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There is little information on the mental health needs of adults with intellectual disability (ID) and autism spectrum disorders (ASDs). Such evidence is much needed for the development of more effective mental health services for this group. The aim of this study is to compare adults with ID and ASD receiving specialist mental health services with participants without ASD. Data were collected from the anonymized case records of a clinic-based population in South East London. Health and social functioning were measured using the Health of the Nation Outcome Scale for people with Learning Disability (HoNOS-LD). A review of case records identified 371 service users in receipt of specialist mental health care who were eligible for the study. There were 117 people (32% of the sample) with a clinical diagnosis of ID and ASD. Participants with ASD were younger, more likely to be male, less likely to live independently and had more severe ID than those without ASD. Furthermore, those with ID and ASD were less likely to be diagnosed with a psychiatric disorder but had significantly higher scores on the HoNOS-LD (indicating lower health and social functioning) than those without ASD. A significant proportion of adults with ID who are in receipt of specialist mental health services also have a clinical diagnosis of ASD. This group has different mental health needs compared with those without ASD. The authors note the need for a more personalized approach to service delivery with a focus on improving social functioning and behavioral impairments.

Background: The abnormal illness behaviours characterising somatisation disorder may be learnt responses acquired through exposure to parental illness and health anxiety in childhood. In this observational study we explore this hypothesis by examining patterns of interaction in mothers and their school age children. Method: A sample of 136 mother and child pairs in 3 groups (42 mothers with somatisation disorder, 44 organically ill mothers and 50 healthy mothers) completed a battery of self-report and interview measures. Their interaction in semi-structured play tasks and a meal was videotaped and later analysed for the presence of "needs" and "offers of care" by researchers who were blind to maternal group membership. Results: During play, a greater proportion of the children of somatising mothers expressed "health and safety" needs than did children of other mothers. In contrast, during a meal, these children expressed fewer needs of all types. Children of somatising mothers were more likely than other children to ignore their mothers' offers of care. The somatising mothers expressed more health and safety needs during the meal than did other mothers and were generally less responsive to all needs expressed by their children. Conclusions: Our study suggests that mothers with somatisation disorder and their children interact differently than other mother-child pairs. This finding supports the theory for environmental influences in the development of this disorder.

In this brief article, I provide a personal perspective and selected literature review on the merits of giving greater attention to interventions that tackle the known social risk factors for common mental disorders. These include both universal actions targeted at the general population and more focused interventions aimed at high-risk subgroups. In practice, most effective efforts involve a combination of both strategies. Psychiatrists and other mental health professionals could have a key role in promoting prevention, working closely with governmental bodies, and nongovernmental organizations that may be in the best position to deliver the required interventions. Having evidence from gold standard randomized controlled trials may be ideal, but in practice, are extremely difficult to deliver in this field and their absence should not be taken as an excuse for inaction. [ABSTRACT FROM AUTHOR]

Background: A higher incidence of psychotic disorders has been consistently reported among black and other minority ethnic groups, particularly in northern Europe. It is unclear whether these rates have changed over time. Methods: We identified all individuals with a first episode psychosis who presented to adult mental health services between 1 May 2010 and 30 April 2012 and who were resident in London boroughs of Lambeth and Southwark. We estimated age-and-gender standardised incidence rates overall and by ethnic group, then compared our findings to those reported in the Aetiology and Ethnicity of Schizophrenia and Other Psychoses (ÆSOP) study that we carried out in the same catchment area around 10 years earlier. Results: From 9109 clinical records we identified 558 patients with first episode psychosis. Compared with ÆSOP, the overall incidence rates of psychotic disorder in southeast London have increased from 49.4 (95% confidence interval (CI) 43.6–55.3) to 63.1 (95% CI 57.3–69.0) per 100 000 person-years at risk. However, the overall incidence rate ratios (IRR) were reduced in some ethnic groups: for example, IRR (95% CI) for the black Caribbean group reduced from 6.7 (5.4–8.3) to 2.8 (2.1–3.6) and the 'mixed' group from 2.7 (1.8–4.2) to 1.4 (0.9–2.1). In the black African group, there was a negligible difference from 4.1 (3.2–5.3) to 3.5 (2.8–4.5). Conclusions: We found that incidence rates of psychosis have increased over time, and the IRR varied by the ethnic group. Future studies are needed to investigate more changes over time and determinants of change. [ABSTRACT FROM AUTHOR]

This paper explores AVATAR therapy, an innovative therapeutic intervention for people experiencing auditory verbal hallucinations (AVH), where participants interact with their 'voice' in the form of a co-designed visual representation of their voice. Previous research has found AVATAR therapy to be successful in its aim to initiate change in the participant's relationship to and experience of their voice, but no study has explored the interactional practices employed as they unfold in this complex multiparty interaction between therapist, participant and avatar voiced by the therapist. We build on previous research and explore what it is about this interactional technique that might be contributing to the efficacy of this therapy. Using conversation analysis, we examine the therapist's use of 'hypothetical active voicing' (HAV), where the therapist formulates a proposed turn at talk in their interaction with the participant for the participant to reformulate in their next turn with the avatar. We show how, unlike in traditional dyadic therapeutic settings, participants are immediately able to enact the therapist-suggested dialogue. We find that as the therapist increases their assertiveness, control and precision in the delivery of HAV, so does the participant increase their assertiveness towards the avatar, thus contributing to the aims of the therapy. [ABSTRACT FROM AUTHOR]