PubMed Health⌕ Search

Biomedical subjects

S Hollins

Publications and source records attributed to S Hollins.

15 recordsLinked to original sources
PubMed2006

Bereaved adults with intellectual disabilities: a combined randomized controlled trial and qualitative study of two community-based interventions.

BACKGROUND: Bereaved adults with intellectual disabilities are known to experience prolonged and atypical grief which is often unrecognized. The aim of this project was to find an effective way to improve mental health and behavioural outcomes. METHODS: Subjects were randomized to two different therapeutic interventions: traditional counselling by volunteer bereavement counsellors, and an integrated intervention delivered by carers which offered bereavement specific support. Qualitative and quantitative methods were used to determine their effectiveness and efficacy. RESULTS: The counselling intervention resulted in measurable gains both clinically and in terms of quality of life; the second intervention proved impracticable in most settings and no improvement in mental health or behaviour resulted. CONCLUSIONS: Despite small numbers, the quantitative findings were highly significant, were supported by the qualitative data, and were of practical relevance to primary care practitioners and specialist mental health and intellectual disability staff.

Adult↗
PubMed2005

A review of the emotional, psychiatric and behavioural responses to bereavement in people with intellectual disabilities.

BACKGROUND: Our knowledge and understanding of grief and its consequences have grown rapidly in recent years. There is a growing understanding that bereavement and loss represent a very significant event in the lives of people with intellectual disabilities (IDs). To date, there is no systematic review of the literature on the emotional, psychiatric and behavioural responses to bereavement in people with IDs. METHOD: This comprehensive literature review firstly examines the current opinion regarding the phenomenology of pathological grief in the general population. Research examining the ability of people with IDs to understand the concept of death is explored. In addition, a systematic review of the literature looking at the emotional, behavioural and psychiatric responses to bereavement is carried out. RESULTS: Bereavement and loss have distinct effects on the mental health, behaviour and emotional lives of people with IDs. Following a bereavement, symptoms of depression and anxiety increase, and general behaviour is altered. Traumatic grief symptoms have not yet been specifically studied and quantified. CONCLUSIONS: Particular difficulties are associated with researching the effects of bereavement on people with IDs. Further work needs to be done to more accurately describe the nature, time-scale, severity and frequency of the symptoms of traumatic grief in people with IDs, in order to improve assessment and treatment of affected individuals.

Affect↗
PubMed2000

Psychotherapy, learning disabilities and trauma: new perspectives.

BACKGROUND: Psychological therapies are rarely used in people with learning disabilities. Learning disability is often given as an exclusion criterion. There is insufficient published research to conduct a systematic review. Few outcome studies of psychoanalytic or cognitive psychotherapy have been reported. AIMS: To describe recent advances in understanding and practice within the learning disability field which have not received wider recognition within mainstream psychotherapy and psychiatry. METHOD: The availability of different psychotherapeutic approaches is discussed. We explore developmental issues including the contribution of attachment theory to our understanding, and the effects of trauma on the lives of people with learning disabilities. RESULTS: Theoretical and clinical perspectives suggest that many therapeutic opportunities exist. CONCLUSIONS: Practitioners are encouraged to extend their therapeutic repertoire, and to report measurable outcomes.

Clinical Competence↗
PubMed2000

Developmental psychiatry--insights from learning disability.

BACKGROUND: The Blake Marsh lecture, an annual lecture on learning disability, was endowed in 1963 in memory of Dr Blake Marsh, the former medical superintendent of Bromham House Colony in Bedford. The first lecture was given in 1967. AIMS: To review the speciality of the psychiatry of learning disability and how it is currently practised in the UK. METHOD: Clinical, service, research and educational issues in learning disability psychiatry are reviewed and illustrated. RESULTS: Key issues which emerge in all four areas include the importance of communication skills, consultation with users and carers, professional education and partnership. CONCLUSIONS: The psychiatry of learning disability is a complex, varied and stimulating branch of psychiatry with a strong developmental focus.

Education, Medical↗
PubMed1999

Bereavement and grief in adults with learning disabilities. A follow-up study.

BACKGROUND: This paper reports on the follow-up of a cohort of parentally bereaved adults with learning disabilities. AIMS: To investigate whether significant psychopathology, present up to 2.1 years after the death, had resolved five years later. METHOD: Of an original sample of 50 adults with learning disabilities, 41 were reassessed. The Aberrant Behaviour Checklist and the Psychopathology Instrument for Mentally Retarded Adults were re-administered to carers. RESULTS: At follow-up, there was a small increase in the measures of aberrant behaviour. Measures of psychopathology showed improvement, and in particular there was a reduction in anxiety. CONCLUSIONS: The response to bereavement by adults with learning disabilities is similar in type, though not in expression, to that of the general population. Learning disability is a significant predictor of mental health problems following bereavement. Participants adapted more easily when basic emotional needs had been constructively met by carers.

