PubMed Health⌕ Search

Biomedical subjects

T Fryers

Publications and source records attributed to T Fryers.

At least 19 recordsLinked to original sources
PubMed2002

Common mental disorder symptom counts in populations: are there distinct case groups above epidemiological cut-offs?

BACKGROUND: At the lower end of IQ distributions in general populations, there is a clear excess of cases, representing the distinct pathology of severe learning disability. This study aimed to establish whether such a subpopulation exists in distributions of common mental disorder and depression symptom scores, above epidemiological 'case' cut-offs. METHOD: Data from 9556 non-psychotic respondents to the 1993 OPCS (Office of Population Censuses and Surveys) National Household Psychiatric Morbidity Survey were analysed. The distribution of total neurotic symptom and depression scores from the revised Clinical Interview Schedule were examined. Automated least squares methods were used to fit the best single statistical distribution to the data. RESULTS: A single exponential curve provided the best fit for the whole population, but floor effects produced deviations at symptom counts of 0-3. After truncation, exponential distributions fitted excellently. Proportions of the population above conventional cut-offs of > or = 12 symptoms differed by < 12% from expected for a range of low and high prevalence groups. The single exponential model also fitted the depression score. CONCLUSIONS: Symptom counts for the common mental disorders fall within single population distributions, with little apparent numerical excess in the case range. High and low prevalences of these disorders appear to be population characteristics, with shifts in exponential means predicting proportions above case cut-offs.

Adolescent↗
PubMed1992

Epidemiology and taxonomy in mental retardation.

The present state of epidemiological research in relation to mental retardation is described, with particular respect to taxonomic issues. A comprehensive taxonomy is proposed, and the problems of establishing it discussed.

Child↗
PubMed1988

The practice of community psychiatric nursing and mental health social work in Salford. Some implications for community care.

The context and content of work undertaken with individual clients by community psychiatric nurses (CPNs) and mental health social workers (MHSWs) in Salford were found to be significantly different. Although there were some areas of overlap, the ways in which the two professions worked were quite distinct. MHSWs discussed a wide range of topics and were as concerned with clients' interactions with family and community networks as they were with symptoms. Their interviews with schizophrenic clients followed a similar pattern to those with other groups, and they worked closely with psychiatrists and other mental health staff. CPNs, on the other hand, focused mainly on psychiatric symptoms, treatment arrangements, and medications, and spent significantly less time with individual psychotic clients than they did with patients suffering from neuroses. They were as likely to be in contact with general practitioners as they were with psychiatrists, and had fewer contacts with other mental health staff than the MHSWs. There was evidence that the long-term care of chronic psychiatric patients living outside hospital required more co-ordinated long-term multidisciplinary input.

Community Mental Health Services↗
PubMed1987

Epidemiological issues in mental retardation.

The basic epidemiological issues have not changed fundamentally in 30 years but emphases are different. Clarity of concept and definition is essential; we need several definitions for different purposes, and should distinguish global criteria defining groups in some way specifically 'retarded' and partial criteria defining groups not exclusive to retardation. Of global definitions, we can distinguish Intellectual Impairment based on IQ, Learning Disability based on educational criteria, and Mental Handicap or Retardation based on service or administrative criteria. The first and second may be co-terminous for children. The first and third are usually co-terminous below a certain IQ level, conventionally 50, as SII and SMH/R. This is not so for higher ability groups: MII and MMR are conceived and defined differently, and suit different research purposes. There may be much unknown need because there have been so few studies of total IQ defined groups above 50. Although organic and psychological factors are very important, the study of MMR needs to recognize its primarily social nature, reflecting determinants of selection into MMR status in legal, organizational and professional structures, activities and attitudes characteristic of particular communities and cultures. If the primary focus is on aetiological factors, natural history, and preventive possibilities, study group should be aetiologically defined and preferably not limited to MR. The same applies to specific impairments, disabilities, diseases, behaviours and disadvantages. The services are also susceptible to epidemiological approaches, descriptive, analytic, interventionist and evaluative, but little is yet available on agency structure and function, professional activities, attitudes and training, legal contexts, and financial constraints. Rigorous outcome studies would greatly benefit rapidly developing services. We know quite a lot about the distribution and associations of SII/SMR, though more is needed, especially to clarify issues of social class distribution. There is a dearth of good research in MII or MMR, and several large scale new studies could be justified. Work on the epidemiology of aetiological entities has progressed, though there are many gaps. Because of their rarity, we should be looking to bring together all the data on aetiological diagnosis now accumulating in good paediatric units throughout the UK.

Epidemiologic Methods↗
PubMed1986

Patients in receipt of community psychiatric nursing care in Salford 1976-82.

Case register data are used to describe the age and diagnostic distribution of people using the community psychiatric nursing (CPN) service in Salford. Data are related to those in hospital-based psychiatric services. Annual prevalence rates grew dramatically, and increasing numbers of people were found to have received continuous CPN care for 2 years and over. Following the establishment of the CPN service in a primary care setting, the proportion of patients suffering from depression in receipt of CPN care increased, and the resulting overall diagnostic distribution of CPN patients became similar to that of the specialist psychiatric services as a whole. Patients under the sole care of community psychiatric nurses (about 19% of the total CPN prevalence each calendar year) contributed to an overall increase in treated prevalence. The data indicate that CPN services in Salford are treating the morbidity found at primary care level, rather than reducing the demands made on the traditional services.

Community Mental Health Services↗
PubMed1986

A comparison of patterns of disability in severely mentally handicapped children of different ethnic origins.

