ABSTRACT
BACKGROUND: Information on the numbers of adult persons (aged 20 years and over) with intellectual disability (ID) is rarely collated at a national level. This is an impediment to service planning especially for a changing population. METHODS: A database of all persons in receipt of ID services has been operating in the Republic of Ireland since 1995. In Northern Ireland, regional databases can be used to provide similar information. RESULTS: A total of 25,134 persons were known to services in 2002; an overall prevalence for the island of 6.34 per 1,000. However this rate varied for different age groupings and across the two parts of the island. General population characteristics, as well as service factors, appear to account for this. Significantly more people lived with family carers in Northern Ireland. By 2021, it was estimated that the population would increase by over 20% with around one-third of persons aged over 50 years. CONCLUSIONS: These data illustrate the variations that exist in the numbers of adult persons with ID known to services across and within regions of a country. Hence caution must be exercised in extrapolating prevalence rates derived in one area to another. The availability of comparative national data highlights issues around the equitable funding and delivery of services.
Subject(s)
Cross-Cultural Comparison , Intellectual Disability/epidemiology , Adult , Aged , Cross-Sectional Studies , Female , Forecasting , Health Planning/trends , Home Nursing/statistics & numerical data , Humans , Incidence , Ireland , Male , Middle Aged , Needs Assessment/trends , Northern Ireland , Population Dynamics , Residential Facilities/statistics & numerical dataABSTRACT
OBJECTIVES: To examine if low parental social class increases children's risk of subsequently developing schizophrenia or modifies the presentation. DESIGN: Case-control study with historical controls. SETTING: Geographically defined region in south Dublin. PARTICIPANTS: 352 patients with first presentation of schizophrenia matched with the next registered same sex birth from the same birth registration district. MAIN OUTCOME MEASURES: Social class at birth. Age at presentation to psychiatric services, admission to hospital, and diagnosis of schizophrenia. RESULTS: Risk of schizophrenia was not increased in people from lower social classes. There was a slight excess risk among people in highest social classes (odds ratio 0.59, 95% confidence interval 0.40 to 0.85). However, the mean age at presentation was 24.8 years for patients whose parents were in the highest social class compared with 33.1 years for those in the lowest social class at birth. CONCLUSIONS: Although social class of origin does not seem to be an important risk factor for schizophrenia, it partially determines the age at which patients receive treatment. The relation between low social class at birth and poor outcome may be at least partially mediated through treatment delay.
Subject(s)
Schizophrenia/etiology , Social Class , Adult , Age Factors , Age of Onset , Case-Control Studies , Female , Hospitalization/statistics & numerical data , Humans , Infant, Newborn , Ireland , Male , Odds Ratio , Patient Acceptance of Health Care/statistics & numerical data , Risk FactorsABSTRACT
The Department of Health established a computerised national mental handicap database in the Republic of Ireland in 1995 for the purposes of providing accurate information for planning services for people with mental handicap. Initial estimates indicate that 27,193 people are either in receipt of or in need of mental handicap services. This paper presents preliminary prevalence data from the database which were analysed by age, sex, degree of handicap and geographical region. Comparisons are drawn with the findings of two previous censuses which are conducted in Ireland in 1974 and 1981 and implications for future service provision are discussed.
Subject(s)
Disability Evaluation , Intellectual Disability/epidemiology , Registries , Adolescent , Adult , Age Distribution , Aged , Child , Child, Preschool , Databases, Factual , Female , Health Services Needs and Demand , Humans , Ireland/epidemiology , Male , Middle Aged , Population Surveillance , Prevalence , Severity of Illness Index , Sex DistributionABSTRACT
Transverse, or spin-spin, relaxation times (T2) from magnetic resonance images of basal ganglia structures were compared between control subjects and patients with schizophrenia, who were subdivided on the basis of the presence or absence of tardive dyskinesia. As a group, schizophrenic patients showed evidence of somewhat more prolonged T2 relaxation times in the right putamen and globus pallidus than did control subjects; there were no significant correlations between hemispheric T2 values and corresponding volumes of the lateral ventricles. Overall, there was little difference in T2 values between patients with and without tardive dyskinesia. These data extend the range of evidence for basal ganglia dysfunction in schizophrenia, but they do not support earlier reports of prominent T2 changes associated with tardive dyskinesia.
Subject(s)
Basal Ganglia Diseases/diagnosis , Basal Ganglia/pathology , Dyskinesia, Drug-Induced/diagnosis , Magnetic Resonance Imaging , Schizophrenia/diagnosis , Schizophrenic Psychology , Adult , Antipsychotic Agents/adverse effects , Antipsychotic Agents/therapeutic use , Basal Ganglia/drug effects , Basal Ganglia Diseases/chemically induced , Cerebral Ventricles/drug effects , Cerebral Ventricles/pathology , Dominance, Cerebral/drug effects , Dominance, Cerebral/physiology , Female , Globus Pallidus/drug effects , Globus Pallidus/pathology , Humans , Male , Middle Aged , Neurologic Examination/drug effects , Putamen/drug effects , Putamen/pathology , Schizophrenia/drug therapyABSTRACT
Using case register data, the overall marital rate among 5158 patients with mental illness was found to be comparable to the general population. The proportion of those ever married was markedly reduced in the schizophrenic group relative to those with a manic or neurotic illness. Men with schizophrenia had a particularly low rate of marriage. The overall marital fertility of the 3 groups was comparable to each other and appeared to be higher than that in the general population. In the schizophrenic group only, married men, particularly those with a family history of mental disorder, produced more children than married women. Men might represent a more fertile group of schizophrenic patients with some biological advantage of increased fecundity, which may help to compensate for negative selection pressures.
Subject(s)
Fertility , Marital Status , Schizophrenia/physiopathology , Schizophrenic Psychology , Sexual Behavior , Analysis of Variance , Bipolar Disorder/physiopathology , Family Characteristics , Female , Humans , Male , Neurotic Disorders/physiopathologyABSTRACT
Twenty eight schizophrenic patients and 20 normal volunteers underwent proton magnetic resonance spectroscopy (MRS) on the left temporal and frontal lobe regions. Male patients showed a significant reduction in frontal but not temporal n-acetylaspartate (an intraneuronally distributed metabolite) in comparison with either male controls or female patients; frontal choline was raised in male patients relative to these groups. Putative neurodevelopmental indices, including obstetric complications, family history of schizophrenia, and minor physical anomalies, proved unrelated to MRS resonances. However, multiple aspects of memory function in patients were related to temporal but not frontal creatine, a pattern that was not apparent among controls. These MRS findings complement some previous structural MRI studies and much clinical and epidemiological evidence of important gender differences in schizophrenia. The findings also suggest that memory dysfunction in patients with schizophrenia may be associated with a particular pattern of temporal lobe metabolism on MRS.
