Child and Adolescent Psychiatric Presentations of Second-Generation Afro-Caribbeans in Britain

1995 ◽  
Vol 167 (3) ◽  
pp. 362-369 ◽  
Author(s):  
Robert Goodman ◽  
Hilary Richards

BackgroundA clinical sample was used to investigate whether second-generation Afro-Caribbean children differed from other British-born children in their psychiatric presentation or vulnerability to risk factors.MethodSecond-generation Afro-Caribbean patients (n = 292) were compared with a predominantly white group of patients (n = 1311) who lived in the same inner-city area and attended the same child psychiatric clinic between 1973 and 1989. Data on psychiatric presentation and background factors were systematically recorded at the time of the initial clinical assessment.ResultsAfro-Caribbean patients were exposed to more socio-economic disadvantage but less family dysfunction. The ratio of emotional to conduct disorders was lower among Afro-Caribbean than among the comparison patients – an effect that was not evidently due to demographic factors or diagnostic bias. Most risk factors for emotional or conduct disorders had comparable effects on Afro-Caribbean and comparison patients. Psychotic and autistic disorders were disproportionately common among the Afro-Caribbean patients.ConclusionsSecond-generation Afro-Caribbean children differ somewhat from other British-born children in their psychiatric presentation – a difference that has persisted over the 1970s and 1980s and that deserves more investigation than it has received to date.

2021 ◽  
pp. 1-14
Author(s):  
Magdalena I. Tolea ◽  
Jaeyeong Heo ◽  
Stephanie Chrisphonte ◽  
James E. Galvin

Background: Although an efficacious dementia-risk score system, Cardiovascular Risk Factors, Aging, and Dementia (CAIDE) was derived using midlife risk factors in a population with low educational attainment that does not reflect today’s US population, and requires laboratory biomarkers, which are not always available. Objective: Develop and validate a modified CAIDE (mCAIDE) system and test its ability to predict presence, severity, and etiology of cognitive impairment in older adults. Methods: Population consisted of 449 participants in dementia research (N = 230; community sample; 67.9±10.0 years old, 29.6%male, 13.7±4.1 years education) or receiving dementia clinical services (N = 219; clinical sample; 74.3±9.8 years old, 50.2%male, 15.5±2.6 years education). The mCAIDE, which includes self-reported and performance-based rather than blood-derived measures, was developed in the community sample and tested in the independent clinical sample. Validity against Framingham, Hachinski, and CAIDE risk scores was assessed. Results: Higher mCAIDE quartiles were associated with lower performance on global and domain-specific cognitive tests. Each one-point increase in mCAIDE increased the odds of mild cognitive impairment (MCI) by up to 65%, those of AD by 69%, and those for non-AD dementia by >  85%, with highest scores in cases with vascular etiologies. Being in the highest mCAIDE risk group improved ability to discriminate dementia from MCI and controls and MCI from controls, with a cut-off of ≥7 points offering the highest sensitivity, specificity, and positive and negative predictive values. Conclusion: mCAIDE is a robust indicator of cognitive impairment in community-dwelling seniors, which can discriminate well between dementia severity including MCI versus controls. The mCAIDE may be a valuable tool for case ascertainment in research studies, helping flag primary care patients for cognitive testing, and identify those in need of lifestyle interventions for symptomatic control.


2003 ◽  
Vol 37 (3) ◽  
pp. 286-293 ◽  
Author(s):  
Gregory L. Carter ◽  
Cathy Issakidis ◽  
Kerrie Clover

Objective: This study (i) explores differences between a clinical sample of deliberate selfpoisoning (DSP) patients and a community sample who reported previous attempted suicide (AS); and (ii) examines correlates of suicidal behaviour in these groups compared with a community control group (CC) with no suicidal behaviour. Method: The study design was: case–case, case–control and cross-sectional population studies. A clinical sample of DSP (n = 51), a community sample of AS (n = 31) and a community sample with no suicidal behaviour (n = 842) were used, all aged 18–24 years. The DSP and AS groups were compared on several variables and two logistic regression models were developed for risk of (i) DSP and (ii) AS compared to community controls. Results: The adjusted odds ratios for DSP were: female gender (OR = 5.7, CI = 1.7–19.4), anxiety (OR = 7.4, CI = 2.2–25.1), affective (OR = 23.0, CI = 6.9–76.5), or substance-use disorder (OR = 19.2, CI = 5.6–65.4) and greater mental health related disability (OR = 0.5, CI = 0.3–0.7 for 1 SD decrease). For AS the results were: anxiety (OR = 9.4, CI = 1.7–52.8) or substance-use disorder (OR = 3.0, CI = 1.1–8.7) and greater mental health disability (OR = 0.5, CI = 0.4–0.7). Affective disorder was close to significant for the AS group (OR = 4.0, CI = 0.9–17.1). Conclusions: Correlates of DSP/AS were usually more powerful in the clinical group, but showed a similar pattern of psychiatric disorder and disability factors in both groups, supporting a continuum of risk factors across these groups. Interventions based on modifiable risk factors could target the same factors for public health, primary care or hospital populations: anxiety, depression and substance use disorders and mental health related disability.


