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

Autistic children with an IQ below 70 and with an IQ above 70 were systematically compared. The two groups differed somewhat in the pattern of symptoms, but were closely similar in terms of the main phenomena specifically associated with autism. However, the low IQ and high IQ autistic children differed more substantially in terms of other symptoms such as self-injury and stereotypies and there were major differences in outcome. The possibility that the nature of the autistic disorder may differ according to the presence or absence of associated mental retardation needs to be taken into account in planning studies of etiology.
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PMID:Differences between mentally retarded and normally intelligent autistic children. 98 85

At the present time, neuroleptics are indicated for the treatment of acute psychotic states as well as Tourette's syndrome in children and adults. Neuroleptics may have a useful role in the attenuation of problem behaviors, such as stereotypies, hyperactivity, self-injury, and aggressive outbursts in infantile autism, pervasive developmental disorder NOS, and mental retardation, but they do not improve the underlying condition. Neuroleptics are not the agents of first choice for treatment of hyperactivity or aggression in children who do not have major developmental handicaps. Common and troublesome side effects associated with neuroleptic use in children and adolescents include sedation, extrapyramidal symptoms, and withdrawal dyskinesias; therefore, close monitoring is required. Neuroleptics should be used cautiously and only as an adjunct to other nonpharmacologic interventions.
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PMID:Neuroleptics in pediatric psychiatry. 134 40

Fragile X syndrome is the second most common chromosomal cause of mental retardation (MR). The calculated incidence is 1/1000, making accurate and early diagnosis important for specific preventive, pharmacologic, and cognitive treatment. The timely diagnosis in males is facilitated by the characteristic phenotype and an association with autism. In contrast, in females heterozygous for fragile X, the characteristic phenotype and infantile autism are rarely reported. We present two females with cytogenetic expression of the fragile X chromosome for whom the studies were performed because of the presence of autism or prominent autistic features and a behavioral and physical phenotype consistent with fragile X syndrome. The first female, age three years, has autism, hyperactivity, echolalia, language delay, hand stereotypies, and mild MR. The characteristic phenotype was not present nor was there a family history of X-linked MR. Fragile X expression was 6% in the proband, 3% in the mother and 1% (normal) in the father. The second child, seven years old, has prominent autistic features, hyperactivity, mild MR, mild language disorder, and a family history consistent with X-linked MR. Fragile X expression was 3% in the proband and 0% in the mother. These cases support the occurrence of fragile X in autistic females and emphasize the importance of cytogenetic screening for fragile X in this high risk population. Early diagnosis of fragile X allows precise genetic counseling and more specific cognitive and pharmacologic treatment.
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PMID:Autism in association with fragile X syndrome in females: implications for diagnosis and treatment in children. 320 May 5

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

Direct observation of blink rate was used as a noninvasive, in vivo estimate of dopamine function in adults with mental retardation and repetitive behavior disorders. Blink rate as measured in groups of stereotypy, compulsion, and control subjects was highly stable. Subjects with stereotypies had significantly lower blink rates than did control subjects. Although blink rates for compulsive subjects were not significantly different from those of control subjects, a subgroup of compulsive subjects with comorbid stereotypic behaviors displayed significantly lower blink rates. Significant inverse correlations were found for blink rate and severity of repetitive behavior disorder and for blink rate and ratings of motor slowness. These findings support the hypothesis that stereotyped behavior among adults with mental retardation is mediated by hypodopaminergic function.
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PMID:Blink rate as an index of dopamine function in adults with mental retardation and repetitive behavior disorders. 769 76

