No abstract

AIMS AND METHODTo study the attitudes and opinions of doctors and medical students with regard to psychiatric illness a questionnaire was sent to all medical students (832) and all doctors of all grades (441) at a London teaching hospital.RESULTSA total of 520 questionnaires were returned. More than 50% felt that people with schizophrenia and drug and alcohol addiction were dangerous and unpredictable. It was felt by the majority that people were not to blame for their conditions and there were low negative responses towards lack of treatability for a majority of conditions.CLINICAL IMPLICATIONSThere were more optimistic views with regard to treatment than the general population. There appeared to be a lessening in stigma as experience increased. This would suggest that early improved education and exposure in the future may lead to a greater decline in stigmatised attitudes.

Research suggests that caring for a child with Fetal Alcohol Spectrum Disorders (FASD) creates unique challenges for carers. To investigate this, three focus groups and education sessions, attended by 66 people, were held in the UK. Knowledge about FASD and its impact on families was evaluated using the focus groups, the Parental Stress Index and knowledge questionnaire. Eight broad themes were identified from thematic analysis of the focus groups. The findings suggest more support is needed for carers of children with FASD, especially as carers grow older. The implication for current practice should be further evaluated in this group.

Prenatal alcohol exposure (PAE) and traumatic childhood experiences (trauma) such as abuse or neglect can each cause central nervous system neurobiological changes or structural damage which can manifest as cognitive and behavioural dysfunction. In cases where both exposures have occurred, the risk of neurodevelopmental impairment may be greater, but this interaction has not been well studied. Here we present a systematic review that identified five primary research studies which investigated either the impact of trauma in children with PAE, or of PAE in children with trauma. Due to the heterogeneity of studies, narrative analysis was applied. Children in these cohorts with both exposures were more likely to show deficits in language, attention, memory and intelligence, and exhibit more severe behavioural problems than children with one exposure in absence of the other. However, the current literature is scarce and methodologically flawed. Further studies are required that: assess dual exposure in other neurodevelopmental domains; feature developmentally impaired yet non-exposed controls; and account for the wide spectrum of effects and different diagnostic criteria associated with PAE.