Not recognized enough: The effects and associations of trauma and intellectual disability in severely mentally ill outpatients

Nieuwenhuis, Jeanet Grietje; Smits, H.J.H.; Noorthoorn, Eric; Mulder, Cornelis L.; Penterman, E.J.M.; Nijman, Henk

doi:10.1016/j.eurpsy.2019.02.002

Cited by 34 publications

(40 citation statements)

References 37 publications

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“…However, because of limited recognition (Nieuwenhuis et al . 2019), people with BIF lacks adequate treatment and support. To bring about a change, BIF needs to be acknowledged not only from the individual perspective but also at the societal level.…”

Section: Introductionmentioning

confidence: 99%

Borderline intellectual functioning: an increased risk of severe psychiatric problems and inability to work

Peltopuro

Vesala

Ahonen

et al. 2020

J intellect Disabil Res

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Background The use of facilities such as disability pension, psychiatric care, health care and services for people with intellectual disabilities and borderline intellectual functioning (BIF) were compared with the general population and two other study groups comprising people with mild intellectual disabilities (MIDs) and learning problems (LPs). Methods The population‐based sample (N = 416,973), ‘Finland‐in‐Miniature’, was gathered in 1962 and followed until 1998. For the purpose of the present study, three groups were formed: BIF (n = 416), MID (n = 312) and LP (n = 284). The use of services was examined with the help of national registers. Results As compared with the general population, people with BIF had been granted disability pension 2.7 times more often and had been patients in psychiatric care 3.4 times more often. They had also systematically used more services than people with LP. Conclusions People with BIF are at risk of inability to work and facing severe mental health problems. They also seem to have more severe psychiatric problems than people with MID and LP. There is, therefore, a crucial need for increasing the awareness in society of BIF. Although this study's follow‐up data were collected about 20 years ago, it is still relevant because people with BIF are a neglected group and still face growing demands in school and work life with no marked changes in services.

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Section: Introductionmentioning

confidence: 99%

Borderline intellectual functioning: an increased risk of severe psychiatric problems and inability to work

Peltopuro

Vesala

Ahonen

et al. 2020

J intellect Disabil Res

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show abstract

“…People with a severe mental illness (SMI) have a higher risk of being traumatized, or become a crime victim (38,39). For example, both physical and emotional neglect and complex PTSD are highly prevalent in this group (40,41), especially if a person is also intellectually disabled (42). Furthermore, trauma is thought to have both a direct and indirect negative effect on the onset and symptomatic course of psychotic disorders (43).…”

Section: Psychological Determinants Traumamentioning

confidence: 99%

“…During the illness, general cognitive functioning is lower for people with schizophrenia compared to healthy controls (25). Approximately 40% of People with a SMI are suspected to have an intellectual disability (42,47), with a decreased cognitive flexibility (i.e., mentally switching between, or adapting to different tasks or stimuli) as a consequence. This negatively influences the course of recovery (48).…”

Section: Cognitive Functionmentioning

confidence: 99%

UP'S: A Cohort Study on Recovery in Psychotic Disorder Patients: Design Protocol

et al. 2021

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Recovery is a multidimensional concept, including symptomatic, functional, social, as well as personal recovery. The present study aims at exploring psychosocial and biological determinants of personal recovery, and disentangling time-dependent relationships between personal recovery and the other domains of recovery in a sample of people with a psychotic disorder. A cohort study is conducted with a 10-year follow-up. Personal recovery is assessed using the Recovering Quality of Life Questionnaire (ReQoL) and the Individual Recovery Outcomes Counter (I.ROC). Other domains of recovery are assessed by the Positive and Negative Symptom Scale Remission (PANSS-R), the BRIEF-A and the Social Role Participation Questionnaire—Short version (SRPQ) to assess symptomatic, functional and societal recovery, respectively. In addition, multiple biological, psychological, and social determinants are assessed. This study aims to assess the course of personal recovery, and to find determinants and time-dependent relationships with symptomatic, functional and societal recovery in people with a psychotic disorder. Strengths of the study are the large number of participants, long duration of follow-up, multiple assessments over time, extending beyond the treatment trajectory, and the use of a broad range of biological, psychological, and social determinants.

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“…Institutions for patients with intellectual disability and general mental health were separately commissioned by different funding streams in the Netherlands, and since then, each institution's knowledge of the other has diminished over the years. As we know from two previous studies, [1][2][3] the prevalence of mild intellectual disability (MID) or borderline intellectual functioning (BIF) is much higher in (general) mental healthcare, as may be expected from the prevalence estimations in the general population. This finding was remarkable, given the background of the development of separate intellectual disability services alongside standard psychiatric care in the Netherlands.…”

Section: Prevalence Of Intellectual Disabilty In Mental Health Carementioning

confidence: 82%

“…This is significantly higher than the prevalence expected in the population, but in keeping with the few existing previous smaller studies. [1][2][3] The prevalence increased with the intensity level of the mental healthcare provided (lowest in out-patient settings, highest in long-stay wards). These findings are in line with a recent forensic sample showing prevalence rates as high as 60%.…”

Section: Discussionmentioning

confidence: 99%

Increased prevalence of intellectual disabilities in higher-intensity mental healthcare settings

et al. 2021

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Background It has been suggested that people with intellectual disabilities have a higher likelihood to develop psychiatric disorders, and that their treatment prognosis is relatively poor. Aims We aimed to establish the prevalence of intellectual disability in different mental healthcare settings, and estimate percentage of cognitive decline. We hypothesised that the prevalence of intellectual disabilities increases with intensity of care. Method A cross-sectional study was conducted in different settings in a mental healthcare trust in the Netherlands. We used the Screener for Intelligence and Learning Disabilities (SCIL) to identify suspected mild intellectual disability (MID) or borderline intellectual functioning (BIF). We identified patients with a high level of education and low SCIL score to estimate which patients may have had cognitive decline. Results We included 1213 consecutive patients. Over all settings, 41.4% of participating patients were positive for MID/BIF and 20.2% were positive for MID only. Prevalence of suspected MID/BIF increased by setting, from 27.1% in out-patient settings to 41.9% in flexible assertive community treatment teams and admission wards, to 66.9% in long-stay wards. Only 85 (7.1%) of all patients were identified as possibly having cognitive decline. Of these, 25.9% were in long-stay wards and had a diagnosis of schizophrenia or substance use disorder. Conclusions Low intellectual functioning is common in Dutch mental healthcare settings. Only a modest number of patients were identified as suffering from cognitive decline rather than suspected MID/BIF from birth. Therefore, we recommend improved screening of psychiatric patients for intellectual functioning at the start of treatment.

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Not recognized enough: The effects and associations of trauma and intellectual disability in severely mentally ill outpatients

Cited by 34 publications

References 37 publications

Borderline intellectual functioning: an increased risk of severe psychiatric problems and inability to work

Borderline intellectual functioning: an increased risk of severe psychiatric problems and inability to work

UP'S: A Cohort Study on Recovery in Psychotic Disorder Patients: Design Protocol

Increased prevalence of intellectual disabilities in higher-intensity mental healthcare settings

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