bluuebunny/crossref_metadata_2025_split huggingface dataset:
Early‐onset psychosis in youth with intellectual disability
Authors: Friedlander R. I. , Donnelly T. 
Published: August 2004

AbstractBackground  Accurate diagnosis of psychotic disorders may be very difficult in youth with intellectual disabilities.Method  The authors reviewed the assessment, treatment and follow‐up of 21 youths with ID referred because of early onset of psychotic symptoms.Results  Just over one half of the patients had a diagnosis of schizophrenia or schizoaffective disorder.One third of the sample carried the diagnosis of psychosis NOS (not otherwise specified). After careful review, five out of seven of these psychotic‐like cases were assessed as non‐psychotic.Patients with Psychosis NOS associated with moderate or severe ID had the worst outcome.Conclusion  This clinical review provides important information about the identification, diagnosis and outcome of psychotic symptoms in youth with low verbal abilities.
Schizophrenia‐spectrum psychoses in people with and without intellectual disability
Authors: Bouras N. , Martin G. , Leese M. , Vanstraelen M. , Holt G. , Thomas C. , Hindler C. , Boardman J. 
Published: August 2004

AbstractBackground  Although there is an increased risk of schizophrenia‐spectrum psychoses (SSP) in people with intellectual disability (ID), there is a paucity of research evidence into clinical presentation of the disorder in comparison with research into SSP in people without ID.Aims  The aims of the study were to compare clinical, functional, and social factors in patients with mild ID (ICD‐10: F70) and SSP (ICD‐10: F20–9) attending a specialist mental health service for people with ID, with a control group of patients without ID but with SSP attending a generic adult mental health (GAMH) outpatient clinic.Method  A total of 106 patients with SSP (53 with ID and 53 from GAMH) were assessed on psychopathological symptoms, functioning scales and quality of life. They were compared using chi‐squared and regression analysis where appropriate.Results  People with ID and SSP appear to be more debilitated by the co‐occurring disorder than those with the same disorder but without ID. Increases in observable psychopathology and ‘negative’ schizophrenic symptoms, and decreased functional abilities were observed in the group with ID when compared to the GAMH group. The clinical implications of these findings are discussed.
The association between severity of intellectual disability and psychiatric symptomatology
Authors: Holden B. , Gitlesen J. P. 
Published: August 2004

AbstractBackground  Mental illness is more prevalent in people with intellectual disabilities (ID) than in the normal population. The association between mental illness and severity of ID is also of importance in the understanding and treatment of maladaptive and challenging behaviours. The aim of this study was to investigate the association between severity of ID and prevalence of mental illness.Methods  Using The Mini PAS‐ADD, an instrument designed to identify psychiatric symptoms in people with ID, informants were interviewed about the presence of symptoms in 96 participants with moderate, severe and profound ID, and asked about the use of psychotropic medication.Results  Mental illness, particularly anxiety, depression and psychosis, was far more prevalent in participants with moderate ID than in people with severe and profound ID. The use of psychotropic medication was not significantly different between the groups.Conclusions  The prevalence of psychiatric illness decreases with severity of ID. The usefulness of psychiatric illness models, in explaining maladaptive and challenging behaviours, also decreases with severity of ID. Drug treatment may become more complicated, and behavioural and environmental interventions may become relatively more important, as severity of ID increases.
Longitudinal prescribing patterns for psychoactive medications in community‐based individuals with developmental disabilities: utilization of pharmacy records
Authors: Lott I. T. , McGregor M. , Engelman L. , Touchette P. , Tournay A. , Sandman C. , Fernandez G. , Plon L. , Walsh D. 
Published: August 2004

