Observational Studies

Observational Studies

This is a collection of completed studies where we looked at the characteristics of a group of individuals. Sometimes this was just at one timepoint, in other cases we continued to see the participants over many years.

The Edinburgh study of adolescents with special educational needs

This is a large prospective study where we have recruited and comprehensively assessed adolescents with special educational needs at intervals over 7 years (so far!).  Through this work we have been able to consider why people with intellectual disability are at greater risk of certain psychiatric disorders than the general population, what factors predict a good functional outcome over the course of the study, and how brain structure is altered in intellectual disability and autism.

Findings which have been published to date include: those who go on to show symptoms suggestive of schizophrenia show changes to their behaviour, cognition and brain structure similar to those previously identified in people at enhanced risk of this disorder due to genetic reasons; functional outcome is best predicted by the level of difficult behaviours, as opposed to intellectual function or autistic traits; and people with intellectual disability and autism show changes to brain function over and above those seen in intellectual disability alone.

You can read some of the publications related to this study by clicking on the links below:

Schizotypal cognitions as a predictor of psychopathology in adolescents with mild intellectual impairment. Johnstone EC, Owens DG, Hoare P, Gaur S, Spencer MD, Harris J, Stanfield AC, Moffat V, Brearley N, Miller P, Lawrie SM, Muir WJ. Br J Psychiatry. 2007; 191:484-92.

Increased right prefrontal cortical folding in adolescents at risk of schizophrenia for cognitive reasons. Stanfield AC, Moorhead TW, Harris JM, Owens DG, Lawrie SM, Johnstone EC. Biol Psychiatry. 2008; 63(1):80-5.

Progressive temporal lobe grey matter loss in adolescents with schizotypal traits and mild intellectual impairment.  Moorhead TW, Stanfield AC, Spencer M, Hall J, McIntosh A, Owens DC, Lawrie S, Johnstone EC. Psychiatry Res. 2009; 174(2):105-9.

Amygdala volume in a population with special educational needs at high risk of schizophrenia. Welch KA, Stanfield AC, Moorhead TW, Haga K, Owens DC, Lawrie SM, Johnstone EC. Psychol Med. 2010; 40(6):945-54.

Longitudinal gray matter change in young people who are at enhanced risk of schizophrenia due to intellectual impairment. Moorhead TW, Stanfield AC, McKechanie AG, Dauvermann MR, Johnstone EC, Lawrie SM, Cunningham Owens DG.Biol Psychiatry. 2013; 15;73(10):985-92.

Determinants of adult functional outcome in adolescents receiving special educational assistance. McGeown HR, Johnstone EC, McKirdy J, Owens DC, Stanfield AC. J Intellect Disabil Res. 2013; 57(8):766-773

Grey matter correlates of early psychotic symptoms in adolescents at enhanced risk of psychosis: a voxel-based study. Spencer MD, Moorhead TW, McIntosh AM, Stanfield AC, Muir WJ, Hoare P, Owens DG, Lawrie SM, Johnstone EC. Neuroimage. 2007 Apr 15;35(3):1181-91.

Structural correlates of intellectual impairment and autistic features in adolescents. Spencer MD, Moorhead TW, Lymer GK, Job DE, Muir WJ, Hoare P, Owens DG, Lawrie SM, Johnstone EC. Neuroimage. 2006 Dec;33(4):1136-44.

Low birthweight and preterm birth in young people with special educational needs: a magnetic resonance imaging analysis. Spencer MD, Moorhead TW, Gibson RJ, McIntosh AM, Sussmann JE, Owens DG, Lawrie SM, Johnstone EC. BMC Med. 2008 Jan 30;6:1. doi: 10.1186/1741-7015-6-1.

Autistic traits and cognitive performance in young people with mild intellectual impairment. Harris JM, Best CS, Moffat VJ, Spencer MD, Philip RC, Power MJ, Johnstone EC. J Autism Dev Disord. 2008 Aug;38(7):1241-9.

The boundaries of the cognitive phenotype of autism: theory of mind, central coherence and ambiguous figure perception in young people with autistic traits. Best CS, Moffat VJ, Power MJ, Owens DG, Johnstone EC. J Autism Dev Disord. 2008 May;38(5):840-7.

Obstetric complications and mild to moderate intellectual disability. Sussmann JE, McIntosh AM, Lawrie SM, Johnstone EC. Br J Psychiatry. 2009 Mar;194(3):224-8.

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A comparison of the autism and schizophrenia spectrums

Although widely regarded as separate conditions, there are clear overlaps between some of the difficulties experienced people with autism spectrum disorders and those with schizophrenia spectrum disorders.  This is particularly the case when one considers people with autism spectrum disorders who do not show marked impairments to communication and those with schizophrenia spectrum disorders who do not show significant levels of delusions and hallucinations, such as is seen in schizotypal disorder.  This study aimed to characterise the shared and distinguishing features of autism spectrum disorders and schizotypal disorders using clinical assessment, neuropsychology and magnetic resonance imaging.  The results are currently being prepared for publication and will be posted here when they are available.

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Cleft palate cohort follow-up study

Children with cleft palate and their families face various challenges in the early years of the child’s life, ranging from the stress surrounding surgery to long-term difficulties with speech and hearing.

Clinically, the issues are tackled on a routine basis, with regular clinic visits and check-ups assessing the child’s dentition, hearing and general progress.

Previous research has shown that some children with cleft palate may encounter difficulties in early development, such as slower language learning and cognitive progression. This aspect of the child’s care and follow-up post-surgery has previously been comparatively neglected, despite its importance in the day to day life of the child. We believe that assessing a child’s behaviour, social skills and everyday conduct is no less important than monitoring their hearing and physical development.

This study focused on cognitive and behavioural outcomes in children with cleft palate between the ages of two and ten years.

The assessment used was the well-established Strengths and Difficulties Questionnaire (SDQ) which is a frequently used parent report measure exploring the following five domains, which cover 25 positive and negative attributes:

  • Emotional symptoms
  • Conduct problems
  • Hyperactivity/inattention
  • Peer relationship problems
  • Prosocial behaviour

What did we find?

Parents and guardians of children with cleft palate aged between two and ten years were invited to fill in the questionnaire assessing these areas and the results were collated. The results supported previous findings, with a higher rate of adjustment difficulties present in the cleft palate cohort compared to the published norms. However we dind’t find any differences betwen the subgroups of the cleft palate cohort.  In our study, the type of cleft didn’t effect outcome.  One possible explanation for this however, is that we didn’t have enough children in the study to detect what might be a small, but important differences.

As this is the first study of its kind in the UK, it is hoped that the results of the study will trigger further research, thus enabling a greater impact on the management of children with cleft palate.


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