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Gabapentin treatment for challenging behaviors in autism spectrum disorder and coexisting intellectual disability: a case report 加巴喷丁治疗自闭症谱系障碍合并智力障碍患者的挑战行为:病例报告
IF 1.1 Q3 Medicine Pub Date : 2024-06-18 DOI: 10.1108/amhid-06-2023-0021
Stefano Marini, Lucia D'Agostino, Carla Ciamarra, Domenico De Berardis, Alessandro Gentile
PurposeThe purpose of this case report is to report the clinical experience of the use of gabapentin in the management of problem behaviors in a person with autism spectrum disorder and comorbid intellectual disability. Autism spectrum disorder is a neurodevelopmental disorder with a high prevalence of intellectual disability. Challenging behaviors in autism spectrum disorder are very common. In recent years, the hypothesis that the symptoms of autism derive from a deficiency of the inhibitory neurotransmission of gamma-aminobutyric acid is gaining considerable weight.Design/methodology/approachExploring behavioral symptoms improvement in an adult man with ASD and severe intellectual disability taking gabapentin.FindingsThe rating scales used show improvement in challenging behaviors and aggressions. No side effects were observed.Originality/valueCurrently, there are no authorized drugs for the treatment of the symptomatic features of autism spectrum disorder, but drugs are used for comorbid psychopathological aspects. The authors want to speculate on a hypothetical function of gabapentin in remodeling the expression of alpha-2-delta subunits in people with autism and the processing of neural information.
目的 本病例报告旨在介绍使用加巴喷丁治疗自闭症谱系障碍和合并智力障碍患者问题行为的临床经验。自闭症谱系障碍是一种神经发育障碍,智障的发病率很高。自闭症谱系障碍患者的挑战行为非常普遍。近年来,自闭症症状源于γ-氨基丁酸抑制性神经递质缺乏的假说越来越受到重视。设计/方法学/方法探讨一名患有自闭症谱系障碍和严重智障的成年男子服用加巴喷丁后行为症状的改善。原创性/价值目前,尚无授权药物用于治疗自闭症谱系障碍的症状特征,但有药物用于治疗合并精神病理学方面的症状。作者希望推测加巴喷丁在重塑自闭症患者体内α-2-δ亚单位的表达和神经信息处理方面的假设功能。
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引用次数: 0
The effectiveness of family-based treatment and pharmacotherapy in an adolescent with anorexia nervosa and intellectual disability: a case report 以家庭为基础的治疗和药物疗法对一名患有神经性厌食症并伴有智力障碍的青少年的疗效:病例报告
IF 1.1 Q3 Medicine Pub Date : 2024-06-18 DOI: 10.1108/amhid-10-2023-0037
Mehri Moradi, Razieh Salehian, Bonnie Bozorg, Mina Bozorg
PurposeThis study aims to report the effectiveness of family based treatment and pharmacotherapy on an adolescent boy with anorexia nervosa and intellectual disability.Design/methodology/approachThe authors reported the case of a 16-year-old boy with AN and ID and referred him to a family therapist and psychiatrist in Tehran.FindingsThe patient experienced fatigue, weakness, dissatisfaction, suicidal thoughts and self-harm signs over the past one year. He also had behaviors such as abstinence from eating and voluntary vomiting. He was diagnosed with AN and MDD.Originality/valueThe results suggest that these interventions can be effective but should be used with special consideration. Combining family therapy and pharmacotherapy might offer a chance to alleviate anorexia symptoms in people with ID.