AbstractBackground  Little is known about longitudinal prescribing practices for psychoactive medications for individuals with intellectual disabilities and developmental disabilities (IDDD) who are living in community settings.Methods  Computerized pharmacy records were accessed for 2344 community‐based individuals with IDDD for whom a total of 3421 prescriptions were written during a 17‐month period of study. Forty‐two psychoactive medications were rank ordered in terms of prescription frequency.Results  Fifty‐two per cent (52%) of all prescriptions written during the study period were for psychoactive medications. Anticonvulsant, antipsychotic and antidepressant medications were the most commonly filled prescriptions among psychoactive medications. Sixty per cent (62%) of the study population was given prescriptions for more than one psychoactive medication and 36% received three or more psychoactive medications. During the study period there was a statistically significant increase in prescriptions filled for olanzapine, risperidone, valproic acid, and clonazepam whereas prescriptions filled for thioridazine, haloperidol, and benzotropine showed a significant decline (P < 0.05–0.001). Distribution of psychoactive drug class by age showed that the majority of prescriptions were filled for individuals between 20 and 50 years with the exception of prescriptions for psychostimulants which peaked for individuals prior to 20 years.Conclusions  (1) Analysis of pharmacy billing records provides a method for assessing prescribing patterns of psychoactive medications in community‐based individuals with IDDD. (2) Polypharmacy for psychoactive medications is prevalent in this setting. (3) The second‐generation antipsychotic medications are prominently represented by an increasing number of filled prescriptions during the study period.
Women with intellectual disability who have offended: characteristics and outcome
Authors: Lindsay W. R. , Smith A. H. W. , Quinn K. , Anderson A. , Smith A. , Allan R. , Law J. 
Published: August 2004

AbstractBackground  There have been a few reports describing the characteristics and outcomes of male offenders with intellectual disability (ID). Therefore, while we are building up a reasonable picture of this client group, there are almost no reports of female offenders with ID. This paper is a preliminary attempt to present information on a small cohort of female offenders.Methods  Characteristics of female offenders are presented including information on age, IQ, mental illness, referring agents, crimes committed, problems identified, sexual and physical abuse and outcome. Some comparisons are made with corresponding descriptions of male cohorts in Lindsay et al. (2004).Results  The main result is that females constitute 9% of referrals to the service. Other notable results are that: at 61% sexual abuse in the cohort of female offenders is higher than in male cohorts but at 38.5% physical abuse is no higher than in appropriate comparison groups; as with mainstream female offenders identification of mental illness is high at 67%; and total re‐offending over 5 years was 22% but, excluding prostitution, was only 16.5%.Conclusions  In some respects, this cohort of female offenders shows similar characteristics to their male counterparts. However, there are higher levels of mental illness, higher levels of sexual abuse and lower levels of re‐offending. It is hypothesized that as females constitute such a low percentage of referrals, it suggests that women with ID do not show the same levels of sexually abusive behaviour or aggressive behaviour – the two most frequent reasons for male referral. Therefore, an intervening variable such as mental illness may indeed be a significant factor. Lower re‐offending rates may indicate the success of interventions directed at psychological problems and mental illness.
Beyond specialist programmes: a study of the needs of offenders with intellectual disability requiring psychiatric attention
Authors: Glaser W. , Florio D. 
Published: August 2004

AbstractBackground  Despite the increased prevalence of psychiatric disorder amongst offenders with an intellectual disability (ID), there is very little known about the characteristics and needs of those with dual disability.Method  A study of admissions to a new community forensic dual disability clinic during the first 10 months of its operation.Results  Typically, the offenders are male, are older than other offenders, exhibit long‐standing and continuing serious behavioural disturbance (independent of their psychiatric diagnosis or level of involvement with the criminal justice system) and require supported or custodial accommodation, despite only mild or borderline levels of ID. Although only one‐third have a diagnosable major nonparaphilic psychiatric disorder, three‐quarters have had prior or current contact with psychiatric services and two‐thirds suffer chronic medical illness.Conclusions  These offenders suffer psychosocial disadvantages far more extensive than those implied by the ‘psychiatric’ or ‘disability’ label. The multiple services provided to this group have been ad hoc, poorly co‐ordinated and sometimes dangerously inappropriate. A service provision model is required which must be integrative and consistent. We suggest the use of multiskilled key workers, who maintain close contact with individual clients. Their role will be to implement management plans from the various specialist agencies who become involved with this group and provide long‐term follow‐up of their recommendations.
Defining the needs of patients with intellectual disabilities in the high security psychiatric hospitals in England
Authors: Thomas S. D. , Dolan M. , Johnston S. , Middleton H. , Harty M. A. , Carlisle J. , Thornicroft G. , Appleby L. , Jones P. 
Published: August 2004

