Improvement in the quality of life of outpatients with severe mental illness in conjunction with intellectual disabilities and post-traumatic stress disorder.

BACKGROUND: Elucidating the influence of mild intellectual disability (MID; IQ 50-70)/borderline intellectual functioning (BIF; IQ 70-85) and (comorbid) post-traumatic stress disorder (PTSD) on the quality of life of patients with serious mental illness (SMI) could improve their mental health care. METHOD: This study comprises a prospective longitudinal cohort study using routine outcome monitoring data. The cohort comprised 601 patients who had undertaken at least one Manchester Short Assessment of Quality of Life (MANSA). The scores for screeners to detect MID/BIF and PTSD were analysed, and a repeated measures analysis of variance and a multi-level linear regression was performed on the MANSA scores. RESULTS: The average quality of life for all patient groups increased significantly over time. A between-subject effect on quality of life was observed for PTSD, but not MID/BIF. CONCLUSIONS: PTSD but not MID/BIF is associated with a lesser quality of life over time.

Screening for intellectual disabilities and borderline intelligence in Dutch outpatients with severe mental illness.

BACKGROUND: The reliability and validity of the Screener for Intelligence and Learning Disabilities (SCIL) are unknown in a population of outpatients with severe mental illness. The prevalence of mild or borderline intellectual disabilities (MBID); an umbrella term for people with borderline intellectual functioning (BIF) and mild intellectual disability (MID) in this population is also unknown. METHODS: A total of 625 patients were screened with the SCIL, 201 of which also had IQ test results. RESULTS: Cronbach's alpha of the SCIL was 0.73. The AUC value for detecting MBID was 0.81, and also 0.81 for detecting MID, with percentages of correctly classified subjects (when using the advised cut-off scores) being 73% and 79%, respectively. The SCIL results suggested that 40% of the patients were suspected of MBID and 20% of MID. CONCLUSION: The SCIL seems to be an appropriate screening tool for MBID. It is important to screen for MBID because a substantial proportion of outpatients with severe mental illness appear to be functioning at this level. It is necessary to adapt treatment for these patients.