目的本研究旨在报告家庭治疗和药物治疗对一名患有神经性厌食症和智障的青少年男孩的疗效。研究结果患者在过去一年中出现了疲劳、虚弱、不满、自杀念头和自残迹象。他还出现了禁食和自愿呕吐等行为。研究结果表明,这些干预措施可能有效,但在使用时应特别注意。将家庭治疗和药物治疗结合起来,或许能缓解ID患者的厌食症状。
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引用次数: 0
Health literacy in parents of children with Down syndrome 唐氏综合征患儿父母的健康素养
IF 1.1 Q3 Medicine Pub Date : 2024-05-07 DOI: 10.1108/amhid-10-2023-0038
Gulfer Akça, Aslıhan Sanrı, Unal Akça
PurposeThis study aims to evaluate the health literacy level of the parents of children diagnosed with Down syndrome (DS) within one institution in Turkey.Design/methodology/approachA cross-sectional survey measuring demographics, information of the child and the parent and health literacy was administered to participants. The health literacy levels in the study were measured with the European Health Literacy Scale (EHLS), which consists of 47 questions.FindingsOf the 65 participants who completed the questionnaire, 56.9% were mothers, 68.1% were diagnosed in the neonatal outpatient clinic examination after birth, and 58.5% stayed in the neonatal intensive care unit after birth. The mean score of the IHLS scale was 25.06 ± 6.59. Of the parents, 63.1% were found to be inadequate, 18.5% problematic-limited, and 18.5% adequate health literate. Any parent with excellent health literacy level was identified. High education level (p < 0.001), high income level (p < 0.001), living in the city center (p < 0.05), planned pregnancy (p < 0.05) and being a health worker (p < 0.001) were found to be statistically significant with a high EHSL score.Research limitations/implicationsThe presence of Down syndrome (DS) in a child also necessitates ongoing monitoring for a range of conditions, including eye diseases and heart disease. Some surgical procedures, such as heart or gastrointestinal surgeries, may also be required. Additionally, the child may require the administration of various medications. Finally, due to the potential lifelong need for assistance, the child may require the support of an adult throughout their lifetime. This is because of the child's inability to live independently due to their mental state. Therefore, parent education is the most important issue in the follow-up of the disease.Practical implicationsTo the best of the authors’ knowledge, this is the first study to determine that parents of children diagnosed with DS have very limited knowledge of the disease and health literacy. Explanation of current diseases, treatments and training of parents should also be included in genetic counseling.Social implicationsDS is a chromosomal disease that requires multidisciplinary care. Parents have to know the course of the disease and its complications.Originality/valueThe findings of this study indicate that parents of children with Down syndrome exhibit a profound lack of knowledge regarding the nature of their child's condition and the available healthcare options. It is therefore imperative that genetic counseling incorporates an explanation of the diagnosed diseases, treatments, and educational resources for parents.
目的 本研究旨在评估土耳其一家医疗机构中被诊断患有唐氏综合征(DS)儿童的父母的健康素养水平。研究中的健康素养水平采用欧洲健康素养量表(EHLS)进行测量,该量表由47个问题组成。研究结果在完成问卷的65名参与者中,56.9%为母亲,68.1%在婴儿出生后在新生儿门诊检查中被确诊,58.5%在婴儿出生后住进了新生儿重症监护室。IHLS 量表的平均得分为(25.06 ± 6.59)分。63.1%的家长健康素养不足,18.5%的家长健康素养有限,18.5%的家长健康素养良好。所有家长的健康素养水平均为优秀。高教育水平(p < 0.001)、高收入水平(p < 0.001)、居住在市中心(p < 0.05)、计划怀孕(p < 0.05)和卫生工作者(p < 0.001)与高 EHSL 分数有统计学意义。可能还需要进行一些外科手术,如心脏或胃肠道手术。此外,患儿可能还需要服用各种药物。最后,由于可能终生需要帮助,儿童可能终生需要成人的支持。这是因为儿童的精神状态导致其无法独立生活。因此,家长教育是疾病后续治疗中最重要的问题。实践意义据作者所知,这是第一项研究确定被诊断为 DS 患儿的家长对疾病和健康知识的了解非常有限。社会意义DS是一种染色体疾病,需要多学科护理。本研究的结果表明,唐氏综合征患儿的父母对其子女病情的性质和现有的医疗保健方案极度缺乏了解。因此,当务之急是在遗传咨询中为家长解释已确诊的疾病、治疗方法和教育资源。
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引用次数: 0
STOMP during COVID-19: use of psychotropic medication in intellectual disabilities community services – pilot QI project COVID-19 期间的 STOMP:智障社区服务中精神药物的使用--试点 QI 项目
