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

Civil libertarians and other conservatives who are interested only in protection against involuntary sterilization argue that a mentally incompetent individual is incapable of ever giving an informed consent. Yet, other liberal thinkers and those who are interested in reproductive freedom for all sexually mature persons maintain that no group of persons should be categorically denied the benefits of sterilization. Rather than clarify, the laws tend to confuse. In most countries, legislation pertaining to voluntary sterilization is nonexistent or nonspecific. Where laws exist, they appear to fall into 3 groups: one group permits consent for surgical treatment to be given by the parents or guardians of incompetent persons without apparent regard to the wishes of the individual; another group considers eugenic sterilization to be legal; and the 3rd group takes into account the probability that there is serious limitation in the capacity of the person concerned to care for a child. In the U.S. 24 states have laws providing for some form of sterilization of persons suffering from mental disorders. The statutes vary in their provisions with some distinguishing between mental illness and mental retardation and others failing to do so. Some laws allow relatives, guardians, physicians, welfare boards or others to initiate sterilization proceedings. Only Colorado allows the mentally retarded individual to petition for his/her own sterilization. The U.S. Department of Health and Human Services was unable satisfactorily to come to terms with the difficult question of sterilization for mentally incompetent persons. The department was not willing to establish a mechanism that would permit some sterilizations under proper safeguards. It chose, instead, to ban all federal funds for programs or projects that would provide sterilization for persons who have been declared mentally incompetent by a court. The department's intention was to protect people from involuntary sterilization, but the unintended effect is also to deny others access to sterilization. From the legal perspective, the most pressing issue is how to ensure that any decision to be sterilized is both informed and unpressured. The purpose and effect of a voluntary sterilization law should be to permit sterilization to be used by all adults who are capable of giving informed consent and who request the procedure. Consent is the central legal issue, and the Association for Voluntary Sterilization model statute authorizes only voluntary sterilization. This model statute permits sterilization after the person requesting it has received counseling and has given consent in writing.
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PMID:The international medicolegal status of sterilization for mentally handicapped people. 710 60

Developmental delay or mental retardation is a frequent component of multi-system anomaly syndromes associated with chromosomal deletions. Isolation of genes involved in the mental dysfunction in these disorders should define loci important in brain formation or function. We have identified a highly conserved locus in the distal part of 11p13 that is prominently expressed in fetal brain. Minimal expression is observed in a number of other fetal tissues. The gene maps distal to PAX-6 but proximal to the loci for brain-derived neurotrophic factor (BDNF) and the beta subunit of follicle stimulating hormone (FSHB), within a region previously implicated in the mental retardation component of some WAGR syndrome patients. Within fetal brain, the corresponding transcript is prominent in frontal, motor and primary visual cortex as well as in the caudate-putamen. The characteristics of this gene, including the striking evolutionary conservation at the locus, suggest that the encoded protein may function in brain development.
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PMID:A WAGR region gene between PAX-6 and FSHB expressed in fetal brain. 752 72

The areas of remedial education and special education have profoundly changed the psychiatric care of mentally retarded persons. Desinstitutionalisation, normalisation and integration are widely recognised concepts today and have since gained relatively substantial empirical support. Definition of these concepts has been broadened to include consideration of the optimal management of environmental conditions as an integral part of the comprehensive living environment. The systemic-ecological approach dislodges psychiatry from its central position in the treatment of the mentally ill retarded, and invests a greater degree of trust in remedial educations and special education. Effective treatment thus involves a joint effort on the part of various mental health professionals working towards a common goal, grounded on the coexistence of mental retardation and mental illness. Psychotherapy should be devised so as to address cognitive deficits no longer considered to be contraindicative to the therapy process. The purpose of pharmacotherapy is to finetune psychotropic medication with pedagogical, psychoeducational and psychotherapeutic methods. Although community-based mental health delivery systems and comprehensive (institutional based) services both show promise for the care and treatment of mentally retarded persons there is evidence for the particular viability of the latter model due to prevailing present conditions and to the aspect of cost effectiveness, particularly due to its utility in promoting still acquisition relevant to workers in this field of mental health.
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PMID:[The new role of psychiatry in the management of mentally retarded patients]. 753 37

The ICF/MR provides services to individuals with a dual diagnosis of mental retardation and mental illness. These services prepare these individuals to the least restrictive environment analogous to the norms and patterns of the mainstream of society. The individuals served are more than 22 years of age and have behavioral problems associated with mental retardation and/or mental illness. In addition, they have multiple medical problems which are related or unrelated to their physical or mental disabilities. These individuals have multiple changing needs which are addressed by an interdisciplinary team. The team develops a unified Individual Program Plan which is the framework for a comprehensive care for these individuals. This is to enable them to live a normal life as possible and to achieve gainful occupational pursuits like any other citizen in the State of South Carolina.
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PMID:A habilitation center for individuals with a dual diagnosis of mental retardation and mental illness. 765 83

