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Query: UMLS:C0025362 (mental retardation)
 15,878 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Five hundred six severe and profoundly mentally retarded persons (247 women and 259 men) from Wisconsin and Louisiana were assessed on the Diagnostic Assessment for the Severely Handicapped Scale. A factor analysis yielded six factor scales: tantrums, aggression/conduct, language disorder/verbal aggression, social withdrawal/stereotypy, eating disorders, and sleep disorders. These data demonstrate a nosology of symptoms loading more heavily on vegetative symptoms than what is evident with persons in the mild and moderate ranges of mental retardation and persons who are not mentally retarded. The implications of these findings are discussed.
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PMID:A factor analytic study of the Diagnostic Assessment for the Severely Handicapped Scale. 183 8

The rating scale used to assess the motivators of maladaptive behaviors in persons with mental retardation was the Motivation Assessment Scale. In the current study, we validated the factor structure of the scale on a sample of 118 subjects with predominately severe or profound mental retardation. They exhibited deviant behaviors such as self-injurious and tantrum behavior, aggression, and passivity. The results of the factor analysis with varimax rotation validated the assumptions of the developers of the scale that the motivators could be grouped into sensory, escape, attention, and tangible reinforcers. These four subscales are easily interpretable and should continue to provide valuable information.
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PMID:Factor structure of the Motivation Assessment Scale for persons with mental retardation. 192 23

Lithium has been recommended for some psychiatric conditions and/or behavior disturbances in patients with mental retardation. Components of an adequate clinical trial were described here and case studies and double-blind cases reviewed. Based on existing data, there are few guidelines for the use of lithium with this population. Of the various indicators for lithium, the most solid are for aggression, although the type of aggression is not specified: (a) achieve a serum concentration of at least 0.5 mEq/1 to 1.0 mEq/1 unless the patient responds or trial-ending side effects appear and (b) treat for 6 to 8 weeks before concluding that the patient will not respond.
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PMID:Towards defining adequate lithium trials for individuals with mental retardation and mental illness. 205 18

This study assessed the impact of choice making on the serious problem behaviors of 3 students with severe autism and/or mental retardation. In the context of within-subject reversal designs, the results showed consistently reduced levels of problem behaviors (e.g., aggression) when the students were given opportunities to make choices among instructional tasks and reinforcers. Additional data showed no systematic differences in the rate of correct responding between the two conditions. The results are discussed in relation to the continuing search for effective, nonintrusive solutions to the occurrence of serious problem behavior.
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PMID:Effects of choice making on the serious problem behaviors of students with severe handicaps. 207 40

The study comprised two cases (male & female sibs) from one family, with Lesch-Nyhan Syndrome. They were subjected to clinical evaluation, pedigree construction, uric acid estimation in blood, urates in urine, metabolic screening of blood and urine for amino acids, examination of oral cavity, histological studies of the gingiva by light and electron microscopy as well as buccal smear for Barr & Y bodies (for the female). The proband, a six years old female presented with self-mutilation, mental retardation, hyperactivity and aggression. She had bitten her index finger causing amputation of its distal phalanx. On family study her younger brother (9 months) was found to have increased uric acid and less severe neurologic involvement. The serum uric acid level of the affected female was higher. Her Barr body showed normal pattern. Oral cavity examination showed no abnormalities. Histological examination of the gingiva showed macrophages around the blood vessels. Ultrastructural studies showed more or less normal epithelium. There was collection of macrophages around the blood vessels in the sub-epithelial layer, the cytoplasm of these macrophages contained stippled cytoplasmic inclusions. The surrounding connective tissue showed thin collagen fibers with sharp delineation between the epithelial and connective tissue layers indicating poor quality of collagen. There was no histological difference between the hemizygous male and the heterozygous female. The present study indicates heterozygous expression of Lesch-Nyhan Syndrome at both the clinical and the ultrastructural levels in favour of extreme lyonization or X-chromosome deletion in the affected female. Our findings also indicate that ultrastructural studies could be sensitive indicators of abnormal uric acid metabolism. Further studies are needed to compare the phenotypic expression of hemizygotes and heterozygotes with Lesch-Nyhan Syndrome at both the clinical and ultrastructural levels.
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PMID:Heterozygous expression of Lesch-Nyhan syndrome clinical and ultrastructural studies. 213 93