IF 1.1 Q3 Medicine Pub Date : 2024-04-16 DOI: 10.1108/amhid-08-2023-0029
Sadia Zahid, Bushra Rauf, Rachel Lee, Hafsa Sheikh, Ashok Roy, Rani Pathania
PurposeA quantitative observational study was conducted. The purpose of this study is to examine the continuing adherence to the stopping over-medication of people with intellectual disability and/or autism guidelines for a cohort of outpatients seen in the outpatients’ clinics in the two teams who participated in this study to review the trend of psychotropic prescribing with a prescription indication along with the utilisation of non-pharmacological interventions.Design/methodology/approachData was retrospectively collected over a period of one year for patients sampled conveniently in the outpatient’s clinic. The data was collected from two sites from psychiatric letters to the general practitioners (GPs), with the focus being psychotropic prescription indication and their adherence to British National Formulary limits, inclusion of a wider multi-disciplinary team or MDT (including nurses, psychologists and health support workers), use of Clinical Global Impression (CGI) scale for assessing medication side effects and response to treatment.FindingsMost of the patients had at least one review in the previous six months. Antipsychotics were the highest prescribed medications without an indication for their use (13.3%) followed by anxiolytics and other medications. CGI recording was suboptimal, with 26% of the patient population did not have medication side effects and effectiveness monitored through this method. In total, 41% of patients were open to community nurses followed by other disciplines.Originality/valueTo the best of the authors’ knowledge, this is an original article following the pilot study completed by the authors.
目的 开展了一项定量观察研究。本研究的目的是对参与本研究的两个团队的门诊病人群组停止对智障人士和/或自闭症患者过度用药的指导原则的持续遵守情况进行检查,以审查具有处方适应症的精神药物处方的趋势以及非药物干预措施的使用情况。设计/方法/方法对方便抽样的门诊病人进行为期一年的数据回顾性收集。数据来自两个医疗点,从精神科医生写给全科医生(GPs)的信件中收集,重点是精神药物处方的适应症及其是否符合《英国国家处方集》的限制、是否纳入了更广泛的多学科团队或 MDT(包括护士、心理学家和健康支持工作者)、是否使用了临床整体印象量表(CGI)来评估药物副作用和对治疗的反应。抗精神病药物是处方量最高的药物,但没有使用指征(13.3%),其次是抗焦虑药和其他药物。CGI记录效果不佳,26%的患者没有通过这种方法监测药物的副作用和疗效。据作者所知,这是作者完成试点研究后发表的一篇原创文章。
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引用次数: 0
Co-design and pilot of a virtual reality intervention to improve mental and physical healthcare accessibility for people with intellectual disability 共同设计和试点虚拟现实干预措施,改善智障人士的身心保健无障碍环境
IF 1.1 Q3 Medicine Pub Date : 2024-04-09 DOI: 10.1108/amhid-10-2023-0039
Daniel Acton, Rosalyn Arnold, Gavin Williams, Nicky Ng, Kirstyn Mackay, S. Jaydeokar
PurposeThis preliminary study aims to examine the use of a co-designed immersive virtual reality intervention programme in improving access to health care for people with intellectual disability.Design/methodology/approachA co-production approach was used to design a virtual reality intervention in collaboration with people with intellectual disability, their families and carers. A mixed-method single sample pre-test-post-test design examined using a virtual reality intervention simulating health-care environments to improve access of attending health-care appointments. Qualitative feedback was used to understand participants’ experience and opinions of using the digital technology.FindingsThe study found that the intervention did help people access health-care appointment and reduced their fear. Improvements were also found in quality-of-life post intervention. Positive feedback was provided from participants on using digital technologies indicating the novelty of the approach and potential further applications.Originality/valueTo the best of the authors’ knowledge, this is the first study which has used virtual reality to support people with intellectual disability access health care.
