The associations of quality of life and general functioning with trauma, borderline intellectual functioning and mild intellectual disability in outpatients with serious mental illness.

BACKGROUND: Trauma and intellectual disability are highly prevalent in the serious mental ill (SMI). Little is known of their impact on general functioning and quality of life. AIM: This study investigated the association of trauma and intellectual disability (ID) with general functioning and quality of life in SMI. METHODS: Patient characteristics and diagnoses were extracted from electronic patient records. We used the Trauma Screening Questionnaire (TSQ), the Screener for Intelligence and Learning Disabilities (SCIL), the Health of the Nation Outcome Scale (HoNOS) and the Manchester Short Assessment of Quality of Life (MANSA) to asses trauma, intellectual impairment, general functioning and quality of life. Proportions on cut-off scores were analysed with cross-tabulations, questionnaire scores with t-tests. Multivariable associations were determined by logistic regression analysis. RESULTS: 611 patients from an outpatient service were assessed. Trauma and ID were associated with each other (r = -0.207). Trauma was associated with worse general functioning and a lower quality of life. Mild intellectual disability (MID) or borderline intellectual functioning (BIF) were associated with worse general functioning. CONCLUSIONS: For patients with SMI, trauma and ID should be identified early in care to treat the lower general functioning and quality of life it caused.

[The predictive value of mild intellectual disability/ borderline intellectual functioning and ptsd for treatment results in severely mentally Ill patients]. / Voorspellende waarde van lichte verstandelijke beperking en PTSS voor behandelresultaten van patiënten met ernstige psychiatrische aandoeningen.

BACKGROUND: Little is known about the influence of mild intellectual disability/borderline intellectual functioning (mid/biF) or posttraumatic stress disorder (ptsd) on treatment results in severely mentally ill (smi).
AIM: To investigate whether screeners determining mid/biF or ptsd are associated with less favorable treatment outcome in smi.
METHOD: The screener for intelligence and learning disabilities (scil) was used to screen for mid/biF. The trauma screening questionnaire (tsq) was used to detect ptsd. Outcomes of these screeners were associated with repeated measures on the health of the nation outcome scales (HoNOS) in 628 smi at the Mental Care Centre of Oost Brabant.
RESULTS: In 628 patients one or more HoNOS was acquired. In 352 (56%) patients a scil was acquired, in 334 (53%) patients a tsq. The largest improvement was observed in patients not meeting the criteria for mid/biF and/or ptsd. Less improvement was observed in patients with ptsd and a suspected iq between 70-85, estimated with the scil. No significant change on the HoNOS was observed in patients with an estimated iq below 70.
CONCLUSION: Routine screening for mid/biF and ptsd symptoms is important for early recognition of the disorder, resulting in providing better treatment interventions for patients with mid/biF and ptsd.

Interactions between gut-associated lymphoid tissue and colonization levels of indigenous, segmented, filamentous bacteria in the small intestine of mice.

Unlike most other indigenous bacteria, segmented filamentous bacteria (SFB) are potent activators of the mucosal immune system. SFB are strongly anchored to the epithelial cells of the small intestine where they have a preference for mucosal lymphoid epithelium. Since SFB are only present in high numbers shortly after weaning, it was investigated whether an SFB-induced immune reaction results in the removal of these bacteria from the small intestine. A correlation was found between age and colonization levels in the small intestines of SFB monoassociated Swiss mice. Five-week-old athymic BALB/c (nu/nu) mice showed lower colonization levels than their heterozygous littermates, but the opposite was found at the age of 12 weeks. However, SFB inoculation of germfree Swiss mice resulted in higher colonization levels in 5-week-old mice when compared with 4-month-old mice. We conclude that SFB colonization levels in the small intestine are likely influenced by the activity of the mucosal immune system. However, an additional age-dependent factor that modulates SFB colonization levels cannot be excluded.

Cardiac size in the supine chestfilm.

The aim of this study was to find a normal value for the cardiac size in the supine position because such a standard is hardly known in the literature. Cardiac size in the erect and supine positions were compared in 165 patients in whom both chest radiographs were performed prior to kidney transplantation. For cardiac size as well as for cardiothoracic ratio (CTR) there is a linear relation between the measured values in the two positions which allows to determine the cardiac size in the supine position from a radiograph taken in the erect position and thus to determine whether cardiac enlargement exists in a supine chest film. A survey of 100 patients without cardiac or pulmonary pathology showed 16 patients with a heart size over 15 cm, the upper limit of normal as established over 20 years ago, which suggests that nowadays a new standard might be set. If so, the upper limit of normal CTR is 0.55 in the erect and 0.58 in the supine position. Two figures are presented to determine cardiac size and CTR in the supine position from the measured values in the erect position and vice versa.