A study on the usefulness and reliability of the "Scheme of Appraisal of Emotional Development" (SAED) for persons with ID using direct observation in a group-based assessment procedure.

INTRODUCTION: Whereas instruments for the assessment of intellectual and social abilities are widely available, instruments for the evaluation of emotional development of persons with intellectual disabilities (ID) are rare. The Scheme of Appraisal of Emotional Development (SAED), an internationally used tool developed by Dosen (2005a. Journal of Intellectual Disability Research, 49, 1, 2005b. Journal of Intellectual Disability Research, 49, 9), is one of the latter and is based on interviews with caregivers. The present study aims to investigate the internal consistency and interrater-reliability by changing the interview procedure into a direct observation and evaluation approach by a whole team instead of by one expert. METHOD: The level of emotional development of 175 patients admitted to a psychiatric inpatient unit specialized in the treatment of adults with ID was evaluated with the SAED by the treatment team after an observation period of up to two weeks. The inter- and intra-rater-reliability was assessed by direct observation of the behaviour of an additional 50 patients by two pairs of raters. RESULTS: The internal consistency of the SAED dimensions, once rated by team approach, is excellent, and the reliability measures show also good statistical results. CONCLUSION AND IMPLICATIONS: The evaluation of the level of emotional development using the SAED by a group-led and/or direct observational procedure show to be a reliable and useful approach. The group-based procedure yields equal results compared with the usual interview guidelines and might lead to an additional training effect within the respective teams. The rater-reliability measures align with those reported in other studies.

[The carbamazepine hypersensitivity syndrome. Differential diagnosis and a representative case history]. / Das Carbamazepin-Hypersensitivitäts-Syndrom. Differentialdiagnostische Erwägungen an einer exemplarischen Fallvorstellung.

In psychiatry the efficacy of the anticonvulsant carbamazepine in the prophylaxis of bipolar affective disorders is very known and so this drug has been used for a long time. But one very important and dangerous side effect of carbamazepine must be emphasized: the "carbamazepine-hypersensitivity-syndrome", which will be presented in this article in a representative example. The allergic reaction can be difficult in differential diagnostic aspects: the clinical symptoms of this reaction can be very similar to viral infections; in the histological view aspects of a lymphoma can even be found. Because of the systemic reactions there are dramatic and very serious courses. So the psychiatrist has to remember the dramatic side effects and must inform the patients about them in using carbamazepine.