目的 本初步研究旨在考察共同设计的沉浸式虚拟现实干预方案在改善智障人士获得医疗保健服务方面的应用。采用单一样本前测-后测的混合方法设计,考察了使用模拟医疗环境的虚拟现实干预措施来改善医疗预约的可及性。研究结果发现,该干预措施确实有助于人们接受医疗预约,并减少了他们的恐惧感。干预后的生活质量也有所改善。据作者所知,这是第一项利用虚拟现实技术帮助智障人士获得医疗保健服务的研究。
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引用次数: 0
Personality in individuals with mild intellectual disability to borderline intellectual functioning: a comparative study 轻度智力障碍至边缘智力功能患者的人格:一项比较研究
IF 1.1 Q3 Medicine Pub Date : 2024-02-21 DOI: 10.1108/amhid-10-2023-0036
Kim P. Lie Sam Foek-Rambelje, Kirsten Copier, R. Didden, Esmay Haacke, Paul van der Heijden, Jos Egger
PurposeThis study aims to investigate the distinctive personality traits and characteristics of individuals with borderline intellectual functioning (BIF) and mild intellectual disability (MID) within specialized centers for MID-BIF treatment and care compared with individuals without MID-BIF diagnosis gathered from general mental health care (GMH) settings.Design/methodology/approachPatients classified with MID-BIF (n = 58), most with comorbid psychopathology, were thoroughly interviewed by trained clinicians who afterward completed the Shedler–Westen Assessment Procedure (SWAP-200) about the patient. The authors compared SWAP-200 profiles of MID-BIF patients with profiles of GMH individuals. In addition, the authors have compared these profiles for the MID and BIF groups (differentiated based on previously known intelligence quotient scores).FindingsResults show significantly higher scores for the MID-BIF group than the GMH group on scales encompassing emotional instability, impulsivity and antagonism. On scales containing constraint and healthy traits, significantly lower scores were found for the MID-BIF group than for the GMH group. Importance of including SWAP-200 personality assessment for a more comprehensive understanding and treatment planning for individuals with MID-BIF is discussed.Originality/valueThis study offers insights into personality within individuals with an MID-BIF diagnosis, compared with individuals in a GMH setting.
目的本研究旨在调查边缘智力功能(BIF)和轻度智力障碍(MID)患者在专门的MID-BIF治疗和护理中心与在普通精神健康护理(GMH)机构收集的未被诊断为MID-BIF的患者相比,其独特的人格特质和特征。设计/方法/途径被归类为MID-BIF的患者(n = 58)大多合并有精神病理学,他们接受了训练有素的临床医生的全面访谈,并在访谈后完成了有关患者的Shedler-Westen评估程序(SWAP-200)。作者将 MID-BIF 患者的 SWAP-200 资料与 GMH 患者的资料进行了比较。此外,作者还比较了 MID 组和 BIF 组(根据之前已知的智商分数进行区分)的情况。结果显示,MID-BIF 组在情绪不稳定性、冲动性和对抗性等量表上的得分明显高于 GMH 组。在包含约束和健康特质的量表上,MID-BIF 组的得分明显低于 GMH 组。本研究探讨了将 SWAP-200 人格评估纳入对 MID-BIF 患者更全面的了解和治疗规划的重要性。
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引用次数: 0
Kind minds: using the ‘compassionate kitbag’ in a compassion focused therapy group for adults with intellectual disabilities 善心:在智障成人同情治疗小组中使用 "同情工具包
IF 1.1 Q3 Medicine Pub Date : 2023-12-25 DOI: 10.1108/amhid-07-2023-0024
Andy Busfield, Charlotte Peters, Karen McKenzie
PurposeThis paper aims to describe and evaluate the impact of a compassion-focused therapy (CFT) group for adults with intellectual disabilities (ID).Design/methodology/approachPeople with ID are commonly subjected to stigmatising experiences that can contribute to feelings of shame. CFT targets shame and self-criticism by helping people to cultivate self-compassion. There is evidence to suggest that CFT can be meaningfully adapted for people with ID. Qualitative and quantitative data were collected using a mixed-methods design, aiming to gain a rich evaluation of the CFT group. Eight adults with ID were referred by their local community psychology team. An 11-week group protocol was based on materials from previous research. The protocol included the development of a “compassion box”, aiming to make CFT concepts more concrete and tangible. Questionnaires measuring psychological distress, self-compassion and negative social comparisons were completed pre- and post-group. Feedback from participants and carers were collated and facilitators’ observations were recorded.FindingsQuestionnaire findings were mixed, and some participants found the measures difficult to understand. Participants’ qualitative feedback and facilitators’ observations suggested that the group created feelings of safety and connectedness whilst facilitating engagement and action with shame and self-criticism. Several participants highlighted the usefulness of the ‘”compassion box”, although some barriers were noted.Originality/valueThis paper provides a rich description of how group CFT can be adapted to meet the needs of adults with ID and is the first study of its kind, to the best of the authors’ knowledge, to evaluate the incorporation of the “compassion box”.
