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Prevalence and characteristics of patients with severe mental illness and borderline intellectual functioning

Report from the UK700 randomised controlled trial of case management

Published online by Cambridge University Press:  03 January 2018

Angela Hassiotis*
Affiliation:
Academic Department of Psychiatry and Behavioural Sciences, University College, London
Obioha Ukoumunne
Affiliation:
Imperial College School of Medicine, Watford, Herts
Peter Tyrer
Affiliation:
Imperial College School of Medicine, Watford, Herts
Jack Piachaud
Affiliation:
Horizon NHS Trust, Watford, Herts
Catherine Gilvarry
Affiliation:
Brixton Community Care Project, Maudsley Hospital, London
Kate Harvey
Affiliation:
St George's Hospital, Community Psychiatry Section, London
Janelle Fraser
Affiliation:
University of Manchester Mental Illness Research Unit, Manchester
*
Angela Hassiotis, Academic Department of Psychiatry and Behavioural Sciences, University College London, Wolfson Building, 48 Riding House Street, London WIN 8AA. Tel: 0171-504 9451; Fax: 0171-323 1459; e-mail: a.hassiotis@ucl.ac.uk

Abstract

Background

Low cognitive ability and developmental delays have been implicated in the causation of mental illness.

Aims

To examine the prevalence, socio-demographic characteristics, psychopathology and social functioning profiles of people with low intelligence and recurrent psychotic illness.

Method

A multi-centre randomised controlled trial of case management provided the opportunity to explore associations between mental illness and borderline intellectual functioning (assessed using the National Adult Reading Test)

Results

Overall prevalence of borderline intelligence was 18%. Significant positive associations were shown with: being Black Caribbean; having a father who worked in a manual occupation; lower educational achievement; having had special education; longer course of illness. Those with borderline intelligence had greater disability and were more likely to suffer extrapyramidal side-effects and show evidence of negative symptoms. Educational achievement, history of special education and social class were the best socio-demographic predictors of intellectual level.

Conclusions

Many patients who attend generic psychiatric services have considerable intellectual deficits. This may lead to difficulties in other domains of adaptive functioning, and merits further investigation as well as clinical vigilance.

Type
Papers
Copyright
Copyright © 1999 The Royal College of Psychiatrists 

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