Royal College of Psychiatrists Centre for Quality Improvement, London, UK.
Curr Opin Psychiatry. 2011 Sep;24(5):372-6. doi: 10.1097/YCO.0b013e3283472524.
This review summarizes recent research into psychiatric services for adults with intellectual disabilities, with a particular focus on inpatient care.
People with intellectual disability appear to be admitted with more severe problems and receive more interventions than those without intellectual disability when admitted to general psychiatric units. Qualitative research has shown poor standards of care on some general psychiatric inpatient units. Studies of supported generic inpatient units have reported successful outcomes, supported by qualitative studies of satisfaction. Length of stay for people with intellectual disability is not consistently longer on specialist than general psychiatric units. Delayed discharge and restrictive practices, however, still need addressing. The important components of community mental health services have been evaluated from the points of view of psychiatrists, patients and carers. Emergency provision of psychiatric assessment and care remains a problem in some centres.
There have been few randomized controlled trials in this field; however, uncontrolled comparisons and service evaluations suggest positive outcomes in specialist services. Qualitative work has made important contributions to understanding the patients' and carers' experiences. Further work should focus on the measurements of outcome and satisfaction.
本文总结了最近关于成年智障人士精神科服务的研究，重点关注住院治疗。
与无智力障碍者相比，智障人士在被收入普通精神科病房时，似乎存在更严重的问题，接受的干预也更多。定性研究表明，一些普通精神科住院病房的护理标准较差。支持通用住院病房的研究报告了成功的结果，定性研究也表明患者满意度较高。智障人士在专科病房和普通病房的住院时间并不总是更长。然而，延迟出院和限制措施仍需解决。从精神科医生、患者和照顾者的角度评估了社区精神卫生服务的重要内容。在一些中心，精神科评估和护理的紧急服务仍然是一个问题。
该领域的随机对照试验较少；然而，非对照比较和服务评估表明，专科服务有积极的效果。定性工作对了解患者和照顾者的体验做出了重要贡献。进一步的工作应集中在结果和满意度的测量上。