目的本文旨在描述和评估针对智障成人的同情疗法(CFT)小组所产生的影响。心理创伤疗法通过帮助人们培养自我同情来消除羞耻感和自我批评。有证据表明,CFT 可以对智障人士进行有意义的调整。我们采用混合方法设计收集定性和定量数据,旨在对 CFT 小组进行丰富的评估。八名成年智障人士由当地社区心理小组转介。根据以往研究的资料,制定了为期 11 周的小组协议。该方案包括开发一个 "同情箱",旨在使 CFT 的概念更加具体化和有形化。在小组活动前和小组活动后,填写了测量心理困扰、自我同情和负面社会比较的调查问卷。对参与者和照顾者的反馈进行了整理,并记录了主持人的观察结果。参与者的定性反馈和主持人的观察表明,该小组营造了安全感和联系感,同时促进了参与者的参与和行动,消除了羞耻感和自我批评。一些参与者强调了 "同情箱 "的实用性,但也指出了一些障碍。原创性/价值本文对如何调整小组 CFT 以满足智障成人的需求进行了丰富的描述,据作者所知,这是第一项评估 "同情箱 "使用情况的研究。
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引用次数: 0
To say (sexual fetish)… or not to say (sexual fetish). That is the question 说(性癖好)......还是不说(性癖好)。这就是问题所在
IF 1.1 Q3 Medicine Pub Date : 2023-11-24 DOI: 10.1108/amhid-08-2023-0032
Robert John Searle
Purpose In a recent report the author wrote about a service user, the author was challenged by the service user’s advocate in respect of the author’s use of the term “sexual fetish”. The author was informed of the advocate’s fears in respect of people involved in the service user’s future care and support needs feeling uncomfortable and possibly stigmatising someone having a sexual fetish. Consequently, the author was asked to change their wording from “sexual fetish” to “sensory need”. The purpose of this study/paper aims to highlight best practice regarding the most appropriate wording for individuals with sexual fetishes. Design/methodology/approach A review of the available evidence was ascertained. Findings A review of British Psychological Society guidelines and recent research highlights that what were once called “perversions” must be destigmatised, which will not be achieved if people continue to sweep the term fetish under the metaphorical carpet. Originality/value It is the author’s sincere hope that use of the term “sexual fetish” embraces and normalises people’s sexual fetish and results in heightened awareness and de-stigmatisation of what is essentially a reference to an element of the wonderful and pleasurable world of sexual behaviour.
目的 在作者最近撰写的一份关于一名服务使用者的报告中,服务使用者的代言人对作者使用 "性癖好 "一词提出质疑。作者被告知,代言人担心参与服务使用者未来护理和支持需求的人员会感到不舒服,并可能会对有性癖好的人产生污名化。因此,作者被要求将措辞从 "性癖好 "改为 "感官需求"。本研究/论文旨在强调有关性恋物者最合适措辞的最佳实践。 设计/方法/途径 对现有证据进行回顾。 研究结果 对英国心理学会指南和最新研究的回顾强调,曾经被称为 "变态 "的东西必须去污名化,如果人们继续将恋物癖一词扫入隐喻地毯之下,就无法实现这一目标。 原创性/价值 作者衷心希望,"性癖好 "一词的使用能够包容人们的性癖好,并使之正常化,从而提高人们对性癖好的认识,并消除其污名化。
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引用次数: 0
Project ECHO-AIDD: recommendations for care of adults with intellectual and developmental disabilities echo - aid项目:关于照顾有智力和发育障碍的成人的建议
Q3 Medicine Pub Date : 2023-11-01 DOI: 10.1108/amhid-06-2023-0019
Olivia Mendoza, Anupam Thakur, Ullanda Niel, Kendra Thomson, Yona Lunsky, Nicole Bobbette
Purpose This study aims to describe patients presented in an interprofessional, virtual education program focused on the mental health of adults with intellectual and developmental disabilities (IDD), as well as present interprofessional recommendations for care. Design/methodology/approach In this retrospective chart review, descriptive statistics were used to describe patients. Content analysis was used to analyze interprofessional recommendations. The authors used the H.E.L.P. (health, environment, lived experience and psychiatric disorder) framework to conceptualize and analyze the interprofessional recommendations. Findings Themes related to the needs of adults with IDD are presented according to the H.E.L.P. framework. Taking a team-based approach to care, as well as ensuring care provider knowledge of health and social histories, may help better tailor care. Originality/value This project draws on knowledge presented in a national interprofessional and intersectoral educational initiative, the first in Canada to focus on this population.