AbstractBackground  Previous studies have suggested that a substantial proportion of the patients with intellectual disabilities (ID) in the high security psychiatric hospitals (HSPHs) should be transferred to more appropriate services to cater for their specific needs in the longer term.Method  The individual and placement needs of high secure psychiatric patients detained under the legal category of mental impairment or severe mental impairment were assessed in a cross‐sectional survey.Results  Patients had a large number of needs (on average 10.8), about a third of which were rated as unmet and therefore represented significant continuing problems. Approximately one‐third of the sample could be moved out of HSPHs if appropriate alternatives were available. Factors associated with the continued need for high security included higher treatment and security needs, younger age, recent violent conduct and their index offence profile.Conclusions  High security services are still required for a number of patients with ID. New and existing services need to be configured to meet specific profiles of need and provide long‐term rehabilitation and specialist care.Declaration of interest  This was part of a larger project funded by grants from the High Security Psychiatric Services Commissioning Board and Department of Health.
The modified CAMDEX informant interview is a valid and reliable tool for use in the diagnosis of dementia in adults with Down's syndrome
Authors: Ball S. L. , Holland A. J. , Huppert F. A. , Treppner P. , Watson P. , Hon J. 
Published: August 2004

AbstractBackground  Dementia because of Alzheimer's disease (AD) commonly affects older adults with Down's syndrome (DS). Methods are needed, with established concurrent and predictive validity, to facilitate the diagnostic assessment of dementia, when it is complicated by pre‐existing intellectual disabilities (ID). We report on the reliability and validity of a modified version of the Cambridge Examination for Mental Disorders of the Elderly (CAMDEX) informant interview, for use when assessing people with DS suspected as having dementia.Methods  As part of a previous epidemiological study of older people with DS, the CAMDEX informant interview was used to determine the prevalence of dementia. The 74 people with DS included at that time (Time 1) had also completed the Cambridge Cognitive Examination (CAMCOG), the neuropsychological assessment from the CAMDEX schedule. Fifty‐six were assessed again 6 years later (Time 2). Based on the CAMDEX informant interview, nine of the 74 at Time 1, and 11 of the 56 at Time 2, were found to meet clinical criteria for AD. Forty‐one scored above floor on the CAMCOG at Time 1 and were included in the analysis of cognitive decline. Concurrent validity was established by comparing diagnosis at Time 2 with independent evidence of objective decline on cognitive tasks since Time 1. Predictive validity was established by examining how accurately diagnosis at Time 1 predicted both cognitive decline and future diagnosis. Inter‐rater reliability was determined by comparing the level of agreement between two raters.Results  CAMDEX‐based diagnosis of AD was shown to be consistent with objectively observed cognitive decline (good concurrent validity) and to be a good predictor of future diagnosis. Although numbers are small, some support is also provided for the accuracy with which diagnosis predicts cognitive decline. Inter‐rater reliability was good with Kappa > 0.8 for 91% of items and > 0.6 for all items.Conclusions  The use of the modified CAMDEX informant interview enables the structured collection of diagnostic information, so that a valid and a reliable diagnosis of dementia can be made in those with pre‐existing ID, using established diagnostic criteria.
Prolonged remission after immunosuppressive therapy in six dogs with pemphigus foliaceus
Authors: OLIVRY THIERRY , BERGVALL KERSTIN E. , ATLEE BARBARA A. 
Published: August 2004

