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

Neuroleptic-induced akathisia is a relatively common side effect of neuroleptic medication, characterized by a subjective sense of restlessness and the inability to sit still. It has been associated with aggression, anxiety, sleep disturbance, and suicide among patients who have mental illness. These side effects are fairly well-researched in the psychiatric literature but rarely addressed in the mental retardation literature. The prevalence, types of akathisia, differential diagnosis, and treatment were reviewed and a relevant case report presented. The importance of the diagnosis and treatment of neuroleptic-induced akathisia in individuals with mental retardation was discussed.
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PMID:Case study of neuroleptic-induced akathisia: important implications for individuals with mental retardation. 810 97

The use of lithium to treat child and adolescent psychiatric disorders is becoming more common. Since the publication of the report of The Committee on Biological Aspects of Child Psychiatry of the American Academy of Child Psychiatry in 1978, a considerable body of literature has accumulated on the efficacy of lithium in treating adolescent bipolar disorders, childhood aggression, and behavioral disorders associated with mental retardation and developmental disorders. Efforts to understand lithium's mechanism(s) and refinements in psychiatric diagnosis have contributed to its growing use.
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PMID:Update on lithium carbonate therapy in children and adolescents. 799 3

Functional assessment seeks to elucidate the variables controlling a maladaptive behavior. Based on such an assessment, effective treatments can be designed that focus on replacing that maladaptive behavior with a functionally equivalent adaptive prosocial behavior. This technique has been promoted as an effective means of improving treatments by increasing the focus on skill development and reducing the use of aversive and restrictive procedures. The literature for the behavioral treatment of aggression for persons with mental retardation or developmental delays was examined from 1979 through 1990. During that period the use of functional assessment and skill training increased; however, the increased use of functional assessment did not result in the reduced use of intrusive procedures. Potential reasons for these results are discussed, and a call for an increased emphasis on functional assessment methodology is made.
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PMID:The relationship between functional assessment and treatment selection for aggressive behaviors. 821 Jun 4

Interictal violence among epileptic patients could result from factors other than epileptiform activity. We characterized 44 patients who presented for psychiatric evaluation because of violent behavior. Most violent acts consisted of verbal or minor physical aggression. Twenty (45%) of these patients met criteria for a schizophrenic disorder, and one committed murder during a paranoid schizophrenic relapse. In addition to schizophrenia, the violence patients had significantly more mental retardation when compared with 88 age- and sex-matched epileptic patients without prior violent behavior. However, violent and nonviolent patients did not differ on seizure variables such as type and frequency of seizures, auras, electroencephalographic changes, epilepsy age of onset, or anticonvulsant therapy. These findings suggest that interictal violence is associated more with psychopathology and mental retardation than with epileptiform activity or other seizure variables.
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PMID:Interictal violence in epilepsy. Relationship to behavior and seizure variables. 824 25

This study evaluated the clinical correlates and inpatient course of self-mutilation in a diagnostically diverse sample of hospitalized forensic patients. Fifty-three male forensic inpatients, treated in a maximum-security hospital, who engaged in at least one instance of self-mutilation during a 2-year period, were studied and compared with 50 male forensic patients at the same hospital who had not engaged in self-mutilation. Self-mutilating patients were younger, more likely to carry a diagnosis of personality disorder or mental retardation, engaged in more outwardly directed aggressive behavior as assessed by the Overt Aggression Scale, were treated with substantially higher doses of neuroleptics, and were more likely to be civil or correctional patients than insanity acquittees. The two groups did not differ on variables such as history of suicide, history of violence, neurological characteristics, and other demographic variables. After an incident of self-mutilation, the probability of recurrence was high. The substantially higher level of outwardly directed aggression of self-mutilating patients, along with their higher apparent need for neuroleptization and the high risk of recurrence of the self-mutilation, suggest that they are a subset of violent individuals who are relatively unresponsive to treatment and who are dangerous to self and others.
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PMID:Clinical predictors of self-mutilation in hospitalized forensic patients. 827 5

A survey of affective symptoms in two groups of institutionalized adults with mental retardation was conducted. The groups were comprised of subjects with prior diagnoses of affective disorders or other psychiatric disorders. Informants reported retrospectively on the presence or absence of DSM-III-R criteria for major depression and mania. Thirteen percent of the affective disorders group did not meet these criteria for depression or mania, whereas 20% of the other psychiatric disorders group did. Aggression was a frequent concomitant of psychopathology in both groups. These findings support previous reports that affective disorders may be underdiagnosed in this population. However, unlike prior investigations, most of the subjects (74%) in the present survey had severe to profound mental retardation.
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PMID:Affective symptoms of institutionalized adults with mental retardation. 829 17

The relationship between aggression and depression was evaluated for 528 adults, adolescents and children, who were rated on either the adult or child versions of the Reiss instruments for dual diagnosis (Reiss 1988; Reiss & Valenti-Hein 1990). Criterion levels of depression were evident in about four times as many aggressive as nonaggressive subjects. Anger was significantly associated with both aggression and depression. Although anger may play a mediational role in the correlation between aggression and depression, in this study there was a significant correlation even after the effects of anger were held constant. The findings provide an initial step toward improving diagnostic specificity when evaluating aggressive behaviour in people with mental retardation.
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PMID:Joint occurrence of depression and aggression in children and adults with mental retardation. 833 20

This review assesses the efficacy and specificity of psychotropic medications used to control aberrant behavior in persons with mental retardation. It is concluded that neuroleptics, the most widely used psychotropic agents in this population, suppress aberrant behavior, but do so by suppressing behavior generally. An exception to this conclusion is that it may be possible to selectively suppress stereotyped behavior with neuroleptics. In addition, the empirical evidence indicates that, in some persons with mental retardation, opioid antagonists and methylphenidate are useful therapies for self-injurious behavior and hyperactivity, respectively. Lithium and beta-blockers are potentially useful for treating aggression.
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PMID:Efficacy and specificity of pharmacological therapies for behavioral disorders in persons with mental retardation. 837 12

The independence of hyperactivity, attention deficits, and conduct problems among mentally retarded children was addressed using factors of the Conners' Teacher Rating Scale-39 (CTRS-39) and the more recently developed IOWA Conners' inattention/overactivity (IO) and aggression (A) subscales. CTRS-39 ratings were obtained for children of normal intelligence and for mentally retarded children. Differences between the groups were examined as were intercorrelations of the Conners' factors and IOWA subscales. Conduct problems proved to be less strongly associated with hyperactivity and attention deficits among mentally retarded children compared to children of normal intelligence. However, attention problems and conduct problems may be associated with mental retardation in general. Implications of these data and CTRS scoring system recommendations for mentally retarded children are discussed.
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PMID:The differential validity of hyperactivity/attention deficits and conduct problems among mentally retarded children. 846 99

Considerable controversy surrounds the continued use of restrictive behavioral procedures in the treatment of destructive behaviors, such as self-injury, aggression, and property damage, displayed by some people with mental retardation. This study reports on the extent that pharmacological and behavioral consequences occur in response to these behaviors within a population of 31,000 people in one state's developmental services system. Data on these individuals are analyzed to determine the degree to which intellectual level, residential setting type, type and extent of problem behaviors, and age are related to the prescriptive use of pharmacologic and behavioral consequences. These variables appear to bear a significant relationship on the extent to which consequences are applied as part of treatment. Furthermore, although pharmacologic and several behavior consequences are applied at similar rates, it was found that generally timeout, as a specific treatment procedure, was applied at rates considerably less than those for psychoactive medication in each population sub-group that was examined.
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PMID:Who is treated using restrictive behavioral procedures? A population perspective. 846 98


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