目的本研究旨在描述在一个专注于智力和发育障碍(IDD)成人心理健康的跨专业虚拟教育项目中出现的患者,并提出跨专业的护理建议。设计/方法/方法在本回顾性图表回顾中,使用描述性统计来描述患者。内容分析用于分析跨专业推荐。作者使用了健康、环境、生活经历和精神障碍(H.E.L.P.)框架来概念化和分析这些跨专业建议。研究结果:与IDD成人需求相关的主题是根据hp框架提出的。采取以团队为基础的护理方法,以及确保护理提供者了解健康和社会历史,可能有助于更好地定制护理。创意/价值该项目借鉴了加拿大第一个以这一群体为重点的全国性跨专业和跨部门教育倡议所提供的知识。
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引用次数: 0
Assessing adherence to National Institute for Health and Care Excellence dementia assessment and diagnosis guidelines in adults with intellectual disability: a retrospective cohort study 评估智力残疾成人对国家健康与护理卓越研究所痴呆评估和诊断指南的依从性:一项回顾性队列研究
Q3 Medicine Pub Date : 2023-11-01 DOI: 10.1108/amhid-07-2023-0022
Caroline Duncan, Ewan Wilkinson, Sujeet Jaydeokar, Daniel James Acton
Purpose This study aims to evaluate the dementia assessment and diagnosis care provided to adults with intellectual disability. The authors selected recommendations from the National Institute for Health and Care Excellence (NICE) standards which could be evidenced in clinical notes and aimed to identify characteristics which may be associated with improved adherence to these recommendations. Design/methodology/approach The study population was adults with an intellectual disability who were diagnosed with dementia between January 2019 and December 2022 by a UK-based intellectual disability service. Data to demonstrate adherence to selected recommendations and demographic and clinical characteristics were extracted from electronic patient records. Findings The authors identified 41 individuals. A mean of six of the eight recommendations were adhered to. There was low adherence with structural imaging to support dementia subtype diagnosis (9 individuals, 22%). This may be linked with the low percentage of people diagnosed with vascular dementia (1 individual, 2%) despite a national figure of 20%. No demographic or clinical characteristics were associated with level of adherence recorded. The authors found incomplete recording of diagnostic clinical coding in electronic patient records. This may disadvantage this population, as they cannot be readily identified for post diagnostic support or resource allocation. Originality/value To the best of the authors’ knowledge, this is the first study to examine adherence to these NICE guidelines in this population.
目的探讨成人智障患者痴呆的评估与诊断护理。作者从国家健康与护理卓越研究所(NICE)的标准中选择了建议,这些建议可以在临床记录中得到证明,旨在确定可能与提高对这些建议的依从性相关的特征。研究人群是在2019年1月至2022年12月期间被英国智力残疾服务机构诊断患有痴呆症的智力残疾成年人。从电子病历中提取数据,以证明对选定建议的依从性以及人口统计学和临床特征。作者确定了41个个体。八项建议中平均有六项得到遵守。结构成像支持痴呆亚型诊断的依从性较低(9人,22%)。这可能与被诊断患有血管性痴呆的人的比例低有关(1人,2%),尽管全国的数字是20%。没有人口学或临床特征与依从性记录相关。作者发现在电子病历中诊断性临床编码记录不完整。这可能不利于这一人群,因为他们不能很容易地确定诊断后的支持或资源分配。原创性/价值据作者所知,这是第一个在这一人群中检查NICE指南遵守情况的研究。
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引用次数: 0
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Advances in Mental Health and Intellectual Disabilities
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