Abstract   Limited information is available on the long‐term outcome of treatment of pemphigus foliaceus in dogs. The purpose of this study is to report that a prolonged remission can occur after discontinuation of immunosuppressive regimens in some animals with this disease. Six dogs were diagnosed with pemphigus foliaceus based on suggestive clinical signs and histopathology. These patients were treated either with immunosuppressive doses of oral glucocorticoids or with a combination of oral glucocorticoids and azathioprine. After clinical signs underwent complete remission, which occurred 1.5–5 months after immunosuppression was initiated, the drugs were tapered progressively and eventually withdrawn. The total duration of immunosuppressive therapy varied between 3 and 22 months. Skin lesions of pemphigus foliaceus did not recur for 1.5–6 years after treatment was stopped. These observations suggest that, in some dogs with pemphigus foliaceus, immunosuppression can lead to long‐term remission of skin lesions, and that discontinuation of treatment is not necessarily followed by a recurrence of clinical signs.
Equine congenital papilloma: pathological findings and results of papillomavirus immunohistochemistry in five cases
Authors: WHITE KELLY S. , FUJI REINA N. , VALENTINE BETH A. , BILDFELL ROBERT J. 
Published: August 2004

Abstract  Congenital cutaneous papillomas were identified in five foals. Age at diagnosis ranged from 305 days’ gestation to 2 days of age. Breeds were thoroughbred (2), standard‐bred (1), warmblood (1) and paint (1). Two were female, one was male and the gender of two cases was not specified. Masses were pedunculated with a roughened, wart‐like (verrucous) or a smoother, cauliflower‐like surface. Masses occurred as single lesions on the forelimb, lip and face, or as multiple lesions on the trunk. Histological features included relatively uniform epidermal papillary hyperplasia with variable melanin pigment within basal layers and vacuolization of keratinocytes in all layers, but with no evidence of nuclear or cytoplasmic changes (koilocytes) characteristic of viral infection. One case showed epidermal proliferation with proliferation of pilosebaceous units. Results of immunohistochemical studies for the detection of papillomavirus antigens were negative in all cases. These results suggest that equine congenital papilloma may be a hamartomatous lesion (epidermal nevus) and not a viral‐induced growth.
Phytoplankton community and algal growth potential in Taipinghu Reservoir, Anhui Province, China
Authors: Kuang Qijun , Bi Yonghong , Xia Yicheng , Hu Zhenyu 
Published: August 2004

AbstractAn integrated investigation of the community structure and growth potential of algae in Taipinghu Reservoir, Anhui Province, China, was conducted from July 1993 to October 1994. A total of 112 algal species belonging to eight phyla were observed. Green algae were the dominant population, representing 55% of the total recorded taxa. Diatoms and blue‐green algae formed the second and the third largest algal groups, respectively. The total species and population of algae were relatively steady in spring, summer and autumn, but exhibited some variety in winter. Compared to earlier data, the species richness decreased by 36% and the number of genera decreased by 23% over an eight‐year period. The maximum values of the annual mean cell count, biomass and chlorophyll a concentration appeared in summer and the minimum in winter. The algal growth potential of the original water without supplemental nutrients was much lower than that of the control culture, but equal to or a little higher than the control culture which was supplemented with complete nutrients. The study results imply that phosphorus is the limiting nutrient for algal growth and that the trophic status of the reservoir is changing from mesotrophic to eutrophic. Based on these data, some advice on how to manage the reservoir is offered.
Limnological variations of a reservoir during two successive years: One wet, another dry
Authors: Geraldes A. M. , Boavida M. J. L. 
Published: August 2004