The purpose of this study was to describe how school-age children perceive mental illness. The specific aims of this study were to describe the impact of age and sex on children's ability to identify and classify deviant behavior, and to identify how school-age children perceive mental illness by looking at how they define the concept, characterize the mentally ill, and understand causality and treatment. The random sample consisted of 90 school-age children. Thirty children were in grade 1, 30 in grade 4, and 30 in grade 7. A multimethods approach combining qualitative and quantitative techniques was used to analyze data. Major study findings indicated that age was not a significant factor in children's ability to classify deviant behavior; however, there was a sex main effect: Boys were able to better identify deviant behaviors than girls. A developmental trend was noted in children's ability to be aware of what mental illness is, to acknowledge characteristics of people who are mentally ill, to differentiate between mental illness and mental retardation, to identify various etiologies of mental illness, and to choose appropriate treatment modalities.
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PMID:School-age children's perceptions of mental illness. 766 Jun 62

A high prevalence of psychiatric illness exists in persons with mental retardation. Among children with mild to moderate retardation, psychiatric illnesses resemble those seen in the general population. Major affective disorders, ADHD, and conduct disorder are common and respond to the same interventions used in children without mental retardation. Persons with severe to profound retardation are more likely to engage in stereotypies and self-injurious behaviors. In addition, certain specific syndromes associated with mental retardation present with particular neurocognitive, behavioral, and psychiatric profiles. Common examples are fetal alcohol syndrome, Down syndrome, fragile X syndrome, and Rett syndrome. Specific challenges exist for pediatricians who diagnose and treat patients with mental retardation and psychiatric illness. The child's impaired ability to communicate his or her thoughts and feelings with words makes clinical history taking difficult. The clinician must frequently rely on the observation of family members and teachers. An understanding of developmental profiles and interpersonal, peer, and family dynamics is important. Specific behaviors must be targeted and realistic objectives set in treatment planning, which may include psychotherapy, medication, behavior management techniques, and rehabilitation therapy.
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PMID:Dual diagnoses. Psychiatric disorders in developmental disabilities. 768 22

Differences in coping by 105 aging mothers of adults with mental illness and 389 similar mothers of adults with mental retardation were investigated. Although no differences in problem-focused coping were found, mothers of adults with mental illness used more emotion-focused coping, which predicted greater maternal depression. For mothers of adults with retardation, depressive symptoms were a function of their child's behavior problems, although this source of stress was buffered by coping. For mothers of adults with mental illness, depression was a function of caregiving demands, but coping did not buffer the effects of stress. Explanations for findings include maternal perceptions of the context of care, of her control over the disability, and her caregiving efficacy.
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PMID:A comparison of coping strategies of aging mothers of adults with mental illness or mental retardation. 777 18

One hundred adults with mental retardation and epilepsy were randomly selected from hospital and community settings for a detailed study of psychopathology (maladaptive behaviour, psychiatric illness and personality disorder). All of them had a recording of interictal EEG within the 12-month study period. Of all the EEG recordings, nine were completely normal, 48 showed excessive slow background wave, and a further 43 showed epileptiform discharges. Of the 43 with epileptiform discharges in the EEG, 12 showed bilateral, diffuse, generalized activities (including 3 Hz abnormality), 18 showed temporal lobe focus (five left-sided, four right-sided and nine bilateral), and the other 13 showed secondary generalization from a temporal lobe focus. A comparison of psychopathology between the groups with a generalized epileptiform activity in the EEG (n = 12) and focal changes (n = 18) did not reveal any significant differences.
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PMID:Electrophysiological correlates of psychopathology in individuals with mental retardation and epilepsy. 778 82

Despite increasing attention to psychiatric disorders in the mentally retarded, suicidal behavior remains an underreported phenomenon in this population, particularly in children and adolescents. This study was aimed at documenting the existence of suicidal behavior among 90 consecutive admissions to a specialty unit for dually diagnosed children and adolescents in a medical school-affiliated children's psychiatric hospital. Archival chart review yielded a total of 19 patients, or 21%, for whom suicidal behavior was a presenting complaint upon admission or during hospitalization. Suicidality was distributed across gender, level of mental retardation, and psychiatric diagnosis. Additional findings of note with regard to family dysfunction and/or abuse history are summarized. Clearly, in this sample, children and adolescents with mental retardation were capable of formulating and engaging in potentially fatal acts. Results of this study suggest that suicidal behavior is an underrecognized, yet significant phenomenon in children and adolescents with mental retardation and psychiatric disorder.
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PMID:Suicidal behavior in children and adolescents with mental retardation. 779 10

An evaluation of the treatment and habilitation services being provided to individuals with dual diagnoses of mental retardation and mental illness was presented. The current status of service delivery is identified as unacceptable. Legal issues relating to the obligation to provide quality services were discussed as were ethical issues relating to where the responsibility for providing such service lies. General ethical principles of nonmaleficence and beneficence were defined, and the codes of ethics for two professional groups were invoked to bolster the position that administrators and supervisors are ultimately responsible for the quality of service provided by their organizations. Recommendations for staff competencies necessary to improve treatment for individuals with dual diagnosis were made.
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PMID:Quality care for individuals with dual diagnosis: the legal and ethical imperative to provide qualified staff. 798 21


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