilities (ID) have focused exclusively on older adults. This study investigates anticholinergic burden and its associations in adults with ID of all ages (17-94 years).

Dental attendance, restoration and extractions in adults with intellectual disabilities compared with the general population: a record linkage study.

Background: Oral health may be poorer in adults with intellectual disabilities (IDs) who rely on carer support and medications with increased dental risks.

Methods: Record linkage study of dental outcomes, and associations with anticholinergic (e.g.

Pharmacogenetics of anxiety disorders.

Anxiety disorders are common and disabling conditions the treatment of which remains a challenge. While different groups of medication are available for their treatment, a substantial proportion of patients remain refractory to pharmacotherapy. The reason for this variation in the individual response to treatment has yet to be understood; however genetic factors have been shown to play an important role.

Detaining patients in the general hospital - current practice and pitfalls.

Aims: Much has been written about the use of the Mental Health Act in psychiatric settings. There is, however, little written on its use to detain patients with mental disorder in general hospitals.

Method And Results: We therefore carried out a survey of the use of the Mental Health Act in general hospital settings in Aberdeen, and also posted a questionnaire to Scottish Liaison Psychiatrists, asking about their experience of the use of the Mental Health Act in general hospitals.

Admission to psychiatric hospital for mental illnesses 2 years prechildbirth and postchildbirth in Scotland: a health informatics approach to assessing mother and child outcomes.

Objective: To identify factors associated with: admission to a specialist mother and baby unit (MBU) and the impact of perinatal mental illness on early childhood development using a data linkage approach in the 2 years prechildbirth and postchildbirth.

Methods: Scottish maternity records (SMR02) were linked to psychiatric hospital admissions (SMR04). 3290 pregnancy-related psychiatric admissions for 1730 women were assessed.

Admission to psychiatric hospital in the early and late postpartum periods: Scottish national linkage study.

Objective: To describe weekly admission rates for affective and non-affective psychosis, major depression and other psychiatric disorders in the early and late postpartum periods. To assess the impact of socioeconomic status, age and parity on admission rates.

Methods: Scottish maternity records were linked to psychiatric hospital admissions.

The Efficacy of Electroconvulsive Therapy in a Perinatal Population: A Comparative Pilot Study.

Objectives: This study aims to investigate the effectiveness of electroconvulsive therapy (ECT) as a treatment for postnatal depression compared with a matched nonpostnatal population. A secondary aim is to compare the number of ECT treatments needed to treat in both groups. As the numbers in this study are small, this would act as a pilot study, allowing a power calculation to determine the numbers needed for a more definitive study.

Commentary: mentally disordered offenders in prison--old problems that still require solutions.

We commend Simpson et al. for addressing an important topic: the care and treatment of prisoners with serious mental illness. We welcome the authors' conclusions, but we identify some problems that can often frustrate attempts to improve services to this group.

Estimating the prevalence of dementia: cognitive screening in Glasgow nursing homes.

Objectives: The purpose of this study is to establish existing levels of dementia in nursing homes.

Design: The design was a randomised sample of every sixth nursing home resident in Glasgow City. Cognitive testing of 341 residents was carried out using the Standardised Mini Mental State Examination (SMMSE).

Commentary: personality disorder and diminished responsibility--the significance of priorities and objectives.

Professor Landy Sparr's paper systematically examines issues and anomalies of courtroom practice in relation to offenders who are considered to have a personality disorder. The in-depth description of a recent case from the International War Crimes Tribunal for the former Yugoslavia forms the basis of the paper. As an international forum, the Tribunal illustrates clearly the different practices and interpretations in various jurisdictions.

Adults with Incapacity (Scotland) Act 2000: implications for medical practice.

The Scottish Parliament has passed a major piece of Legislation, The Adults with Incapacity (Scotland) Act 2000. Various Sections of this Act will be implemented on a phased basis between April 2001 and April 2002. This article summarises the major provisions of the Act and describes the duties of doctors and the impact on medical treatment and research where the person is incapable of giving consent.

Person-centred care in dementia.

People with dementia, particularly in its early stages, are aware of their problems, therefore it is vital that they are told of their diagnosis so they can make decisions about their future. The development of new drugs has led to major changes in the management of dementia, but 'postcode prescribing' means that all drugs are not widely available. Various means of support are available for patients and their carers but at all times healthcare professionals must ensure that the person is at the centre of a patient's care.

Behaviour problems and assessment in dementia.

People with dementia develop behaviour problems, the causes of which are often complex. Such behaviour often challenges the ability to provide care. Patient dignity must always be considered when attempting to reduce antisocial behaviour.

Dementia: Alzheimer's disease.

Dementia is a common condition that will increase as the average age of the population increases. It is a syndrome with major health and social implications. There are many different types of dementia and the effects of the illness relate to which parts of the brain are affected.

Common forms of dementia.

Dementia occurs in various forms and may be associated with other conditions (secondary dementias). Each type has a different impact on the brain, leading to a variety of cognitive losses and behaviour problems. Appropriate identification is vital so that the most suitable treatment can be instigated.

An overview of behaviour difficulties found in long-term elderly care settings.

Study Objective: To provide an understanding of the nature and prevalence of behaviour difficulties in long-term care facilities, to compare care settings and comment on the appropriateness of the need for specialist care.

Design: Nurses or carers implemented two rating scales in randomly selected settings.

Setting: Nursing homes, residential homes and NHS elderly long-stay wards.

Effects of hospital closure on mortality rates of the over-65 long-stay psychiatric population.

The closure of this 100-year-old hospital has allowed us to look at the effect on mortality of moving the whole over-65 long-stay population to other settings. Our results confirm that there is a slight excess of deaths during and immediately after these moves, but that there is no longer-term effect on mortality rates.

Partnership nursing home care for dementia: the Glasgow experience--one-year follow-up.

The outcome of the transfer of 60 elderly patients suffering from dementia from hospital to nursing home care under a partnership contract was reviewed at 6 and 12 months following transfer. The nursing home population had fared badly compared with patients remaining in hospital during the first 3 months. This difference was less evident at 6 months follow-up and had disappeared at 12 months follow-up.

Partnership nursing home care for dementia: the Glasgow experience--one-year follow-up.

The outcome of the transfer of 60 elderly patients suffering from dementia from hospital to nursing home care under a partnership contract was reviewed at 6 and 12 months following transfer. The nursing home population had fared badly compared with patients remaining in hospital during the first 3 months. This difference was less evident at 6 months follow-up and had disappeared at 12 months follow-up.

Munchausen syndrome by proxy.

This article provides an overview of Munchausen syndrome by proxy. It examines current definitions and looks at the varied clinical presentations. The characteristics of the perpetrators are described with a view to aiding early identification and intervention.

A double-blind multicenter trial comparing sertraline and fluoxetine in outpatients with major depression.

Background: Sertraline and fluoxetine have pharmacokinetic and pharmacologic differences, which may be of clinical relevance.

Method: A randomized, double-blind, parallel-group study of 6 weeks' duration comparing the efficacy and safety of sertraline (50-100 mg/day) with those of fluoxetine (20-40 mg/day) was conducted in 286 psychiatric outpatients with DSM-III-R major depression or bipolar disorder (depressed). Primary efficacy measurements consisted of the 17-item Hamilton Rating Scale for Depression (HAM-D) and the Clinical Global Impressions (CGI) scale.