A systematic review of the evidence on substance misuse prevalence in patients with traumatic brain injury (TBI) and outcomes associated with this population is presented. Building upon an earlier review of the area by Corigan (1995), this review is limited to research published between 1994 and 2004. Psycinfo and Medline abstract databases were searched for English-language publications citing research from Western countries on the epidemiology and outcomes of adult TBI patients (aged 15 years or older). The majority of reviewed studies were undertaken in the USA and the investigation foci and methods used were multifarious, constraining the generalisation of the review findings. Prevalence for alcohol intoxication at time of injury in the review was found to be almost identical to that in Corrigan's review: 37-51% and 36-51%, respectively. Pre-TBI history of alcohol misuse was found to be less prevalent in the present as opposed to Corrigan's review: 37-51% and 55-66%, respectively. Outcome findings were mixed (also found by Corrigan), but mainly in the expected direction of poorer outcomes (neurological, medical, neuropsychological, and functional) in patients with pre-TBI substance misuse. Further research and implications for services are outlined.
Background Individuals with intellectual disability are at higher risk of premature death compared with individuals without intellectual disability, and therefore parents of people with intellectual disability are more likely to outlive their children. However, there has been relatively little research investigating the bereavement experiences of parents of deceased children with intellectual disability.
Method Semi‐structured interviews were used to explore the experiences of nine mothers whose child with intellectual disability had died. The transcripts were analysed qualitatively using Interpretative Phenomenological Analysis.
Results Five themes emerged from the analysis: loss, benefit finding, coping, sources of support and medical relationships. An analysis of the accounts indicated similarities and differences between the experiences of the mothers. In particular, continuing in their caring role by working within the world of intellectual disability following the death of their child was important to all of the mothers. Support from similarly bereaved parents was the most useful source of support, although it was not always readily accessible.
Conclusions Implications for theory and practice are described including suggestions that service providers should aim to maintain links with families after the death of their child, a parent‐to‐parent programme that enables parents to contact others in a similar situation might be beneficial, and further research into the functions of coping strategies and supports in loss would be worthwhile.
The feasibility of a brief home based cognitive behavioural intervention for depression associated with Parkinson's Disease (PD) was evaluated. Five depressed patients with PD participated. Their ages ranged from 54 to 82 and they all attended a movement disorder clinic. Outcome was assessed using mood and quality of life inventories (Beck Depression Inventory; Geriatric Depression Scale; Parkinson's Disease Quality of Life Questionnaire). Four individuals demonstrated a clinically reliable reduction of symptoms according to the GDS scores, with greater improvement reported for the two individuals with more severe pre-therapy levels of depression. The BDI findings suggested most of the improvement related to the cognitive dimensions of guilt, pessimism and failure. Overall, the change in mood was not accompanied by an enhancement of perceived quality of life, and little variation in the frequency of activities was reported over the course of therapy. Possible explanations for the findings are considered along with implications for theory and clinical practice.
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