Brief report: the sexual and physical abuse histories of offenders with intellectual disability.

BACKGROUND: Some studies have found higher rates of childhood sexual abuse in sex offenders while others have failed to find such relationships. METHOD: This study reviews the sexual and physical abuse histories of 156 male sex offenders with intellectual disability (ID), 126 non-sexual male offenders with ID and 27 female offenders with ID. RESULTS: Sexual offenders reported a higher rate of sexual abuse in childhood than non-sexual male offenders (32.6% vs. 17.8%), while the opposite was true for non-accidental injury (16.0% vs. 32.5%). Female offenders reported the highest rates of sexual abuse in childhood (59.3%). CONCLUSIONS: Some specificity of childhood abuse was evident in the male cohorts suggesting limited evidence of a developmental pathway to offending, while the women were a group highly vulnerable to all forms of abuse.

Prevention of clozapine-induced granulocytopenia/agranulocytosis with granulocyte-colony stimulating factor (G-CSF) in an intellectually disabled patient with schizophrenia.

BACKGROUND: While clozapine is an effective treatment for refractory schizophrenia, its use is limited by haematological side effects. Treatment options that allow continued prescription of clozapine by tackling these side effects will greatly aid patients for whom this medication is all too often their only hope of recovery. METHOD: In this case report, we describe what we believe are two 'firsts' in the clozapine literature: the use of granulocyte-colony stimulating factor on a prophylactic basis in an intellectually disabled patient receiving clozapine for refractory schizophrenia. RESULT: Treatment with granulocyte-colony stimulating factor prevented discontinuation of clozapine, enabling our intellectually disabled patient's recovery from a schizophrenic illness.

Accidents don't happen any more: junior doctors' experience of fatal accident inquiries in Scotland.

OBJECTIVE: To determine the experience of junior doctors cited as witnesses at fatal accident inquiries (FAIs). DESIGN: Retrospective questionnaire study. SETTING AND SUBJECTS: 40 junior doctors who had been involved in FAIs from January 1998 to August 2002 were identified by the Medical Protection Society and Medical and Dental Defence Union of Scotland: 21 completed questionnaires were returned, a response rate of 52.5%. RESULTS: The process and objectives of FAIs were poorly understood. Few participants were proactive in contacting their defence union. There was a perceived lack of both formal and informal supports with respondents describing a "blame culture" within the medical profession. The experience of the FAI was generally considered stressful with respondents describing possible improvements relating to support, information, training, and the FAI procedure. CONCLUSIONS: Junior medical staff are poorly informed in this medicolegal area. There is a need for the development of mechanisms both to support junior doctors and to ensure that adverse incidents are dealt with using modern risk management techniques to minimise the risk of recurrence.