Children born to parents with mild intellectual disability: Register-based follow-up of psychiatric and neurodevelopmental diagnoses and out-of-home placements.

AIM: Study the outcomes in terms of registered neurodevelopmental diagnoses and out-of-home placements in children whose parents had been diagnosed with mild intellectual disability (ID) in childhood. METHODS: The study groups consist of (1) a population-based sample of 78 individuals, born in 1979-1985, meeting criteria for mild ID during childhood, and (2) their 88 children. From national registers, data on outcomes were retrieved in 2020 regarding psychosocial and psychiatric outcomes for the adults, and neurodevelopmental diagnoses and out-of-home placements for the children. RESULTS: Of the 78 adults with mild ID, 31 were parents of 88 children, aged 0-21 . The age-adjusted prevalence of neurodevelopmental disorders among the children was 67%. Of the 27 children aged between 13 and 21 years at follow-up, 16 had at least one registered neurodevelopmental diagnosis; 11 had ADHD and 7 had ID. Nine of these 27 children had experienced out of home placement. CONCLUSION: Children of parents with mild ID are at high risk of neurodevelopmental disorders, in particular ADHD and ID, and out-of-home placements. Our findings indicate that individuals with mild ID who become parents routinely should be offered individually tailored parent support and their children offered assessment regard neurodevelopmental disorders.

Adult psychiatric and psychosocial outcomes of children with mild intellectual disability: a register follow-up of a population-based cohort.

BACKGROUND: Very few longitudinal psychiatric and psychosocial outcome studies of children with mild intellectual disability (MID) have been performed. METHODS: The study group was population based and consisted of 82 individuals, born in 1979-1985 and diagnosed in childhood at ages between 3 and 15 years with MID. In the present study, register data regarding school attendance, employment, economic situation, psychiatric diagnoses and criminal sentences were retrieved for the years 1997-2018, when the individuals were up to 39 years old. RESULTS: At follow-up, data were obtained for 78 of the 82 individuals (47 male and 31 female). Mean age at follow-up was 36 years. Of the 78 individuals, 57 (73%) had exclusively received education for pupils with MID, but 21 (27%) had graduated from regular education of some sort (at least 9 years). Forty-four (56%) had never been employed, and 34 (44%) had been registered as employed for at least a shorter period. Forty-seven (60%) had received a sick pension at some point in adulthood. Of the 78 individuals, 44 (56%) had any psychiatric disorder recorded and about half of these (n = 21) had had inpatient treatment. A total of 31 of the 44 individuals in psychiatric care (70%) had ID noted as one of their diagnoses. Of the 78 individuals, 48 (62%) had support from the Act concerning Support and Service for Persons with Certain Functional Impairments (Swedish LSS law) as adults. Twenty-one individuals (27%) had had a criminal conviction, of whom five male individuals had been incarcerated. CONCLUSIONS: Individuals with MID constitute a heterogeneous group with regard to severity of functional impairment, co-occurring psychiatric disorders and need of support from society. Primary health care, psychiatry and habilitation services need to work together in order to meet the multiple needs of this group.

Randomised trial of 23-valent pneumococcal capsular polysaccharide vaccine in prevention of pneumonia in middle-aged and elderly people. Swedish Pneumococcal Vaccination Study Group.

BACKGROUND: We assessed the effectiveness of a 23-valent pneumococcal vaccine in the prevention of pneumococcal pneumonia and of pneumonia overall in non-immunocompromised middle-aged and elderly people. METHODS: The prospective, multicentre, double-blind, randomised, placebo-controlled trial was carried out across departments of infectious diseases at six tertiary-care or university hospitals in Sweden. 691 non-immunocompromised patients aged 50-85 years who had been treated as inpatients for community-acquired pneumonia (CAP) were randomly assigned either 23-valent pneumococcal capsular polysaccharide vaccine or placebo (sodium chloride). We used Cox regression models to estimate the relative risks of pneumonia overall and pneumococcal pneumonia for the placebo group compared with the vaccine group. FINDINGS: 63 (19%) of 339 patients in the vaccine group and 57 (16%) of 352 patients in the placebo group developed a new pneumonia, corresponding to a relative risk over time for the placebo group compared with the vaccine group of 0.83 (95% CI 0.58-1.12, p=0.31). Pneumococcal pneumonia was diagnosed in 16 (4.5%) patients in the placebo group and in 19 (5.6%) in the vaccine group, corresponding to a relative risk for the placebo group of 0.78 (95% CI 0.40-1.51, p=0.45). We found no difference in the death rate between the two study groups. INTERPRETATION: The 23-valent pneumococcal polysaccharide vaccine did not prevent pneumonia overall or pneumococcal pneumonia in middle-aged and elderly individuals.

Spectral analysis of tachygastria recorded during motion sickness.

The purpose of the present experiment was to study frequency changes in gastric myoelectric activity of healthy human subjects and the development of symptoms of motion sickness as brought about by vection or illusory self-motion. Fifteen fasted healthy human subjects were seated inside a circular vection drum, the rotation of which produces visual signals of self-motion that are in conflict with vestibular signals (i.e., mismatched sensory input). An electrogastrogram was obtained for three 15-min. periods: baseline, rotation, and after drum rotation stopped. Respiration, symptoms volunteered by subjects, and a continuous measure of intensity of symptoms were recorded. Five subjects showed a continuation of normal 3-cycles/min. activity during drum rotation and reported no symptoms of motion sickness. Ten subjects showed a shift of their dominant gastric frequency from 3 cycles/min. to 4-9 cycles/min. during drum rotation and reported symptoms of motion sickness. Running spectral analysis revealed a close correspondence over time between tachygastria and reports of symptoms of motion sickness.

Tachygastria and motion sickness.

Cutaneously-recorded electrogastrograms (EGGs) were obtained from 21 healthy volunteers who were seated within a drum, the rotation of which produced vection or illusory self-motion. Fourteen subjects developed symptoms of motion sickness during vection and in each the EGG frequency shifted from the normal 3 cpm to 5-8 cpm, tachygastria, an abnormal pattern. In 6 of 7 asymptomatic subjects, the 3 cpm EGG pattern was unchanged during vection. It was concluded that illusory self-motion produces tachygastria and motion sickness in susceptible subjects.

The effect of contrast on sustained detection.

During a 1 min observation, the percentage of time a high spatial frequency grating can be detected is influenced by the contrast and spatial frequency of a second, superimposed and orthogonally-oriented sine wave grating. Increasing contrast of the second pattern aids detection of the first by providing a more effective accommodative stimulus. The function relating spatial frequency and the minimum contrast needed to activate accommodation is similar in shape to the classical contrast sensitivity function. However, an order of magnitude more contrast is required to stabilize accommodation than is required to simply detect a pattern. These results suggest that performance on visual tasks requiring sustained rather than brief detection may be markedly impaired under low contrast conditions.

Quantitative evaluation of chest pain.

The perception of pain in three groups of patients with angina pectoris has been studied. All patients went through a bicycle ergometer test with an increase of 10 wat each minute. Heart rates and ratings of pain were collected towards the end of each work load. Reliable results of diagnostic interest were obtained. The rating procedure is discussed and a new category rating scale with ratio properties is also presented.