Objectives: To determine the prevalence of psychiatric disorders in adults with learning disabilities, and the relationship with severity of learning disabilities.

Method: The study is population-based. Detailed psychiatric assessments on 207 adults with learning disabilities living in Leicestershire, UK. were conducted by a learning disabilities psychiatrist, using the Present Psychiatric State - Learning Disabilities; and Disability Assessment Schedule. Diagnostic criteria are clearly defined. Developmental assessments were undertaken using the Vineland Scale (survey form).

Results: Psychiatric disorders were found in 49.2%, and rates for most individual disorders were higher than those found in the general population. Comparison with the two previous population-based studies shows the ascertained rates were broadly similar to those reported by Corbett but higher than those reported by Lund. Adults with more severe learning disabilities had higher rates of additional psychiatric disorders.

Conclusions: The results may be explained by a combination of the genetic, physical, psychological and social factors associated with learning disabilities also being aetiological to psychiatric disorders. The high prevalence rates of psychiatric disorders demonstrate the importance of health service provision for adults with learning disabilities.

Objectives: To evaluate factors that predict HIV testing using the model of health care utilisation as its conceptual framework and to analyse some of the factors that encourage or inhibit seeking an HIV test in this population.

Method: A cross sectional questionnaire study in two Genito-Urinary Medicine (GUM) clinics in central Scotland. A final sample of 195 represented a 91% response rate. Participants were categorised by their HIV testing status (already tested, planning to be tested, no intention to seek testing).

Results: The ‘already tested’ and ‘planning to be tested’ groups were combined as there were no significant differences on reported risk behaviours. Analysis therefore compared two groups those ‘testing’ (n = 66) and ‘not testing’ (n = 129). 67% of those not tested for HIV reported at least one HIV risk factor. Perceived risk was the strongest predictor of HIV testing using our model. Perception of risk and actual risk were not correlated. Those not seeking testing endorsed less benefits of testing and more denial of the need to be tested. Same day testing and testing without an appointment were endorsed as factors to promote testing.

Conclusion: To encourage people who have high risk factors to access HIV testing, programmes should: (1) highlight the benefits of testing which would be lost if people do not test, eg. effective drug treatments (2) increase the range of HIV testing services available (eg. same day testing). Furthermore, studies to determine the main predictors of perceived risk are needed if we are to increase testing in relevant populations.

Objectives: To establish the prevalence of psychological problems in early school leavers, who attend training schemes.

Method: The Youth self report inventory was completed by teenagers as part of a group setting. Percentages of those scoring above clinical threshold were calculated and gender differences examined.

Results: 78 teenagers participated in the study, 40 males and 38 females. 24% were classified as being in the clinical range of total problem score. Girls reported more total, internalising and externalising problems than boys. 13% of girls frequently thought of suicide and 7% had frequent thoughts of self harm, this contrasts with none of the boys admitting suicidal ideation and 2.5% reporting thoughts of self harm.

Conclusions: 24% of this group experienced problems which placed them within the clinical range. Girls experienced greater problems than boys and appear to be at greater risk of self harm. This group appear to be representative of those who attend training programmes, however it is not possible to determine whether they are representative of all early school leavers. This highlights the vulnerability of older adolescents, and in particular those who leave school early. More detailed examination of issues facing this group are needed and should be a priority along with greater service provision from the educational and health sectors.

Objectives: To measure the level of psychological distress caused to supporters of a football team by relegation from the English Premier League. The relationship between age, sex and psychological distress are examined.

Method: Opportunity sample cross-sectional survey. Participants were approached through networks of fans and through e-mail networks. Participants were supporters (n = 65) of two relegated premiership football teams. Participants completed the Impact of Event Scale.

Results: Mean total Impact of Event Scale scores indicated a clinically significant degree of psychological distress for the majority of respondents. Age or sex of the participants did not predict Impact of Event Scale scores.

Conclusions: The results are discussed in terms of the magnitude of Impact of Event Scale scores in relation to other stressors. It is concluded that the impact of such sporting events is psychologically significant. The psychological literature has considered traumatic stress responses to a number of stressors such as threats to life, threats to psychological well-being, threats to physical/ psychological well-being of others, witnessing traumatic events and involvement in a human or natural disaster.

Objectives: There have been concerns in the international literature that the manner in which psychiatry and psychiatric patients is portrayed in the print media is negative and sensational. If correct this has serious implications for the stigma and prejudice that our patients will suffer. This study was designed to evaluate the content and tone of articles relating to psychiatry. It was compared with a broadly similar study published in 1995 and will form the base from which to measure changes in psychiatric coverage over time.

Method: All the daily broadsheets, one daily tabloid and three Sunday broadsheets were examined for a six month period in 1999 and all articles, letters or headlines incorporating psychiatry-related material were examined. Using specific definitions, articles and headlines were examined for tone and content as well as for the contribution of mental health professionals.

Results: Overall 0.65 articles per newspaper per day were found. News items and feature predominated, with forensic issues receiving the greatest attention. The tone of the articles was either neutral or positive and the improvement in the tone of articles in the tabloids was particularly noticeable when compared with an earlier study. This is very different from the findings of international studies. However, the headlines were more sensational in tone than the contents of the articles themselves. Increasingly the opinion of health professionals was sought but contributions from psychiatrists remained low, writing just two articles and constituting 15% of health professionals whose opinions were sought. Nine per cent of items constituted misuse of terms.

Conclusions: The Irish print media are not hostile to psychiatry and there has been an improvement in tone and type of article in the past five years. Greater involvement of psychiatrists in the media and particularly more direct engagement with editors is required if there is to be a shift from coverage of forensic matters in favour of informative articles as well as improvement in the headline tone.

This review identifies similarities between behavioural indicators of children with future schizophrenia-spectrum disorders and prodromal symptoms in the first episode of schizophrenia. An alternative concept of prodrome is described with implications for early recognition, monitoring and intervention of individuals at risk of future schizophrenia spectrum disorders.

Health policy documents recommend screening for cognitive impairment, although in practice this is not implemented. This article looks at the issues which require consideration in implementing a screening programme. These include factors pertinent to the disease under consideration, resources, both personnel and time, lack of experience of cognitive screening at a primary care level, use of screening instruments and uncertainty about management of positive cases. Only by identifying the practical difficulties involved in screening, can steps can be taken to overcome them and to implement screening programmes which are acceptable to the population under consideration and their primary care physicians.