2011 ◽  
Vol 26 (S2) ◽  
pp. 326-326
Author(s):  
K. Mehrotra ◽  
S. Ahamad Manzur ◽  
Y.P. Ooi ◽  
C.G. Lim ◽  
D.S.S. Fung ◽  
...  

IntroductionStudies have shown that children with learning difficulties are likely to demonstrate a host of shared behavioral and emotional problems that affect their daily functioning.Objectives/AimsThe goal of this study was to examine profiles of behavioral and emotional problems in children at risk for Learning Disorders (LD) and Communication Disorders (COMM), without intellectual disabilities.MethodData on the Child Behavior Checklist (CBCL) of 52 participants (4–12 years old) at-risk for LD and 52 age- and gender- matched participants at-risk for COMM were obtained from the archival records of a local outpatient child psychiatric clinic. For all CBCL scales, T scores ranging from 65 to 69 are in the borderline clinical range, whereas a T score of 70 and above are in the clinical range. T scores of below 65 are considered as non-clinical. For the purposes of this study, a T score of 65 and above for the CBCL syndromes indicated the problem to be of clinical concern.ResultsA total of 51.9% of these children had at least one problem of clinical concern, with Attention Problems (LD: 36.5% vs. COMM: 17.3%), Social Problems (LD: 21.2% vs. COMM: 30.8%), and Withdrawn/Depressed (LD: 23.1% vs. COMM: 26.9%) syndromes being commonly reported. There were no significant differences between the 2 groups on the CBCL syndromes.ConclusionsFindings from the study suggest that children with any form of learning difficulties demonstrate high prevalence of behavioral and emotional problems, suggesting possible comorbidities such as Attention Deficit Hyperactivity and Depression.


2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
K Ogata ◽  
H Koiwaya ◽  
K Shinzato ◽  
Y Goriki ◽  
G Yoshioka ◽  
...  

Abstract Background Percutaneous coronary Intervention (PCI) with rotational atherectomy (RA) was useful for severe calcified lesions. However, the long-term clinical outcomes of PCI with second-generation drug eluting stent (DES) following RA has been still unclear. Purpose The purpose of this study was to investigate the long-term clinical outcomes of RA followed by second-generation DES. Methods We retrospectively enrolled 254 consecutive patients treated with second-generation DES following RA. The primary outcome was the cumulative 5-year incidence of MACE, defined as cardiac death, myocardial infarction, clinically-driven target lesion revascularization and definite stent thrombosis. Results The incidence of MACE was 22.8% at 5-years. Multivariate analysis showed 3 predictors of MACE, hemodialysis, diabetic mellitus and extremely angulated lesions (>90°).Significantly higher MACE was observed in the high-risk (≥2 risk factors) group, compared with the low-risk (2< risk factors) group (68.7% vs. 18.7%, P<0.001, Figure). Multivariate analysis for MACE at 5 year Hazard ratio (95% Confidence Interval) P-value Diabetic Mellitus 2.58 (1.35–4.91) 0.004 Hemodialysis 4.57 (1.64–12.76) 0.004 extremely angulated (>90°) 3.08 (1.06–8.93) 0.04 Kaplan-Meier curves for 5-years MACE Conclusions The long-term clinical outcomes of PCI for severely calcified lesions was acceptable. However, the clinical outcomes of patients classified high risk cohort was unsatisfactory.


Author(s):  
Shoichi Kuramitsu ◽  
Masanobu Ohya ◽  
Tomohiro Shinozaki ◽  
Hiromasa Otake ◽  
Kazunori Horie ◽  
...  

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