To investigate the relationship between psychiatric disorders and severe behavior problems in mental retardation, statewide client databases from developmental disabilities services in California (N = 89,419) and New York (N = 45,683) were analyzed and juxtaposed. The study focussed on nine major DSM-III-R psychiatric categories (or their equivalents), and severe forms of aggressive behavior, property destruction, self-injurious behavior, and stereotyped behavior in individuals 45 years old and younger with mental retardation of all levels of severity. In California, 3.9% had at least one psychiatric diagnosis; in New York, 5.4%. The rate of specific psychiatric diagnoses was variable across states, suggesting local preferences in diagnostic practices. Severe behavior problems occurred in 22.1% in California and in 41.4% in New York. This difference in rates can be attributed in part to different recording criteria for behavior problems. With regard to the association between psychiatric diagnoses and problem behaviors the results were consistent across databases: No compelling correlations were found. This means that neither aggression, self-injury, destruction, nor stereotypies determine whether a person receives a psychiatric diagnosis or not.
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PMID:The association between psychiatric diagnoses and severe behavior problems in mental retardation. 790 16

A set of research diagnostic criteria was developed to identify potential obsessive-compulsive disorders among individuals with mental retardation and aberrant behaviors. The behavior disorders of 10 subjects who met criteria for compulsive behavior disorder and 6 subjects who did not (comparison subjects) were treated using the medication fluoxetine. All subjects were evaluated using an A-B open-trial method with 4-month baseline and treatment phases. Seven of the 10 subjects with compulsive behavior disorder responded favorably to fluoxetine treatment; none of the comparison subjects responded favorably to this medication. Further, there appeared to be a relation between manifest motor stereotypies, compulsive behaviors, and response to fluoxetine.
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PMID:Diagnosis and fluoxetine treatment of compulsive behavior disorder of adults with mental retardation. 829 12

The facial stereotypies of adults diagnosed as having mental retardation and tardive dyskinesia were examined through a kinematic analysis of video-taped lip and tongue motions. A control group of healthy adult subjects without mental retardation was also examined in the production of preferred rates of lip and tongue oscillatory motions to provide a basis to assess the degree of movement variability in the stereotypies. The inter- and intraindividual variability of the movement form characteristics of the lip and tongue stereotypic motions was higher in the subjects with mental retardation. Results suggest that the low variability of discrete properties of movement kinematics may not be a defining feature of stereotypies. The concept of invariance in stereotypies may relate only to the topological kinematic properties of the movement sequence that provide the basis to infer that the same stereotypic movement sequence was reproduced from observation to observation.
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PMID:Facial stereotypic movements and tardive dyskinesia in a mentally retarded population. 871 90

We screened for the occurrence of dyskinetic and stereotypic movement disorders using item-independent screening protocols to determine whether these forms of movement disorder can be distinguished among adults with mental retardation. Stereotypies and dyskinesias were reliably distinguished in terms of topography. Tardive dyskinesia occurred in 18.2% of a cohort of individuals receiving chronic neuroleptic treatment. Stereotypic movement disorder was associated with increased dyskinesia scores and increased prevalence of tardive dyskinesia. Increased dyskinesia scores were also found for subjects exhibiting stereotypy who had been free of neuroleptic treatment for 3 years. Results indicate that dyskinesia and stereotypy are discriminable movement disorders and provide preliminary support for the hypothesis that they may be related by common mechanisms.
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PMID:Dyskinetic movement disorder among adults with mental retardation: phenomenology and co-occurrence with stereotypy. 888 67

Stereotypies are patterned, repetitive, purposeless movements that are performed the same way each time. They are commonly seen in individuals with autism, schizophrenia, or mental retardation, and also occur as a feature of tardive dyskinesia and as movements in those with akathisia. We studied 10 children who had stereotypies but were not autistic or mentally retarded. Although most had an uneventful delivery, seven had mild to moderately delayed developmental milestones. Five had hyperactive behavior or attention-deficit problems. All appeared to be of normal intelligence. The median age of onset of stereotypies was 12 months. The stereotypies including arm flapping, arm and hand posturing, finger wiggling, body rocking, leg shaking, facial grimacing, involuntary noises, neck extension, and eye blinking. Of the 10 children, only two stopped having stereotypies eventually without medications.
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PMID:The characterization and outcome of stereotypical movements in nonautistic children. 899 53


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