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Biomedical subjects

R Chaplin

Publications and source records attributed to R Chaplin.

10 recordsLinked to original sources
PubMed2006

The impact of intellectual functioning on symptoms and service use in schizophrenia.

BACKGROUND: This study aims to evaluate differences in the clinical profiles and use of psychiatric services by people with schizophrenia with and without borderline intellectual functioning. Both groups in this study were receiving standard community psychiatric care. METHODS: A naturalistic sample of 372 people with schizophrenia completed the National Adult Reading Test. Data were collected prospectively over 18 months on psychiatric symptoms and service use. Three hundred and thirteen had normal intellectual functioning (mean age 43, range 20-76 years) and 59 had borderline or lower intellectual functioning (mean age 45, range 21-81 years). This was defined by a National Adult Reading Test error score of more than 40. RESULTS: People with borderline or lower intellectual functioning had a lower quality of life, more severe psychotic symptoms, reduced functioning and fewer antidepressant prescriptions. There were no significant differences in service use including hospital admission. CONCLUSIONS: People with schizophrenia and borderline or lower intellectual functioning are a more disabled group within general adult psychiatric services who should be the focus of initiatives for improved service delivery.

Activities of Daily Living↗
PubMed2004

General psychiatric services for adults with intellectual disability and mental illness.

BACKGROUND: Adults with intellectual disability (ID) and mental illness may use general or specialist psychiatric services. This review aims to assess if there is evidence for a difference in outcome between them. METHODS: A literature review was conducted using a variety of electronic databases and hand-search strategies to identify all studies evaluating the outcome of people with ID and mental illness using general psychiatric services. RESULTS: There is no conclusive evidence to favour the use of general or specialist psychiatric services. People with ID stay less time on general psychiatric than specialist inpatient units. People with severe ID appear not to be well served in general services. Older studies of inpatient samples suggest a worse outcome for people with ID. Novel specialist services generally improve upon pre-existing general services. Assertive outreach in general services may preferentially benefit those with ID. Recent studies suggest similar lengths of stay in general psychiatric beds for people with and without ID. CONCLUSIONS: Although 27 studies were located, only two were randomized controlled trials. The evidence is poor quality therefore further evaluation of services employing a variety of designs need to be employed to give more robust evidence as to which services are preferred.

Adult↗
PubMed2000

Household spending on health care.

OBJECTIVES: This article examines changes in household spending on health care between 1978 and 1998. It also provides a detailed look at household spending on health care in 1998. DATA SOURCES: Data on household spending are from Statistics Canada's Family Expenditure Survey for survey years between 1978 and 1996, and from the annual Survey of Household Spending for 1997 and 1998. ANALYTICAL TECHNIQUES: Proportion of after-tax spending was calculated by subtracting average personal income taxes from average total expenditures and then dividing health care expenditures by this figure. Per capita spending was calculated by dividing average household spending by average household size. Constant dollar figures and adjustments for inflation were calculated using the Consumer Price Index (1998 = 100) to control for the effect of inflation over time. MAIN RESULTS: Almost every Canadian household (98.2%) reported health care expenditures in 1998, spending an average of close to $1,200, up from around $900 in 1978. In 1998, households dedicated a larger share of their average after-tax spending (2.9%) to health care than they did 20 years earlier (2.3%). Health insurance premiums claimed the largest share (29.8%) of average health care expenditures, followed by dental care, then prescription medications and pharmaceutical products.

Budgets↗
PubMed1998

Informing patients about tardive dyskinesia. Controlled trial of patient education.

BACKGROUND: This paper evaluates the effects on knowledge and clinical stability of an educational intervention about tardive dyskinesia. METHOD: Fifty-six patients receiving antipsychotic maintenance completed a questionnaire assessing their knowledge about tardive dyskinesia. After random allocation to either an educational intervention or a control group, their knowledge was reassessed at six months. RESULTS: Ninety-five per cent of patients completed the study. The study patients gained significantly more knowledge than the controls, who made modest gains. There were no significant differences in clinical outcome between the groups. CONCLUSION: Patients can learn about serious toxic effects of antipsychotic treatment with a low risk of non-compliance. Discussion about tardive dyskinesia is necessary in the process of obtaining informed consent to treatment.

Antipsychotic Agents↗
PubMed1996

The psychiatric care of people with intellectual disabilities: the perceptions of consultant psychiatrists in Victoria.

OBJECTIVE: This study was undertaken to establish the perceptions of psychiatrists regarding the care of people of intellectual disabilities. METHOD: A 28-item self-administered questionnaire was developed, piloted and sent on two occasions to 467 psychiatrists who receive the newsletter of the Victorian branch of the Royal Australian and New Zealand College of Psychiatrists. The questionnaire incorporated a Likert scale to document the opinions of the respondents. RESULTS: A response rate of 51.1% was achieved. The respondents indicated that, in their opinion, people with intellectual disabilities receive a poor standard of care in the inpatient and community setting. To improve this situation, the following strategies were recommended: the development of improved liaison between services; improved training for all personnel who provide services to people with intellectual disabilities; the development of greater resources; and support for professionals working in the area. The study also indicates that there is a core group of very interested psychiatrists who are currently practising and that people with intellectual disabilities are accessing private psychiatric services. In addition, the results suggest that diagnostic overshadowing is not a major barrier to psychiatric assessment, and that disorders which were presumed to be commonly overlooked by doctors (such as depression) are in fact frequently being diagnosed. CONCLUSIONS: Despite some positive findings, the majority of psychiatrists who responded held major concerns about the situation of people with intellectual disabilities. To improve the care provided to these people, it is recommended that these concerns are addressed by the psychiatric profession and responsible government departments in conjunction with university departments of psychiatry.

Australia↗
PubMed1995

The psychiatric care of people with intellectual disabilities: the perceptions of trainee psychiatrists and psychiatric medical officers.

OBJECTIVE: The main aim of this study was to document the perceptions of trainee psychiatrists and psychiatric medical officers regarding the psychiatric care of people with intellectual disabilities. METHOD: A 28-item self-administered questionnaire was developed by the investigators and pretested on eight psychiatrists and psychiatric trainees. A revised version of the questionnaire was then sent to 128 psychiatric trainees and 27 medical officers working in the public psychiatric services in Victoria. 116 questionnaires were returned, and the responses analysed. RESULTS: The results indicate a high degree of interest in the psychiatry of intellectual disability, however this was tempered by a feeling that the respondents and their senior colleagues are inadequately trained. The respondents expressed major concerns regarding the care of people with dual disabilities in the hospital and community setting, and significant support for the development of specialised units and subspecialisation within psychiatry. The major concerns which were identified would in part explain why 30% of the respondents felt that they would prefer not to treat people with an intellectual disability and a psychiatric disorder. CONCLUSION: We can only support the assertion made by the Burdekin Report [12] that "there is an urgent need for academic research, increased clinical expertise and substantial increased resources in the much neglected area of dual disability.

Attitude of Health Personnel↗