Persistent aggressive behavior may develop in patients with brain disorders of various types, including seizure disorders, mental retardation, metabolic disorders, head injury, and in some instances schizophrenia. Although a neurochemical basis for aggression in these cases is unclear, a hyperadrenergic state is considered to be one possibility. This has led to the hypothesis that beta blockers may be useful in the control of aggression. The original assumption was that the site of antiaggressive action of beta blockers is in the brain. However, the antiaggressive efficacy of nadolol, which does not cross the blood-brain barrier to any great extent, suggests a peripheral site or sites. A review of several studies in which both old and young aggressive patients with various organic brain disorders received propranolol showed that aggressive behavior was reduced in 75 (86%) of 87. These results are encouraging because none of the patients had responded to earlier drug treatment. However, with the exception of one study of nine patients, none of the studies were controlled for placebo effects and most were retrospective. Preliminary results suggest tentative guidelines for treatment of aggressive behavior with beta blockers. Further studies are needed, and these should use a prospective, longitudinal double-blind design; large enough patient samples to permit testing hypotheses about disease-specific or symptom-specific responses to beta blockers; and improved instruments for measuring and classifying aggression.
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PMID:Can aggressive behavior in humans be modified by beta blockers? 289 57

In present-day African psychiatry, there is a sharp differentiation between serious mental illness, which requires medically orientated treatment and chemotherapy, and the more superficial disturbances of personality for which psychological, sociological and educational measures are indicated. With the severe shortage of Western psychiatrists who are prepared to undertake this work, it is providential that black traditional healers address themselves to the latter group of mental abnormalities with a measure of success comparable to psychotherapy in First-World practice. In the back wards of a mental hospital (run on First-World lines) and in outpatient clinics in periurban Durban townships, one meets a large number of patients with severe and chronic disease. All those conditions (mental retardation, organic brain syndromes, schizophrenia and affective disorders) with positive symptomatology (excitement, restlessness and aggression) are found to respond to neuroleptic drugs. Possible reasons why patients with negative symptoms (emotional withdrawal, poverty of ideas and speech), especially in schizophrenia, do not react, are discussed, and administrative and socio-economic implications are reviewed.
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PMID:Severe invalidism--the dominant feature of Third-World psychiatry in southern Africa. 335 19

This study reviews current treatment research on aggression of mentally retarded persons. Twenty-seven studies meet methodological criteria from an initial pool of 47. All the studies reviewed were empirical and had been published in national and internationally recognized journals. Treatments were behavioral and level of mental retardation and ages of the persons studied varied widely. Age and level of mental retardation proved to be significant factors in predicting treatment outcome. Also, it was found that some types of behaviors were treated more frequently than others, with inappropriate verbal responses being the most common, followed by aggression toward others and noncompliance. The implications of these findings are discussed.
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PMID:A review of treatment research for aggressive and disruptive behavior in the mentally retarded. 351 69

Homocystinuria commonly affects the central nervous system (CNS), primarily as mental retardation, seizures, and stroke. Case reports have long suggested a predisposition to schizophrenia, but no careful study of predisposition to psychiatric illness has been performed. Accordingly, we evaluated 63 persons with homocystinuria due to cystathionine beta-synthase deficiency for psychiatric disturbance, intelligence, evidence of other CNS problems, and responsiveness to vitamin B6. The overall rate of clinically significant psychiatric disorders was 51%, predominated by four diagnostic categories: episodic depression (10%), chronic disorders of behavior (17%), chronic obsessive-compulsive disorder (5%), and personality disorders (19%). The average IQ was 80 +/- 27 (1 SD); and an IQ of less than or equal to 79 was two-thirds more common among vitamin B6-nonresponsive patients compared to vitamin B6-responsive patients. Aggressive behavior and other disorders of conduct were particularly common among patients with mental retardation and among vitamin B6-nonresponsive patients.
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PMID:Psychiatric manifestations of homocystinuria due to cystathionine beta-synthase deficiency: prevalence, natural history, and relationship to neurologic impairment and vitamin B6-responsiveness. 359 41

Recent studies have confirmed that gout is an inborn error of metabolism. It has now become evident that the hyperuricemia associated with gout might occur either due to overproduction of uric acid, underexcretion of uric acid or a combination of these processes. Furthermore, patients with excessive purine synthesis may have a specific enzyme defect resulting in altered feedback inhibition of purine synthesis. A neurological disease manifest by mental retardation, choreo-athetosis, aggressive behavior, lip-biting and self-mutilation and associated with decidedly increased purine biosynthesis serves as a prototype of this kind of disorder. Other defects in regulation of purine biosynthesis have been postulated but their existence not yet confirmed. It has been demonstrated that urate crystals which are deposited from hyperuricemic body fluids set up an acute inflammatory reaction by means of a variety of chemical mediators. Thus, acute gouty arthritis is now recognized as an example of "crystal induced" synovitis. The treatment of gout consists of (1) the control of acute gouty attacks, and (2) the maintenance of normal serum uric acid concentrations. This latter may be achieved either with uricosuric drugs or with xanthine oxidase inhibition. With these principles in mind, it is now possible to avoid many of the severe crippling effects of gout and to restore the vast majority of gouty patients to useful and productive lives.
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PMID:Current concepts of hyperuricemia and gout. 577 83


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