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2 results

  • Viewpoint: do antipsychotics protect against early death? A critical view

  • Robert Whitaker
  • Journal:
    Psychological Medicine / Volume 50 / Issue 16 / December 2020
    Published online by Cambridge University Press:
    14 October 2020, pp. 2643-2652

  • In the past 15 years, researchers utilizing prescription databases to assess medication usage have concluded that antipsychotics reduce mortality in patients diagnosed with schizophrenia and other psychotic disorders. These findings stand in contrast to studies in non-psychiatric patients that have found that antipsychotics, because of their adverse effects on physical health, increase the risk of early death. A critical review of the evidence reveals that the worry remains. There is reason to conclude that antipsychotics contribute to the ‘mortality gap’ between the seriously mentally ill and the general population and that the database studies are plagued with methodological and reporting issues. Most importantly, the database studies tell of mortality rates within a drug-centered paradigm of care, which confounds any comparison of mortality risks when patients are on or off antipsychotics.

  • Not recognized enough: The effects and associations of trauma and intellectual disability in severely mentally ill outpatients

  • Jeanet Grietje Nieuwenhuis, Hedwig Johanna Henrica Smits, Eric Onno Noorthoorn, Cornelis Lambert Mulder, Engelbertus Johannes Maria Penterman, Henk Llewellyn Inge Nijman
  • Journal:
    European Psychiatry / Volume 58 / May 2019
    Published online by Cambridge University Press:
    02 March 2019, pp. 63-69
    • Article
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  • Background:

    Little is known about the association between trauma and intellectual disability in SMI patients.

    Aim:

    To establish the prevalence of trauma and its association with intellectual functioning in SMI outpatients.

    Methods:

    A cross-sectional study was conducted in two mental health trusts in the Netherlands. We used the Trauma Screening Questionnaire (TSQ) to screen for trauma and PTSD, and the Screener for Intelligence and Learning disabilities (SCIL) for suspected MID/BIF. Chi-square and t-tests were used to test differences in outcome over patient characteristics. Post-hoc analysis was used to investigate gender differences between patients with and without MID/BIF on trauma and sexual trauma.

    Results:

    Any trauma was found in 86% of 570 patients and 42% were suspected for PTSD. The SCIL suggested that 40% had Borderline Intellectual Functioning (BIF), half of whom were suspected of having Mild Intellectual Disability (MID). These patients had more traumatic experiences (1.89 in BIF, 1.75 in MID, against 1.41 in SCIL-negative patients). Female MID/BIF patients (61%) had experienced significantly more sexual abuse than male MID/BIF patients (23%).

    Conclusions:

    Significantly more SMI outpatients who screened positive for MID/BIF reported having experienced traumatic events than those who screened negative. Rates of all trauma categories were significantly higher in the screen-positive group, who were also more likely to have PTSD. Sexual abuse occurred more in all females but the SCIL positive women are even more often victim. Clinical practice has to pay more attention to all of these issues, especially when they occur together in a single patient.