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.

Background The reliability and validity of the Screener for Intelligence and Learning Disabilities (SCIL) are unknown in a population of outpatients with severe mental illness. The prevalence of mild or borderline intellectual disabilities (MBID); an umbrella term for people with borderline intellectual functioning (BIF) and mild intellectual disability (MID) in this population is also unknown. Methods A total of 625 patients were screened with the SCIL, 201 of which also had IQ test results. Results Cronbach’s alpha of the SCIL was 0.73. The AUC value for detecting MBID was 0.81, and also 0.81 for detecting MID, with percentages of correctly classified subjects (when using the advised cut‐off scores) being 73% and 79%, respectively. The SCIL results suggested that 40% of the patients were suspected of MBID and 20% of MID. Conclusion The SCIL seems to be an appropriate screening tool for MBID. It is important to screen for MBID because a substantial proportion of outpatients with severe mental illness appear to be functioning at this level. It is necessary to adapt treatment for these patients.

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Background: Elucidating the influence of mild intellectual disability (MID; IQ 50-70)/ borderline intellectual functioning (BIF; IQ 70-85) and (comorbid) post-traumatic stress disorder (PTSD) on the quality of life of patients with serious mental illness (SMI) could improve their mental health care.Method: This study comprises a prospective longitudinal cohort study using routine outcome monitoring data. The cohort comprised 601 patients who had undertaken at least one Manchester Short Assessment of Quality of Life (MANSA). The scores for screeners to detect MID/BIF and PTSD were analysed, and a repeated measures analysis of variance and a multi-level linear regression was performed on the MANSA scores. Results:The average quality of life for all patient groups increased significantly over time. A between-subject effect on quality of life was observed for PTSD, but not MID/BIF. Conclusions: PTSD but not MID/BIF is associated with a lesser quality of life over time.