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[Dynamics of the psychopathy-like disturbances in patients with a history of head injury].

As a result of long-time examination of 306 patients with a history of craniocerebral injuries some variants of the psychopathy-like syndrome, such as, asthenic, explosive, hyperthymic and apathic ones, were revealed. In addition, a hyperthymic variant with a moral defect and the same variant with hypersocial behaviour are described. The patients' behaviour and social adaptation and dysadaptation are determined to a great extent by the peculiarities of the clinical picture of one or another variant of the psychopathy-like syndrome.

Brain Damage, Chronic↗

Can alternative schools succeed where Benjamin Spock, Spiro Agnew, and B. F. Skinner have failed?

This study sought to determine whether student behavior was as great a problem in a sample of 18 California alternative high schools. As a result of on-site observations and interviews with students and teachers, the authors concluded that discipline rarely was a major concern in the alternative schools. General agreement existed among both students and teachers. Fourteen possible reasons to account for the basic finding were hypothesized. The reasons included small school size, flexible schedules, frequent informal interaction between students and teachers, and fewer rules.

Achievement↗

The pattern of psychiatric admissions to a hospital for people with a learning disability in the Grampian region between 1989 and 1991.

It is known that a substantial proportion of people with a learning disability also have associated emotional problems in the form of psychiatric illness and disturbed behaviour. In the UK various health authorities are developing in-patient facilities for assessment and treatment of this group of people by default rather than by planning. We report the prospective findings of psychiatric admissions to a hospital for learning disabled people in the Grampian region of Scotland over a three year period between 1.1.89 to 31.12.91. Nine beds were deemed necessary for a health district with a general population of 500,000. Average bed occupancy was 66.7%. The most common conditions leading up to an admission was disturbed behaviour followed by affective disorder and psychoses. The majority of the admissions were of adults with a mild to moderate degree of learning disability as opposed to severe and profound learning disability. A hard-core group of patients had many re-admissions. Some acute admissions became long-stays (over one year), although average stay of admissions were between four to six weeks.

Adult↗

Relation between economic disadvantage and psychosocial morbidity in children.

OBJECTIVE: To examine the relation between low income and child psychosocial morbidity cross-sectionally and longitudinally. DESIGN: Cross-sectional survey with follow-up. SETTING: Ontario. PARTICIPANTS: Children aged 4 to 16 years from families selected by means of stratified, clustered and random sampling of 1981 Canada Census data. Results were based on the responses of 2503 children interviewed in 1983 and 1076 re-interviewed in 1987. OUTCOME MEASURES: Prevalence rates of psychiatric disorders, poor school performance and social impairment. RESULTS: There was a significant relation between low income and psychosocial morbidity, with a threshold at an income level of less than $10,000. Poor children 4 to 11 years of age were at greater risk of morbidity than poor children 12 to 16, but there were no significant age differences. Logistic regression revealed that low income and noneconomic factors (low maternal education and family dysfunction) shared significant independent influences on the prevalence of psychosocial morbidity. CONCLUSIONS: Low income is strongly associated with psychosocial morbidity in children. Both economic and noneconomic factors showed independent influences on morbidity. These findings have important clinical, scientific and policy implications.

Adolescent↗

Social phobia. The most common anxiety disorder.

Social phobia, the avoidance of social situations for fear of humiliation and embarrassment, has historically been under-recognised. Today, social phobia is the third most common psychiatric disorder that, left untreated, has been shown to have a marked impact upon the quality of life and success of sufferers. Specific pharmacotherapy and psychological therapies used simultaneously or alone, have been shown to be efficacious in the treatment of this disorder.

Anxiety↗

Rehabilitation of the handicapped child--what about the caregiver?

The mental health of caregivers of handicapped children (n = 68) and of caregivers of children with minor ailments (n = 40) was assessed using the General Health Questionnaire (GHQ). In the comparative study, the caregivers of handicapped children had a significantly higher mean score (6.8), which was above the threshold score of 4. This suggests that the task of caring for disabled children may have a stressful impact on the caregivers which may contribute to psychiatric morbidity. There is a need periodically to assess the mental health of the caregiver, even as the rehabilitation of the handicapped child progresses. Addressing the psychological disturbances in the caregiver should form part of the treatment of the handicapped child.

Adult↗

Behaviour problems of the mentally retarded.

The behaviour profiles of 176 mentally retarded individuals from two reception centres and nine group homes were assessed. The correlations between behaviour and age, sex, degree of mental retardation, etiology of mental retardation and medical diagnosis were assessed using the Revised Child Behaviour Profile. The severity of behaviour disturbance did not vary with age or medical diagnosis. The moderately retarded subjects presented with more severe behaviour problems, such as aggression, than the severely mentally retarded subjects. The variable most predictive of behavioural problems was etiology of the disorder. Individuals with Down's syndrome had significantly fewer behaviour disturbances and those with autism and pervasive developmental disorder had significantly more behaviour disturbances than other subjects. A psychiatric disorder was found in 10.2% of the sample. The implications of these findings are discussed with respect to public policy.

Activities of Daily Living↗