All severely mentally handicapped children aged 5-19 years from the city of Manchester were identified in a cross-sectional study. A standardized Disability Assessment Schedule was used to assess the variety and degree of disabilities experienced by each child and by specific subgroups of the children. This paper focuses upon differences between groups of European and Non-European ethnic origin. Boys showed more disabilities than girls in both groups, but non-European children had more severe disabilities in virtually all categories.

Activities of Daily Living↗
PubMed1983

Psychiatric service use in Salford. A comparison of point-prevalence ratios 1968 and 1978.

Using data from the Salford Psychiatric Case Register, point-prevalence patterns of service use in Salford County Borough are compared for 1968 and 1978 with respect to type of care, age and diagnosis. In a declining population, overall point-prevalence ratios increased from 9.52 to 13.44/1,000 adults, due almost entirely to two extensive new services--"injection-only" nurse contact with out-patients, and community psychiatric nurse domiciliary contact. Their development has apparently hardly affected use of other services. The increase was similar in most age-groups and in the predominating diagnostic groups (schizophrenia and depression). Prevalence ratios for long-stay patients barely changed in total, and increased for those accumulated in a ten-year period, but there was an upward shift in age. Day care increased, but its contribution remained relatively small. The diagnostic distribution of social work contact changed, as community psychiatric nurses (CPNs) assumed domiciliary care of people with schizophrenia.

Adolescent↗
PubMed1982

Medical education in action: community-based experience and service in Nigeria.

Problem-based, student-centred learning at the Faculty of Health Sciences, Unilorin, Nigeria were incorporated in the overall objectives of producing students with a sense of service and a strong inclination toward broad community care and preventive medicine. The educational programme reflecting this concept was called COBES (community-based experience and service). Twice a year groups of between seven and fourteen students, each accompanied by two to three staff members, settled in a village or other community for 1 month. According to the Faculty's objectives, each group assessed the size of its community (population, areal map) at first. Malnutrition and infectious diseases were selected as the two health problems which were to be studied in depth during the first two COBES placements. Data were collected and analysed by the students from which deductions were made, and at the end of the placement a written report was required by the Faculty. Three learning situations and the experience gained from them by one group of students are reported: (1) What was our community? (2) The nutritional status of children, and (3) Guinea-worm infection. The educational benefits of the programme are discussed and the view of the students is brought out. A correct assessment of students' performances proved difficult. Other problems were related to the experimental situation of COBES, such as insufficient support of the programme by some staff members, the lack of programme structure and logistical shortcomings. The COBES programme, however, set a pattern of medical education which specifically suits Nigerian needs and probably those of other African countries.

Child↗
PubMed1979

Down syndrome: prevalence at birth, mortality and survival. A 17-year study.

Analysis of comprehensive records over a period of 15 yr permits calculation of the total prevalence of Down Syndrome in an industrial city. The prevalence at birth is shown to have fallen from 1.70 per 1000 births in the period 1961--65 to 0.84 per 1000 births in 1971--75. The fall in prevalence can be shown to be largely due to a change in distribution of maternal age. An earlier increase in the number of Down Syndrome children is shown to reflect a greatly improved survival in the first 5 yr of life to a continuing level of 81%. The number of Down Syndrome children is unlikely to increase much even with increase of birth rate unless older mothers have further pregnancies. For these reasons the policies of amniocentesis of older women and termination of affected pregnancies will have progressively less effect on the number of affected children if this demographic trend continues. A further effect is that special schools will have a proportionately greater burden as the younger children being admitted have less prospect of development and may be more demanding of staff than Down Syndrome children.

Actuarial Analysis↗
PubMed1979

The epidemiology of severe mental handicap.

Prevalence studies of severe mental handicap in an industrial area in the North West area of the United Kingdom have shown a marked increase between 1961 and 1977, with the hint of a reduction in the most recent years. Further analysis of causes of severe mental handicap shows that the prevalence of Down Syndrome is decreasing, certain causes remain constant in prevalence, and perinatal metabolic causes are shown to be increasing through a period of 15 yr ending in 1975. While improved survival of children influences the total prevalence, high mortality in some conditions makes the analysis of prevalence at birth more significant in considering changes in the pattern of aetiology. These studies are fundamental to the formulation of policies of prevention of severe mental handicap, whether these be social or dependent solely on health care services.

Adolescent↗
PubMed1979

Accumulating long-stay in-patients in Salford: monitoring further progress.

Data derived from a psychiatric case-register are presented on the accumulation of new long-stay cases in Salford from 1967 to 1976. The analysis supports the general decline reported in an earlier shorter-term study except for the over 65s, where the trend was reversed. The implications of the findings are discussed.

Adolescent↗
PubMed1973

Psychiatric impatients from an urban community, 1968-72.

The psychiatric inpatient population from Salford was analysed in five successive annual censuses, from 1 January 1968 to 1 January 1972. Short-stay and medium-stay patients (under one year) remained constant. Long-stay patients reduced only slowly, and the length of stay increased. Over 200 patients (60%) had been in for 20 years or more at 1 January 1972. Analysis showed that the 1968 long-stay cohort diminished by 122 patients (29%) in four years, while 54 new long-stay patients accumulated. There seems little prospect of emptying large psychiatric hospitals of their long-stay population.

Adult↗
PubMed1969

Psychiatric emergencies in an urban borough.

An analysis is presented of all emergency calls made in one year, "out of hours," to local authority mental health social workers as part of a comprehensive psychiatric service in an urban community. Of 212 calls received, more related to men than women, and in both sexes the peak age group was 40 to 49 years; 72% of referrals were in the psychosis or personality disorder diagnostic groups. A minority of cases referred had symptoms of only recent onset, and 70% of all calls related to patients previously known to the local services.

Adolescent↗