AbstractChanges in environmental variables, as well as in planktonic algae and in crustacean zooplankton abundance, were investigated in a meso‐eutrophic reservoir during two successive years: one wet, another dry. In the wet winter, both total phosphorus and soluble reactive phosphorus reached their maxima, whereas water transparency achieved the minimum during the same period. The obtained data suggest that total phosphorus and soluble reactive phosphorus peaks were related to the increase in nutrient loading as a consequence of the intense rainfall which occurred during this period. Phytoplankton composition was dominated by Cyclotella spp., except during the dry winter when Anabaena became dominant. The dominance of this alga seemed to be related to nitrate depletion. The establishment of more stable environmental conditions (e.g. low water turbulence, longer water retention time) and the increase of irradiance during the dry period (summer 2001 and winter 2001/2002) also favoured growth of this cyanobacterium. Concomitant to Anabaena dominance, Ceriodaphnia abundance decreased while nauplii increased. Although variation between the two years of study seemed to be related to the sequence of a pluvial and a dry year, further research is needed to evaluate whether variations in precipitation intensity influence reservoir ecological processes.
The environmental status of a Kashmir Himalayan wetland game reserve: Aquatic plant communities and eco‐restoration measures
Authors: Khan M. A. , Shah M. A. , Mir S. S. , Bashir Suzana 
Published: August 2004

AbstractThe data (November 2000 – October 2001) are presented on environmental status, hydrology, sedimentation rate, water quality and macrophytic community architecture of an important game reserve (Hokersar Wetland) in the Kashmir Himalayan valley. Of the total water input, 91% was contributed from surface inlets and just 9% through precipitation. Of the total surface water output, 67% occurred through outlets while evapotranspiration and other losses accounted for 33%. The net annual sediment accumulation was principally a function of suspended load carried by Doodganga inlet. The ecosystem supports diverse aquatic plant communities (emergents, rooted–floating leaf type, free‐floating leaf type, submersed type) marked by striking variability in composition, frequency and extent of colonization. Several ecological factors, such as habitat loss related to siltation, pollution, expanding agricultural activities and drastic hydrological fluctuations, have induced considerable changes in the dynamics and distribution pattern of sustained biota. The shift in macrophytic community structure is evidenced by the decline of Nelumbio nucifera and the near‐disappearance of some economically important plants (Euryale ferox, Acorus calamus). The shrinkage of the wetland area, once spread over 1800 ha, by ≈28% is a cause for environmental concern. The paper highlights the rapidly deteriorating environmental status of the Kashmir Himalayan Hokersar Wetland game reserve and stresses the need for its urgent ecological restoration.
Equations for designing tidally affected harbours and lagoons, and for calculating water exchange in coast‐connected lakes
Authors: Essa Sawsan S. 
Published: August 2004

AbstractA three‐dimensional flow and transport model was used to simulate the flow of water and assumed conservative substance in a large number of hypothetical, sea‐connected lagoons and harbours experiencing tidal effects. The dimensions of the lagoons and harbours were selected to cover a wide range of widths, lengths, depths and entrance channel widths. The tidal flow in and out of each lagoon and harbour was simulated for durnal and semidurnal conditions for different tidal ranges. The water exchange for each lagoon and harbour was assessed on the basis of the exchange coefficient. The results of model runs and non‐linear multiple regression techniques were used to develop equations for calculating the average exchange, in terms of lagoon dimensions, depth and tidal range for durnal and semidurnal conditions. These equations can be used for a quick assessment of water exchange conditions in lagoons and harbours, upon which their water quality depends. In designing an artificial, sea‐connected lagoon and harbour, the developed equations can be used in the preliminary stages for testing options regarding the number and widths of entrances and the physical layout of the lagoon and harbour. This approach also allows for identification of unsuitable options, with the acceptable options being subjected to detailed mathematical modelling to assess their expected water exchange and water quality. The same approach can be applied to existing lagoons (natural or artificial) and harbours in designing layout modifications for improving water exchange and water quality conditions, as well as lakes directly connected to coastal waters and subject to tidal effects. The use of the equations presented in this report also can provide knowledge regarding the preferred water flushing conditions and/or improvements needed to enhance the water exchange in order to preserve the ecosystems in such water systems.