Adult↗
PubMed1998

Mortality in people with learning disability: risks, causes, and death certification findings in London.

Two thousand people with learning disabilities registered as service users in two London districts were followed up for 8 years to ascertain, in those who died, age and cause of death and significant associations with early death. Respiratory disease was documented as the leading cause of death in 52% of the study population compared with only 15% of males and 17% of females in the whole population. People with learning disabilities have an increased risk of early death. Although the majority of deaths (83%) in the whole population occur in people aged 65 years and over, less than 50% of deaths in the study population were in this age group, and the risk of dying before the age of 50 was 58 times higher than in England and Wales generally. Early death was significantly associated with cerebral palsy, incontinence, problems with mobility, and residence in hospital. Death certificates were not found to be a reliable source of data about factors contributing to cause of death, and learning disabilities were rarely mentioned. The authors recommend an extension to the current format of the Medical Certificate of Death to include recording of chronic disabling conditions.

Adolescent↗
PubMed1997

Bereavement and grief in adults with learning disabilities.

BACKGROUND: This paper reports the results of the first systematic study of the reaction of people with learning disabilities to bereavement. METHOD: A sample of 50 parent-bereaved people with learning disabilities was compared with a matched control group of 50 non-bereaved people. A semi-structured bereavement questionnaire was used along with the following instruments: the Aberrant Behaviour Checklist (ABC), the Psychopathology Instrument for Mentally Retarded Adults (PIMRA) and the Life Events Checklist. RESULTS: Highly significant differences are demonstrated between bereaved and non-bereaved samples on both the total scores and most of the subscores of the ABC and PIMRA. Staff and carers did not usually attribute behaviour problems to the bereavement and its concomitant life events, nor was there a recognition of psychopathology due to bereavement. CONCLUSIONS: The impact in terms of psychiatric and behavioural morbidity of loss of a parent, with its concomitant life events, in adults with learning disabilities has been underestimated.

Adult↗
PubMed1995

Menopause in women with learning disabilities.

A brief questionnaire concerning previous and current menstrual status was sent to 280 women over the age of 35 on the Wandsworth Register for People with Learning Disabilities: 196 questionnaires (70.4%) were returned. One hundred and seventy-one were used in the analyses; 45 were from women with Down's syndrome. The results suggested that, compared with data on normal women, menopause may occur earlier in women with learning disabilities and earlier still in women with Down's syndrome.

Adult↗
PubMed1995

Age-specific standardized mortality rates in people with learning disability.

The aim of the present study was to calculate the age-and sex-specific standardized mortality ratios (SMRs) in two populations of people with learning disability (LD). These populations included people living in institutions and community settings. It was found that SMRs tended to be raised for both males and females in each population, but SMRs do not always significantly differ from unity. For the combined Register populations, SMRs are generally significantly greater than unity. We conclude that these data provide evidence that death rates for people with LD are often higher than in the general population.

Activities of Daily Living↗
PubMed1989

Main autopsy findings in liver transplant patients.

The major autopsy findings from 22 patients (6 children, 16 adults) having undergone therapeutic orthotopic liver transplant are summarized. The mean age for children was 4.2 yr (range 4 mo to 9 yr) and 41 yr (range 20 to 57 yr) for adults. The mean posttransplant survival time in these patients was 16.7 d for children and 72.5 d for adults. The changes present in hepatic allograft included graft rejection (13), viral infections (11), massive necrosis due to hepatic arterial thrombosis (6), and recurrent hepatitis B (3). Infectious complications were present in 20 of 22 patients. The extrahepatic organs primarily involved by infection were lungs and brain. Bronchopneumonia and abscess formation were the most common lung findings, whereas cerebral edema and herniation, and infection occurred in the brain. Cardiac findings included acute myocardial infarction, mycotic mural thrombus and cytomegalovirus myocarditis. The gastrointestinal tract, adrenals, and kidneys were virtually spared. No significant changes were found in the pancreas and urogenital tract.

Adult↗
PubMed1985

The nutritional care of people with mental handicap.

An introduction to the changing field of mental handicap and to possible roles for the dietitian in this field illustrated with specific examples from clinical practice. The dietitian who specialises in mental handicap may work in both institutional and community settings and with all ages. Current views on prevention, treatment and rehabilitation are reviewed.

Adult↗