Use of antipsychotic drugs in individuals with intellectual disability (ID) in the Netherlands: prevalence and reasons for prescription

BACKGROUND

We investigated antipsychotic drug prescription practice of Dutch ID physicians, studying prevalence of antipsychotic drug use, reasons for prescription and the relationship between these reasons and patient characteristics.

METHODS

A cross-sectional study of medical and pharmaceutical records in a population living in residential settings of three care providers for persons with IDs in the Netherlands (n = 2373).

RESULTS

Prevalence of antipsychotic drug use was 32.2% (95% CI 30.1-33.9). Behavioural problems were the reason for prescription of antipsychotic drugs in 58% of cases and psychotic disorder or psychotic symptoms in 22.5%. In 11.7% the diagnosis of psychotic disorder was specified according to DSM-IV criteria. In 18.5% the reason for prescription was not noted in the medical record. Behavioural problems as reason for prescription was associated with profound and severe ID, living in a central location and male sex. Psychotic disorder specified according to DSM-IV as indication for prescription was negatively associated with profound and severe ID and with presence of an additional mental disorder. Absence of a noted reason for prescription was associated with female sex and with the presence of an additional mental disorder.

DISCUSSION

Current prevalence and reason for prescription of antipsychotic drugs are similar with outcomes of previous studies. Our results show the continuing lack of evidence-based psychopharmacological treatment in mental health care for persons with IDs.

Autoimmunity in Tic Disorders: Where do we Stand?

New findings on serum antibodies against pyruvate kinase and lysogangliosides plus cytokine data in children with tic disorders compared to helathy control children are presented. Also blood-based gene expression data related to autoimmunity in children with tic disorders are discussed.

Global distribution of halogenated dimethyl bipyrroles in marine mammal blubber

Four halogenated dimethyl bipyrroles (HDBPs), hypothesized to be naturally produced, were quantitated in marine mammal blubber from a number of species obtained from various locations worldwide. HDBPs were found in samples from all locations studied. Concentrations of total HDBPs (SigmaHDBPs) ranged from 0.4 ng/g lipid weight in ringed seals (Phoca hispida) from the White Sea to 2,540 ng/g lipid weight in Dall's porpoise (Phocoenoides dalli) from the northwestern North Pacific Ocean. At their highest levels, SigmaHDBPs made up 11% of the total quantitated organohalogen body burden of adult male Dall's porpoises. In two beluga (Delphinapterus leucas) data subsets, it was found that males contained significantly higher concentrations of SigmaHDBPs than females. No significant effects of age or sex on SigmaHDBPs were observed in harbor seal (Phoca vitulina) and bowhead whale (Balaena mysticetus) data subsets. The geographical distribution of concentrations did not resemble that of the ubiquitous anthropogenic organohalogen, polychlorinated biphenyl congener CB-153. Higher concentrations of HDBPs and different patterns of congeners were observed in samples from Pacific as opposed to non-Pacific Ocean influenced environments. Concentrations of HDBPs in beluga from the Arctic and St. Lawrence River were similar. Their high abundance in north Pacific Ocean biota and widespread occurrence suggest that HDBPs undergo extensive transport from a source located primarily in the Pacific Ocean. Evidence from HDBP congener patterns indicates that both ocean currents and atmospheric transport likely play a role in the movement of HDBPs. These results imply that HDBPs and anthropogenic organohalogens have different sources and support the natural production hypothesis.

[Criteria for evaluation of methods, systems and interference procedures to which animals are submitted (author's transl)]

Veterinarians can be expected to play a particular role in the relationship between man and animals. Dutch laws and formal agreements on the subject are briefly reviewed. The following main points that should be taken into account are discussed. (1) detailed description of the method, system and interference; (2) their purpose, (3) consequences for the welfare of animals; (4) aspects relevant to human society: importance of purpose, international aspects, significance for public health and environment, public opinion; (5) alternatives, with description of points (1), (3) and (4); (6) considerations of usefulness and necessity from the practical point of view and acceptability from the point of view of ethics; (7) position of the veterinarian; (8) conclusion.

Cheilognathoschisis in Texel sheep

In view of the birth of abnormal Texel lambs sired by a single ram, experimental matings were carried out to determine the extent to which the malformations shown by the lambs were clear-cut inherited defects and, if so, which was the mode of hereditary transmission. From investigations on six abnormal lambs and a study of the literature it was concluded that these were inherited defects not previously described and marked by cheilognathoschis which was almost invariably associated with an unduly light birth weight, brachycephaly and cardiac septal defects. The placenta of one of the abnormal lambs, which was studied, showed marked changes. The proportional numbers showed that, when the more complicated inheritance patterns are not taken into account, the defect is transmitted by a recessive autosomal gene.

Effects of training on maximal working capacity and haemodynamic response during arm and leg-exercise in a group of paddlers

Maximal oxygen uptake and circulatory adaptation to work with legs and arms were studied in a group of 5 paddlers members of the Belgian national squad and a control-group of 9 trained subjects. The results showed that the specific armtraining of paddlers induced changes in the arm-to-leg ration of physiological parameters at submaximal and maximal work. In the group of paddlers maximal oxygen intake and workload during arm-exercise averaged respectively 88.6% and 80.3% of the scores obtained with leg-exercise. In the control group the arm to leg ratio varied between 81.2% and 65.2%. At a submaximal load of 100 W the difference in heartfrequency was 21 beats/min in the canoe group and 35 beats/min in the control group. Oxygen consumption and ventilation during work with the arms was lower in the group of paddlers. The data of our study suggest that the specific training of paddlers do result in a effect on the haemodynamic adaptations to arm work.

Crystallization of Clay-Adsorbed Water

The nature of crystalline water in frozen pastes made from representative clay minerals and water was studied by x-ray diffraction. Only the diffraction peaks corresponding to the normal hexagonal ice structure were detected. The relative intensities of the diffraction peaks revealed evidence of epitaxy in that the ice crystals appeared to be preferentially oriented with their c-axes perpendicular to the c-axes of the individuial clay crystallites.